Air pollution in households is a prime contributor to health issues in developing countries, as in the case of India. According to the latest National Family Health Survey Report 2022, more than half of India’s rural population and 41 per cent overall still depend on solid or unclean fuel combustions, which may reflect in future health hazards. Thus, it is crucial to understand the issue empirically. To that end, the study traces the transitional pattern of unclean cooking fuel users towards clean fuel over the last 30 years using responses from all five National Family Health Survey rounds. Further, the study uses an adjusted probit model to analyse the determinants that lead to the choice of cooking fuel in a household and a logistic model to examine the association between the choice made and the respiratory health of children under five. The empirical results show that the number of households using unclean fuel has declined over the years, with a slightly higher decline in the last five years. Moreover, it also shows that poverty status and place of residence significantly influence cooking fuel choice. Additionally, children residing in households that use clean fuels are less likely to suffer respiratory infections. In conclusion, the present study provides strong evidence to ameliorate the existing policies in a way that exhorts clean energy use. The authors propose pro-poor, pro-rural policies to expedite the clean energy transition, benefitting the most vulnerable households.

Bangladesh is experiencing a rapid increase in hypertension prevalence, particularly in socio-economically disadvantaged communities. The higher use of solid fuel in these communities could be one of the significant factors contributing to this trend, but evidence supporting this hypothesis is limited in Bangladesh. Therefore, this study aims to investigate the associations of household solid fuel use and its exposure level with systolic and diastolic blood pressure (DBP) and hypertension. We analysed 7,320 women’s data from 2017/18 Bangladesh Demographic and Health Survey. We considered three outcome variables: (i) systolic blood pressure (BP) (continuous response), (ii) DBP (continuous response), and (iii) hypertension status (yes, no). Our primary exposures of interest were fuel type (clean vs solid) and the potential level of household air pollution exposure through solid fuel use (unexposed, moderately exposed, and highly exposed). We used a multilevel mixed-effects Poisson regression model with robust variance to determine association between exposure and outcome variables while adjusting for confounders. Of the total respondents analysed, approximately 82% used solid fuel for cooking. The age-standardised prevalence of hypertension was 28%. Respondents using solid fuel were found to be 1.44 times (95% confidence interval [CI], 1.04–1.89) more likely to develop hypertension compared to clean fuel users. Compared to women using clean fuel, the likelihood of hypertension was found to be 1.61 times (95% CI, 1.07–2.20) higher among the moderately exposed group and 1.80 times (95% CI, 1.27–2.32) higher among the highly exposed group. Similar associations were reported for systolic and DBP. The use of solid fuel increases the risk of becoming hypertensive and elevates systolic and DBP. Policies and programmes are necessary to increase awareness of the adverse effects of solid fuel use on health, including hypertension. Efforts should be made to reduce solid fuel use and ensure proper ventilation systems in households where solid fuel is used.

Developing countries experience both household air pollution resulting from the use of biomass fuels for cooking and industrial air pollution. We conceptualise and estimate simultaneous exposure to both outdoor and household air pollution by adapting the Total Exposure Assessment model from environmental health sciences. To study the relationship between total exposure and health, we collected comprehensive data from a region (Goa) in India that had extensive mining activity. Our data allowed us to apportion individuals’ exposure to pollution in micro-environments: indoor, outdoor, kitchen, and at work. We find that higher cumulative exposure to air pollution is positively associated with both self-reported and clinically- diagnosed respiratory health issues. Households in regions with higher economic (mining) activity had higher incomes and had switched to cleaner cooking fuels. In other words, household air pollution due to higher biomass use had been substituted away for outdoor air pollution in regions with economic activity.

This introduction provides an overview and analysis of key scientific data regarding air pollution in China. It constitutes a reference for understanding how policymakers, media and population in China make sense of and deal with air pollution, as discussed in the other articles of the section. We summarize the major characteristics and trends regarding air pollution in China, including its main sources and composition, levels of population exposure across the country, attributable mortality, and mitigation efforts. We also compare current levels of air pollution in China with other parts of the world and in a historical perspective. While the situation remains dire in many regions, particularly the Northeast, we conclude that there are signs of relief, or at least a halt to the increase in ambient air pollution levels. At the same time, critical issues regarding unequal levels of exposure remain, and health damaging levels of air pollution in cities will undoubtedly remain high for a long time to come. The rural population residing in areas close to industry and polluted cities and still depending on solid household fuels will likely be the worst off when it comes to air pollution exposure.