Household Air Pollution in Low- and Middle-Income Countries: Health Risks and Research Priorities

Martin, William J.; Glass, Roger I.; Araj, Houmam; Balbus, John; Collins, Francis S.; Curtis, Siân L.; Diette, Gregory B.; Elwood, William N.; Falk, Henry; Hibberd, Patricia L.; Keown, Susan E. J.; Mehta, Sumi; Patrick, Erin; Rosenbaum, Julia; Sapkota, Amir; Tolunay, Hatice; Bruce, Nigel

doi:10.1371/journal.pmed.1001455

Cited by 69 publications

(54 citation statements)

References 30 publications

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“…The scale of the problem is daunting, with a need to reach hundreds of millions of households and to find the best solutions and the best mechanisms to implement such strategies. The consensusbased research priorities to reduce the global burden of diseases from HAP and its burden on women and children are clear and many relate to the reduction of adverse respiratory outcomes (46). The United States government and the United Nations Foundation formed a public private partnership in 2010 called the Global Alliance for Clean Cookstoves that offers a platform to support research and implementation of clean cooking solutions, as noted in their mission statement to "save lives, improve livelihoods, empower women, and protect the environment."…”

Section: Sociocultural Context Of Women's Respiratory Disease Women Amentioning

confidence: 99%

Women and Lung Disease. Sex Differences and Global Health Disparities

Pinkerton

Harbaugh

Han

et al. 2015

Am J Respir Crit Care Med

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125

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There is growing evidence that a number of pulmonary diseases affect women differently and with a greater degree of severity than men. The causes for such sex disparity is the focus of this Blue Conference Perspective review, which explores basic cellular and molecular mechanisms, life stages, and clinical outcomes based on environmental, sociocultural, occupational, and infectious scenarios, as well as medical health beliefs. Owing to the breadth of issues related to women and lung disease, we present examples of both basic and clinical concepts that may be the cause for pulmonary disease disparity in women. These examples include those diseases that predominantly affect women, as well as the rising incidence among women for diseases traditionally occurring in men, such as chronic obstructive pulmonary disease. Sociocultural implications of pulmonary disease attributable to biomass burning and infectious diseases among women in low-to middle-income countries are reviewed, as are disparities in respiratory health among sexual minority women in high-income countries. The implications of the use of complementary and alternative medicine by women to influence respiratory disease are examined, and future directions for research on women and respiratory health are provided.

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Section: Sociocultural Context Of Women's Respiratory Disease Women Amentioning

confidence: 99%

Women and Lung Disease. Sex Differences and Global Health Disparities

Pinkerton

Harbaugh

Han

et al. 2015

Am J Respir Crit Care Med

Self Cite

125

View full text Add to dashboard Cite

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“…There has been much debate about how low exposure needs to be to deliver substantive health benefits, given that the transition from the use of open fires in households that collect all or most of their fuel to near exclusive use of clean technologies and fuels incurring higher costs will be neither quick nor straightforward, particularly for low-income and rural homes 285. This issue is one of three key questions that should be considered during development of an intervention strategy, along with the performance of currently available interventions and the factors that can help to ensure adoption and sustained use (panel 2).…”

Section: Introductionmentioning

confidence: 99%

Respiratory risks from household air pollution in low and middle income countries

Gordon¹,

Bruce²,

Grigg³

et al. 2014

The Lancet Respiratory Medicine

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775

592

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A third of the world’s population uses solid fuel derived from plant material (biomass) or coal for cooking, heating, or lighting. These fuels are smoky, often used in an open fire or simple stove with incomplete combustion, and result in a large amount of household air pollution when smoke is poorly vented. Air pollution is the biggest environmental cause of death worldwide, with household air pollution accounting for about 3·5–4 million deaths every year. Women and children living in severe poverty have the greatest exposures to household air pollution. In this Commission, we review evidence for the association between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases. Respiratory infections (comprising both upper and lower respiratory tract infections with viruses, bacteria, and mycobacteria) have all been associated with exposure to household air pollution. Respiratory tract cancers, including both nasopharyngeal cancer and lung cancer, are strongly associated with pollution from coal burning and further data are needed about other solid fuels. Chronic lung diseases, including chronic obstructive pulmonary disease and bronchiectasis in women, are associated with solid fuel use for cooking, and the damaging effects of exposure to household air pollution in early life on lung development are yet to be fully described. We also review appropriate ways to measure exposure to household air pollution, as well as study design issues and potential effective interventions to prevent these disease burdens. Measurement of household air pollution needs individual, rather than fixed in place, monitoring because exposure varies by age, gender, location, and household role. Women and children are particularly susceptible to the toxic effects of pollution and are exposed to the highest concentrations. Interventions should target these high-risk groups and be of sufficient quality to make the air clean. To make clean energy available to all people is the long-term goal, with an intermediate solution being to make available energy that is clean enough to have a health impact.

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“…According to the Global Alliance for Cleaner Cookstoves, one person dies every eight seconds due to biomass smoke inhalation (2). Yet, 3 billion people worldwide, especially individuals with a low socioeconomic status, are exposed to biomass smoke (3). Women and children often breathe high levels of biomass smoke since they usually spend the most time near household fires based on cultural practices (2, 4).…”

Section: Introductionmentioning

confidence: 99%

Comparison of in vitro toxicological effects of biomass smoke from different sources of animal dung

McCarthy

Duffney

Wyatt

et al. 2017

Toxicology in Vitro

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Worldwide, over 4 million premature deaths each year are attributed to the burning of biomass fuels for cooking and heating. Epidemiological studies associate household air pollution with lung diseases, including chronic obstructive pulmonary disease, lung cancer, and respiratory infections. Animal dung, a biomass fuel used by economically vulnerable populations, generates more toxic compounds per mass burned than other biomass fuels. The type of animal dung used varies widely depending on local agro-geography. There are currently neither standardized experimental systems for dung biomass smoke research nor studies assessing the health impacts of different types of dung smoke. Here, we used a novel reproducible exposure system to assess outcomes related to inflammation and respiratory infections in human airway cells exposed to six different types of dung biomass smoke. We report that dung biomass smoke, regardless of species, is pro-inflammatory and activates the aryl hydrocarbon receptor and JNK transcription factors; however, dung smoke also suppresses interferon responses after a challenge with a viral mimetic. These effects are consistent with epidemiological data, and suggest a mechanism by which the combustion of animal dung can directly cause lung diseases, promote increased susceptibility to infection, and contribute to the global health problem of household air pollution.

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Household Air Pollution in Low- and Middle-Income Countries: Health Risks and Research Priorities

Abstract: William Martin and colleagues report on their stakeholder meetings that reviewed the health risks of household air pollution and cookstoves, and identified research priorities in seven key areas. Please see later in the article for the Editors' Summary

Cited by 69 publications

References 30 publications

Women and Lung Disease. Sex Differences and Global Health Disparities

Women and Lung Disease. Sex Differences and Global Health Disparities

Respiratory risks from household air pollution in low and middle income countries

Comparison of in vitro toxicological effects of biomass smoke from different sources of animal dung

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