Health and Household Air Pollution from Solid Fuel Use: The Need for Improved Exposure Assessment

Abstract

Background: Nearly 3 billion people worldwide rely on solid fuel combustion to meet basic household energy needs. The resulting exposure to air pollution causes an estimated 4.5% of the global burden of disease. Large variability and a lack of resources for research and development have resulted in highly uncertain exposure estimates.Objective: We sought to identify research priorities for exposure assessment that will more accurately and precisely define exposure–response relationships of household air pollution necessary to inform future cleaner-burning cookstove dissemination programs.Data Sources: As part of an international workshop in May 2011, an expert group characterized the state of the science and developed recommendations for exposure assessment of household air pollution.Synthesis: The following priority research areas were identified to explain variability and reduce uncertainty of household air pollution exposure measurements: improved characterization of spatial and temporal variability for studies examining both short- and long-term health effects; development and validation of measurement technology and approaches to conduct complex exposure assessments in resource-limited settings with a large range of pollutant concentrations; and development and validation of biomarkers for estimating dose. Addressing these priority research areas, which will inherently require an increased allocation of resources for cookstove research, will lead to better characterization of exposure–response relationships.Conclusions: Although the type and extent of exposure assessment will necessarily depend on the goal and design of the cookstove study, without improved understanding of exposure–response relationships, the level of air pollution reduction necessary to meet the health targets of cookstove interventions will remain uncertain.Citation: Clark ML, Peel JL, Balakrishnan K, Breysse PN, Chillrud SN, Naeher LP, Rodes CE, Vette AF, Balbus JM. 2013. Health and household air pollution from solid fuel use: the need for improved exposure assessment. Environ Health Perspect 121:1120–1128; http://dx.doi.org/10.1289/ehp.1206429

Consequences of household air pollution on child survival: evidence from demographic and health surveys in 47 countries

“…While assessing exposure to HAP by type of cooking fuel used in the household is a crude estimate of exposure, having a high percentage of wood use within the solid fuel group eliminates some of the heterogeneity from categorizing all solid fuels together. 26 Our findings are consistent with other studies that found exposure to HAP is associated with an increased risk of under-five mortality. Bruce et al (2013) published a systematic review of outcomes associated with HAP for children 0-59 months.…”

Levels of PM 2.5 /PM 10 and associated metal(loid)s in rural households of Henan Province, China

“…The pollutants produced from combustion of solid fuels include suspended particulates (PM 10 and PM 2.5 ), carbon monoxide (CO), carbon dioxide (CO 2 ), nitrogen oxides (NO x ), sulfur dioxide (SO 2 ) and heavy metals (Clark et al, 2013). Combustion of biomass and coal is the dominant source of indoor air pollution in China Zhang and Smith, 2007).…”

Perspectives in Household Air Pollution Research: Who Will Benefit from Interventions?

“…These exposures are disproportionately experienced by women and children due to domestic roles typically encountered in least-developed or developing countries [2]. Average daily PM concentrations in homes burning solid fuels can range from 300 to 3,000 μg/m 3 [5,6], substantially greater than the World Health Organization guidelines for ambient and indoor air quality intended to protect public health (e.g., the guidelines for daily mean PM 2.5 [PM with an aerodynamic diameter less than or equal to 2.5 microns] and PM 10 are 25 μg/m 3 and 50 μg/ m 3 , respectively) [7]. Often characterized by large variability and uncertainty due to differences in factors such as stove use and time-activity patterns, household room configuration and ventilation, fuel type and moisture, weather, and instrument error [5], exposure to household air pollution has been linked to serious global health impacts, both acute and chronic [3].…”

“…Average daily PM concentrations in homes burning solid fuels can range from 300 to 3,000 μg/m 3 [5,6], substantially greater than the World Health Organization guidelines for ambient and indoor air quality intended to protect public health (e.g., the guidelines for daily mean PM 2.5 [PM with an aerodynamic diameter less than or equal to 2.5 microns] and PM 10 are 25 μg/m 3 and 50 μg/ m 3 , respectively) [7]. Often characterized by large variability and uncertainty due to differences in factors such as stove use and time-activity patterns, household room configuration and ventilation, fuel type and moisture, weather, and instrument error [5], exposure to household air pollution has been linked to serious global health impacts, both acute and chronic [3]. Air pollution from household solid fuel combustion is the third leading risk factor for morbidity and mortality globally, responsible for an estimated 3.9 million premature deaths per year and approximately 4.8 % of disability-adjusted life years [3,8].…”

“…Emerging evidence also suggests associations with adverse pregnancy outcomes [20], tuberculosis [21][22][23], and cognitive impairment [24]. Furthermore, recent publications have identified important gaps in knowledge focusing on the shape of the exposure-response curves [25], the need for improved exposure assessment, particularly challenging when long-term exposures are of interest [5], as well as the implications that solid fuel cookstove emissions have on climate-level impacts [26]. Ideally, the solution to household air pollution exposures is to transition households to cleaner fuels (e.g., liquid petroleum gas, electricity).…”