Indoor air pollution as a lung health hazard: focus on populous countries (original) (raw)
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Environmental Health Perspectives, 2002
Globally, almost three billion people rely on biomass (wood, charcoal, crop residues, and dung) and coal as their primary source of domestic energy. Exposure to indoor air pollution from the combustion of solid fuels has been implicated, with varying degrees of evidence, as a causal agent of of disease and mortality in developing countries. We review the current knowledge on the relationship between indoor air pollution and disease, and on the assessment of interventions for reducing exposure and disease. Our review takes an environmental health perspective and considers the details of both exposure and health effects that are needed for successful intervention strategies. We also identify knowledge gaps and detailed research questions that are essential for successful design and dissemination of preventive measures and policies. In addition to specific research recommendations, we conclude that given the central role of housing, household energy, and day-to-day household activities in determining exposure to indoor smoke, research and development of effective interventions can benefit tremendously from integration of methods and analysis tools from a range of disciplines-from quantitative environmental science and engineering, to toxicology and epidemiology, to the social sciences.
Indoor air pollution in developing countries: a major environmental and public health challenge
Bulletin of the World Health Organization, 2000
Around 50% of people, almost all in developing countries, rely on coal and biomass in the form of wood, dung and crop residues for domestic energy. These materials are typically burnt in simple stoves with very incomplete combustion. Consequently, women and young children are exposed to high levels of indoor air pollution every day. There is consistent evidence that indoor air pollution increases the risk of chronic obstructive pulmonary disease and of acute respiratory infections in childhood, the most important cause of death among children under 5 years of age in developing countries. Evidence also exists of associations with low birth weight, increased infant and perinatal mortality, pulmonary tuberculosis, nasopharyngeal and laryngeal cancer, cataract, and, specifically in respect of the use of coal, with lung cancer. Conflicting evidence exists with regard to asthma. All studies are observational and very few have measured exposure directly, while a substantial proportion have...
BMC Pediatrics
Background: Household air pollution from combustion of solid fuels for cooking and space heating is one of the most important risk factors of the global burden of disease. This study was aimed to determine the association between household air pollution due to combustion of biomass fuel in Sri Lankan households and self-reported respiratory symptoms in children under 5 years. Methods: A prospective study was conducted in the Ragama Medical Officer of Health area in Sri Lanka. Children under 5 years were followed up for 12 months. Data on respiratory symptoms were extracted from a symptom diary. Socioeconomic data and the main fuel type used for cooking were recorded. Air quality measurements were taken during the preparation of the lunch meal over a 2-h period in a subsample of households. Results: Two hundred and sixty two children were followed up. The incidence of infection induced asthma (RR = 1.77, 95%CI;1.098-2.949) was significantly higher among children resident in households using biomass fuel and kerosene (considered as the high exposure group) as compared to children resident in households using Liquefied Petroleum Gas (LPG) or electricity for cooking (considered as the low exposure group), after adjusting for confounders. Maternal education was significantly associated with the incidence of infection induced asthma after controlling for other factors including exposure status. The incidence of asthma among male children was significantly higher than in female children (RR = 1.17; 95% CI 1.01-1.37). Having an industry causing air pollution near the home and cooking inside the living area were significant risk factors of rhinitis (RR = 1.39 and 2.67, respectively) while spending less time on cooking was a protective factor (RR = 0.81). Houses which used biomass fuel had significantly higher concentrations of carbon monoxide (CO) (mean 2.77 ppm vs 1.44 ppm) and particulate matter 2.5 (PM 2.5) (mean 1.09 mg/m 3 vs 0.30 mg/m 3) as compared to houses using LPG or electricity for cooking. Conclusion: The CO and PM 2.5 concentrations were significantly higher in households using biomass fuel for cooking. There was a 1.6 times higher risk of infection induced asthma (IIA) among children of the high exposure group as compared to children of the low exposure group, after controlling for other factors. Maternal education was significantly associated with the incidence of IIA after controlling for exposure status and other variables.
