Household level of Air Pollution and its impact on the occurrence of Acute Respiratory Illness among children under five: Secondary analyses of Demographic and Health Survey in West Africa (original) (raw)
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BMC Public Health
Background One out of ten deaths of children under five are attributable to indoor air pollution. And Acute Respiratory Illness (ARI) is among the direct causes. Objective This study showed the possibilities of characterizing indoor air pollution in West African Economic and Monetary Union (WAEMU) area and it also made it possible to estimate its impact on the occurrence of ARI in children under five. Methods It has been a secondary analysis based on Demographic and Health Surveys (DHSs) from WAEMU countries’ data.. “Household level of air pollution” is the created composite variable, from questions on the degradation factors of indoor air quality (domestic combustion processes) which served to characterize indoor air pollution and to measure its impact by a logistic regression. Results Burkina Faso stands out with a greater number of households with a high level of pollution (63.7%) followed by Benin (43.7%) then Togo (43.0%). The main exposure factor "Household level of air p...
Environmental Health and Preventive Medicine
Background Globally, over four million deaths are attributed to exposure to household air pollution (HAP) annually. Evidence of the association between exposure to HAP and under-five mortality in sub-Saharan Africa (SSA) is insufficient. We assessed the association between exposure to HAP and under-five mortality risk in 14 SSA countries. Methods We pooled Demographic and Health Survey (DHS) data from 14 SSA countries (N = 164376) collected between 2015 and 2018. We defined exposure to HAP as the use of biomass fuel for cooking in the household. Under-five mortality was defined as deaths before age five. Data were analyzed using mixed effects logistic regression models. Results Of the study population, 73% were exposed to HAP and under-five mortality was observed in 5%. HAP exposure was associated with under-five mortality, adjusted odds ratio (OR) 1.33 (95% confidence interval (CI) [1.03–1.71]). Children from households who cooked inside the home had higher risk of under-five morta...
The Lancet Planetary Health
Background WHO estimates that, in 2015, nearly 1 million children younger than 5 years died from lower respiratory tract infections (LRIs). Ambient air pollution has a major impact on mortality from LRIs, especially in combination with undernutrition and inadequate health care. We aimed to estimate mortality due to ambient air pollution in 2015, particularly in children younger than 5 years, to investigate to what extent exposure to this risk factor affects life expectancy in different parts of the world. Methods Applying results from a recent atmospheric chemistry-general circulation model and health statistics from the WHO Global Health Observatory, combined in integrated exposure-response functions, we updated our estimates of mortality from ambient (outdoor) air pollution. We estimated excess deaths attributable to air pollution by disease category and age group, particularly those due to ambient air pollution-induced LRIs (AAP-LRIs) in childhood. Estimates are presented as excess mortality attributable to ambient air pollution and years of life lost (YLLs). To study recent developments, we calculated our estimates for the years 2010 and 2015. Findings Overall, 4•55 million deaths (95% CI 3•41 million to 5•56 million) were attributable to air pollution in 2015, of which 727 000 deaths (573 000-865 000) were due to AAP-LRIs. We estimated that AAP-LRIs caused about 237 000 (192 000-277 000) excess child deaths in 2015. Although childhood AAP-LRIs contributed about 5% of air pollutionattributable deaths worldwide, they accounted for 18% of losses in life expectancy, equivalent to 21•5 million (17 million to 25 million) of the total 122 million YLLs due to ambient air pollution in 2015. The mortality rate from ambient air pollution was highest in Asia, whereas the per capita YLLs were highest in Africa. We estimated that in sub-Saharan Africa, ambient air pollution reduces the average life expectancy of children by 4-5 years. In Asia, all-age mortality increased by about 10% between 2010 and 2015, whereas childhood mortality from AAP-LRIs declined by nearly 30% in the same period. Interpretation Most child deaths due to AAP-LRIs occur in low-income countries in Africa and Asia. A three-pronged strategy is needed to reduce the health effects of ambient air pollution in children: aggressive reduction of air pollution levels, improvements in nutrition, and enhanced treatment of air pollution-related health outcomes.
