Indoor air pollutants and respiratory outcomes among residents of an informal urban setting in Uganda: a cross-sectional study (original) (raw)
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2022
Background Poor indoor air quality (IAQ) is a leading cause of respiratory and cardiopulmonary illnesses. Particulate matter (PM 2.5) and carbon monoxide (CO) are critical indicators of IAQ, yet there is limited evidence of their concentrations in urban informal settlements in low-income countries. Objective This study assessed household characteristics that predict the concentrations of PM 2.5 and CO within households in an informal settlement in Fort Portal City, Uganda. Methodology: A cross-sectional study was conducted in 374 households. Concentrations of PM 2.5 and CO were measured using Multipurpose Laser Particle detector and the Carbon Monoxide IAQ Meter respectively. Data on household characteristics were collected using a structured questionnaire and an observational checklist. Data were analysed using STATA version 14.0. Linear regression was used to establish the relationship between PM 2.5, CO concentrations and household characteristics. Results The majority, 88.8% (332/374) of the households used charcoal for cooking. More than half, 51.9% (194/374) cooked from outdoors. Cooking areas had signi cantly higher PM 2.5 and CO concentrations compared to the living area (t = 18.14, p ≤ 0.05) and (t = 5.77 p ≤ 0.05) respectively. Cooking from outdoors was associated with a 0.112 increase in the PM 2.5 concentrations in the cooking area (0.112
BMC Public Health
Background Poor indoor air quality (IAQ) is a leading cause of respiratory and cardiopulmonary illnesses. Particulate matter (PM2.5) and carbon monoxide (CO) are critical indicators of IAQ, yet there is limited evidence of their concentrations in informal urban settlements in low-income countries. Objective This study assessed household characteristics that predict the concentrations of PM2.5 and CO within households in an informal settlement in Fort Portal City, Uganda. Methodology A cross-sectional study was conducted in 374 households. Concentrations of PM2.5 and CO were measured using a multi-purpose laser particle detector and a carbon monoxide IAQ meter, respectively. Data on household characteristics were collected using a structured questionnaire and an observational checklist. Data were analysed using STATA version 14.0. Linear regression was used to establish the relationship between PM2.5, CO concentrations and household cooking characteristics. Results The majority (89%,...
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...
Background One in ten deaths of children under five are attributable to indoor air pollution, and Acute Respiratory Illness (ARI) are a direct cause. Objective This study made it possible to characterize indoor air pollution in West African Economic and Monetary Union (WAEMU) area and to estimate its impact on occurrence of ARI in children under five. Methods This is a secondary analysis on dataset from WAEMU member states’ Demographic and Health Survey (DHS). Pollution is characterized by using a composite variable called “Household level of air pollution”, created from questions related to degradation factors of indoor air quality (domestic combustion processes) and impact measurement was carried out by 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 pollution" was only associated with ARI in Togo (p...
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.
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...
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...
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.
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.
Human exposure to indoor air pollution in Ethiopian households
Heliyon
Because most people spend the majority of their time in microenvironments, indoor air pollution (IAP) has gained more attention than outdoor air pollution recently. It is indeed crucial to understand IAP sources and the factors that influence human exposure. We synthesized evidence on IAP levels and contributing factors in Ethiopia from available literature, utilizing findings from 19 studies to retrieve 66 relevant values. Particulate matters (PM 2.5 , PM 4 , PM 10 , and TSP), as well as gaseous pollutants such as carbon monoxide (CO), nitrogen dioxide (NO 2), polyaromatic hydrocarbons (PAHs), and total volatile organic compounds (TVOCs), were analyzed. The calculated mean concentrations for PM 2.5 , PM 10 , NO 2 , TVOCs, and CO were 477.47 μg/m 3 , 228.38 μg/m 3 , 63.84 μg/ m 3 , 1361.79 μg/m 3 , and 18.82 ppm, respectively, all of which exceeded the annual WHO exposure guidelines. Geographical location, stove type, and household activities showed a variation in pollutants concentration. The higher levels of pollutants were attributed to emissions from biomass fuel used for baking injera, wot preparation, and conducting a coffee ceremony, as well as poor ventilation, season, cooking time, and tobacco smoke. The health risk assessments for exposure to various domestic activities were found to be acceptable, except for PM 10 , with the highest correlation with an acute respiratory infection. Although improved cookstove technology has been proposed as a sustainable energy source, investigations in Ethiopia have revealed that there is still room for public health protection. There is a paucity of research on the relationship between indoor and outdoor air pollution. Future research should prioritize these issues, with a focus on the link between IAP exposure and health effects. In conclusion, there is a higher IAP concentration in Ethiopia so the community should be made aware of it as well as related health effects, and immediate mitigation measures are needed to achieve a reduction in exposure.