An Empirical Study of the Association Between Indoor Air Pollution and Respiratory Health in Rural Kebbi State

Biomass fuel combustion for cooking and heating in poorly ventilated households is the primary source of indoor air pollution in rural northern Nigeria, and its respiratory health consequences represent a major preventable disease burden. This study empirically examined the association between indoor air pollution exposure and respiratory health outcomes in rural Kebbi State, North West Nigeria. A cross-sectional analytical study was conducted in four rural communities in Argungu and Bagudo LGAs, enrolling 380 adults aged 18 years and above through systematic household sampling. Indoor air pollution exposure was assessed through household cooking fuel type, cooking location, ventilation quality, and a structured exposure history questionnaire. PM2.5 proxy estimation was conducted using a smoke exposure scoring tool. Respiratory outcomes assessed included self-reported chronic cough, wheeze, dyspnoea, and clinical assessment using standardised spirometry performed by trained research assistants. Results showed that 78.9 percent of households used biomass fuel exclusively. Chronic respiratory symptoms were significantly more prevalent in biomass fuel users than LPG users (42.8 percent versus 21.3 percent; p < 0.001). Spirometric abnormality (FEV1/FVC below 0.70) was detected in 18.4 percent, significantly more prevalent among women who cooked predominantly indoors (OR 3.1; p < 0.001). Women with more than 15 years of cooking history showed the highest symptom and spirometry-defined disease burden. The study recommends clean cooking fuel subsidies, improved cooking stove promotion, and respiratory disease screening for biomass-exposed women in Kebbi State. Keywords: indoor air pollution, biomass fuel, respiratory health, Kebbi State, North West Nigeria