Household Air Pollution and Acute Lower Respiratory Infections in Adults: A Systematic Review

Abstract

Introduction: Household air pollution from solid fuel burning kills over 4 million people every year including half a million children from acute lower respiratory infections. Although biologically plausible, it is not clear whether household air pollution is also associated with acute lower respiratory infections in adults. We systematically reviewed the literature on household air pollution and acute lower respiratory infection in adults to identify knowledge gaps and research opportunities.

Methods: Ten bibliographic databases were searched to identify studies of household air pollution and adult acute lower respiratory infection. Data were extracted from eligible studies using standardised forms.

Results: From 4617 titles, 513 abstracts and 72 full-text articles were reviewed. Eight studies met the inclusion criteria of which 2 found a significant adjusted increased risk of acute lower respiratory infection, 2 identified a univariate association whilst 4 found no significant association. Study quality was generally limited. Heterogeneity in methods and findings precluded meta-analysis.

Discussion: A systematic review of the literature found limited evidence for an association between household air pollution and risk of acute lower respiratory infection in adults. Additional research, with carefully defined exposure and outcome measures, is required to complete the risk profile caused by household air pollution in adults.

Registration number: CRD42015028042.

Fig 1. PRISMA Flow Chart A flow chart depicting the inclusion and exclusion of identified studies

Fig 2. Forest Plot A forest plot showing the Odds Ratio (and lower and upper 95% Confidence Intervals) for different exposures and outcome in the included studies.

Adjusted results are shown where available. Key: ICS: improved cookstove; kero: kerosene; *indicates that the study is assessing for the protective effect of an intervention.