Indoor Pollution and Women’s Health

Over the years, there have been growing concerns about air pollution as a public health hazard. According to the World Health Organization (WHO), the smoke from burning solid fuels is estimated to be responsible for 1.6 million deaths each year in the world’s poorest countries.[1] Various studies suggest that women are amongst the worst affected by air pollution, and the impact of indoor air pollution that disproportionately affects women remains largely ignored.

This article will discuss the impact of air pollution on women’s health. It will focus on indoor air pollution, highlight factors contributing to the disproportionate effect of indoor air pollution on women’s health, and consider solutions. Finally, it will consider recommendations to improve women’s participation in conversations around climate change.

What is indoor air pollution, and how does it disproportionately affect women?
The WHO describes indoor air pollution as household air pollution generated by the continued use of polluting fuels and inefficient technologies.[2] Burning biomass (wood, crop residues, charcoal, and dung) and using poorly constructed stoves in households is common in developing countries because such resources are cheaper and more readily available for most people. Almost one-half of the world’s population still relies on solid fuels for everyday cooking and heating; some 2.4 billion people burn biomass and a further 0.6 billion burn coal.[3] The smoke emitted from burning biomass contains a range of health-damaging pollutants that can cause asthma, tuberculosis, cataracts, low birth weight and infant mortality.[4]Particles from burning wood and charcoal make the lungs vulnerable to acute lower respiratory infections, such as pneumonia and chronic obstructive pulmonary disease.[5]

Around the world, women spend more time than men engaging in unpaid domestic and care labour.[6]Unpaid care labour is work that is concentrated in the domestic environment and includes cooking, cleaning, washing, maintenance, household management, and childcare. Women in Uganda are 18% more likely than men to perform care labour, while women in India are ten times more likely than men to perform care labour.[7] Since a significant source of pollution lies in the cooking fuel used in a domestic environment, women bear a greater risk to their health from this exposure, as cooking accounts for a significant portion of women’s care labour. Thus, assigned gender roles and economic hindrances disproportionately place women from lower-income communities in developing countries at a higher risk of exposure to indoor air pollution.

Health concerns for women caused by indoor air pollution
A report by the WHO in 2000 states that women make up nearly 60% of all deaths attributed to indoor air pollution.[8] As mentioned above, primary health outcomes of indoor air pollution include acute respiratory infections, chronic obstructive pulmonary disease, lung cancer, asthma, etc. Research in India suggests that the relative risk of chronic obstructive pulmonary disease and lung cancer (from exposure to charcoal smoke) is a substantial health outcome for women over 30.[9] The risk is moderate for men. Cataract, the condition where damage to the protein and fibre in the eye’s lens causes blurry vision, is also found to be an outcome due to indoor smoke exposure and women are most affected.[10]

Moreover, an increasing amount of data suggests a relationship between high indoor air pollution exposure and pregnancy complications for mothers.[11] Pregnant women and their foetuses are at higher risk of developing health complications from indoor air pollution than the average population because women tend to spend more time indoors during pregnancy and are more vulnerable to toxins from indoor air pollution.[12]Biomass combustion in inefficient cooking stoves and poorly ventilated conditions causes heavy exposure to carbon monoxide (CO), which binds to haemoglobin, forms carboxyhaemoglobin, and reduces the oxygen-carrying capacity of the blood.[13] A developing foetus, deprived of adequate oxygen, suffers intrauterine growth retardation and a greater risk of reduced birth weight.[14]

Indoor air pollution-related health concerns for women in Pakistan
94% of households in Pakistan’s rural areas use solid biomass for cooking and heating.[15] Rural women spend more time cooking than men and are highly vulnerable to hazardous pollutants. Rural households in Pakistan use three stone stoves (made of clay and husk) without chimneys to remove excess smoke.[16]This leads to incomplete combustion and releases a high concentration of particulate matter, carbon monoxide and other organic compounds.[17] Absence of low-combustion stoves and adequate indoor ventilation results in different diseases, including acute and chronic respiratory illnesses in households in Pakistan. Research conducted in over 250 households by the Pakistan Institute of Development Economics (PIDE) states that closed kitchens, solid fuels, and prolonged exposure to toxins contribute to respiratory health issues amongst women.[18] There is also evidence to suggest that the burning of biomass causes respiratory problems such as chronic bronchitis among women in Pakistan.[19]

