Abstract:
More than 3 billion people worldwide continue
to depend on solid fuels such as wood, dung, or
crop residues for cooking and heating [1]. Use of
these fuels in traditional stoves or open fires results
in very high levels of household air pollution
(HAP), with women and young children bearing
a disproportionate burden of the health effects.
The World Health Organization estimates that
indoor air pollution from solid fuel use accounts
for more than 1.9 million (3.3%) of annual deaths,
making household air pollution the largest environ-
mental contributor to mortality in the world, even
greater than unsafe water and sanitation [2].
Evidence suggests that HAP is associated with
increased susceptibility to lung diseases [3], and
there is much interest in fuel-efficient, low-emission
cook stoves as a way to improve respiratory health
and decrease mortality in resource-poor countries.
Fewer studies have evaluated the effects of HAP
on the cardiovascular system, and only 1 study has
examined associations between solid fuel use and
self-reported diagnosis of cardiovascular diseases
(CVD) [4]. However, combustion-generated aero-
sols from other sources, and especially fine particu-
late matter, are considered important causes of
CVD and mortality [5].
Whereas CVD mortality has substantially
declined in the developed world, there is an emerging
CVD epidemic in low- and middle-income countries