Environmental Health Perspectives
BACKGROUND: Globally, household air pollution (HAP) is a major environmental hazard that affects respiratory health. However, few studies have examined associations between HAP and lung function decline and respiratory disease and mortality. METHODS: We used data from the Prospective Urban and Rural Epidemiology study and examined adults residing in 240 rural communities in 11 low-and middle-income countries where HAP from cooking with solid fuels is common. Spirometry was conducted for 28,574 individuals at baseline and 12,489 individuals during follow-up (mean of 8 y between spirometry measures). In cross-sectional analyses, we compared lung function measurements [forced expiratory volume in 1 s (FEV 1), forced vital capacity (FVC), and FEV 1 /FVC ratio] in those who used solid fuels for cooking in comparison with clean fuels. Using repeated measurements of lung function, we examined the percent change in lung function measures per year, comparing individuals by baseline fuel type and individuals who used solid fuels at baseline but switched to clean fuels during follow-up. We also examined associations with prospective health events (any respiratory diseases, respiratory disease hospitalizations, and allcause mortality). RESULTS: In adjusted cross-sectional models, use of solid fuel in comparison with clean fuels was associated with lower FEV 1 of −17:5 mL (95% CI: −32:7, −2:3) and FVC of −14:4 mL (95% CI: −32:0, 3.2), but not FEV 1 /FVC. In longitudinal analyses, individuals who switched from solid fuels to clean cooking fuels during follow-up (n = 3,901, 46% of those using solid fuel at baseline), showed no differences in the annual rate of change in FEV 1 or FVC, but had small improvements in FEV 1 /FVC change (0.2% per year, 95% CI: 0.03, 0.3). Individuals who switched from solid to clean fuels had a decreased hazard ratio for respiratory events of 0.76 (95% CI: 0.57, 1.00) in comparison with persistent solid fuel users, which was not attenuated by lung function measures. CONCLUSION: We observed modest associations between HAP exposure and lung function, lung function change, and respiratory disease and mortality.
Air Quality, Atmosphere & Health, 2013
ABSTRACT Domestic cooking with biomass fuels exposes women and children to pollutants that impair health. The objective of the study was to investigate the extent of household air pollution from biomass fuels and the effectiveness of stove intervention to improve indoor air quality, exposure-related health problems, and lung function. We conducted a community-based pilot study in three rural communities in southwest Nigeria. Indoor levels of particulate matter (PM2.5) and carbon monoxide (CO) were measured, and exposure-related health complaints were assessed in 59 households that used firewood exclusively for cooking. Fifty-nine mother–child pairs from these households were evaluated pre-intervention and 1 year after distribution and monitored use of low-emission stoves. Mean age (± SD; years) of mothers and children were 43.0 ± 11.7 and 13.0 ± 2.5, respectively. Median indoor PM2.5 level was 1414.4 μg/m3 [interquartile range (IQR) 831.2–3437.0] pre-intervention and was significantly reduced to 130.3 μg/m3 (IQR 49.6–277.1; p < 0.0001) post-intervention. Similarly, the median CO level was reduced from 170.3 ppm (IQR 116.3–236.2) to 14.0 ppm (IQR 7.0–21.0; p < 0.0001). There were also significant reductions in frequency of respiratory symptoms (dry cough, chest tightness, difficult breathing, and runny nose) in mothers and children. Over 25 % of mothers and children had moderate airway obstruction on spirometry pre-intervention that did not improve 1 year after intervention period. Cooking with firewood causes household air pollution and compromised lung health. Introduction of low-emission stoves was effective at improving indoor air quality and reducing exposure-related symptoms.
Asia-Pacific Journal of Public Health, 2011
Indoor air pollution is an ongoing problem in developing countries. Respiratory diseases are common worldwide in rural communities. This study was undertaken to estimate the respirable particulate matter (PM 10 ) concentrations emitted from cooking fuels and their effects on the respiratory health of the rural population of Jalgaon district. The respiratory status of the exposed population was assessed by conducting pulmonary function tests in the study area. The levels of forced vital capacity and forced expiratory volume in 1 second were lower, and difficulty in respiration and frequent coughing were more common with higher odds ratios (OR) of 2.53 (95% confidence interval [CI] = 1.1-2.83) and 1.84 (95% CI = 0.95-2.10) in agrowaste-user female subjects. Ventilatory impairment among the agrowaste-user subjects was higher than among users of gas and wood. Difficulty in respiration and frequent coughing were strongly associated in wood-user female subjects as well with ORs of 2.10 (95% CI = 0.85-2.49) and 1.79 (95% CI = 0.91-1.98), respectively. Chest pain was significantly associated in agrowaste-and wood-user female subjects. This study confirms an association between the reductions in lung efficiency with high PM 10 exposure in the rural population. The result of this study reveals an association between respiratory diseases symptoms and indoor air quality in the biomass-using rural population of Jalgaon district.
