The Effects of Indoor Air Pollution from Solid Fuel Burning on Neurological and Neuropsychiatric Diseases - A Review of Epidemiological Evidence

Indoor air pollution (IAP) from using unclean fuel has brought huge disease and economic burden, and we aim to analyse the effect of IAP from using solid fuels on neurodevelopmental disorders (NDDs), cognitive impairment and neurodegenerative diseases (NDGDs), as well as mental disorders. We conducted a search of PubMed database from inception to 29th July 2025. We found that the number of studies focusing on the effects of solid fuel burning on NDDs and NDGDs is limited, and the association remains uncertain. However, the evidence regarding cognitive impairment and mental disorders was abundant, and most studies indicated that participants using solid cooking fuels had a higher risk of these diseases. The most important common limitation is that many studies formulaically analyse big health data sets, which leads to problems like residual confounding due to the incomplete information in the datasets. Policy makers of developing countries can prioritize gas as the transitional option from solid fuels to electricity, while developed countries should attach importance to policies related to wood heating. It is crucial to implement policy such as providing financial incentives and offering public education.