Is biomass fuel smoke exposure associated with anemia in non-pregnant reproductive-aged women?

PLoS One. 2022 Aug 19;17(8):e0272641. doi: 10.1371/journal.pone.0272641. eCollection 2022.


Objectives: Sri Lanka is a developing country where the majority of households still rely on firewood for cooking. Furthermore, the prevalence of anemia among reproductive-aged women is of moderate public health importance, according the classification of World Health Organization. Despite the researchers' ongoing efforts to investigate a link between solid fuel smoke exposure and anemia, the veracity of their findings remains uncertain. As a result, the purpose of this study was to examine the relationship between biomass fuel smoke exposure and anemia in non-pregnant reproductive-aged women in Sri Lanka.

Methods: A descriptive cross-sectional study was conducted among 382 non-pregnant reproductive-aged (15 to 49 years) women in Central Province, Sri Lanka. Data was collected using a standardized interviewer-administered questionnaire, and exposure was assessed using a breath carbon monoxide monitor. Drabkin's cynomethhemoglobin technique was used to determine blood hemoglobin concentration.

Results: The overall prevalence of anemia was 36.1%. The logistic regression model revealed no effect of cooking fuel type on anemic or non-anemic status after adjusting for potential confounding factors (p > 0.05). The multivariate regression analysis also discovered that cooking fuel type had no effect on women's blood hemoglobin concentration.

Conclusions: The study results suggest no impact of solid fuel smoke exposure on anemia among non-pregnant, reproductive-aged women. Larger scale prospective cohort studies are recommended. The reasons behind the high prevalence of anemia among reproductive-aged women should be further investigated, and corrective measures should be implemented urgently.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Air Pollution, Indoor* / adverse effects
  • Air Pollution, Indoor* / analysis
  • Anemia* / epidemiology
  • Anemia* / etiology
  • Biomass
  • Cooking / methods
  • Cross-Sectional Studies
  • Female
  • Hemoglobins / analysis
  • Humans
  • Prospective Studies
  • Smoke / adverse effects
  • Smoke / analysis


  • Hemoglobins
  • Smoke

Associated data

  • figshare/10.6084/m9.figshare.19807693

Grant support

The project was funded by the University Research Grant 2018 (URG/2018/AHS/06) of University of Peradeniya, Sri Lanka.