Household Air Pollution (HAP) from burning biomass fuels is a major cause of mortality and morbidity in low-income settings worldwide. Little is known about the differences in objective personal HAP exposure by age and gender.We measured personal exposure to HAP across six groups defined by age and gender (young children, young males, young females, adult males, adult females, and elderly) in rural households in two sub-Saharan African countries.Data on 24-hour personal exposure to HAP were collected from 215 participants from 85 households in Uganda and Ethiopia. HAP exposure was assessed by measuring carbon monoxide (CO) and/or fine particulate matter (PM2.5) concentrations using five types of devices.24 h PM2.5 personal exposure was highest among adult females with Geometric Mean (GM) and Geometric Standard Deviation (GSD) concentrations of 205 μg/m3 (1.67) in Ethiopia; 177 μg/m3 (1.61 GSD) in Uganda. The lowest PM2.5 exposures were recorded among young males GM (GSD) 30.2 μg/m3 (1.89) in Ethiopia; 26.3 μg/m3 (1.48) in Uganda. Young females had exposures about two-thirds of the adult female group. Adult males, young children and the elderly experienced lower exposures reflecting their limited involvement in cooking. There was a similar pattern of exposure by age and gender in both countries and when assessed by CO measurement.There are substantial differences in exposure to HAP depending on age and gender in sub-Saharan Africa rural households reflecting differences in household cooking activity and time spent indoors. Future work should consider these differences when implementing exposure reduction interventions. There was a strong agreement between optical and gravimetric devices measurements although optical devices tended to overestimate exposure. There is need to calibrate optical devices against a gravimetric standard prior to quantifying exposure.
Over 700 million people in Sub-Saharan Africa depend on solid biomass fuel and use simple cookstoves in poorly ventilated kitchens, which results in high indoor concentrations of household air pollutants. Switching from biomass to biogas as a cooking fuel can reduce airborne emissions of fine particulate matter (PM) and carbon monoxide (CO), but households often only partially convert to biogas, continuing to use solid biomass fuels for part of their daily cooking needs. There is little evidence of the benefits of partial switching to biogas. This study monitored real-time PM and CO concentrations in 35 households in Cameroon and Uganda where biogas and firewood (or charcoal) were used. The 24 h mean PM concentrations in households that used: (1) firewood and charcoal; (2) both firewood (mean 54% cooking time) and biogas (mean 46% cooking time); and (3) only biogas, were 449 μg m, 173 μg m and 18 μg m respectively. The corresponding 24 h mean CO concentrations were 14.2 ppm, 2.7 ppm and 0.5 ppm. Concentrations of both PM and CO were high and exceeded the World Health Organisation guidelines when firewood and charcoal were used. Partially switching to biogas reduced CO exposure to below the World Health Organisation guidelines, but PM concentrations were only below the 24 h recommended limits when households fully converted to biogas fuel. These results indicate that partial switching from solid fuels to biogas is not sufficient and continues to produce concentrations of household air pollution that are likely to harm the health of those exposed. Programmes introducing biogas should aim to ensure that household energy needs can be fully achieved using biogas with no requirement to continue using solid fuels.
Adoption of smoke-free measures has been one of the central elements of tobacco control activity over the past 30 years. The past decade has seen an increasing number of countries and proportion of the global population covered by smoke-free policies to some extent. Despite reductions in global smoking prevalence, population growth means that the number of non-smokers exposed to the harms caused by secondhand smoke remains high. Smoke-free policy measures have been shown to be useful in protecting non-smokers from secondhand smoke, and can additionally increase cessation and reduce smoking initiation. Policies tend to be aimed primarily at enclosed public or workplace settings with very few countries attempting to control exposure in private or semiprivate spaces such as homes and cars, and, as a result, children may be benefiting less from smoke-free measures than adults. Compliance with legislation also varies by country and there is a need for education and empowerment together with guidance and changing social norms to help deliver the full benefits that smoke-free spaces can bring. Restrictions and policies on use of electronic cigarettes (e-cigarettes) in smoke-free settings require more research to determine the benefits and implications of bystanders’ exposure to secondhand e-cigarette aerosol, dual use and smoking cessation.
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