147,895 research outputs found

    Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000-18: a geospatial modelling study.

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    BACKGROUND: More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. METHODS: We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. FINDINGS: Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000-257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. INTERPRETATION: Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. FUNDING: Bill & Melinda Gates Foundation

    Exposure to Household Air Pollution from Biomass-Burning Cookstoves and HbA1c and Diabetic Status Among Honduran Women

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    Household air pollution from biomass cookstoves is estimated to be responsible for more than two and a half million premature deaths annually, primarily in low and middle‐income countries where cardiometabolic disorders, such as Type II Diabetes, are increasing. Growing evidence supports a link between ambient air pollution and diabetes, but evidence for household air pollution is limited. This cross‐sectional study of 142 women (72 with traditional stoves and 70 with cleaner‐burning Justa stoves) in rural Honduras evaluated the association of exposure to household air pollution (stove type, 24‐hour average kitchen and personal fine particulate matter [PM2.5] mass and black carbon) with glycated hemoglobin (HbA1c) levels and diabetic status based on HbA1c levels. The prevalence ratio (PR) per interquartile range increase in pollution concentration indicated higher prevalence of prediabetes/diabetes (vs normal HbA1c) for all pollutant measures (eg, PR per 84 μg/m3 increase in personal PM2.5, 1.49; 95% confidence interval [CI], 1.11‐2.01). Results for HbA1c as a continuous variable were generally in the hypothesized direction. These results provide some evidence linking household air pollution with the prevalence of prediabetes/diabetes, and, if confirmed, suggest that the global public health impact of household air pollution may be broader than currently estimated

    Exposure to Household Air Pollution from Biomass Cookstoves and Levels of Fractional Exhaled Nitric Oxide (FeNO) among Honduran Women

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    Household air pollution is estimated to be responsible for nearly three million premature deaths annually. Measuring fractional exhaled nitric oxide (FeNO) may improve the limited understanding of the association of household air pollution and airway inflammation. We evaluated the cross-sectional association of FeNO with exposure to household air pollution (24-h average kitchen and personal fine particulate matter and black carbon; stove type) among 139 women in rural Honduras using traditional stoves or cleaner-burning Justastoves. We additionally evaluated interaction by age. Results were generally consistent with a null association; we did not observe a consistent pattern for interaction by age. Evidence from ambient and household air pollution regarding FeNO is inconsistent, and may be attributable to differing study populations, exposures, and FeNO measurement procedures (e.g., the flow rate used to measure FeNO)

    Association between Household Air Pollution Exposure and Chronic Obstructive Pulmonary Disease Outcomes in 13 Low- and Middle-Income Country Settings.

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    RATIONALE: Forty percent of households worldwide burn biomass fuels for energy, which may be the most important contributor to household air pollution. OBJECTIVES: To examine the association between household air pollution exposure and chronic obstructive pulmonary disease (COPD) outcomes in 13 resource-poor settings. METHODS: We analyzed data from 12,396 adult participants living in 13 resource-poor, population-based settings. Household air pollution exposure was defined as using biomass materials as the primary fuel source in the home. We used multivariable regressions to assess the relationship between household air pollution exposure and COPD outcomes, evaluated for interactions, and conducted sensitivity analyses to test the robustness of our findings. MEASUREMENTS AND MAIN RESULTS: Average age was 54.9 years (44.2-59.6 yr across settings), 48.5% were women (38.3-54.5%), prevalence of household air pollution exposure was 38% (0.5-99.6%), and 8.8% (1.7-15.5%) had COPD. Participants with household air pollution exposure were 41% more likely to have COPD (adjusted odds ratio, 1.41; 95% confidence interval, 1.18-1.68) than those without the exposure, and 13.5% (6.4-20.6%) of COPD prevalence may be caused by household air pollution exposure, compared with 12.4% caused by cigarette smoking. The association between household air pollution exposure and COPD was stronger in women (1.70; 1.24-2.32) than in men (1.21; 0.92-1.58). CONCLUSIONS: Household air pollution exposure was associated with a higher prevalence of COPD, particularly among women, and it is likely a leading population-attributable risk factor for COPD in resource-poor settings

