Cultural practices and exposure to particulate pollution from indoor biomass cooking: Effects on respiratory health and nutritional status among the Aymara Indians of the Bolivian highlands.

Abstract

The traditional focus of air pollution studies has been the urban outdoor environment of industrialized countries. This fails to consider the use of biomass fuels by roughly half the world's population for indoor cooking. In order to address the problem of air pollution from indoor biomass cooking, this research examined the relationship among health, cultural practices associated with cooking, and exposure to indoor biomass cooking by comparing two Bolivian Aymara Indian villages that were the same in every respect except for their cooking practices: in one of the villages biomass cooking was done exclusively indoors while in the other village biomass cooking was done exclusively outdoors. The quantification of total human exposure to pollution showed that cultural patterns, especially those related to cooking practices and human activity patterns, are important determinants of pollution exposure. While kitchen concentrations in the indoor cooking village were significantly higher (p $<$ 0.0001) than those in the outdoor cooking village, differences in exposure were relatively small, but still statistically significant, because the home in the outdoor cooking village was unexpectedly an important source of particulate pollution. The results of the health component of the study showed a significantly higher incidence of acute respiratory infections in the indoor cooking village compared to the outdoor cooking village for all tests (p $<$ 0.05). Differences in the prevalence of chronic bronchitis, while not always significant, were systematically higher in the indoor cooking village compared to the outdoor cooking village. In addition, adolescent and adult females from the indoor cooking village exhibited a greater delay in growth and reduction in fat reserves than their counterparts in the outdoor cooking village. The present study shows that indoor cooking and the cultural factors associated with indoor cooking lead to high pollutant exposures which in turn adversely affect respiratory health and nutritional status. From an anthropological perspective this shows clearly the intimate relationship that exists between the culture and the biology of a population. As such, research in human biology and air pollution epidemiology must consider cultural practices in order to gain better insight into the health status of a population.