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. 2022 Oct;10(10):e1395-e1411.
doi: 10.1016/S2214-109X(22)00332-1.

Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000-18: a geospatial modelling study

Local Burden of Disease Household Air Pollution Collaborators
Collaborators

Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000-18: a geospatial modelling study

Local Burden of Disease Household Air Pollution Collaborators. Lancet Glob Health. 2022 Oct.

Abstract

Background: More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels.

Methods: We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution.

Findings: Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000-257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution.

Interpretation: Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution.

Funding: Bill & Melinda Gates Foundation.

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Conflict of interest statement

Affiliations Institute for Health Metrics and Evaluation (J J Frostad MPH, Q P Nguyen BS, M M Baumann BS, B F Blacker MPH, L B Marczak PhD, K E LeGrand MPH, K B Johnson MS, Prof L Dandona MD, Prof R Dandona PhD, Prof S D Dharmaratne MD, N M Martinez MPSA, B K Mayala PhD, T Mestrovic PhD, A H Mokdad PhD, Prof C J L Murray DPhil, Prof M Naghavi PhD, E E Spurlock MPH, C A Welgan BS, Prof M Brauer DSc, Prof S I Hay FMedSci, R C Reiner Jr PhD), Department of Health Metrics Sciences, School of Medicine (Prof R Dandona, Prof S D Dharmaratne, A H Mokdad, Prof C J L Murray, Prof M Naghavi, Prof S I Hay, R C Reiner Jr), University of Washington, Seattle, WA, USA; Department of Epidemiology, Emory University, Atlanta, GA, USA (A Deshpande MPH); Department of Epidemiology (K E Wiens PhD), Department of Radiology and Radiological Science (N Hafezi-Nejad MD, S Sheikhbahaei MD), Johns Hopkins University, Baltimore, MD, USA; Social Determinants of Health Research Center (M Abbasi-Kangevari MD), Injury Prevention and Safety Promotion Research Center (T Yousefinezhadi PhD), Shahid Beheshti University of Medical Sciences, Tehran, Iran (M Khayamzadeh MD); Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran (A Abdoli PhD); Research Center for Immunodeficiencies (H Abolhassani PhD, Prof N Rezaei PhD), Multiple Sclerosis Research Center (S Eskandarieh PhD), School of Medicine (N Hafezi-Nejad MD), Department of Environmental Health Engineering (Prof A Maleki PhD), Digestive Diseases Research Institute (Prof R Malekzadeh MD, S G Sepanlou MD), Department of Epidemiology and Biostatistics (M Mansournia PhD), Water Quality Research Center (R Mirzaei PhD), Metabolomics and Genomics Research Center (F Rahim PhD), Non-communicable Diseases Research Center (N Rezaei PhD, S Saeedi Moghaddam MSc), Endocrinology and Metabolism Research Institute (N Rezaei PhD), Tehran University of Medical Sciences, Tehran, Iran; Department of Biosciences and Nutrition, Karolinska University Hospital, Huddinge, Sweden (H Abolhassani PhD); Department of Pediatric Dentistry (Prof L G Abreu PhD), Department of Maternal and Child Nursing and Public Health (Prof D C Malta PhD), Department of Clinical Medicine (Prof B R Nascimento PhD), Clinical Hospital (Prof B R Nascimento PhD), Federal University of Minas Gerais, Belo Horizonte, Brazil; Department of Research, Philippine Institute for Development Studies, Quezon City, Philippines (M R M Abrigo PhD); Institute of Community and Public Health, Birzeit University, Ramallah, Palestine (Prof N M Abu-Rmeileh PhD); Department of Obstetrics & Gynecology, University of Texas, Galveston, TX, USA (V Adekanmbi PhD); Trivedi School of Biosciences, Ashoka University, Sonipat, India (Prof A Agrawal PhD); Section of General Internal Medicine, Baylor College of Medicine, Houston, TX, USA (Prof A Agrawal); Department of Epidemiology, Jimma University, Jimma, Ethiopia (M B Ahmed MPH); Australian Center for Precision Health, University of South Australia, Adelaide, SA, Australia (M B Ahmed); John T Milliken Department of Internal Medicine, Washington University in St Louis, St Louis, MO, USA (Z Al-Aly MD); Clinical Epidemiology Center, US Department of Veterans Affairs, St Louis, MO, USA (Z Al-Aly); Environmental Health Department (S M A Dahlawi