Academic journal article Bulletin of the World Health Organization

Household Air Pollution and the Sustainable Development goals/Pollution De L'air Domestique et Objectifs De Developpement durable/Contaminacion del Aire En Los Hogares Y Objetivos De Desarrollo Sostenible

Academic journal article Bulletin of the World Health Organization

Household Air Pollution and the Sustainable Development goals/Pollution De L'air Domestique et Objectifs De Developpement durable/Contaminacion del Aire En Los Hogares Y Objetivos De Desarrollo Sostenible

Article excerpt

Introduction

Globally, 41% of households, over 2.8 billion people, rely on solid fuels (coal and biomass) for cooking and heating. (1) In developing countries, solid fuels are typically burnt in open fires and inefficient traditional cookstoves, often in poorly ventilated cooking spaces. Women who are customarily responsible for cooking, and their young children, are most exposed to the resulting high levels of air pollutants released including carbon monoxide (CO) and particulate matter (PM).

In 2010, household air pollution was estimated to be responsible for 3.5 million premature deaths worldwide. (2) Household air pollution also contributes to outdoor air pollution, causing an additional 370000 deaths and 9.9 million disability-adjusted life years globally in 2010. (3) There is strong evidence linking household air pollution exposure with cardiovascular diseases, (4-5) acute lower respiratory infections, chronic obstructive pulmonary disease and chronic bronchitis, lung cancer, cataract, (6-7) low birth weight and stillbirth. (8-9) Other health outcomes associated with household air pollution, for which evidence is less robust, include pharyngeal and laryngeal cancer, (10-11) otitis media, (12) asthma, (13-11) tuberculosis, (15) neonatal mortality (16) and nutritional deficit. (17) Indirect health effects from collecting firewood include assault of women and girls, insect (including disease vector) and snake bites, school absenteeism and musculoskeletal injuries from having to carry large bundles of firewood on the head and back for long distances. (18)

Solid fuels are still in widespread use in developing countries and it appears that intervention efforts are not keeping pace with population growth. (19) The population mainly using solid fuel for cooking has remained unchanged over the last three decades at around 2.7 to 2.8 billion. (1) Between 1980 and 2010, the population exposed to household air pollution increased from 333 million to 646 million in sub-Saharan Africa and from 162 million to 190 million in the eastern Mediterranean. In south-east Asia, the population exposed to household air pollution remained stable during the period at around 1 billion people. (1)

Recently, the World Health Organization (WHO) asserted that action to address the household air pollution problem has historically been slow, under-funded and ineffective. (20) A systematic review of factors influencing uptake of cookstove interventions was recently published. (21) Another review focusing on all interventions to reduce household air pollution and improve health in developing countries is in progress. (22) Here we pinpoint the challenges, suggest improvements to existing interventions and identify new opportunities for addressing household air pollution in relation to the sustainable development goals (SDGs). (23)

Indoor air quality guidelines

The recent WHO indoor air quality guidelines (20) are tailored to the particular needs of developing countries where the burden of household air pollution is greatest. The guidelines recognize the challenges likely to be faced in implementation and provide detailed information on cookstove performance and potential health risks. Effective implementation of the guidelines will require strong environmental health programmes to improve understanding of the complexities of the household air pollution problem and inform national response.

Improved cookstoves

Interventions to reduce household air pollution have primarily focused on the promotion and dissemination of improved cookstoves. However, despite the distribution of millions of improved cookstoves in developing countries over the last three decades, problems with household air pollution persist. This limited success is due to several factors, including lack of awareness of the problem and a lack of affordable stoves and fuels that reduce exposures appreciably. (24-25) Lack of reliable exposure-response data has also been suggested as a reason for the failure of improved cookstoves to achieve the desired exposure reductions and health benefits. …

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