Abstract
BACKGROUND AND AIMS: Literature suggests that outdoor air pollutant exposure is associated with hearing problems, but examination of this link has not extended to any potential association between hearing ability and the use of unclean cooking fuels. The current paper investigates whether such a link exists, utilizing a large sample of older adults from low- and middle-income countries (LMICs) where such fuels are commonly used. METHODS: Data from the Study on global AGEing and adult health (SAGE) were analyzed. This is a nationally representative and cross-sectional data set collected for the World Health Organization for residents of South Africa, China, Ghana, India, Mexico, and Russia. A range of "unclean" cooking fuels were assessed, namely agriculture or crop, animal dung, coal or charcoal, Kerosene or paraffin, shrubs or grass, and wood. Hearing problems referred to the interviewer-rated presence of this condition. Statistical analysis was done using multivariable logistic regression. RESULTS: The present work analyzed data from 14,585 individuals aged ≥ 65 years [mean (SD) age 72.6 (11.5) years; 55.0% females]. In the overall sample and in the final adjusted model, unclean cooking fuel use was associated with a significantly increased risk of hearing problems (OR = 1.68 (95% CI = 1.22-2.30). This association was significant for females (OR = 2.36; 95% CI = 1.53-3.63) but not for males (OR = 1.20; 95% CI = 0.79-1.81). CONCLUSION: Unclean cooking fuel use is associated with an increased risk of hearing problems among adult residents of LMICs over 65 years of age, particularly among females. Findings from this study support the development of Sustainable Development Goal 7 (United Nations), which advocates for fairer and more sustainable access to modern energy, as well as a means to prevent avoidable hearing problems.