Exposure to solid and non-clean cooking fuels and the risk of obesity, hypertension, anemia, depression, and anxiety in women of reproductive age: a nationwide population-based study.

BACKGROUND

Solid and non-clean fuels are primary contributors to household air pollution (HAP), yet their impact on women's health remains relatively underexplored. This study aimed to investigate the associations of solid and non-clean cooking fuel use with obesity, hypertension, anemia, depression, and anxiety among reproductive-aged women in Nepal.

METHODS

Utilizing nationally representative data from the 2022 Nepal Demographic and Health Survey (NDHS), we analyzed 4,129 participants for hypertension, anemia, and obesity and 6,992 for depression and anxiety, all aged 15-49 years, with household cooking fuel information available. Solid and non-clean cooking fuel refers to kerosene/paraffin/gasoline, coal/charcoal, wood, straw/shrubs/grass/crops, garbage and animal dung. Hypertension (systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg or currently taking antihypertensive medication), anemia [blood hemoglobin (Hb) < 12 g/dL], and obesity [body mass index (BMI) ≥ 25 kg/m²] were defined and assessed following World Health Organization (WHO) guidelines, whereas depression and anxiety were evaluated using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Assessment (GAD-7), respectively. Linear and logistic regression models, adjusting for multiple confounders, were performed.

RESULTS

Participants using solid and non-clean cooking fuel exhibited a higher prevalence of anemia (36.94% vs. 32.76%, p = 0.003), depression (6.10% vs. 4.67%, p = 0.004), and anxiety (23.43% vs. 20.15%, p = 0.001) compared to clean fuel users. Solid and non-clean cooking fuel users had an increased risk of anemia [odds ratio (OR), 95% CI: 1.58; 1.29-1.92], depression (OR, 95% CI: 1.33; 1.07-1.65), and anxiety (OR, 95% CI: 1.21; 1.08-1.36). There was an inverse association between obesity and solid and non-clean cooking fuel use (OR, 95% CI: 0.73; 0.59-0.91), whereas no significant association was observed with hypertension.

CONCLUSION

The use of solid and non-clean cooking fuels increases the risk of anemia, depression, and anxiety in reproductive-aged women. This study adds valuable insights into the growing discussion on the health risks linked to the use of solid and non-clean cooking fuels. The findings underscore the urgent need for nationwide public health awareness and interventions aimed at promoting cleaner cooking technologies and mitigating these associated risks, particularly among women.

CLINICAL TRIAL NUMBER

Not applicable.