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Not only toilets, focus on kitchen too for better health

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Poor kitchens cause household air pollution and along with poor sanitation, results in millions of annual premature deaths globally, says study

Apart from air and water pollution, a significant public health concern in India at a household level is the lack of proper sanitation. According to a United Nations report, globally, 240 crore people lack access to essential sanitation services, such as toilets and India has been trying to address this through initiatives such as the ‘Swachh Bharat Abhiyan’ (Clean India Mission).  But there is another significant risk lurking, which we have ignored for too long!  The pollution in our kitchens!

In a recent study, published in the journal Environmental Science and Pollution Research, researchers from the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, and University of California, Berkeley, USA, have highlighted the urgency to address the issue of cleanliness in both kitchens and toilets simultaneously.

Kitchens, especially those that burn biomass such as cow dung, charcoal, wood and crop waste for cooking, contribute significantly to household air pollution (HAP), also known as the indoor air pollution. The fumes from these fuels are known to cause respiratory infections and many other non-communicable diseases. The World Health Organisation (WHO) estimates that around 300 crores ‘forgotten’ people still use biomass globally, and 38 lakh premature deaths occur in a year from illness ‘attributable to household air pollution’. The problem is severe in developing countries like India where such pollution killed about 12 lakh people in  2012, as the present study elaborates.

“Water, sanitation and hygiene get most of the public/media attention as their adverse health effects are immediate. In contrast, health effects of household air pollution take time to develop and are non-communicable, hence are often ignored. Recent studies highlight that outdoor and indoor pollution are leading causes of diseases and disability in Asia.  Hence, we feel that issue of household air pollution should also be a major component of ‘Swachh Bharat’ Mission”, says Dr Ravindra Khaiwal, Professor of Environment Health at PGIMER, who is also an author of the study.

The researchers of the study point out that in India, lack of proper toilets and kitchens affect the poorest and most vulnerable population in rural areas or urban slums. While there are water and sanitation departments and various schemes for improving access to toilets, there are no similar schemes to address the shortcomings in the kitchens. “Most rural households and urban slums in developing countries have a single room, where they cook and sleep; this makes them vulnerable to toxic HAP exposure”, say the researchers pointing out to the hazards of kitchens.

In this study, the researchers advocate integration of sanitation and HAP schemes as it reduces the cost of interventions including survey, monitoring, and evaluation of programmes. Although schemes like Pradhan Mantri Ujjwala Yojana (PMUY) exist to provide free LPG (liquefied petroleum gas) schemes to the poor, the researchers push for reducing the natural tendency of households to maintain some usage of biomass during the initial years of LPG use.

“There is need to generate a shared pool of funding to better address the sanitation and HAP issues. We feel that the private sector should take the lead under corporate social responsibility. At the same time, there is a need to bring the key players such as the Ministry of Drinking Water and Sanitation and the Ministry of Petroleum and Natural Gas to jointly plan strategies and policy intervention to timely attain the ‘better health for all’ by 2030 under our commitment to the UN’s Sustainable Development Goal.”

The major issue with our kitchens is not only the continued use of biomass instead of clean fuels like LPG but also the poor ventilation that retains the pollutants long after the fuel is burnt.  Building sufficiently ventilated kitchens might require bold signalling in terms of policies such as indoor air quality guidelines.  Therefore, along with improved sanitation facilities, affordable, clean fuel, improved stoves and proper ventilation are the major factors for a healthier India. Developing a country-specific indoor air quality guidelines and action framework, with a particular focus on HAP, could facilitate necessary legal mandate and financial support, the researchers say.

“We would like to pilot some intervention in our field practice area and see how can we build a sustainable model to address the sanitation and HAP by creating awareness and building capacity of local communities to reduce the disease burden. Further, there is no India specific indoor air quality guideline, and we aim to generate data to fill the science-policy framework gap better,” says Dr Khaiwal, outlining their plans on the future of this research.