Indoor Air Pollution and Respiratory Symptoms among Residents in Urban and Rural Community

Background: Indoor air pollution poses a significant public health issue linked to respiratory symptoms and diseases. This study aimed to assess indoor particulate matter levels and related respiratory symptoms with functional impairments affecting residents in urban and rural areas. Methods: This cross-sectional comparative study was conducted from January to December 2023 and included 422 participants - half from rural Moricha Union in Birganj Upazila, Dinajpur District, and half from urban Kafrul Thana, Dhaka District, Bangladesh. Data was collected using a semi-structured questionnaire, a checklist, and a portable digital PM detector. Study areas were selected through multistage sampling, while participants were chosen using simple random sampling. Results: Most participants were female, with 32.75% from urban & 36.75% from rural areas. The largest age group was 30-39 years (39.8%). Education varied significantly: 23.0% of urban participants held a graduate degree, while 29.6% of rural participants were illiterate. Urban incomes were higher, with 17.3% earning 30,001-40,000 taka, compared to 29.4% of rural participants earning up to 10,000 taka. Housing conditions varied, with 49.8% of urban participants living in pukka houses, while 40.3% of rural participants resided in tin-shed buildings. Urban areas predominantly used gas cookers (47.9%), while rural areas relied on clay ovens (49.3%) and biomass fuel (48.8%). Urban kitchens had better ventilation, with 46% having adequate airflow and 42.4% with exhaust fans, while 44.5% of rural areas cooked outdoors. Inadequate air quality for PM2.5 and PM10 was reported by 80.3% and 82.0% of participants, respectively. Respiratory symptoms were more common in rural areas (37.8%), including cough (9.7%), breathlessness (10.7%) & chest tightness (7.8%). Functional impairments were also more frequent among rural participants: urban participants showed 3.3% mild, 6.2% moderate, and 3.8% severe impairment, compared to 12.8% mild, 6.6% moderate, and 7.1% severe impairment in rural areas. Logistic regression revealed significant associations between respiratory symptoms and PM2.5 and PM10 exposure. Conclusion: Indoor air pollution significantly impacts respiratory health in both urban and rural areas of Bangladesh, making it essential to urgently adopt cleaner cooking methods and improve ventilation.