Causative Factors of Indoor Air Pollution in Nigerian Households
Air pollution is one of the leading causes of human mortality in the world. Within a space of one year, 396,000 deaths arising from indoor air pollution (IAP) in sub-Sahara Africa was reported in 2006. Besides the loss of human lives, public health challenges such as pneumonia in children, asthma, tuberculosis, upper airway cancer and cataract are caused or aggravated by IAP. A study was conducted among households in Lagos and Ogun States in order to determine risk patterns of IAP among residents through the distribution of questionnaires to 2000 households. Random sampling was adopted in the distribution of the questionnaires. A total of 1,616 responses (81% return rate) was achieved. Questions addressed include type of building, smoking habits of residents, use and location of electricity generating sets, location of cooking, cooking methods and use of alternative lighting system in the event of power failure. Results indicate that 62.2% of the residents lived in buildings where some form of commercial activities are taking place. Also, 6.4% of the residents admitted to smoking within living quarters, 9.2% used electricity generators within the building confines; about 35.2% used kerosene stoves for cooking; and 4% of the respondents cooked in kitchens where there was no proper ventilation. 18.3% of the respondents used candle for lighting in closed rooms while 14.4% used palm oil lit lamps. It was concluded that the use of IAP enhancing methods of illumination and cooking within the households were informed by poverty, poor ventilation within households, security related issues. The enforcement of building codes and environmental regulations could forestall avoidable deaths in future.
BackgroundIndoor air pollutants (IAP) such as particulate matter (PM) and carbon monoxide (CO) are a leading cause of acute respiratory symptoms, and long-term health impacts such as respiratory diseases, heart diseases and cancers. In Uganda, literature on the effects of IAP on respiratory outcomes in informal settlements is limited. This study investigated the association of selected IAPs and cooking fuels with respiratory symptoms among children and adults.MethodsThis study was conducted among 284 households in an informal settlement in Uganda from April to May 2022. Information on indoor air conditions, fuel type and adults reported the respiratory symptoms of their children as well as their respiratory symptoms within the previous 30 days. Same-day concentrations of PM less than 2.5 μm (PM2.5) and less than 10 μm(PM10) in diameter were monitored from 9 am to 2 pm using Temptop M2000c 2nd edition particle sensor while CO was measured using a carbon monoxide meter. Robust Poisson...
IOSR Journal of Environmental Science, Toxicology and Food Technology (IOSR-JESTFT), 2021
Background Household Air Pollution is perceived to increase the risk of developing acute respiratory infection (ARI) specifically among young children. A cohort study involving 430 children (228 exposed to Household Air Pollution and 202 non-exposed to indoor air pollution) was conducted to explore the association of Household Air Pollution upon respiratory infections of children aged less than five years, in Nyeri, central Kenya. Methods Quantitative data were collected monthly for twelve months from participants using a questionnaire. Meteorological data on temperature, relative humidity, and rainfall were also collected at the same interval and period. A randomized sample of 60 households was selected in which 24hour monitoring for particulate matter of less than 10 microns in diameter was carried out. Results The overall, mean particulate matter of less than 10 microns in diameter was 68.6 + 90 .1 µg/m 3 in the exposed households, the mean PM10 level was 100.8 + 95.3 µg/m 3 compared to mean of particulate matter of less than 10 microns in diameter level in the non-exposed household of 4.1 + 4.0 µg/m 3 (students t-test 4.88, p<0.01). The particulate matter of less than 10 microns in diameter from exposed households was 2 times (100.8g/m) higher than the 50g/m tolerable standards set by British Health Panel and adopted by European Commission, whereas those from non-exposed households were 12.2 times lower (4.1 µg/m 3). Children exposed to particulate matter of > 50 µg/m 3 were (10) at times at risk of developing more than five (5) episodes of acute respiratory infections within a year (RR= 10, 98% CI 3.3 to 30). There was also a positive linear correlation between a particulate matter of less than 10 microns in diameter and the development of acute respiratory infection (R = 0.358, p<0.01). The rates ratio for acute respiratory infections (ARI) was 1.57(95% CI, 1.19-2.07) and an attributable fraction of 68.6%. The risk of getting ARI during the cold season was 3.6 (RR=3.6, 95% CI 3.1-4.2) compare to the hot season. Exposure to HAP, stunting condition of the children were variables identified by the multivariate model as independently associated with ARI. Conclusion In conclusion, this study found that the incidence rate for acute respiratory infections was high in the study population and there was a statistically significant association between Household Air Pollution and acute respiratory infections (RR=1.57, 95% CI,1.19-2.07). the mean PM10 levels were higher than the standard set by the British Health Panel and European Commission. Besides exposure to indoor air pollution, stunting and time spent in the cooking place were risk factors for acute respiratory infections. Recommendations It is recommended that the government develop an air pollution policy aimed at reducing Household Air Pollution and also promote the adoption of superior fuel for cooking to reduce indoor air pollution. there is a need to conduct further studies on HAP monitoring and conduct comparative cost-effective studies between curative and preventive interventions for acute respiratory infections. Future similar studies should incorporate spirometry assessments. Finally, interventions on acute respiratory infections should not only involve reducing Household Air Pollution which are potential risk factors for acute respiratory infections.
