title: A cross-sectional study of household biomass fuel use among a periurban population in Malawi.
abstract: BACKGROUND
  The Global Burden of Disease Study suggests almost 3.5 million people die as a consequence of household air pollution every year. Respiratory diseases including chronic obstructive pulmonary disease and pneumonia in children are strongly associated with exposure to household air pollution. Smoke from burning biomass fuels for cooking, heating, and lighting is the main contributor to high household air pollution levels in low-income countries like Malawi. A greater understanding of biomass fuel use in Malawi should enable us to address household air pollution-associated communicable and noncommunicable diseases more effectively.
  
  
  OBJECTIVE
  To conduct a cross-sectional analysis of biomass fuel use and population demographics among adults in Blantyre, Malawi.
  
  
  METHODS
  We used global positioning system-enabled personal digital assistants to collect data on location, age, sex, marital status, education, occupation, and fuel use. We describe these data and explore associations between demographics and reported fuel type.
  
  
  RESULTS
  A total of 16,079 adults participated (nine households refused); median age was 30 years, there was a similar distribution of men and women, 60% were married, and 62% received secondary school education. The most commonly reported occupation for men and women was "salaried employment" (40.7%) and "petty trader and marketing" (23.5%), respectively. Charcoal (81.5% of households), wood (36.5%), and electricity (29.1%) were the main fuels used at home. Only 3.9% of households used electricity exclusively. Lower educational and occupational attainment was associated with greater use of wood.
  
  
  CONCLUSIONS
  This large cross-sectional study has identified extensive use of biomass fuels in a typical sub-Saharan Africa periurban population in which women and people of lower socioeconomic status are disproportionately affected. Biomass fuel use is likely to be a major driver of existing communicable respiratory disease and the emerging noncommunicable disease (especially respiratory and cardiovascular) epidemic in this region. Our data will help inform the rationale for specific intervention studies and the development of appropriately targeted public health strategies to tackle this important and poverty-related global health problem.
authors: 1 Respiratory Medicine, Aintree University Hospital, Liverpool, United Kingdom.
authors: Katy C
authors: KC
authors: Piddock
authors: Stephen B
authors: SB
authors: Gordon
authors: Andrew
authors: A
authors: Ngwira
authors: Malango
authors: M
authors: Msukwa
authors: Gilbert
authors: G
authors: Nadeau
authors: Kourtney J
authors: KJ
authors: Davis
authors: Moffat J
authors: MJ
authors: Nyirenda
authors: Kevin
authors: K
authors: Mortimer
mesh_terms: D000293:Adolescent; D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D018533:Biomass; D002648:Child; D003296:Cooking / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects; D008295:Malawi / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D014505:Urban Population; D014934:Wood; D055815:Young Adult
keywords: biomass fuel use; household air pollution; noncommunicable diseases