India's progress on clean cooking fuel - Why it is time for a rethink
There are several studies establishing that people exposed to solid fuel and kerosene use for both heating home and cooking showed significant associations with TB.
All About It
Data from the National Family Health Survey - 5 (NFHS 5: 2019-21) have recently been analyzed in a variety of ways to draw a number of different conclusions. A few really important datasets, however, have not received the attention they merit. And they deal with the effects of cooking fuels.
According to NFHS 5:
(i) only 59% of families use clean fuel for cooking, and
(ii) 41% of households cook using solid fuel, mostly wood or dung cakes, chiefly in rural regions.
Additionally, 94.8% of homes in India that are dependent on solid fuels use chullah, and their split seems to be approximately even in urban and rural areas. Haryana, Himachal Pradesh, Rajasthan, Uttarakhand, Chhattisgarh, Madhya Pradesh, Uttar Pradesh, Bihar, Jharkhand, Odisha, and West Bengal are the states where more than 40% of households cook using solid fuels. Specifically, in states like Rajasthan, Chhattisgarh, Madhya Pradesh, Bihar, Jharkhand, Odisha, and West Bengal, this percentage is as high as 60%.
The observation made by NFHS, however, is even more concerning: "There is a great deal of variation in the prevalence of medically treated TB according to the type of cooking fuel the household uses, ranging from a low of 179 persons per 100,000 usual residents in households using electricity, liquid petroleum gas, natural gas, or biogas to a high of 490 persons per 100,000 in households using straw, shrubs, or grass for cooking. High TB prevalence is also seen among households using other fuels."
Numerous investigations have demonstrated a connection between TB and exposure to solid fuels and kerosene usage for cooking and house heating.