    Household Air Pollution

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    Household air pollution from the use of biomass fuels is a major public health hazard affecting over 3 billion people living in developing countries most of whom are women and children. In Sudan the national burden of disease attributed to biomass fuel use is estimated to be 0.7% but may be significantly higher as this is an estimate based on estimates of exposure. Biomass fuel combustion releases many toxic pollutants which are damaging to the respiratory tract, the cardiovascular and neurologic systems and are associated with low birth weight and fetal wastage. Household air pollution has been studied primarily by using devices which measure exposure in dwellings and on the clothes of the residents. These devices measure the most important pollutants, carbon monoxide, sulfur dioxide, and particulate matter. Although inhaled sulfur dioxide and particulate matter damage the lungs, only carbon monoxide is systemically absorbed and only carbon monoxide can be measured in the body. In this paper, we will review the pathophysiology of carbon monoxide poisoning and report some preliminary results of the study which we, Prof. Suliman and our colleagues from Sudan carried out immediately prior to this conference

    Estimation of the Global Health Impacts of Air Pollution

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    Air pollution is increasingly recognized as a significant contributor to global health outcomes. A methodological framework for evaluating the global health related outcomes of outdoor and indoor (household) air pollution is presented and validated for the year 2005. Ambient concentrations of PM2.5 re estimated with a combination of energy and atmospheric models, with detailed representation of urban and rural spatial exposures. Populations dependent on solid fuels are established with household survey data. Health impacts for outdoor and household air pollution are independently calculated using the fractions of disease that can be attributed to ambient air pollution exposure and solid fuel use. Estimated ambient pollution concentrations indicate that more than 80% of the population exceeds the WHO Air Quality Guidelines in 2005. In addition, 3.26 billion people were found to use solid fuel for cooking in three regions of Sub Saharan Africa, South Asia and Pacific Asia in 2005. Outdoor air pollution results in 2.7 million deaths or 23 million DALYs while household air pollution from solid fuel use and related indoor smoke results in 2.1 million deaths or 41.6 million DALYs. The higher morbidity from household air pollution can be attributed to children below the age of five in Sub Saharan Africa and South Asia. The burden of disease from air pollution is found to be significant, thus indicating the importance of policy interventions

    Controlling Urban Air Pollution Caused by Households: Uncertainty, Prices, and Income

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    We examine the control of air pollution caused by households burning wood for heating and cooking in the developing world. Since the problem is one of controlling emissions from nonpoint sources, regulations are likely to be directed at household choices of wood consumption and combustion technologies. Moreover, these choices are subtractions from, or contributions to, the pure public good of air quality. Consequently, the efficient policy design is not independent of the distribution of household income. Since it is unrealistic to assume that environmental authorities can make lump sum income transfers part of control policies, efficient control of air pollution caused by wood consumption entails a higher tax on wood consumption and a higher subsidy for more efficient combustion technologies for higher income households. Among other difficulties, implementing a policy to promote the adoption of cleaner combustion technologies must overcome the seemingly paradoxical result that efficient control calls for higher technology subsidies for higher income households.efficiency, urban air pollution, nonpoint pollution, environmental policy, uncertainty

    Household Air Pollution and Acute Lower Respiratory Infections in Adults: A Systematic Review.

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    INTRODUCTION: Household air pollution from solid fuel burning kills over 4 million people every year including half a million children from acute lower respiratory infections. Although biologically plausible, it is not clear whether household air pollution is also associated with acute lower respiratory infections in adults. We systematically reviewed the literature on household air pollution and acute lower respiratory infection in adults to identify knowledge gaps and research opportunities. METHODS: Ten bibliographic databases were searched to identify studies of household air pollution and adult acute lower respiratory infection. Data were extracted from eligible studies using standardised forms. RESULTS: From 4617 titles, 513 abstracts and 72 full-text articles were reviewed. Eight studies met the inclusion criteria of which 2 found a significant adjusted increased risk of acute lower respiratory infection, 2 identified a univariate association whilst 4 found no significant association. Study quality was generally limited. Heterogeneity in methods and findings precluded meta-analysis. DISCUSSION: A systematic review of the literature found limited evidence for an association between household air pollution and risk of acute lower respiratory infection in adults. Additional research, with carefully defined exposure and outcome measures, is required to complete the risk profile caused by household air pollution in adults. REGISTRATION NUMBER: CRD42015028042
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