Indoor Air Pollution

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 Indoor Air Pollution
One of the 4 most Critical Global Environmental Problems

Upto 60 times the outdoor concentrations ; WHO ‘rule of 1000’

Pollutants – Physical, Chemical, Biological

Respirable Particles - Tobacco Smoke, Stoves, Aerosol sprays
Carbon monoxide - Stoves, Combustion equipment
Nitrogen dioxide - Gas Cookers, Cigarettes
Sulphur dioxide - Coal Combustion
Carbon dioxide - Combustion, Respiration
Other Organic vapours - Aerosol Sprays, Solvents, Adhesives
Radon & “daughters” - Building Materials
Asbestos Mineral Fibres - Insulation, Fireproofing appliances

Developing Countries - Incomplete combustion of Coal or unprocessed

Biomass fuel
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 Magnitude & Population at Risk

Women and toddlers face greatest risk

700 million women in the developing countries are “at risk” , in their kitchens

“ As many as one billion people, mostly women and children, are regularly exposed to
levels of indoor air pollution exceeding WHO guidelines by up to 100 times ” - quoted at
the WHO strategy meeting on Air Quality and Health, Geneva, Sep 2000

Cooking and heating with solid fuels,

fuels that is wood, coal, dung, crop residues and
charcoal, still occurs for over half the world's population

In India,
India where 80% of households use solid fuel,
fuel there are estimates that half a million
children die annually from indoor air pollution,

A deadly combination of

1) Solid fuels 2) Inefficient stoves 3) Poor ventilation

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 Evidence from Studies on the Effects of Indoor Air Pollution

Class I. Strong evidence

ARI in children under 5 years

COPD in women
Lung cancer in women
Class III. Suggestive evidence

Class II. Intermediate evidence Heart disease in women

Blindness (cataract) in women

TB in women
Asthma
Adverse pregnancy outcomes

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Mechanisms by which some key pollutants in smoke from domestic sources may
increase the risk of respiratory and other health problems

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 Estimated burden of disease (DALYs) in India for selected major risk factors and
diseases compared with that from indoor air pollution.

National burden of disease in India

from indoor air pollution - Kirk R.
Smith, PNAS November 21, 2000, vol.
97, no. 24

Evaluates the existing epidemiological

studies and applies the resulting risks to
the more than three-quarters of all Indian
households dependent on solid fuels.

Attributable risks are calculated in

reference to the demographic conditions
and patterns of each disease in India.

conservative estimates

400–550 thousand premature deaths

4–6% of the Indian national burden of disease (DALYs)

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Estimates listed in order of the strength of evidence under Indian conditions. APO, adverse pregnancy outcomes. Indian total deaths
for each disease are listed in parentheses.
*Under 5 years only.
†Women only.
‡Disability-adjusted life year5(years lost to premature death)1(years lost to
disability) p (severity factor) (37).
§Full range for Class I plus low end of ranges for Classes II and III.

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Estimated distribution of the annual health burden from indoor air pollution in India in terms
of deaths (A), YLL (B), DALYs (C), and sickdays (D).

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 Intervention

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Summary of health and development issues associated with the use of household energy

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 Intervention

(i) Public awareness

(ii) Change in pattern of fuel use

(iii) Modification in stove design

(iv) Improvement in the ventilation

(v) Multisectoral approach

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 The Energy Ladder

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 References

1. Indoor Air Pollution In India – A Major Environmental And Public Health Concern
ICMR Bulletin Vol.31, No.5 May, 2001

2. Addressing the Links between Indoor Air Pollution, Household Energy and Human
Health – WHO, 2002 Based on the WHO-USAID Global Consultation on the “Health
Impact of Indoor Air Pollution and Household Energy in Developing Countries”
Countries .

3. National burden of disease in India from indoor air pollution - Kirk R. Smith,
Smith PNAS
November 21, 2000, vol. 97, no. 24

4. Indoor air pollution in developing countries: a major environmental and public health
challenge - Nigel Bruce,
Bruce Bulletin of the World Health Organization, 2000, 78 (9)

5. Biofuels, air pollution, and health - a global review – Smith KR.

KR New York, Plenum
Press, 1987.

6. Danger In The Air – WHO Press Release 56, 14 September 2000

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