Abstract
Globally, almost 3 billion people rely on biomass (wood, charcoal, crop residues, and dung) and coal as their primary source of domestic energy. Exposure to indoor air pollution (IAP) from the combustion of solid fuels is an important cause of morbidity and mortality in developing countries. In this paper, we review the current knowledge on the relationship between IAP exposure and disease and on interventions for reducing exposure and disease. We take an environmental health perspective and consider the details of both exposure and health effects that are needed for successful intervention strategies. We also identify knowledge gaps and detailed research questions that are essential in successful design and dissemination of preventive measures and policies. In addition to specific research recommendations, we conclude that given the interaction of housing, household energy, and day-to-day household activities in determining exposure to indoor smoke, research and development of effective interventions can benefit tremendously from integration of methods and analysis tools from a range of disciplines in the physical, social, and health sciences.
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- Albalak R., Bruce N., McCracken J. P., Smith K. R., De Gallardo T. Indoor respirable particulate matter concentrations from an open fire, improved cookstove, and LPG/open fire combination in a rural Guatemalan community. Environ Sci Technol. 2001 Jul 1;35(13):2650–2655. doi: 10.1021/es001940m. [DOI] [PubMed] [Google Scholar]
- Anderson H. R. Chronic lung disease in the Papua New Guinea Highlands. Thorax. 1979 Oct;34(5):647–653. doi: 10.1136/thx.34.5.647. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Anderson H. R. Respiratory abnormalities in Papua New Guinea children: the effects of locality and domestic wood smoke pollution. Int J Epidemiol. 1978 Mar;7(1):63–72. doi: 10.1093/ije/7.1.63. [DOI] [PubMed] [Google Scholar]
- Bang A. T., Bang R. A., Tale O., Sontakke P., Solanki J., Wargantiwar R., Kelzarkar P. Reduction in pneumonia mortality and total childhood mortality by means of community-based intervention trial in Gadchiroli, India. Lancet. 1990 Jul 28;336(8709):201–206. doi: 10.1016/0140-6736(90)91733-q. [DOI] [PubMed] [Google Scholar]
- Boy Erick, Bruce Nigel, Delgado Hernán. Birth weight and exposure to kitchen wood smoke during pregnancy in rural Guatemala. Environ Health Perspect. 2002 Jan;110(1):109–114. doi: 10.1289/ehp.02110109. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Britton A., McKee M., Black N., McPherson K., Sanderson C., Bain C. Threats to applicability of randomised trials: exclusions and selective participation. J Health Serv Res Policy. 1999 Apr;4(2):112–121. doi: 10.1177/135581969900400210. [DOI] [PubMed] [Google Scholar]
- Britton A., McKee M. The relation between alcohol and cardiovascular disease in Eastern Europe: explaining the paradox. J Epidemiol Community Health. 2000 May;54(5):328–332. doi: 10.1136/jech.54.5.328. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brook R. H., Lohr K. N. Efficacy, effectiveness, variations, and quality. Boundary-crossing research. Med Care. 1985 May;23(5):710–722. doi: 10.1097/00005650-198505000-00030. [DOI] [PubMed] [Google Scholar]
- Bruce N. Household energy, health and development. J Epidemiol Community Health. 2001 Apr;55(4):221–222. doi: 10.1136/jech.55.4.221. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bruce N., Neufeld L., Boy E., West C. Indoor biofuel air pollution and respiratory health: the role of confounding factors among women in highland Guatemala. Int J Epidemiol. 1998 Jun;27(3):454–458. doi: 10.1093/ije/27.3.454. [DOI] [PubMed] [Google Scholar]
- Bruce N., Perez-Padilla R., Albalak R. Indoor air pollution in developing countries: a major environmental and public health challenge. Bull World Health Organ. 2000;78(9):1078–1092. [PMC free article] [PubMed] [Google Scholar]
- Cerqueiro M. C., Murtagh P., Halac A., Avila M., Weissenbacher M. Epidemiologic risk factors for children with acute lower respiratory tract infection in Buenos Aires, Argentina: a matched case-control study. Rev Infect Dis. 1990 Nov-Dec;12 (Suppl 8):S1021–S1028. doi: 10.1093/clinids/12.supplement_8.s1021. [DOI] [PubMed] [Google Scholar]
