Air Pollution At Home: What's Harming You?

Domestic air pollution, also known as household air pollution, is a significant health risk that affects millions of people worldwide. It refers to the contamination of indoor air by various pollutants, including physical, chemical, and biological agents. These pollutants are released into the air through the use of solid fuels such as wood, charcoal, and kerosene for cooking and heating, as well as from tobacco smoking, building materials, cleaning products, and mosquito repellents. The health impacts of domestic air pollution are wide-ranging, including respiratory and cardiovascular issues, an increased risk of cancer, and adverse effects on pregnant women and children. With nearly 3.2 million premature deaths attributed to household air pollution annually, it is essential to address this issue through the adoption of clean fuels, improved ventilation, and awareness campaigns to reduce exposure and protect public health.

Indoor air quality problems

One of the leading causes of indoor air pollution is the use of polluting fuels and technologies for cooking, heating, and lighting. For example, the use of solid fuels such as wood, crop waste, charcoal, coal, and dung, as well as kerosene, in open fires and inefficient stoves, can lead to the incomplete combustion of fuels and the release of harmful pollutants. These pollutants include particulate matter, which can cause respiratory and cardiovascular problems, and ozone, which can irritate the eyes and throat and worsen respiratory conditions. The impact of indoor air pollution from cooking is particularly harmful to women and children, who are typically responsible for household chores such as cooking.

Another source of indoor air pollution is tobacco smoking, which releases harmful gases and particles into the air. This can include secondhand smoke, which can be detrimental to the health of those nearby. Additionally, the use of incense, mosquito repellents, pesticides, and cleaning chemicals can also contribute to indoor air pollution.

Indoor air pollution has been linked to various health issues, including an increased risk of low birth weight, stillbirths, and infant mortality. It is also associated with an increased risk of non-communicable diseases such as stroke, ischaemic heart disease, chronic obstructive pulmonary disease (COPD), and lung cancer. The exposure to indoor air pollutants during pregnancy and early childhood can have long-lasting impacts on health, with studies showing compromised lung function in children exposed to indoor air pollution.

To improve indoor air quality, it is essential to adopt clean fuels and technologies, such as solar, electricity, biogas, liquefied petroleum gas (LPG), and natural gas. Additionally, improving ventilation and housing design can help reduce the concentration of pollutants indoors. It is also crucial to address behavioural factors, such as encouraging smoke-free environments and promoting the proper use and maintenance of combustion appliances and ventilation systems.

Health impacts

Domestic air pollution, also known as household air pollution, is caused by the use of inefficient and polluting fuels and technologies in and around the home. Polluting fuels include wood, animal dung, charcoal, crop waste, coal, and kerosene, which are often burned in open fires or inefficient stoves. These fuels contain a range of health-damaging pollutants, including small particles that penetrate deep into the lungs and enter the bloodstream.

The health impacts of domestic air pollution are significant and wide-ranging, affecting all stages of life, from prenatal development to old age. Here are some of the key health effects associated with exposure to domestic air pollution:

Prenatal and Childhood Effects

• Increased risk of low birth weight, pre-term birth, and compromised lung function in children.
• Exposure to indoor air pollution during pregnancy has been linked to fetal thrombosis, resulting in increased stillbirths and infant mortality.
• Exposure to household air pollution in children under five is responsible for almost half of all pneumonia deaths in this age group.
• Emerging evidence suggests a possible link between domestic air pollution and asthma, ear infections, upper respiratory infections, tuberculosis, and other health issues in children.

Cardiovascular and Respiratory Effects

• Domestic air pollution is a risk factor for cardiovascular problems, including strokes, ischaemic heart disease, and heart attacks.
• It can also cause respiratory issues such as chronic obstructive pulmonary disease (COPD) and lung cancer.
• Fine particulate matter in indoor smoke can cause inflammation in the airways and lungs, impairing immune response and reducing oxygen-carrying capacity in the blood.

Other Health Effects

• Exposure to indoor air pollution has been associated with an increased body mass index in children.
• Domestic air pollution may also contribute to short-term health issues such as burning eyes, coughing, and nose and throat irritation.
• The use of polluting fuels can increase the risk of musculoskeletal damage from carrying heavy loads of fuel, leading to muscle strains, spinal injuries, fractures, and pregnancy complications.
• Kerosene, often used in households, is a leading cause of childhood poisoning.
• Burns and scalds from open fires or unstable stoves are a significant cause of injury and death, especially among children.

According to the World Health Organization (WHO), over 3 million people die prematurely each year from diseases caused by household air pollution. It is a leading cause of disability-adjusted life years (DALYs) in Southeast Asia and the third leading cause globally. The impact is particularly pronounced in low- and middle-income countries, where the majority of those affected by household air pollution reside.

Solid fuels and kerosene

Domestic air pollution, also known as household air pollution, is a leading cause of disability-adjusted life years (DALYs) in Southeast Asia and the third leading cause of DALYs globally.