PhD), Forensic Medicine Division (Prof R G Menezes MD), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia (F M Alanezi PhD); Center for Health Systems Research (J E Alcalde-Rabanal PhD), Center for Nutrition and Health Research (E Denova-Gutiérrez DSc), National Institute of Public Health, Cuernavaca, Mexico; Health Management and Economics Research Center (V Alipour PhD, J Arabloo PhD, A Rezapour PhD), Department of Health Economics (V Alipour), Hospital Management Research Center (S Azari PhD), Department of Medical Laboratory Sciences (F Dorostkar PhD), Minimally Invasive Surgery Research Center (A Kabir MD), Comprehensive Research Laboratory (R Mirzaei PhD), Preventive Medicine and Public Health Research Center (M Moradi-Lakeh MD), Iran University of Medical Sciences, Tehran, Iran; Pediatric Intensive Care Unit (K A Altirkawi MD, M Temsah MD), Internal Medicine Department (Y Mohammad MD), King Saud University, Riyadh, Saudi Arabia; Research Group in Hospital Management and Health Policies (Prof N Alvis-Guzman PhD), Department of Economic Sciences (N J Alvis-Zakzuk MSc), Universidad de la Costa (University of the Coast), Barranquilla, Colombia; 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Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland (T J Meretoja MD); University of Helsinki, Helsinki, Finland (T J Meretoja); University Centre Varazdin, University North, Varazdin, Croatia (T Mestrovic PhD); Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland (I Michalek PhD); Internal Medicine Programme, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan (Prof E M Mirrakhimov PhD); Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan (Prof E M Mirrakhimov); Institute of Addiction Research, Frankfurt University of Applied Sciences, Frankfurt, Germany (B Moazen MSc); Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran (A Mohammadian-Hafshejani PhD); Health Systems and Policy Research Unit (S Mohammed PhD), Department of Community Medicine (M B Sufiyan MD), Ahmadu Bello University, Zaria, Nigeria; Department of Health Care Management, Technical University of Berlin, Berlin, Germany (S Mohammed PhD); Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy (L Monasta DSc, L Ronfani PhD, E Traini MSc); Computer, Electrical, and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia (P Moraga PhD); International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD, Australia (Prof L Morawska PhD); Department of Clinical Biochemistry (A Mosapour PhD), Social Determinants of Health Research Center (S Mouodi PhD), Babol University of Medical Sciences, Babol, Iran; Department of Fruit and Vegetable Product Technology, Prof Wacław Dąbrowski Institute of Agricultural and Food Biotechnology State Research Institute, Warsaw, Poland (Prof A Mousavi Khaneghah PhD); Department of Endocrinology & Metabolism, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India (Prof S Mukhopadhyay MD); Scientific Communications Department, Invitae, Boulder, CO, USA (S B Munro PhD); Research and Analytics Department, Initiative for Financing Health and Human Development, Chennai, India (A J Nagarajan MTech); Department of Research and Analytics, Bioinsilico Technologies, Chennai, India (A J Nagarajan); Department of Pulmonary Medicine, Government Medical College Trivandrum, Trivandrum, India (S Nair MD); Health Action by People, Trivandrum, India (S Nair); Suraj Eye Institute, Nagpur, India (V Nangia MD); Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran (J Nazari MD); Department of General Surgery (I Negoi PhD), Emergency Hospital of Bucharest, Bucharest, Romania; College of Medicine and Health Sciences, Bahir Dar University, Gondar, Ethiopia (H B Netsere MS); Department of Biological Sciences, University of Embu, Embu, Kenya (J W Ngunjiri DrPH); Institute for Global Health Innovations, Duy Tan University, Hanoi, Viet Nam (H L T Nguyen MPH); Administrative and Economic Sciences Department (Prof B Oancea PhD), University of Bucharest, Bucharest, Romania; Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia (F A Ogbo PhD); Department of Preventive Medicine, Kyung Hee University, Dongdaemun-gu, South Korea (I Oh PhD); Department of Psychiatry and Behavioural Neurosciences (A