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Household air pollution exposure and mental and physical health-related quality of life among female primary cooks in peri-urban sub-Saharan Africa
Williams, H., Baame, M., Lorenzetti, F., Mangeni, J., Betang, E., Chartier, R. T., Sang, E., Tawiah, T., Quansah, R., Menya, D., Mbatchou-Ngahane, B. H., Pope, D., Asante, K. P., & Shupler, M. (2026). Household air pollution exposure and mental and physical health-related quality of life among female primary cooks in peri-urban sub-Saharan Africa. Abstract from ISEE 2026, Munich, Germany.
Objective: There has been limited investigation of how household air pollution (HAP) exposure contributes to health-related quality of life (HRQoL). We therefore quantified the association between HAP exposure and HRQoL in sub-Saharan Africa, where almost one billion people use solid cooking fuels (e.g., charcoal, wood).
Material and methods: We linked 24-hour mean fine particulate matter (PM2.5) and carbon monoxide (CO) kitchen concentrations and female primary cook exposures from three peri-urban communities (Eldoret, Kenya; Mbalmayo, Cameroon; Obuasi, Ghana) with survey data on HRQOL using the Short-Form 36 (SF-36) questionnaire. Mental and physical HRQoL were summarized by the SF-36 mental component summary (MCS) and physical component summary (PCS) score, respectively. We developed generalized additive mixed models to quantify the exposure-response relationship between HAP exposure and MCS and PCS scores, adjusting for sociodemographic, health-related, and energy-poverty covariates.
Results: The association between PM2.5 and CO cook exposures and MCS and PCS scores was generally log-linear. A 10 µg/m3 increase in mean 24-hour PM2.5 cook exposure (e.g., from 35 µg/m3 [WHO Interm-1 target level] to 45 µg/m3) was associated with a 0.62 (95%CI: -1.16, -0.08) decrease in mean MCS score and a 0.57 (95%CI: -1.11, -0.04) decrease in mean PCS score. A 1 ppm increase in mean 24-hour CO cook exposure (e.g., 1 to 2 ppm) was associated with a 0.84 (95%CI: -1.66, -0.03) decrease in mean MCS score and a 0.88 (95%CI: -1.71, -0.05) decrease in mean PCS score. Associations between PM2.5 and CO kitchen concentrations and MCS and PCS scores were linear but statistically insignificant.
Conclusion: We observed negative associations between physical and mental HRQoL and PM2.5 and CO cook exposures, but not kitchen concentrations. Reducing HAP exposure may improve HRQoL among female primary cooks.
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