- Cleary G. J., Blackburn R. B. Air pollution in native huts in the highlands of New Guinea. Arch Environ Health. 1968 Nov;17(5):785–794. doi: 10.1080/00039896.1968.10665320. [DOI] [PubMed] [Google Scholar]
- César J. A., Victora C. G., Barros F. C., Santos I. S., Flores J. A. Impact of breast feeding on admission for pneumonia during postneonatal period in Brazil: nested case-control study. BMJ. 1999 May 15;318(7194):1316–1320. doi: 10.1136/bmj.318.7194.1316. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ellegård A. Cooking fuel smoke and respiratory symptoms among women in low-income areas in Maputo. Environ Health Perspect. 1996 Sep;104(9):980–985. doi: 10.1289/ehp.104-1469451. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Evans A. S. Causation and disease: a chronological journey. The Thomas Parran Lecture. Am J Epidemiol. 1978 Oct;108(4):249–258. doi: 10.1093/oxfordjournals.aje.a112617. [DOI] [PubMed] [Google Scholar]
- Evans A. S. Causation and disease: the Henle-Koch postulates revisited. Yale J Biol Med. 1976 May;49(2):175–195. [PMC free article] [PubMed] [Google Scholar]
- Ezzati M., Kammen D. M. Quantifying the effects of exposure to indoor air pollution from biomass combustion on acute respiratory infections in developing countries. Environ Health Perspect. 2001 May;109(5):481–488. doi: 10.1289/ehp.01109481. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ezzati M., Kammen D. Indoor air pollution from biomass combustion and acute respiratory infections in Kenya: an exposure-response study. Lancet. 2001 Aug 25;358(9282):619–624. doi: 10.1016/s0140-6736(01)05777-4. [DOI] [PubMed] [Google Scholar]
- Ezzati M., Saleh H., Kammen D. M. The contributions of emissions and spatial microenvironments to exposure to indoor air pollution from biomass combustion in Kenya. Environ Health Perspect. 2000 Sep;108(9):833–839. doi: 10.1289/ehp.00108833. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Graham N. M. The epidemiology of acute respiratory infections in children and adults: a global perspective. Epidemiol Rev. 1990;12:149–178. doi: 10.1093/oxfordjournals.epirev.a036050. [DOI] [PubMed] [Google Scholar]
- Horwitz R. I., Viscoli C. M., Clemens J. D., Sadock R. T. Developing improved observational methods for evaluating therapeutic effectiveness. Am J Med. 1990 Nov;89(5):630–638. doi: 10.1016/0002-9343(90)90182-d. [DOI] [PubMed] [Google Scholar]
- Kirkwood B. R., Gove S., Rogers S., Lob-Levyt J., Arthur P., Campbell H. Potential interventions for the prevention of childhood pneumonia in developing countries: a systematic review. Bull World Health Organ. 1995;73(6):793–798. [PMC free article] [PubMed] [Google Scholar]
- Lan Qing, Chapman Robert S., Schreinemachers Dina M., Tian Linwei, He Xingzhou. Household stove improvement and risk of lung cancer in Xuanwei, China. J Natl Cancer Inst. 2002 Jun 5;94(11):826–835. doi: 10.1093/jnci/94.11.826. [DOI] [PubMed] [Google Scholar]
- Levy J. I., Houseman E. A., Ryan L., Richardson D., Spengler J. D. Particle concentrations in urban microenvironments. Environ Health Perspect. 2000 Nov;108(11):1051–1057. doi: 10.1289/ehp.108-1240162. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lye M. S., Nair R. C., Choo K. E., Kaur H., Lai K. P. Acute respiratory tract infection: a community-based intervention study in Malaysia. J Trop Pediatr. 1996 Jun;42(3):138–143. doi: 10.1093/tropej/42.3.138. [DOI] [PubMed] [Google Scholar]
- McKee M., Britton A., Black N., McPherson K., Sanderson C., Bain C. Methods in health services research. Interpreting the evidence: choosing between randomised and non-randomised studies. BMJ. 1999 Jul 31;319(7205):312–315. doi: 10.1136/bmj.319.7205.312. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McMichael A. J., Smith K. R. Seeking a global perspective on air pollution and health. Epidemiology. 1999 Jan;10(1):1–4. doi: 10.1097/00001648-199901000-00001. [DOI] [PubMed] [Google Scholar]
- Mtango F. D., Neuvians D. Acute respiratory infections in children under five years. Control project in Bagamoyo District, Tanzania. Trans R Soc Trop Med Hyg. 1986;80(6):851–858. doi: 10.1016/0035-9203(86)90241-5. [DOI] [PubMed] [Google Scholar]
- Murray C. J., Lopez A. D. On the comparable quantification of health risks: lessons from the Global Burden of Disease Study. Epidemiology. 1999 Sep;10(5):594–605. [PubMed] [Google Scholar]
