Indoor air pollutants and respiratory symptoms among residents of an informal urban settlement in Uganda: A cross-sectional study

Solomon T Wafula; Aisha Nalugya; Hilbert Mendoza; Winnifred K Kansiime; Tonny Ssekamatte; Abel W Walekhwa; Richard K Mugambe; Florian Walter; John C Ssempebwa; David Musoke

doi:10.1371/journal.pone.0290170

Indoor air pollutants and respiratory symptoms among residents of an informal urban settlement in Uganda: A cross-sectional study

PLoS One. 2023 Aug 17;18(8):e0290170. doi: 10.1371/journal.pone.0290170. eCollection 2023.

Authors

Affiliations

¹ Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda.
² Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
³ Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
⁴ Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.

Abstract

Background: Indoor air pollutants (IAP) and household conditions such as dampness, crowding and chemical exposures have been associated with acute and chronic respiratory infections. In Uganda, literature on the effects of IAP on respiratory outcomes in informal settlements is limited.

Methods: We describe the baseline household characteristics of 284 adults and their children in an informal settlement in Uganda from April to May 2022. We monitored same-day indoor concentrations of particulate matter PM2.5, PM10, Carbon monoxide (CO), relative humidity %, and temperature from 9 am to 2 pm and interviewed caregivers/mothers about their respiratory symptoms and those of their children in the previous 30 days. We employed robust Poisson regressions to evaluate the associations between indoor air indicators and respiratory health symptoms.

Results: Approximately 94.7% of households primarily used biomass fuels and 32.7% cooked from inside their dwelling rooms. The median PM2.5, PM10 and CO levels were 49.5 (Interquartile range (IQR) = 31.1,86.2) μg/m3, 73.6 (IQR = 47.3,130.5) μg/m3 and 7.70 (IQR = 4.1,12.5) ppm respectively. Among adults, a 10 unit increase in PM2.5 was associated with cough (Prevalence Ratio (PR) = 3.75, 95%CI 1.15-1.55). Dwelling unit dampness was associated with phlegm (PR = 2.53, 95%CI = 1.39-4.61) and shortness of breath (PR = 1.78, 95% CI 1.23-2.54) while cooking from outside the house was protective against shortness of breath (PR = 0.62, 95% CI = 0.44-0.87). In children, dampness was associated with phlegm (PR = 13.87, 95% CI 3.16-60.91) and cough (PR = 1.62, 95% CI 1.12-2.34) while indoor residual spraying was associated with phlegm (PR = 3.36, 95%CI 1.71-6.61).

Conclusion: Poor indoor air conditions were associated with respiratory symptoms in adults and children. Efforts to address indoor air pollution should be made to protect adults and children from adverse health effects.

Copyright: © 2023 Wafula et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Air Pollutants* / adverse effects
Alarmins
Child
Cough / epidemiology
Cough / etiology
Cross-Sectional Studies
Drug-Related Side Effects and Adverse Reactions*
Dyspnea
Humans
Particulate Matter / adverse effects
Uganda / epidemiology

Substances

Air Pollutants
Particulate Matter
Alarmins

Grants and funding

This work was supported by Makerere University School of Public Health under the Small Grants Programme (MakSPH-GRCB/18-19/01/02). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.