Quantifying the effects of exposure to indoor air pollution from biomass combustion on acute respiratory infections in developing countries.

Abstract

Acute respiratory infections (ARI) are the leading cause of burden of disease worldwide and have been causally linked with exposure to pollutants from domestic biomass fuels in developing countries. We used longitudinal health data coupled with detailed monitoring and estimation of personal exposure from more than 2 years of field measurements in rural Kenya to estimate the exposure-response relationship for particulates < 10 microm diameter (PM(10)) generated from biomass combustion. Acute respiratory infections and acute lower respiratory infections are concave, increasing functions of average daily exposure to PM(10), with the rate of increase declining for exposures above approximately 1,000-2,000 microg/m(3). This first estimation of the exposure-response relationship for the high-exposure levels characteristic of developing countries has immediate and important consequences for international public health policies, energy and combustion research, and technology transfer efforts that affect more than 2 billion people worldwide.

Impact of improved stoves, house construction and child location on levels of indoor air pollution exposure in young Guatemalan children

“…The impact these lower levels of exposure would have on health outcomes, in particular the incidence of ALRI, remains to be firmly established through intervention studies such as that underway in Guatemala (Dooley 2003). However, some evidence is becoming available to suggest there would be some benefit at the level of exposures seen for open fires and planchas in the current study (Ezzati and Kammen, 2001). In the meantime, this study shows clearly that stove programmes such as the FIS F although limited in some respects F can have quite a substantial impact on indoor air pollution in poor rural populations, and there would seem to be the potential to increase this impact further, even before a transition to cleaner fuels becomes economically feasible and culturally appropriate.…”

Exposure assessment for respirable particulates associated with household fuel use in rural districts of Andhra Pradesh, India

“…Recent studies have shown strong associations between biomass fuel combustion and increased incidence of chronic bronchitis in women and acute respiratory infections in children (Armstrong and Campbell, 1991;Bruce et al, 1998;Ezzati and Kammen, 2001). Many recent studies have also been conducted in rural Indian villages (Behera et al, 1991;Smith 1993;Awasthi et al, 1996;Mishra and Retherford 1997).…”

“…Many recent studies have also been conducted in rural Indian villages (Behera et al, 1991;Smith 1993;Awasthi et al, 1996;Mishra and Retherford 1997). A recent study characterized the exposure -response relationship between biomass smoke exposure and acute respiratory infection in rural Kenyan households (Ezzati and Kammen, 2001).…”

Expressing urine from a gel disposable diaper for biomonitoring using phthalates as an example

“…The indoor exposure pathway is especially the world's population and up to 90% of rural households in developing countries still rely on coal or unprocessed biomass material in the form of wood, dung, and crop residues for fuel . High levels of indoor air pollutants result from the use of either open fires or poorly functioning stoves to burn biomass or coal (Ezzati & Kammen, 2001). Women, especially those responsible for cooking, are the ones most heavily exposed.…”