When smoke gets in your lungs

Abstract

A major source of air pollution exposure in the developing world is smoke due to inefficient cooking with biomass fuels in poorly ventilated homes. Biomass fuel refers to any recently living plant- and/or animal-based material that is deliberately burned by humans as fuel, including wood, crop residues, and animal dung. The levels of exposure to particulate matter in such homes are often at least an order of magnitude higher than the highest concentrations that occur in the ambient air of the developed world. Because roughly half the world's population cooks daily with unprocessed biomass fuel, the potential public health impact is huge. The World Health Organization has estimated that indoor air pollution from solid fuel use is responsible for 2.6% of the total global burden of disease and between 1.5 and 2 million deaths each year, primarily due to acute lower respiratory infection in young children and chronic obstructive pulmonary disease in adult women. Major limitations of the existing epidemiologic literature include lack of actual exposure measurements, lack of longitudinal studies, inadequate exposure-response information, and few intervention studies. Ongoing research in Guatemala is attempting to address these data gaps.

Figure 1.

The plancha is a wood-burning stove constructed from bricks and concrete blocks. It has a steel top-plate with three holes for pots and a metal chimney that directs the smoke outside the house. This stove was developed locally, is well accepted in the communities, and is built by local masons. Drawing by Nigel Bruce reproduced with permission.