T Olagunju MD), Population Health Research Institute (T Sathish PhD), McMaster University, Hamilton, ON, Canada; Department of Psychiatry, University of Lagos, Lagos, Nigeria (A T Olagunju MD); Centre for Healthy Start Initiative, Lagos, Nigeria (B O Olusanya PhD, J O Olusanya MBA); Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria (Prof O E Onwujekwe PhD); Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia (N Otstavnov BA, S S Otstavnov PhD); Department of Project Management, National Research University Higher School of Economics, Moscow, Russia (S S Otstavnov PhD); Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India (Prof M P A DNB); Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea (Prof E Park PhD); Department of Poverty, Gender and Youth, Population Council, New Delhi, India (S K Patel PhD); Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Viet Nam (H Q Pham MD, G T Vu BA); Department of Cardiology, University of Bern, Bern, Switzerland (T Pilgrim MD); HIV and Mental Health Department, Integrated Development Foundation Nepal, Kathmandu, Nepal (K N Pokhrel PhD); University Medical Center Groningen (Prof M J Postma PhD), School of Economics and Business (Prof M J Postma PhD), University of Groningen, Groningen, Netherlands; School of Engineering, Macquarie University, Sydney, NSW, Australia (N Rabiee PhD); Pohang University of Science and Technology, Pohang, South Korea (N Rabiee); College of Medicine, University of Central Florida, Orlando, FL, USA (A Radfar MD); Department of Community Medicine, Maharishi Markandeshwar Medical College & Hospital, Solan, India (M Rahman PhD); School of Nursing and Healthcare Professions, Federation University Australia, Berwick, VIC, Australia (M Rahman); Future Technology Research Center, National Yunlin University of Science and Technology, Yunlin, Taiwan (A Rahmani PhD); Research Department, Policy Research Institute, Kathmandu, Nepal (C L Ranabhat PhD); Health and Public Policy Department, Global Center for Research and Development, Kathmandu, Nepal (C L Ranabhat PhD); Department of Oral Pathology, Sharavathi Dental College and Hospital, Shimogga, India (S Rao MDS); Department of Forensic Medicine and Toxicology (Prof P Rastogi MD), Kasturba Medical College (Prof B Unnikrishnan MD), Manipal Academy of Higher Education, Mangalore, India; University College London Hospitals, London, UK (D L Rawaf MD); Academic Public Health England, Public Health England, London, UK (Prof S Rawaf MD); School of Health, Medical and Applied Sciences, CQ University, Sydney, NSW, Australia (L Rawal PhD); School of Medicine and Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia (Prof A M N Renzaho PhD); Department of Health Information Management (B Reshmi PhD), Department of Community Medicine (R S Shetty MD), Manipal Academy of Higher Education, Manipal, India; Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network, Tehran, Iran (Prof N Rezaei PhD); Department of Surgery, University of Minnesota, Minneapolis, MN, USA (J Rickard MD); Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda (J Rickard); Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil (L Roever PhD); School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran (M Rostamian PhD); African Genome Center, Mohammed VI Polytechnic University (UM6P), Ben Guerir, Morocco (E Rubagotti PhD); Center for Research in Congenital Anomalies and Rare Diseases, ICESI University (Centro de Investigaciones en Anomalías Congénitas y Enfermedades Raras, Universidad Icesi), Cali, Colombia (E Rubagotti); Department of Internal Medicine, University of Botswana, Gaborone, Botswana (G M Rwegerera MD); Sharjah Institute for Medical Research (B Saddik PhD), University of Sharjah, Sharjah, United Arab Emirates; Applied Biomedical Research Center and Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran (A Sahebkar PhD); Department of Public Health, Madda Walabu University, Bale Robe, Ethiopia (B Sahiledengle MPH); Department of Entomology (A M Samy PhD), Department of Neurology (Prof A S Shalash PhD), Ain Shams University, Cairo, Egypt; Independent Consultant, Thiruvananthapuram, India (S Y Saraswathy PhD); Geriatric and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar (B Sathian PhD); Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK (B Sathian PhD); Department of Psychology (D C Schwebel PhD), School of Medicine (Prof J A Singh MD), University of Alabama at Birmingham, Birmingham, AL, USA; Public Health Division, An-Najah National University, Nablus, Palestine (A A Shaheen PhD); Department of Internal Medicine, Ziauddin University, Karachi, Pakistan (I Shahid MBBS); Independent Consultant, Karachi, Pakistan (M A Shaikh MD); School of Medicine, Alborz University of Medical Sciences, Karaj, Iran (M Shams-Beyranvand MSc); Symbiosis Medical College for Women, Symbiosis International University, Pune, India (M Shannawaz PhD); Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK (Prof A Sheikh MD); National Institute of Infectious Diseases, Tokyo, Japan (M Shigematsu PhD); Department of Public Health Dentistry, Krishna Institute of Medical Sciences Deemed to be University, Karad, India (Prof K M Shivakumar PhD); School of Health, University of Technology Sydney, Sydney, NSW, Australia (S Siabani PhD); Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (T J Siddiqi MB); School of Public Health & Zoonoses, Guru Angad Dev Veterinary & Animal Sciences University, Ludhiana, India (B B Singh PhD); Medicine Service, US Department of Veterans Affairs, Birmingham, AL, USA (Prof J A Singh MD); Department of Midwifery, Dire Dawa University, Dire Dawa, Ethiopia (Y Sintayehu MSc); Department of Public Health, Arba Minch University, Arba Minch, Ethiopia (M B Sorrie MPH); Hull York Medical School, University of Hull, Hull, UK (I N Soyiri PhD); Division of Community Medicine, International Medical University, Kuala Lumpur, Malaysia (C T Sreeramareddy MD); Occupational and Environmental Medicine Department, University of Gothenburg, Gothenburg, Sweden (L Stockfelt PhD); National Institute of Epidemiology, Indian Council of Medical Research, Chennai, India (R Suliankatchi Abdulkader MD); Department of Medicine, University of Valencia, Valencia, Spain (Prof R Tabarés-Seisdedos PhD); Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network, Madrid, Spain (Prof R Tabarés-Seisdedos PhD); Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan (T Tabuchi MD); Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran (A Taherkhani PhD); Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, India (Prof K R Thankappan MD); Modestum, London, UK (M R Tovani-Palone PhD); Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India (E Upadhyay PhD); Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran (S Valadan Tahbaz PhD, S Yahyazadeh Jabbari MD); Department of Microbiology, Islamic Azad University, Tehran, Tehran, Iran (S Valadan Tahbaz PhD); Department of Nephrology, Christian Medical College and Hospital, Vellore, India (Prof S Varughese FRCP); Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy (Prof F S Violante MD); Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy (Prof F S Violante); Faculty of Information Technology, HUTECH University, Ho Chi Minh City, Viet Nam (B Vo PhD); Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan (Prof Y Waheed PhD); Demographic Change and Aging Research Area, Federal Institute for Population Research, Wiesbaden, Germany (A Werdecker PhD); Health Services Management Research Center, Kerman University of Medical Sciences, Kerman, Iran (V Yazdi-Feyzabadi PhD); Department of Health Management, Policy, and Economics, Kerman University of Medical Sciences, Kerman, Iran (V Yazdi-Feyzabadi); Department of Public Health, Wollega University, Nekemte, Ethiopia (M T Yilma MPH); Department of Neuropsychopharmacology, National Center of Neurology and Psychiatry, Kodaira, Japan (N Yonemoto PhD); Department of Public Health, Juntendo University, Tokyo, Japan (N Yonemoto PhD); Department of Health Policy and Management, Jackson State University, Jackson, MS, USA (Prof M Z Younis PhD); School of Business & Economics, University Putra Maylisia, Kuala Lumpur, Malaysia (Prof M Z Younis PhD); Department of Epidemiology and Biostatistics (Prof C Yu PhD), School of Medicine (Z Zhang PhD), Wuhan University, Wuhan, China; School of Public Health and Management, Hubei University of Medicine, Shiyan, China (Y Yu MS); Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh (S Zaman MPH); School of Public Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China (Y Zhang PhD); School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada (Prof M Brauer DSc). Declaration of interests R Ancuceanu reports consultancy or speakers’ fees from UCB, Sandoz, Abbvie, Zentiva, Teva, Laropharm, CEGEDIM, Angelini, B Braun, Biessen Pharma, Hofigal, AstraZeneca, and Stadam. M L Bell reports grants or contracts from the US Environmental Protection Agency, National Institutes of Health, High Tide Foundation, Yale Climate Change and Health Center, Robert Wood Johnson Foundation, Environmental Defense Fund, Health Effects Institute and the Wellcome Trust, all as payments to their institution; consulting fees from the Environmental Protection Agency as personal payments for membership on the Clean Air Scientific Advisory Committee; payment or honoraria for lectures, presentations, speakers bureaus, grant reviews, manuscript writing, external advisory committees, or educational events from Boston University, Korea University, the Organization of Teratology Information Specialists, the NIH, Health Canada, PAC-10, UK Research Institute, Harvard University, and the University of Montana; support for attending meetings or travel from Boston University, Harvard University, University of Illinois at Champaign, and the University of Texas; participation on a data safety monitoring board or advisory board with National Academies Panels and Committees; membership of Lancet Countdown, Fifth National Climate Assessment, Johns Hopkins University Deptartment of Environmental Health and Engineering Advisory Board, WHO Global Air Pollution and Health Technical Advisory group, and the US Environmental Protection Agency Clean Air Scientific Advisory Board. J M Castaldelli-Maia reports grants from the French National Institute for Cancer and Pfizer and consulting fees from L’Oreal for participation on international multidisciplinary scientific boards around skin conditions and mental wellness. A Deshpande reports consulting fees from Epidemiology Research & Methods. SMS Islam reports grants from the National Heart Foundation of Australia and from the Australian National Health and Medical Research Council. K Krishan reports non-financial support from UGC Centre of Advanced Study, CAS II, Department of Anthropology, Panjab University, Chandigarh, India. P W Mahasha reports leadership or fiduciary roles or membership in the Federation of Infectious Diseases Societies of Southern Africa, the EU-Africa PerMed Consortium, the South African Society for Biochemistry and Molecular, the International Society for Infectious Diseases, the Global Burden of Disease Collaborator Network, the South African Society of Microbiology, the COVID-19 Clinical Research Coalition, the Scholars Academic and Scientific Society, and the South African Council for Natural Scientific Professions. S Mohammed reports support from the Bill & Melinda Gates Foundation and a fellowship grant from the Alexander von Humboldt Foundation. S B Munro reports stock in Invitae and other financial or non-financial interests as an employee of Invitae. T Pilgrim reports grants or contracts from Biotronik, Boston Scientific, and Edwards Lifesciences as personal payments; participation on a data safety monitoring board or advisory board with Highlife SAS on the Clinical Event Adjudication Committee; and other financial and non-financial interests with Boston Scientific and Medtronic for proctoring. M J Postma reports stock or stock options in Health-Ecore (25%) and Pharmacoeconomics Advice Groningen (100%). A Radfar reports financial or non-financial support from Avicenna Medical and Clinical Research Institute. E Upadhyay reports published patents for “a system and method of reusable filters for anti-pollution mask” and “a system and method for electricity generation through crop stubble by using microbial fuel cells”, and filed patents for “a system for disposed personal protection equipment (PPE) into biofuel through pyrolysis and method” and “a novel herbal pharmaceutical aid for formulation of gel and method thereof” and is Joint Secretary of the Indian Meteorological Society, (Jaipur Chapter).

