Association of Anaemia with Indoor Air Pollution Among Older Indian Adult Population: Multilevel Modelling Analysis of Nationally Representative Cross-Sectional Study

Abstract

Abstract Introduction- Anaemia is a disease of public health importance with multi-causal pathways. Previous literature suggests the role of indoor air pollution (IAP) on haemoglobin levels, but this has been studied less due to logistic constraints. A high proportion of the population in developing countries, including India, still depends on unclean fuel, which exacerbates IAP. The objective was to study the association between anaemia and IAP among the older Indian adult population (>45 years) as per gender. Methods- Our study analysed the nationally representative dataset of the Longitudinal Ageing Study in India (LASI 2017–18, Wave-1). Bivariate analysis and logistic regression were used to depict the association of anaemia (outcome variable) with IAP (explanatory variable). Multivariable logistic regression was conducted by adjusting for covariates as per their models. P value<0.05 was considered statistically significant. SATA version 17 was used for analysis. Results- Almost half (50.38%) of the participants were exposed to IAP (female (52.40%) > male (47.60%)). The adjusted likelihood of having anaemia was 19% higher (aOR 1.19; 1.09-1.31) among participants exposed to unclean/solid fuel. The adjusted odds were significantly higher among participants exposed to pollution-generating sources (aOR 1.30; 1.18-1.43), and household indoor smoking (aOR 1.17 (1.07-1.29. The adjusted odds of having anaemia were significantly higher (aOR 1.27; 1.16-1.39) among participants exposed to IAP, which was higher in males (aOR 1.36; 1.15-1.61) than females (aOR 1.21; 1.09-1.35). Conclusion- This study established the positive association of anaemia with indoor air pollution among older Indian adults through a nationally representative large dataset. The association was higher among men. Further research is recommended to understand detailed causation and to establish temporality. It is a high time to implement positive intervention nationally to decrease solid/ unclean fuel usage, vulnerable ventilation, indoor smoking, IAP and health hazards associated with these.