How can we mitigate the hazardous effects of indoor air pollution on women’s health?
One of the main barriers to reducing health hazards caused by indoor air pollution is the affordability of improved cooking stoves and less polluting fuels. The Nepal Environmental Watch initiative (NEW initiative) found a solution when it installed over one thousand Matribhumi Improved Cooking Stoves (M-ICS) in different districts. M-ICS save approximately 65% of firewood usage compared to other stoves while producing 25% more heat. This means M-ICS require less fuel burning but produce more heat than regular clay stoves. They reduce cooking time, use less firewood, reduce costs, and save time collecting firewood while not altering the taste of the food.

Similarly, the United Nations Development Programme in Pakistan gave 200 locally designed and produced fuel-efficient stoves to 50 households in 15 valleys of Gilgit Baltistan to mitigate the harmful effects of the indoor burning of wood.[20] The stoves are easy to handle, ash from burning is contained in an underlying chamber that can be cleaned easily, and the hazardous smoke can escape through a chimney. The amount of wood consumed is reduced by half as a result of this intervention.

Improving women’s overall position in the household may also contribute to reducing risk factors relating to indoor air pollution. The power relation within the household is an essential determinant of a household’s fuel choice.[21] Greater decision-making power in the household will provide women with more control over the type of fuel used for cooking. Similarly, an equal division of domestic labour amongst adult household members (both men and women) would significantly reduce women’s long-term exposure to toxins released from burning biomass.

Raising the adult female literacy rate significantly contributes to reducing indoor air pollution-induced health hazards at the household level.[22] Raising awareness amongst women would help in choosing the right fuel as well as adopting more efficient cooking stoves. Research findings from PIDE state that closed kitchens without windows are significantly more hazardous than outdoor kitchens. As a result, education amongst women could create awareness about alternatives like the outdoor kitchen and the importance of windows as ventilators to let out toxic fumes.[23] Education can also help women diversify their work and improve their economic condition. Women who rely on biomass to run their stoves spend up to three mornings a week collecting fuel such as wood.[24] The opportunity cost of their labour is paid work that could potentially raise their family’s income, improve their standard of living, and enhance their nutritional and health status.[25]

Increasing women’s participation in conversations relating to air quality
Gender equality and climate change are intricately linked. All forms of environmental degradation, including indoor air pollution, lead to increased poverty amongst the most marginalised groups. Women and girls are disproportionately affected by worsening air quality which makes them best suited to find solutions to prevent air pollution inside households. A sustainable solution to improve indoor air pollution is to ensure that women are recognised for providing air pollution-related solutions and have positions available at all levels of decision-making. Research shows that when women are in decision-making and leadership roles, there is a positive impact on sustainable natural resource management and climate change adaptation activities.[26]In 2022, Pakistan launched its first-ever Climate Change Gender Action Plan (ccGAP), which aims to ensure that women can influence climate change decisions and that women and men are represented equally in all aspects to increase its effectiveness.[27] While significant progress has been made internationally, a 2015 survey of 65 countries found that only 35% of environmental sector ministries have a gender focal point for integrating gender considerations into the ministry’s policies.[28] Women must be engaged in leadership and decision-making roles to respond to the negative impacts of climate change. They should not only assume political office but also participate in the planning and implementation of sustainable natural resource management practices, climate change mitigation, and adaptation interventions, including at the local level.[29]

Indoor air pollution poses a significant threat to women’s health because women, as primary caregivers, spend more time in the presence of toxic fumes. Since health hazards are created from readily available biomass fuel and low-cost clay stoves, women from low-income communities are more vulnerable to health hazards caused by harmful particles within the household. Successful projects like the M-ICS in Nepal and fuel-efficient stoves from Gilgit-Baltistan show that improvements can be made when women’s needs are adequately considered. However, conversations around clean air lack female voices, especially in Pakistan, making it imperative for policymakers, non-governmental organisations, and climate change activists to create space where more women can hold positions of power and take part in decision-making at all levels of climate action.


