Indoor pollution in high-altitude dwellings: An assessment of affecting factors across four Sherpa villages in the Khumbu region, Nepal

Household air pollution (HAP) from biomass fuel smoke is a major health risk, especially in developing countries. The ventilation of buildings and the type of fume discharge could also affect HAP. The present study aims to investigate the impact of stove type and kitchen characteristics on levels of pollutants. In particular, we investigated the potential geometric ventilation of buildings using geometric ventilation index (GVI), the presence of chimneys, the type of fuel and the environmental carbon monoxide level (a marker of indoor pollution) in the households of four Sherpa villages located in a mountain region of Nepal at altitudes between 2500 and 3900 m. We analysed 114 buildings (76 private residences and 38 lodges that accommodate tourists). Lodges had a more effective discharge system and a higher GVI, which had an inverse, significant correlation with indoor CO levels (r = 0.52). The level of indoor CO was more than 50% higher in private residences than in lodges. In the univariate analysis, only the absence of a chimney was associated with higher indoor CO (OR 3.4 (CL95%, 1.2–10.0), p = 0.02). We conclude that the adoption of chimneys and sealed stoves with exhaust pipes should be the first measure taken to reduce pollutants inside the households of high mountain regions until a switch to clean fuels can be achieved.