“Interventions to reduce household air pollution exposures must lower exposures substantially in order to produce large health benefits. Such reductions will be difficult to achieve with current technologies using solid fuels, although there is much ongoing effort to do better […] Thus much remains to be learned about how to achieve these reductions, but avoiding millions of premature deaths annually in the world’s most vulnerable populations provides a compelling reason to do so.”
In the Comparative Risk Assessment (CRA) done as part of the Global Burden of Disease project (GBD-2010), the global and regional burdens of household air pollution (HAP) due to the use of solid cookfuels, were estimated along with 60+ other risk factors. This article describes how the HAP CRA was framed; how global HAP exposures were modeled; how diseases were judged to have sufficient evidence for inclusion; and how meta-analyses and exposure-response modeling were done to estimate relative risks. We explore relationships with the other air pollution risk factors: ambient air pollution, smoking, and secondhand smoke. We conclude with sensitivity analyses to illustrate some of the major uncertainties and recommendations for future work. We estimate that in 2010 HAP was responsible for 3.9 million premature deaths and ∼4.8% of lost healthy life years (DALYs), ranking it highest among environmental risk factors examined and one of the major risk factors of any type globally.
Primary health outcomes include:
- Acute lower respiratory infections in children
- Chronic obstructive pulmonary disease (COPD)
- Lung cancer
- CVD in adults