Household air pollution and cognitive health among Indian older adults: Evidence from LASI

Modelling the relationship between industrial air pollution and perceived health effects of households in the three most air-polluted cities of Pakistan

Industrialization contributes to economic growth; however, its negative impacts cannot be overlooked. The emission of toxic pollutants into the atmosphere by industries poses a serious threat to both environmental and human health. We conducted a field study in the top three most polluted cities of Pakistan to quantify the impacts of industrial air pollution on the perceived health effects of households. We also analyzed the factors influencing households' adoption of preventive practices to mitigate the effects of air pollution. Data were collected from households residing in both industrial and non-industrial areas. Our findings revealed that short-term health issues including cough, sore throat, rhinitis, eye irritation, and dermatitis were 25% more prevalent among respondents living in industrial areas ompared to those in non-industrial areas. Estimates from the negative binomial (NB) regression model indicated that age, education level, gender, occupation, media influence, comorbidity, and proximity to industrial sites were significant determinants of households' perceived health effects. Approximately 40% of respondents in industrial areas and 44% in non-industrial areas reported adopting preventive practices to avoid the detrimental effects of air pollution. Further analysis identified perceived health effects (β = 0.252, p < 0.05) and the proximity of residential sites to industry (β = 0.973, p < 0.05) as significant factors influencing the adoption of preventive measures. Based on our findings, we recommend that authorities locate factories away from residential areas, schools, and healthcare facilities. Additionaly, raising awareness through mainstream and social media can help mitigate health risks associated with industrial air pollution. Furthermore, Individuals working in factories or sufferring from comorbidities should receive trainings on adopting effective preventive measures to avert health effects of air pollution.

Neurotoxic and developmental effects of scented incense stick smoke: Network toxicology and zebrafish model study

Burning incense sticks is a traditional practice in many cultures, especially in Southeast Asia. While it is often regarded as sacred and beneficial, modern incense sticks contain various chemicals that can pose health risks. A GCMS analysis of the ICS revealed potential compounds. Network toxicology revealed that ICS contains compounds violating Lipinski's rule of five, leading to potential neurotoxic effects. Key pathways affected include neuroactive ligand-receptor interaction and calcium signaling, associated with neurodegenerative diseases like Parkinson's and Alzheimer's. Significant genes involved are STAT3, BCL2, and MTOR, emphasizing the chemical hazards of ICS exposure. We investigated the toxicity of ICS using zebrafish (Danio rerio) embryos as a mode. ICS exposure resulted in a dose-dependent increase in toxicity. High concentrations (7 and 14 µg/ml) led to immediate mortality, while lower concentrations (0.1, 0.3, 0.5, and 1 µg/ml) caused developmental defects such as yolk sac edema, skeletal malformations, and pericardial edema. Mortality rates increased with higher concentrations, confirming dose-dependent ICS exposure caused hypoactive locomotion, with reduced distance traveled and velocity toxicity. Higher concentrations of ICS led to increased ROS levels and cellular damage, as evidenced by enhanced staining levels. A dose-dependent increase in lipid peroxidation (DPPP assay) and lipid accumulation (Nile red assay) was observed. Higher ICS concentrations led to significant oxidative damage to lipids and increased lipid deposition. Enzymatic assays showed that ICS exposure significantly decreased the activities of antioxidant enzymes SOD and CAT, indicating impaired antioxidant defense, while increasing LDH activity, signaling tissue damage and cytotoxicity. Gene expression analysis revealed downregulation of SOD1 and CAT genes, upregulation of inflammatory genes TNF-α and IL-1β, and increased expression of the apoptotic gene p53 with decreased expression of Bcl-2 and BDNF. These findings highlight ICS's potential to cause oxidative stress, inflammation, apoptosis, and neurodevelopmental impairments.

Association of solid fuel use with cognitive function and the modifying role of lifestyle: A nationwide cohort study in China

BACKGROUND

As opposed to a healthy lifestyle, indoor air pollution from solid fuel use may be harmful for cognitive function. However, the extent to which lifestyle modifies the association between solid fuel use and cognitive function remains unknown.

METHODS

A total of 21,008 individuals aged 16 to 92 were enrolled in 2010 and followed up to 2014 in the China Family Panel Studies (CFPS). Cognitive function was assessed using standardized math and word tests in two waves. Solid fuel use at baseline was assessed by self-reporting of firewood, straw, or coal used for cooking. Lifestyle profile was classified into two groups (favorable vs. unfavorable) based on five modifiable lifestyle factors including alcohol drinking, smoking, body mass index, diet, and physical activity. Linear mixed-effects models were employed to assess the association of solid fuel use and lifestyle with cognitive function. The effect modification of lifestyle was analyzed.

