Household air pollution from solid fuel use evidence for links to CVD

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