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Household cooking fuels associated with elevated blood pressure among adult women: a national-wide assessment in Bangladesh


Household air pollution from cooking fuel may have adverse health effects, particularly among women from countries like Bangladesh, where women participate in most household cooking activities. However, little is known about how cooking fuel influences adult women’s blood pressure (BP) status in Bangladesh. This study assessed the association between household cooking fuel and women’s BP in Bangladesh. Data of 6543 women (aged ≥18 years) from the latest nationally representative Bangladesh Demographic and health survey 2017-18 were used in this study. This survey collected data on various variables, including women’s BP and cooking fuel. Multivariable regression models were used for this evaluation. About 82.3% of women were living in households using solid cooking fuel. Women’s average systolic BP (SBP) and diastolic BP (DBP) were 121.5 mmHg and 80.7 mmHg, respectively, and 25% had elevated BP. Women residing in a household using solid fuel had significantly higher SBP (β 3.76 mmHg, 95 confidence interval (CI) 2.00, 5.51) and DBP (β 1.17 mmHg, 95% CI 0.17, 2.18) relative to women from households using clean fuel. The odds of elevated BP was 58% higher (adjusted odds ratio, 1.58, 95% CI 1.19, 2.11) among women residing in households using solid fuels compared to their counterparts. Usage of solid cooking fuel was predominantly high and negatively impacted women’s BP status in Bangladesh. In addition to other lifestyle change interventions, improved cooking facilities and clean cooking fuel provision and monitoring could be important initiatives to reduce the burden of elevated BP among women.

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The authors would like to acknowledge the contributions of NIPORT, ICF International, and Mitra & Associates to conduct the survey and to provide open access to the data set.

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Data are available on request from the DHS program website (

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Authors and Affiliations



JRK conceptualised the study and contributed to data preparation, synthesised the analysis plan, performed data analysis, interpreted findings, and wrote the manuscript. MBH helped to synthesise the analysis plan and write the manuscript. The manuscript was critically reviewed and edited by RDG. All authors contributed significantly to the preparation of the manuscript.

Corresponding author

Correspondence to Jahidur Rahman Khan.

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Ethical approval

The BDHS 2017-18 was carried out through a joint effort between the National Institute of Population Research and Training (NIPORT), ICF International, and Mitra and Associates. This survey’s ethical approval was taken from the ICF International Institutional Review Board (USA) and Bangladesh Medical Review Council (Bangladesh). All individuals were deidentified before making data sets publicly available. This present study used secondary BDHS 2017-18 data sets. The authors, too, had permission, and the data set is publicly available in

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The authors declare no competing interests.

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Responsible Editor: Lotfi Aleya

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Khan, J.R., Hossain, M.B. & Gupta, R.D. Household cooking fuels associated with elevated blood pressure among adult women: a national-wide assessment in Bangladesh. Environ Sci Pollut Res 28, 67814–67821 (2021).

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  • Elevated blood pressure
  • Cooking fuel type
  • Association