THE INDOOR-OUTDOOR AIR-POLLUTION CONTINUUM AND THE BURDEN OF CARDIOVASCULAR DISEASE: AN OPPORTUNITY FOR IMPROVING GLOBAL HEALTH

Abstract

Current understanding of the association between household air-pollution (HAP) and cardiovascular disease is primarily derived from outdoor air-pollution studies. The lack of accurate information on the contribution of HAP to cardiovascular events has prevented inclusion of such data in global burden of disease estimates with consequences in terms of health care allocation and national/international priorities. Understanding the health risks, exposure characterization, epidemiology and economics of the association between HAP and cardiovascular disease represents a pivotal unmet public health need. Interventions to reduce exposure to air-pollution in general, and HAP in particular are likely to yield large benefits and may represent a cost-effective and economically sustainable solution for many parts of the world. A multi-disciplinary effort that provides economically feasible technologic solutions in conjunction with experts that can assess the health, economic impact and sustainability are urgently required to tackle this problem.

FIGURE 1

Estimates of global exposure to particulate matter and the relative contribution of indoor and outdoor sources. Reproduced with permission from Smith, K.R. Fuel Combustion Air Pollution. Exposure and Health: the situation in Developing Countries.” Annual Review of Energy and the Environment 18; 529-566, 1993.