In low-income communities, non-electric fuel sources are typically the main cause of
Household Air Pollution (HAP). In Umlazi, a South African coastal, informal settlement, households
use electric- and non-electric (coal, wood, gas, paraffin) energy sources for cooking and heating.
The study aimed to determine whether respiratory ill health status varied by fuel type use. Using
a questionnaire, respondents reported on a range of socio-demographic characteristics, dwelling
type, energy use for cooking and heating as well as respiratory health symptoms. Multivariate
Poisson regression was used to obtain the adjusted Odds Ratios (ORs) for the effects of electric and
non-electric energy sources on prevalence of respiratory infections considering potential confounding
factors. Among the 245 households that participated, Upper Respiratory Tract Infections (URTI,
n = 27) were prevalent in respondents who used non-electric sources compared to electric sources for
heating and cooking. There were statistically significant effects of non-electric sources for heating
(adjusted OR = 3.6, 95% CI (confidence interval): 1.2–10.1, p < 0.05) and cooking (adjusted OR = 2.9,
95% CI: 1.1–7.9, p < 0.05) on prevalence of URTIs. There was a statistically significant effect of electric
sources for heating (adjusted OR = 2.7, 95% CI: 1.1–6.4, p < 0.05) on prevalence of Lower Respiratory
Tract Infections (LRTIs) but no evidence for relations between non-electric sources for heating and
LRTIs, and electric or non-electric fuel use type for cooking and LRTIs. Energy switching, mixing
or stacking could be common in these households that likely made use of multiple energy sources
during a typical month depending on access to and availability of electricity, funds to pay for the
energy source as well as other socio-economic or cultural factors. The importance of behaviour and
social determinants of health in relation to HAP is emphasized.
Supplementary Material: Figure S1: Household and health survey questionnaire.