The World Health Organization (WHO) estimates that 3.2 million people die prematurely each year due to illnesses caused by the incomplete combustion of solid fuels and kerosene used for cooking. This accounts for 32% of ischaemic heart disease deaths, 12% of stroke deaths, 21% of lower respiratory infection deaths, 19% of chronic obstructive pulmonary disease (COPD) deaths, and 6% of lung cancer deaths. The risk of childhood pneumonia is especially high, with household air pollution contributing to 44% of all pneumonia deaths in children under five.

Women and children, who typically perform household chores like cooking and collecting firewood, are disproportionately affected by the use of polluting fuels and technologies. They spend more time near the domestic hearth, exposing them to harmful pollutants. Additionally, the reliance on these fuels requires significant time for cooking on inefficient devices and gathering and preparing fuel.

To address this issue, the WHO has issued guidelines for indoor air quality, recommending against the use of kerosene and unprocessed coal. Clean fuels and technologies, such as solar, electricity, biogas, liquefied petroleum gas (LPG), natural gas, and alcohol fuels, are encouraged to reduce household air pollution and protect health.

Ambient air pollution

According to the World Health Organization (WHO), ambient air pollution caused approximately 4.2 million premature deaths globally in 2016, with 58% of these deaths caused by ischaemic heart disease and strokes. In 2019, the number of deaths remained at 4.2 million, with 68% caused by ischaemic heart disease and stroke, 14% by chronic obstructive pulmonary disease, 14% by acute lower respiratory infections, and 4% by lung cancers. People in low- and middle-income countries are disproportionately affected by ambient air pollution, with 89% of premature deaths occurring in these areas, particularly in the WHO South-East Asia and Western Pacific Regions.

The main sources of ambient air pollution are both natural and man-made, including transport, industry, and agriculture. Pollutants of significant concern for public health include particulate matter (PM), ozone (O3), nitrogen dioxide (NO2), and sulphur dioxide (SO2). Particulate matter, a mixture of solid and liquid particles, poses health risks when inhaled and accumulated in the respiratory system. Fine particles, less than 2.5 micrometres in diameter (PM2.5), can lodge deeply into the lungs, causing respiratory and cardiovascular problems, including cancer, strokes, and heart attacks.

To address ambient air pollution, concerted action is required from local, national, and regional policymakers. Successful policies have been implemented in sectors such as transport, with a focus on promoting public transportation, walking, and cycling instead of private motor vehicles. In the energy sector, the adoption of clean and renewable fuels in power plants and the improvement of energy efficiency in homes and buildings are crucial. Additionally, waste management strategies, such as waste reduction, separation, recycling, and the use of biogas, play a vital role in reducing ambient air pollution.

While air quality in high-income countries has shown improvement over the years, the adverse health effects of particulate air pollution remain a global concern. It is essential to increase awareness about the health risks associated with air pollution and implement country-specific interventions to mitigate its impact on public health and the environment.

Interventions and initiatives

Clean Household Energy and Technologies: The transition to clean household energy and technologies is essential. This includes promoting access to and use of cleaner fuels such as biogas, ethanol, and liquefied petroleum gas for cooking, heating, and lighting. Electric stoves, including induction cookers, are recommended as the cleanest option, provided there is a reliable and affordable electricity supply. Additionally, cleaner technologies, such as improved stoves and ventilation systems, can significantly reduce indoor air pollution. Chimneys, hoods, and proper window placement can help reduce smoke inhalation indoors and improve overall air quality.

Behavioural Changes: Individuals can make behavioural changes to reduce their exposure to domestic air pollution. This includes actions such as staying indoors, reducing physical activity, altering transportation methods, and using respirators or masks when outdoors. Behavioural changes related to social and cultural practices are also crucial when transitioning to clean energy devices. For example, cooking outdoors or opening windows and doors while cooking can help reduce exposure to harmful pollutants.

Government Policies and Initiatives: Governments play a pivotal role in reducing domestic air pollution through various initiatives. These include implementing cleaner technologies in industries to reduce emissions, improving waste management practices, and promoting energy-efficient homes and buildings. Policies can also provide financial support and incentives for households to adopt cleaner energy devices and fuels, making them more accessible and affordable.

Urban Planning and Transport: Urban planning interventions can contribute to reducing domestic air pollution. This includes redesigning urban areas to promote walkability, cycling networks, and efficient public transportation systems. Prioritising cleaner modes of power generation and encouraging the use of low-emission vehicles, such as electric cars, can also significantly reduce air pollution at the domestic level.

International Cooperation and Agreements: Addressing domestic air pollution requires collaboration between nations. The World Health Organization (WHO) plays a crucial role in supporting countries through evidence-based policies and actions. WHO's Air Quality and Health Unit works across knowledge, evidence, and progress measurement to tackle air pollution and protect public health. Additionally, international agreements, such as resolution A68.8, "Health and the Environment: addressing the health impact of air pollution," demonstrate a global commitment to addressing this issue.

These interventions and initiatives provide a framework for reducing domestic air pollution and improving the health and well-being of populations worldwide. By implementing these strategies, individuals, communities, and governments can make significant strides toward creating a cleaner and healthier living environment.

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