PublicationJournal Article Indoor air pollution from biomass combustion and acute respiratory infections in Kenya: an exposure-response study

Published:
August 25, 2001
Publication Type:
Journal Article
Abstract:

Background

Acute res­pi­ra­to­ry infec­tions (ARI) are the lead­ing cause of the glob­al bur­den of dis­ease and have been causal­ly linked with expo­sure to pol­lu­tants from domes­tic bio­mass fuels in less-devel­oped coun­tries. We used lon­gi­tu­di­nal health data cou­pled with detailed mon­i­tor­ing of per­son­al expo­sure from more than 2 years of field mea­sure­ments in rur­al Kenya to esti­mate the expo­sure-response rela­tion for par­tic­u­lates small­er than 10 μm in diam­e­ter (PM10) gen­er­at­ed from bio­mass combustion.

Methods

55 ran­dom­ly-select­ed house­holds (includ­ing 93 infants and chil­dren, 229 indi­vid­u­als between 5 and 49 years of age, and 23 aged 50 or old­er) in cen­tral Kenya were fol­lowed up for more than 2 years. Lon­gi­tu­di­nal data on ARI and acute low­er res­pi­ra­to­ry infec­tions (ALRI) were record­ed at week­ly clin­i­cal exam­i­na­tions. Expo­sure to PM10 was mon­i­tored by mea­sure­ment of PM10 emis­sion con­cen­tra­tion and time-activ­i­ty budgets.

Findings

With the best esti­mate of the expo­sure-response rela­tion, we found that ARI and ALRI are increas­ing con­cave func­tions of aver­age dai­ly expo­sure to PM10, with the rate of increase declin­ing for expo­sures above about 1000–2000 μg/​m3. After we had includ­ed high-inten­si­ty expo­sure episodes, sex was no longer a sig­nif­i­cant pre­dic­tor of ARI and ALRI.

Interpretation

The ben­e­fits of reduced expo­sure to PM10 are larg­er for aver­age expo­sure less than about 1000–2000 μg/​m3. Our find­ings have impor­tant con­se­quences for inter­na­tion­al pub­lic-health poli­cies, ener­gy and com­bus­tion research, and tech­nol­o­gy trans­fer efforts that affect more than 2 bil­lion peo­ple worldwide.

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