2015
Wood and Charcoal are fuels widely used for cooking by almost 85% of Zanzibar households in both urban and semi-urban areas. This wide spread use of wood and charcoal may impact indoor air quality in homes. Combustion of these traditional fuels produces a range of substances detrimental to human-health. So far, there is lack of data to quantify the levels of pollutants and their impacts in Zanzibar households. This study aimed to assess the levels of exposure to fine indoor particulate matter (PM) with aerodynamic size of 2.5µm (PM 2.5) and carbon monoxide (CO) emitted by combustion of biomass fuels, and determine any association with the respiratory health of women and children less than 5 years old living in Chukwani-Zanzibar. Methods: A total of 200 households comprising of a mother child pair were sampled for the study and 200 questionnaires constituting questions for both mothers and their children were administered. In a sub-sample of 20 households, 24-hour integrated samples were collected in non-uniform households with different kitchen types, using different fuels i.e. wood, charcoal and liquefied petroleum gas. Cumulative and 24-hour Time Weighted Average (TWA) exposure to biomass pollutants among women and children less than five years of old were estimated using information on PM concentration levels, and time-activity patterns. Prevalence of respiratory symptoms associated with biomass fuels use was determined in women biomass as fuel. Similar procedures and measurement were performed in households using LPG Results: The measured mean 24-hour TWA concentrations and (standard deviation) for PM 2.5 in all 10 homes cooking with biomass fuels was 329 (121) µg/m 3 (range 28-1600 µg/m 3) with an average of 600 (28-2600) µg/m 3 during cooking hours and 12 (10)µg/m 3 (range 0-352 ppm) for CO. Households using cleaner fuel (Liquefied Petroleum Gas) had much lower concentrations 22 (11) µg/m 3 range (4-48 µg/m 3) with an average of 65µg/m 3 during cooking hours for PM and 1.5 (3.5) range (0-36 µg/m 3) for CO. From the logistic regression analysis, an increase of 100 µg/m 3 PM 2.5 was associated with increased frequency of reporting of phlegm in the morning 1.75 (95%, CI 1.40-2.29), and tightness in chest 2.53 (95% CI 1.12-5.31) for women and between 1.38 (0.87-2.22)-3.28 (1.56-6.90) for all symptoms in children. The 24-TWA mean exposure hours for women and children were 192.4µg/m 3 and 173.6µg/m 3 respectively. Conclusion: The results from this study suggest a relationship between respiratory health and biomass smoke exposure, thus emphasizing the need for potential interventions for the reduction of exposure to indoor air pollution in Chukwani.
Health Risk Assessment of Indoor Air Quality in Developing Countries
The health effects of many pollutants such as particulate matter, carbon monoxide, oxides of sulfur and nitrogen, and polycyclic aromatic hydrocarbons Reparable particulate matter is now regarded as the single best indicator pollutant for review the overall health-damaging potential of most types of combustion, including that of biomass. Rural societies use fuel wood and biomass fuel for cooking and heating, which is not only expensive but also produces smokes that influences their health and pollute indoor environment. Usually, cow dung is generally put in the courtyard of rural households, which harbors insects, flies and produce vulgar smell that affects the health of the dwellers. A preliminary review of the literature reflects that there exist a substantial amount of literature and existing data in the form of published report on indoor air pollution. The overall research design is exploratory the review is related to the indoor air pollutant status among the developing countries. The main diseases according to above literature were asthma, respiratory tract infections, chronic pulmonary diseases, lungs cancer etc. the studies were conducted in the developing countries such as Pakistan, India, Bangladesh, Uganda, Africa, Sri Lank, China, Ethiopia, Nepal.. So it concluded that developing countries had major problem of health hazards because use of biomass fuel for the purposes of cooking.
Indoor air pollution and the respiratory health of children
Pediatric Pulmonology, 1999
Indoor air pollution (IAP) is a key contributor to the global burden of disease mainly in developing countries. The use of solid fuel for cooking and heating is the main source of IAP in developing countries, accounting for an estimated 3.5 million deaths and 4.5% of Disability-Adjusted Life Years in 2010. Other sources of IAP include indoor smoking, infiltration of pollutants from outdoor sources and substances emitted from an array of human utilities and biological materials. Children are among the most vulnerable groups for adverse effects of IAP. The respiratory system is a primary target of air pollutants resulting in a wide range of acute and chronic effects. The spectrum of respiratory adverse effects ranges from mild subclinical changes and mild symptoms to life threatening conditions and even death. However, IAP is a modifiable risk factor having potential mitigating interventions. Possible interventions range from simple behavior change to structural changes and from shifting of unclean cooking fuel to clean cooking fuel. Shifting from use of solid fuel to clean fuel invariably reduces household air pollution in developing countries, but such a change is challenging. This review aims to summarize the available information on IAP exposure during childhood and its effects on respiratory health in developing countries. It specifically discusses the common sources of IAP, susceptibility of children to air pollution, mechanisms of action, common respiratory conditions, preventive and mitigating strategies.