RESULTS

A total of 49.7% of the study population used solid fuels for cooking and 17.4% had a favorable lifestyle. Solid fuel use was associated with a significant decrease in cognitive function (β = -0.29, 95% CI: -0.39, -0.19 for math test; β = -0.62, 95% CI: -0.84, -0.41 for word test). Lifestyle significantly modified this association (p-interaction: 0.006 for math test; 0.016 for word test), with the corresponding association being less pronounced among participants adhering to a favorable lifestyle compared to those with an unfavorable lifestyle.

CONCLUSION

A favorable lifestyle may attenuate the adverse association between solid fuel use and cognitive function. Adopting a favorable lifestyle has the potential to mitigate the adverse neurological effects due to indoor air pollution.

In-utero exposure to multiple air pollutants and childhood undernutrition in India

BACKGROUND

Several studies have been conducted to understand the impact of socioeconomic and maternal factors on child undernutrition. However, the past literature has not directly examined the joint impacts of fuel use and ambient pollution and have primarily focused on PM2.5.

OBJECTIVE

This study explored the individual and community-level associations of both indoor (cooking fuel type) and ambient air pollution (PM2.5, NO2 and SO2) during maternal gestation on child undernutrition.

METHODS

This study analysed stunting, being underweight, and anaemia of children aged 0-59 months (n = 259,627) using the National Family Health Survey. In-utero exposures to ambient PM2.5, NO2, and SO2 were measured using satellite data and self-reported fuel type was a marker of indoor pollution exposure. The study used univariate and bivariate Moran's I, spatial lag model and multivariable logistic regression models after adjusting for other covariates to understand the effect of pollution on in-utero exposure and child health status at the individual and community-levels.

RESULTS

Higher concentration of indoor and ambient air pollution was found in the Northern and parts of Central regions of India. Estimates of spatial modelling show that each 1 μg/m-3 increase in maternal exposure to ambient PM2.5 across the clusters of India was associated with a 0.11, 9 and 19 percentage points increase in the prevalence of stunting, underweight and anaemia, respectively. The results of multi-pollutant model show that a higher ambient PM2.5 exposure during pregnancy was linked to higher odds of stunting (AOR:1.38; 95% CI:1.32-1.44), underweight (AOR:1.59; 95% CI:1.51-1.67) and anaemia (AOR:1.61; 95% CI:1.52-1.69) in children. Weaker but similar associations were observed for NO2, but not with SO2. Indoor pollution exposure during in-utero periods was also significantly associated with childhood undernutrition and this association was modified by ambient PM2.5 levels, where exposure to both indoor and ambient air pollution had even greater odds of being undernourished.

IMPACT STATEMENT

Our research on multi-pollutant models has revealed the initial proof of the individual impacts of indoor and outdoor pollution (PM2.5, NO2, and SO2) exposure during fetal development on children's nutrition.

Household air pollution and urinary incontinence symptoms among older adults in LASI: a large-scale population-based study

BACKGROUND

The effects of household air pollution on urinary incontinence (UI) symptoms and stress urinary incontinence (SUI) symptoms have not been studied. This study seeks to investigate the correlation between household air pollution and UI/SUI symptoms among middle-aged and elderly adults in India.

METHODS

We employed data derived from individuals aged 45 years and older who participated in the inaugural wave (2017-2018) of the Longitudinal Aging Study in India (LASI). The assessment of household air pollution exposure and the occurrence of UI/SUI symptoms relied on self-reported data. The analytical approach adopted was cross-sectional in nature and encompassed a cohort of 64,398 participants. To explore relationships, we utilized multivariate logistic regression analysis, incorporating subgroup analysis and interaction tests.

RESULTS

1,671 (2.59%) participants reported UI symptoms and 4,862 (7.55%) participants reported SUI symptoms. Also, the prevalence of UI/SUI symptoms is much higher among middle-aged and elderly adults who use solid polluting fuels (UI: 51.23% vs. 48.77%; SUI: 54.50% vs. 45.50%). The results revealed a noteworthy correlation between household air pollution and the probability of experiencing UI/SUI symptoms, persisting even after adjusting for all conceivable confounding variables (UI: OR = 1.552, 95% CI: 1.377-1.749, p < 0.00001; SUI: OR: 1.459, 95% CI: 1.357-1.568, p < 0.00001). Moreover, significant interaction effects were discerned for age, education level, tobacco consumption, alcohol consumption, and physical activity (p for interaction < 0.05).

CONCLUSIONS

The results of our study indicate that the utilization of solid fuels in the home increases the likelihood of developing urinary incontinence and stress urinary incontinence. As a result, we argue that there is an immediate need to reform the composition of cooking fuel and raise public awareness about the adverse effects of air pollution in the home.