While episodes of unusually high air pollution attract attention and public health concern, the greatest damage to public health is associated with long-term exposure to air pollution (HEI 2017). Outdoor and indoor personal exposure to air pollution, combined, comprise the largest environmental risk factor for mortality, responsible for 6.4 million deaths in 2015 (11% of global deaths) (Cohen et al. 2017). The costs of air pollution in Africa are high-estimated at around USD450 billion in 2013 (Roy 2016). The economic impacts include life years lost, increased healthcare (and subsequent demand on government) and lost worker productivity due to air pollution impacts on health. Globally, epidemiological studies and systemic reviews have shown associations between exposure to household air pollution (HAP) and a variety of diseases and symptoms (Jedrychowski et al. 2017; Tanaka et al. 2012; Koo et al. 2011; Pope et al. 2010). The indoor environment represents an important microenvironment in which people spend approximately 90% of their time each day (WHO 2014a). According to the World Health Organization (WHO), HAP is responsible for more than 1.6 million annual deaths globally, and 2.7% of the global burden of disease (WHO 2014b). HAP is reported to increase irritation of the airways, coughing, irregular heartbeat, difficulty breathing and premature death in people with heart and lung disease (Gurley et al. 2013; Laumbach and
Respiratory risks from household air pollution in low and middle income countries
The Lancet Respiratory Medicine, 2014
* Section leads Contributors SBG and WJM both wrote the outline of the Commission and the text for the introduction and conclusion sections. SBG and WJM reviewed and edited the entire Commission as it was developed by the other authors. SJ contributed to the introduction. PLH was the lead author for the section on respiratory infections. MNB wrote the text related to infants and children and older children and adults. JR wrote the text on mechanisms of defence, PM wrote the text on other risk factors and NB-Z wrote the text on vaccinations. PLH structured and contributed text to all parts in this section. KM was the lead author for the section on obstructive lung diseases. KM wrote the first draft for this section, with JB, SB, DH, RP-P, and KM contributing equally to reviewing and revising. OPK and K-bHL were the lead authors for the section on lung cancer and upper airway cancers, and were responsible for the concept and writing. HK and ZC contributed to reviewing and revising this section. JG was the lead author for the section on exposure and biomarkers. JG wrote the parts about direct biomarkers of exposure, risks across the lifecycle, and gender differences. PNB wrote the parts about indoor and outdoor air pollution, and secondhand smoking, SS wrote the part about exposure assessment and additional respiratory risks, and LN wrote the part about indirect biomarkers of exposure. AP contributed to the part about gender differences. NGB was lead author for the section about interventions, with KPA, KB, SM, DP, and DJ contributing equally to reviewing and revising. Declaration of interests JG reports personal fees from GlaxoSmithKline and personal fees from Novartis. He is a member of the UK Government's Committee on the medical effects of air pollution and is co-chair of the Royal College of Physicians working party on the long-term effects of air pollution.
Chest, 2020
BACKGROUND: Exposure to household air pollution is associated with an increased risk of pneumonia in children in low-and middle-income countries; however, exposure-response data are limited, and there are uncertainties around the extent to which biomass-fueled cookstoves can reduce these exposures. RESEARCH QUESTION: What is the association between exposure to household air pollution and pneumonia in children under the age of 5 years in rural Malawi and what are the effects of a biomass-fueled cookstove intervention on personal exposure to household air pollution? STUDY DESIGN AND METHODS: We measured personal exposure to carbon monoxide (CO; 48 hours of continuous measurement and transcutaneous carboxyhemoglobin) every 6 months in children who participated in a cluster-randomized controlled trial of a cleaner burning biomass-fueled cookstove intervention to prevent pneumonia in children under the age of 5 years in rural Malawi (the Cooking And Pneumonia Study). Exposure-response and multivariable analyses were done. RESULTS: We recruited 1805 (928 intervention; 877 control) children (mean age, 25.6 months; 50.6% female). We found no evidence of an association between exposure to CO (incident rate ratio, 1.0; 95% CI, 0.967 to 1.014; P ¼ .53) or carboxyhemoglobin (incident rate ratio, 1.00; 95% CI, 0.993 to 1.003; P ¼ .41) in children who experienced pneumonia vs those who did not. Median exposure to CO in the intervention and control groups was was 0.34 (interquartile range, 0.15 to 0.81) and 0.37 parts per million (interquartile range, 0.15 toa 0.97), respectively. The group difference in means was 0.46 (95% CI, À0.95 to 0.012; P ¼ .06). INTERPRETATION: Exposure to CO in our population was low with no association seen between exposure to CO and pneumonia incidence and no effect of the Cooking And Pneumonia Study intervention on these exposures. These findings suggest that CO may not be an appropriate measure of household air pollution exposure in settings such as rural Malawi and that there is a need to develop ways to measure particulate matter exposures directly in young children instead. CLINICAL TRIAL REGISTRATION: ISRCTN59448623.