One in three people worldwide is at risk of ill health from household air pollutionBMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6102 (Published 08 October 2014) Cite this as: BMJ 2014;349:g6102
Household air pollution—caused by burning biomass (solid fuel derived from plant material) or coal for cooking, heating, or lighting—puts more than one in three people worldwide at risk of ill health and early death, a commission has found.
Led by Stephen Gordon from the Liverpool School of Tropical Medicine, United Kingdom, the commission reviewed evidence for the link between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases. The researchers found that household air pollution puts an estimated 600-800 million families worldwide at increased risk of illnesses such as respiratory tract infections, pneumonia, chronic obstructive pulmonary disease, asthma, and lung cancer. They reported their findings in the Lancet Respiratory Medicine.1
Gordon and colleagues found that exposure to household air pollution was significantly associated with upper and lower respiratory tract infections caused by viruses, bacteria, and mycobacteria. Respiratory tract cancers—such as nasopharyngeal cancer and lung cancer—were strongly associated with pollution from coal burning, but there was insufficient information about the effect of other solid fuels on cancer risk. Using biomass for cooking was substantially associated with a higher incidence in women of chronic lung diseases such as chronic obstructive pulmonary disease and bronchiectasis, the researchers noted.
Using solid fuel—particularly wood—is common in southern Asian countries (especially India, Pakistan, Bangladesh, and Nepal) and sub-Saharan African countries. India uses about 30% of the total solid fuel consumed worldwide, with huge differences among states; 85% of households in Odisha use solid fuel, compared with 40% in Punjab.
“Air pollution is the biggest environmental cause of death worldwide, with household air pollution accounting for about 3.5-4 million deaths every year,” wrote the researchers. “Women and children living in severe poverty have the greatest exposures to household air pollution.”
Gordon told The BMJ, “We must not make the mistake of assuming that the only exposed people are the billions in the least economically developed countries who burn solid fuel, although these are indeed the one third of the world’s population at greatest risk. There are problems of household air pollution—including sidestream tobacco smoke, aeroallergens, and intruding environmental smoke—throughout the world, including in the UK.”
Gordon said that, although much progress has been made in identifying associations between pollution and disease, a multidisciplinary effort will now be needed to mitigate the health effects of household air pollution. “This will involve policy makers, health professionals, and communities themselves. Region specific, acceptable, and affordable solutions to reduce household air pollution will have to be chosen and adopted now and far into the future,” he added. “The eventual solution is to make clean energy available for all. While we wait for this, we must make the available fuel as clean as possible, accepting that this is not the final solution and will not prevent all the associated morbidity and mortality.”
Cite this as: BMJ 2014;349:g6102