Indoor pollution: The hidden air crisis suffocating women and children in Bangladesh

Illustration: TBS

Indoor air pollution is an unseen public health disaster facing Bangladesh and other developing countries. While much attention has focused on finding solutions to seemingly intractable outdoor environmental problems, indoor air pollution generated by everyday activities has become a major public health concern that demands immediate attention. 

This is especially true for Bangladesh's vulnerable women and children, who bear the burden of the negative health impacts caused by the air they breathe at home.

In heavily populated urban settings, the most significant contributors to indoor air pollution are particles and gases emitted during cooking, whether on an open fire or a biomass- or biofuel-fuelled stove. The reliance on solid fuels — typically wood, crop residues, animal dung, and coal – for basic household cooking tasks further deteriorates indoor air quality, particularly in the poorly ventilated kitchens common to many under-resourced regions. 

Exposure to indoor air pollutants also results from the use of household products containing volatile organic compounds, such as cleaning products and perfumes, as well as their emission from furnishings and construction materials.

Indoor air pollution is a growing issue worldwide. In rural Bangladesh, nearly 90% of households use biomass as their primary cooking fuel, resulting in high levels of indoor smoke exposure and serious health consequences. Women, as the primary cooks in most Bangladeshi households, are exposed to toxic fumes for extended periods, risking their health with acute and chronic respiratory problems, heart disease, and reproductive health issues. 

Long-term inhalation of particulate matter, carbon monoxide, and other pollutants released from biomass combustion can result in conditions such as chronic obstructive pulmonary disease (COPD) and acute respiratory infections, and, for pregnant women, low birth weight and preterm delivery. 

Children's health is equally at risk. Because their lungs are still developing, children are particularly susceptible to acute respiratory illness and long-term conditions such as asthma, which can have lifelong developmental consequences and affect their capacity to fulfil their potential.

Indoor air pollution is a "silent killer" that eludes attention, largely due to a lack of awareness among the public and policymakers. In Bangladesh, where most healthcare attention goes to curable acute and infectious diseases, indoor air pollution is viewed as a minor public health problem. 

For many households, smoke from cooking or poor ventilation is seen as a normal part of daily life rather than a serious health threat. Yet the risks are very real — indoor air pollution contributes to more than 90,000 deaths annually in the country, and the air indoors can often be more dangerous than outdoor air.

Discussions around environmental issues typically focus on outdoor air pollution, caused mainly by vehicles and industrial emissions. Indoor air quality, by contrast, is widely neglected. Indoor air pollution (IAP), however, is a fundamental aspect of public health that cannot be ignored when formulating and implementing strategies for achieving the Sustainable Development Goals (SDGs) in Bangladesh.

IAP is a particularly pernicious health problem, as it is closely linked to socio-economic status. The poorest families resort to the least expensive cooking fuels available, and as climate change reduces the availability of conventional fuels, people are increasingly turning to even more hazardous materials. 

Most households living on less than $2 per day cannot afford cleaner-burning fuels such as liquefied petroleum gas (LPG), making cheap fuels such as wood, kerosene, and charcoal the norm. These fuels fill homes with particulate matter, carbon monoxide, polyaromatic hydrocarbons, and other toxic emissions, making poor indoor air quality a pervasive and growing health issue in both rural and urban slum communities.

Indoor air pollution also has significant economic consequences. The costs associated with its health effects are often borne by poor families, who are pulled further into poverty by the additional burden of medical treatment and lost income and productivity.

Societal stigma can further compound the problem. In many communities, speaking about poor health is seen as a sign of weakness, and families living in poverty may prefer to remain invisible rather than risk further marginalisation by revealing their circumstances. 

Resources may exist within the community, but families in need are reluctant to draw attention to themselves. The perceived poor health of family members thus becomes a normal way of life, with emphasis placed on short-term survival rather than on improving living conditions — a hidden problem that goes unaddressed.

Lack of knowledge, coupled with inadequate government regulation, allows indoor air pollution to continue devastating populations. Although numerous policy frameworks and regulations exist, there is often a significant implementation gap caused by insufficient resources, inertia, or a lack of prioritisation of environmental health. Manufacturers and suppliers frequently go unregulated, resulting in the distribution of low-quality fuels and substandard cooking stoves and appliances.

These challenges — rooted in the socio-economic environment, the education system, social stigma, and inadequate regulation — are locked in a cycle that hinders change and perpetuates indoor air pollution. 

Women and children are forced into environments that threaten their health and future. Awareness of these societal dynamics must be accompanied by critical discussions that challenge existing norms and enable people to make choices that promote their health.

Addressing indoor air pollution in Bangladesh requires a broad approach encompassing awareness-raising, community engagement, and policy reform. Community education is the foundation of any effective intervention. 

Campaigns can inform local populations about the sources and health effects of common indoor air pollutants, as well as the specific risks faced by women and children. Workshops, pamphlets, and mobile outreach programmes can integrate health education into the normal routines of daily life.

Local authorities could form partnerships with NGOs to pool resources and share expertise. NGOs specialising in health and environmental issues can collaborate with community-level figures such as teachers, health workers, and community leaders, training them to educate local people about the health risks of conventional biomass burning and the benefits of alternative cookstoves. This ground-up approach fosters participation and ensures that messages reach those for whom they are intended.

Transitioning to cleaner cooking technologies must become a central priority. The government and private sector can play a decisive role by creating incentives for households to adopt energy-efficient stoves, solar cookers, and other locally appropriate solutions that reduce harmful emissions. 

Alongside LPG, greater investment is needed in expanding access to biogas, particularly in rural areas where organic waste is readily available. Biogas offers a practical, low-emission alternative that can be produced at the household or community level, reducing both indoor air pollution and dependence on biomass. 

In rural Bangladesh, nearly 90% of households use biomass as their primary cooking fuel, resulting in high levels of indoor smoke exposure and serious health consequences. Women, as the primary cooks in most Bangladeshi households, are exposed to toxic fumes for extended periods, risking their health with acute and chronic respiratory problems, heart disease, and reproductive health issues.

Public support mechanisms — such as targeted subsidies for LPG and biogas systems — can make these options affordable for low- and middle-income families. Community-based demonstrations and training on the safe and effective use of these technologies are essential to build trust and encourage adoption. 

When people see the benefits firsthand — less smoke, cleaner kitchens, better health — the shift becomes not just possible but sustainable.

Urban planning should also be improved to promote better air quality, particularly through stronger ventilation standards in homes and public spaces such as restaurants and shopping centres. Green buildings can play an important role by incorporating natural ventilation into their design, reducing reliance on mechanical systems that may lack the filtration capacity to remove all indoor pollutants. 

Many local authorities are already assessing existing buildings to determine the adequacy of their ventilation, and improving both natural and mechanical ventilation is one of the most straightforward steps available to enhance indoor air quality in crowded cities.

Monitoring technology could also be deployed to measure indoor pollution levels and publish the findings, enabling communities to draw connections between pollution and health outcomes and to stimulate local action. Media coverage of success stories could allow lessons learnt to be replicated elsewhere, building a growing wave of community-led improvement.

Ultimately, for all this effort to yield tangible results, community engagement must be integrated with education and policy. People need to feel that their contributions to community forums will lead to real change. By raising awareness, promoting accessible alternatives, and ensuring that policy follows evidence and community needs, it is possible to save the lives of Bangladeshi women and children and improve the environment for future generations.

Shahriar Hossain, PhD is an environmental scientist, journalist, and Social Justice advocate, involved in the Minamata Convention and plastic treaty negotiations. He can be reached at shahriar25@gmail.com.