- Naeher L. P., Smith K. R., Leaderer B. P., Neufeld L., Mage D. T. Carbon monoxide as a tracer for assessing exposures to particulate matter in wood and gas cookstove households of highland Guatemala. Environ Sci Technol. 2001 Feb 1;35(3):575–581. doi: 10.1021/es991225g. [DOI] [PubMed] [Google Scholar]
- Pandey M. R., Sharma P. R., Gubhaju B. B., Shakya G. M., Neupane R. P., Gautam A., Shrestha I. B. Impact of a pilot acute respiratory infection (ARI) control programme in a rural community of the hill region of Nepal. Ann Trop Paediatr. 1989 Dec;9(4):212–220. doi: 10.1080/02724936.1989.11748635. [DOI] [PubMed] [Google Scholar]
- Pearson T. A., Feinberg W. Behavioral issues in the efficacy versus effectiveness of pharmacologic agents in the prevention of cardiovascular disease. Ann Behav Med. 1997 Summer;19(3):230–238. doi: 10.1007/BF02892288. [DOI] [PubMed] [Google Scholar]
- Pope C. A., 3rd, Dockery D. W., Spengler J. D., Raizenne M. E. Respiratory health and PM10 pollution. A daily time series analysis. Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):668–674. doi: 10.1164/ajrccm/144.3_Pt_1.668. [DOI] [PubMed] [Google Scholar]
- Puddey I. B., Rakic V., Dimmitt S. B., Beilin L. J. Influence of pattern of drinking on cardiovascular disease and cardiovascular risk factors--a review. Addiction. 1999 May;94(5):649–663. doi: 10.1046/j.1360-0443.1999.9456493.x. [DOI] [PubMed] [Google Scholar]
- Rahman Q., Nettesheim P., Smith K. R., Seth P. K., Selkirk J. International conference on environmental and occupational lung diseases. Environ Health Perspect. 2001 Apr;109(4):425–431. doi: 10.1289/ehp.01109425. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rhodes F., Wood M. M., Booth R. E. Efficacy and effectiveness issues in the NIDA Cooperative Agreement: interventions for out-of-treatment drug users. National Institute on Drug Abuse. J Psychoactive Drugs. 1998 Jul-Sep;30(3):261–268. doi: 10.1080/02791072.1998.10399701. [DOI] [PubMed] [Google Scholar]
- Smith K. R. National burden of disease in India from indoor air pollution. Proc Natl Acad Sci U S A. 2000 Nov 21;97(24):13286–13293. doi: 10.1073/pnas.97.24.13286. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith K. R., Samet J. M., Romieu I., Bruce N. Indoor air pollution in developing countries and acute lower respiratory infections in children. Thorax. 2000 Jun;55(6):518–532. doi: 10.1136/thorax.55.6.518. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Snow R. W., Armstrong J. R., Forster D., Winstanley M. T., Marsh V. M., Newton C. R., Waruiru C., Mwangi I., Winstanley P. A., Marsh K. Childhood deaths in Africa: uses and limitations of verbal autopsies. Lancet. 1992 Aug 8;340(8815):351–355. doi: 10.1016/0140-6736(92)91414-4. [DOI] [PubMed] [Google Scholar]
- Sofoluwe G. O. Smoke pollution in dwellings of infants with bronchopneumonia. Arch Environ Health. 1968 May;16(5):670–672. doi: 10.1080/00039896.1968.10665126. [DOI] [PubMed] [Google Scholar]
- Torres A. A glance at child health. J Epidemiol Community Health. 2001 Sep;55(9):610–610. doi: 10.1136/jech.55.9.610. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wang T. J., Zhou B. S., Shi J. P. Lung cancer in nonsmoking Chinese women: a case-control study. Lung Cancer. 1996 Mar;14 (Suppl 1):S93–S98. doi: 10.1016/s0169-5002(96)90214-7. [DOI] [PubMed] [Google Scholar]
- Woodward A., al-Delaimy W. Measures of exposure to environmental tobacco smoke. Validity, precision, and relevance. Ann N Y Acad Sci. 1999;895:156–172. doi: 10.1111/j.1749-6632.1999.tb08083.x. [DOI] [PubMed] [Google Scholar]
- Woolcock A. J., Blackburn C. R. Chronic lung disease in the territory of Papula and New Guinea--an epidemiological study. Australas Ann Med. 1967 Feb;16(1):11–19. doi: 10.1111/imj.1967.16.1.11. [DOI] [PubMed] [Google Scholar]
- YERUSHALMY J., PALMER C. E. On the methodology of investigations of etiologic factors in chronic diseases. J Chronic Dis. 1959 Jul;10(1):27–40. doi: 10.1016/0021-9681(59)90015-3. [DOI] [PubMed] [Google Scholar]
- de Koning H. W., Smith K. R., Last J. M. Biomass fuel combustion and health. Bull World Health Organ. 1985;63(1):11–26. [PMC free article] [PubMed] [Google Scholar]
- van Ginneken J. K., Lob-Levyt J., Gove S. Potential interventions for preventing pneumonia among young children in developing countries: promoting maternal education. Trop Med Int Health. 1996 Jun;1(3):283–294. doi: 10.1046/j.1365-3156.1996.d01-56.x. [DOI] [PubMed] [Google Scholar]