A study about the impact of indoor air pollution on cognitive function among middle-aged and older adult people in India

BACKGROUND

In the 21st century, people still use solid fuel for cooking at home, resulting in poor indoor air quality. Prolonged exposure to such conditions may negatively affect one's cognitive function. So, the present study examines the possible association between IAP and the cognitive function of individuals aged 45 years or above in India.

METHODS

The study utilizes secondary data, procured from the longitudinal ageing study in India (2017-18). Treatment effects through regression-adjusted models were applied to represent the association between IAP and cognitive health and the results are represented by beta coefficient (β). Three separate models with a 95% confidence interval adjusting with the other factors like housing environment, individual and behavioural were framed.

RESULTS

The study revealed that households without a separate kitchen (β = -0.64; 95%CI: -0.90 to -0.39) and electricity (β = -0.97; 95%CI: -1.34 to -0.61) significantly affect cognitive strength. Cognitive decline is likely more pronounced among older adults (β = -1.19; 95%CI: -1.42 to -0.96) than the middle-aged population. Moreover, the cognitive ability of rural residents (β = -1.11; 95%CI: -1.49 to -0.73) and women (β = -2.05; 95%CI: -2.29 to -1.81) is negatively associated with IAP exposure. Older adults with no reading habits (β = -6.28; 95%CI: -6.72; to -5.85) and physical inactivity (β = -0.96; 95%CI: -1.22 to -0.70) had a sign of notable decline in cognitive ability.

CONCLUSIONS

Findings revealed that cognitive function is negatively associated with IAP, demanding a deep intervention plan to minimize the detrimental effect.

Impact of indoor air pollution from cooking fuel usage and practices on self-reported health among older adults in India: Evidence from LASI

This research aims to explore the impact of various components of Indoor air pollution (IAP) on the Self-Reported Health (SRH) of older adults in India. Using a sample of 27,090 from the Longitudinal Aging Study in India (LASI) Wave-1, a multiple binary logistic regression model was employed to identify specific risk factors associated with poor SRH among older adults. Adjusting for demographic, socioeconomic, and IAP-related components, it was revealed that IAP significantly contributes to poor SRH. The adjusted model indicated that individuals using solid cooking fuels face a higher risk of poor SRH compared to those using liquid fuels. Additionally, individuals not using electric chimneys and cooking near windows are associated with an elevated risk of poor SRH, highlighting the importance of adequate ventilation. Health risk factors, including lung disease, diabetes, cough, and depression, further contribute to poor SRH among older adults exposed to IAP. Overall, the study offers crucial insights for policymakers, healthcare professionals, and environmentalists to improve the well-being of the vulnerable older population in India.

Association between the domestic use of solid cooking fuel and increased prevalence of depression and cognitive impairment in a big developing country: A large-scale population-based study

Background

Previous studies have suggested that air pollution affects physiological and psychological health. Using solid fuel at home is a significant source of indoor air pollution. The associations between solid fuel use and depressive symptoms and cognitive health were unclear among older adults from low- and middle-income countries (LMICs).

Methods

To evaluate the association of solid fuel use with depressive symptoms and cognitive health among older adults, we obtained data from the Longitudinal Aging Study in India (LASI) and excluded subjects younger than 60 years and without critical data (solid fuel use, depressive symptoms, and cognitive health). The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to assess depressive symptoms, with more than ten indicative of depression. Cognitive health was assessed using measures from the Health and Retirement Study (HRS), and subjects with the lowest 10th percentile were considered to have cognitive impairment. The participants' responses defined solid fuel use. Multivariable logistic regression, linear regression, subgroup analysis, and interaction tests were performed to appraise the relationship between solid fuel use and depression and cognitive impairment.

Results

A total of 29,789 participants over 60 years old were involved in this study. Almost half of the participants (47.5%) reported using solid fuel for home cooking. Compared with clean fuel use, solid fuel use was related to an increased prevalence of depression [odds ratio (OR) 1.09, 95% CI 1.03-1.16] and higher CES-D-10 scores (β 0.23, 95% CI 0.12-0.35) after fully adjusted covariables. Using solid fuel was also related to a higher risk of cognitive impairment (OR 1.21, 95% CI 1.11-1.32) and a lower cognitive score (β -0.63, 95% CI -0.79 to -0.47) compared with those who used clean fuel. In the subgroup analysis, the prevalence of depression increased in females and non-smokers. The association of solid fuel use with depression and cognitive impairment exists in subgroups of BMI, economic status, caste, living area, education, and drinking.

Conclusions

The use of solid fuel at home was associated with an increased prevalence of depression and cognitive impairment among older adults in India.