Ochieng, Caroline A.2016-11-292016-11-292007-09http://ir-library.ku.ac.ke/handle/123456789/15193A Research Thesis Submitted in Partial Fulfillment for the Award of the Degree of Master of Public Health in the School Of Health Sciences of Kenyatta University September, 2007.Indoor air pollution from biofuel use has been found to be responsible for more than 1.6million annual deaths and 2.7% of the global burden of disease. This makes it the second biggest environmental contributor to ill health, after unsafe water and sanitation. Respiratory system is the most affected. However, nearly all studies have been conducted in households, leaving out occupational environments where the same fuels are used. The main objective of this study was therefore to investigate the impact of use of biofuels on respiratory health among workers in food catering enterprises in Nairobi. A crosssectional design was employed, and data collected using structured questionnaires, observation checklist and interviews. Data was analysed using descriptive statistics and chi square tests. Of the 370 respondents in the 250 randomly selected enterprises, 56% were males and 44% females, mostly aged between 20 to 40 years. Majority (86%) had not gone beyond secondary school, and were mostly casual employees or own account workers. Most of the enterprises (71%) were unregistered, and 81% utilized biofuels because they were cheaper than processed fuels. The study found significantly higher .prevalence of respiratory symptoms among workers in enterprises using biofuels compared to those using processed fuels. p values were significant for cough (X2=38.16;df=l; P=O.OOO), phlegm (X2=6.46; df=l; P=O.OII), breathlessness (l=8.29; df=l;P=0.004) and wheezing (l=16.56; df=l; P=O.OOO). Within the biofuels, fuelwood users recorded higher prevalence of symptoms compared to charcoal users. Prevalence of respiratory health outcomes was also considerably higher in those who were aged 40 years and above and who spent longer hours indoors, similar to findings by Ezzati et at (2000) and Shrestha et at (2005) in household studies. Significantly higher prevalence was also recorded in respondents in unregistered enterprises (p=0.002), and those that were poorly ventilated (p=0.000). The study has demonstrated that biofuels are a major public health threat to workers in food establishments, and urgent intervention is required. It therefore recommends a switch from biofuels to processed fuels in order to protect the health of the workers. Other measures that can be employed include a switch from more polluting biofuels such as fuelwood to less polluting ones such as charcoal, ensuring adequate ventilation, spending less hours indoors and awareness creation. However, for such interventions to occur, the activities of the sector needs to be formalised, because this would encourage investments in the sector that would lead to adoption of cleaner fuels and healthy work environments. Targeted energy sector policies that would make processed fuels more affordable and financial support measures are also required.enThesis