Indoor Air Pollution Greatly Increases Respiratory Infection Risk in Young Children, suggests study

Written By : Dr. Shravani Dali Published On 2025-12-08T20:15:06+05:30 | Updated On 9 Dec 2025 11:10 AM IST

A systematic review of 36 studies from low- and middle-income countries has revealed a strong link between indoor air pollution and acute respiratory infections in children under five (pooled prevalence 13.56%). Key risk factors included lack of a kitchen window, use of traditional stoves, secondhand smoke exposure, and unclean fuels. Diarrhea and stunting further increased vulnerability.

Indoor air pollution is a major public health issue and contributor to acute respiratory infections among under-five children in low- and middle-income countries. Although numerous studies have explored this association, existing evidence is fragmented, varies across settings and lacks comprehensive synthesis. This study addresses this gap by quantifying the pooled effect size of the association between indoor air pollution exposure and acute respiratory infection and identifying determinant factors among under-five children in low- and middle-income countries.

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline was used for this review. The study reviewed 36 research articles obtained from databases including PubMed, ScienceDirect, HINARI, and Google Scholar from January 1, 2015, to September 1, 2024. Data were extracted using Microsoft Excel and then analyzed in STATA-17 software. The Joanna Briggs Institute quality appraisal tool was utilized to evaluate the included studies. A random effects model was applied to calculate the pooled effect size, while publication bias was examined using funnel plots and Egger’s regression test. Additionally, subgroup analysis, meta-regression, and sensitivity analysis were performed. Results: The pooled effect size of acute respiratory infection among under-five children associated with exposure to indoor air pollution was 13.56% (95% CI: 11.88–15.25), with high heterogeneity (I2 = 99.9%, p-value < 0.001). Exposure-related factors, including absence of a kitchen window (OR = 4.47, 95% CI: 1.66–7.28), use of traditional stoves (OR = 2.53, 95% CI: 1.02–4.03), secondhand smoke exposure (OR = 1.19, 95% CI: 1.06–1.32), and use of unclean fuels (OR = 1.16, 95% CI: 1.07–1.25) were significantly associated with acute respiratory infection among under-five children. In addition, child health and nutritional factors such as diarrhea (OR = 3.76, 95% CI: 3.51–4.01), and stunting (OR = 1.16, 95% CI: 1.02–1.31) were also linked to increased risk. Furthermore, demographic and household characteristics, including child’s age, sex, wealth index, lack of separate kitchen, presence of children near in stove during cooking and birth order were identified as significant predictors. This study highlights a significant association between indoor air pollution and acute respiratory infection in under-five children. Targeted interventions, including the promotion of clean cooking fuels, smoke-free households, and improved household ventilation are essential.

Reference:

Desye, B., Geto, A.K., Daba, C. et al. Indoor air pollution exposure and acute respiratory infection among under-five children in low- and middle-income countries: a systematic review and meta-analysis of epidemiological studies. BMC Infect Dis (2025). https://doi.org/10.1186/s12879-025-12148-y

Keywords:

Desye, B., Geto, A.K., Daba, C, Indoor air pollution, exposure, acute respiratory infection, among, under-five children, low- and middle-income countries, systematic review, meta-analysis, epidemiological studies, BMC Infectious Diseases

Indoor air pollutionexposureacute respiratory infectionamongunder-five childrenlow- and middle-income countriessystematic reviewmeta-analysisepidemiological studiesBMC Infectious Diseases

Source : BMC Infectious Diseases

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.