[1] “Smoke in the Kitchen: Health Impacts of Indoor Air Pollution | United Nations Development Programme.” UNDP, 2015,

[2] “Household Air Pollution and Health.” World Health Organization, World Health Organization: WHO, 26 July 2022,

[3] “Smoke in the Kitchen: Health Impacts of Indoor Air Pollution | United Nations Development Programme.” UNDP, 2015,

[4] ibid.

[5] ibid.

[6] Ortiz-Ospina, Esteban, et al. “Women’s Employment.” Our World in Data, 24 Mar. 2018,

[7] ibid.

[8] “Addressing the Links between Indoor Air Pollution, Household Energy and Human Health Based on the WHO-USAID Global Consultation on the Health Impact of Indoor Air Pollution and Household Energy in Developing Countries (Meeting Report).” World Health Organization, 3 May 2000.

[9] Dutta, Sabitri, and Sarmila Banerjee. “Exposure to Indoor Air Pollution & Women Health: The Situation in Urban India.” Environment and Urbanization ASIA, vol. 5, no. 1, Mar. 2014, pp. 131–145, doi:10.1177/0975425314521545.

[10] ibid.

[11] Sun, Jing, et al. “Association between Maternal Exposure to Indoor Air Pollution and Offspring Congenital Heart Disease: A Case–Control Study in East China.” BMC Public Health, vol. 22, no. 1, 15 Apr. 2022,, 10.1186/s12889-022-13174-0.

[12] ibid.

[13] “Indoor Air Pollution: From Solid Fuels and Risk of Low Birth Weight and Stillbirth.” World Health Organization, 29 Mar. 2007,

[14] ibid.

[15] Tanvir, Muhammad. “Unveiling the Effects of Indoor Air Pollution on Health of Rural Women in Pakistan – PIDE.” Pakistan Institute of Development Economics, Dec. 2020,

[16] ibid.

[17] ibid.

[18] ibid.

[19] Siddiqui, A. R., Lee, K., Gold, E. B., & Bhutta, B. A. (2005). Eye and respiratory symptoms among women exposed to wood smoke emitted from indoor cooking: a study from southern Pakistan.  Energy for Sustainable Development, 9,  58–66.

[20] “Locally Designed Fuel-Efficient Stoves Help Households in Gilgit Baltistan to Breathe Clean Air Indoors | United Nations Development Programme.” UNDP, 2020,

[21] Dutta, Sabitri, and Sarmila Banerjee. “Exposure to Indoor Air Pollution & Women Health: The Situation in Urban India.” Environment and Urbanization ASIA, vol. 5, no. 1, Mar. 2014, pp. 131–145, doi:10.1177/0975425314521545.

[22] ibid.

[23] Tanvir, Muhammad. “Unveiling the Effects of Indoor Air Pollution on Health of Rural Women in Pakistan – PIDE.” Pakistan Institute of Development Economics, Dec. 2020,

[24] “Smoke in the Kitchen: Health Impacts of Indoor Air Pollution | United Nations Development Programme.” UNDP, 2015,

[25] ibid.

[26] “Invest in Women to Tackle Climate Change and Conserve the Environment – Women Deliver.” Women Deliver, 16 Oct. 2018,

[27] “IUCN and MoCC Launch Pakistan’s First-Ever Climate Change Gender Action Plan.” IUCN, 22 July 2022, Accessed 9 Aug. 2022.

[28] “Invest in Women to Tackle Climate Change and Conserve the Environment – Women Deliver.” Women Deliver, 16 Oct. 2018,

[29] Ibid

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