Indoor Air Pollution Exposure of Women in Adama, Ethiopia, and Assessment of Disease Burden Attributable to Risk Factor

Abstract

Introduction and aim: Air pollution, a major environmental threat to human health, contributes to the premature deaths of millions of people worldwide. Cooking with solid fuels, such as charcoal and wood, in low- and middle-income countries generates very high emissions of particulate matter within and near the household as a result of their inefficient combustion. Women are especially exposed, as they often perform the cooking. The purpose of this study was to assess the burden of disease attributable to household air pollution exposure from cooking among women in Adama, Ethiopia. Methods: AirQ+ software (WHO Regional Office for Europe, Copenhagen, Denmark) was used to assess the health impact of household air pollution by estimating the burden of disease (BoD) including Acute Lower Respiratory Infections (ALRI), Chronic Obstructive Pulmonary Disease (COPD), Ischemic Heart Disease (IHD), lung cancer, and stroke, among a cohort of women in Adama. Household air pollution exposure estimated by cooking fuel type was assessed through questionnaires. Results: Three-quarters (75%) of Adama’s population used solid fuel for cooking; with this, the household air pollution attributable mortality was estimated to be 50% (95% CI: 38–58%) due to ALRI, 50% (95% CI: 35–61%) due to COPD, 50% (95% CI: 27–58%) due to lung cancer, (95% CI: 23–48%) due to IHD, and (95% CI: 23–51%) due to stroke. The corresponding disability-adjusted life years (DALYs) per 100,000 women ranged between 6000 and 9000 per disease. Conclusions: This health impact assessment illustrates that household air pollution due to solid fuel use among women in Adama leads to premature death and a substantial quantity of DALYs. Therefore, decreasing or eliminating solid fuel use for cooking purposes could prevent deaths and improve quality of life.

Characterization of fine particulate matter from indoor cooking with solid biomass fuels

“…A systematic review from 2020 found positive associations between wood smoke and increased blood pressure, low birth weight, esophageal cancer, sick building syndrome, non‐syndromic cleft lip and/or cleft palate, and under‐five mortality. That indoor air pollution from solid biomass fuels is a strong risk factor for hypertension was also shown by, for example, Li et al 18 A recent health impact assessment study 19 estimated the burden of disease of acute lower respiratory infections, chronic obstructive pulmonary disease, ischemic heart disease, lung cancer, and stroke in an Ethiopian cohort of 2000 women and concluded that the disability‐adjusted life‐years (DALYs) lost per 100 000 women ranged between 6000 and 9000, per disease.…”

Human exposure to indoor air pollution in Ethiopian households

“…IAP is a less studied subject in Ethiopia, and synthesizing available evidence in the literature is very challenging owing to the evidence quality and heterogeneity. Several studies have found a link between biomass fuel use and acute respiratory infections, asthma, chronic obstructive pulmonary disease, and tuberculosis in Ethiopian households ( Andarge et al., 2021 ; Balidemaj et al., 2021 ; Desalegn et al., 2011 ; Downward et al., 2018 ; Mengesha et al., 2004 ; Tamire et al., 2020 ; Andualem et al., 2020 ). According to a study conducted in Gondor, the prevalence of respiratory symptoms among women was 46.1% [95% CI: 42.6 %–49.7 %], with a runny nose, shortness of breath, and phlegm accounting for 32.07 %, 15.03 %, and 12.63 %, respectively ( Andualem et al., 2020 ).…”

Respiratory-related deaths and associated factors in Alicho-Weriro district, southern Ethiopia: verbal autopsy data analysis

“…Moreover, larger households often consume a high volume of biomass fuel for domestic purposes, such as cooking, heating and lighting, which would increase the concentration of harmful particulate matter in the indoor environment 31 32. Previous studies from Ethiopia have revealed that using firewood for cooking was responsible for about half of acute lower-respiratory tract infections and deaths from lung cancer 33. In this study, the odds of dying from respiratory-related diseases were observed to be higher among households that used wood and/or animal dung for cooking purposes.…”