Abstract:
BACKGROUND : Household air pollution (HAP) is associated with adverse human health
impacts. During COVID-19 Lockdown Levels 5 and 4 (the most stringent levels), South
Africans remained at home, potentially increasing their exposure to HAP.
OBJECTIVES : To investigate changes in fuel use behaviours/patterns of use affecting HAP
exposure and associated HAP-related respiratory health outcomes during COVID-19
Lockdown Levels 5 and 4.
METHODS : This was a cross-sectional online and telephonic survey of participants from
an existing database. Logistic regression and McNemar’s test were used to analyse
household-level data.
RESULTS : Among 2 505 participants, while electricity was the main energy source for
cooking and heating the month before and during Lockdown Levels 5 and 4, some
households used less electricity during Lockdown Levels 5 and 4 or switched to “dirty
fuels.” One third of participants reported presence of environmental tobacco smoke in the
home, a source of HAP associated with respiratory illnesses. Prevalence of HAP-related
respiratory health outcomes were <10% (except dry cough). Majority of households
reported cooking more, cleaning more and spending more time indoors during Lockdown
Levels 5 and 4 – potentially exposed to HAP.
CONCLUSION : Should South Africa return to Lockdown Levels 5 or 4, awareness raising
about the risks associated with HAP as well as messaging information for prevention of
exposure to HAP, including environmental tobacco smoke, and associated adverse health
impacts will be necessary.
