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

August 25, 2001
Publication Type:
Journal Article


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.


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.


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.


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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