Figures

Figure 1
Figure 1
Prevalence of, and change from 2000 to 2018, in solid-fuel use, household air pollution, total air pollution, and deaths attributable to LRTI in children younger than 5 years in low-income and middle-income countries (A) Mean prevalence of solid-fuel use for cooking, 2018 (as indicated by primary fuel type). (B) Total concentration of PM2·5 in air by source, 2018. (C) Mean number of deaths from LRTIs (per 1000 children younger than 5 years) attributable to total concentration of PM2·5 in air, 2018. (D) Overlapping terciles of mean risk-weighted prevalence (SEV) of HAP in 2018 and relative uncertainty. These data were used for our projections of SDG attainment in 2030. (E) Percentage change in mean proportion of solid-fuel use for cooking, 2000 to 2018. (F) Percentage change in total concentration of PM2·5 in air, 2000 to 2018. (G) Percentage change in the proportion of LRTI deaths (per 1000 children younger than 5 years) attributable to total concentration of PM2·5 in air, 2000 to 2018. (H) Probability of attaining SDG 7.1 by 2030. All panels are aggregated to the second administrative-level unit. Maps reflect administrative boundaries, land cover, lakes, and population. Grey-coloured grid cells had fewer than ten people per 1 km × 1 km grid cell and were classified as barren or sparsely vegetated, or not included in this analysis. HAP=household air pollution. PM2·5=particulate matter of less than 2·5 μm in diameter. SEV=summary exposure value. LRTI=lower respiratory tract infection. SDG=Sustainable Development Goal.
Figure 2
Figure 2
Geographical variations in the prevalence of solid-fuel use for cooking in 98 low-income and middle-income countries Each bar represents the range of the prevalence of solid-fuel use for cooking (as represented by primary fuel type) across all districts within each country. The Xs and dashed bars represent the mean and range in 2000, whereas the dots and solid bars represent the mean and range in 2018. Countries are grouped according to geographical region and coloured according to the Global Burden of Disease 2019 super-regions (see inset thumbnail). Each country is labelled by its ISO-3 code.
Figure 3
Figure 3
Projections of the probability of attainment of SDG 7.1 by 2030 Progress towards SDG 7.1 was monitored by estimating access to clean cooking fuel across the study period, calculating the annualised rate of change and forecasting to 2030. The bars represent the share of population living in districts that were projected (with 95% certainty) to be above (negative values) or below (positive values) a threshold of 5% for attainment in 2030. The translucent, lighter-coloured sections of the bars represent projections in districts with less certainty (greater than 50%, but less than 95%). The bars are coloured according to Global Burden of Disease 2019 super-regions (see inset thumbnail). Only the 48 countries where at least one district was projected to be above the threshold and at least one was projected to be below the threshold were included. Each country is labeled by its ISO-3 code. SDG=Sustainable Development Goal.
Figure 4
Figure 4
All-age population (A) and LRTI deaths attributable to total PM2·5 concentrations in air in children younger than 5 years (B) in 2000 and 2018, distributed as a function of PM2·5 Within each distribution, the darker shading represents the portion of air pollution contributed by household sources, whereas the lighter shading represents the portion contributed by ambient sources. The plotted data represent local smoothing of normalised distributions that were computed over 400 logarithmically spaced bins. The dashed vertical line indicates WHO's interim threshold for PM2·5 air pollution (35 μg/m3). The y-axis labels provide the total area under the curve. Data for all other LMICs included in the study are broken down by country in the appendix (p 42). LRTI=lower respiratory tract infection. HAP=household air pollution. AAP=ambient air pollution. PM2·5=particulate matter of less than 2·5 μm in diameter. LMICs=low-income and middle-income countries.
Figure 5
Figure 5
Air pollution risk transition, 2000–18 (A) Trends in the proportion of LRTI deaths attributed to total air pollution at the second administrative unit (district) level in five low-income and middle-income countries. These countries were chosen to exemplify different stages of air-pollution risk transition (all other countries included in the study are illustrated in the appendix [p 63]). The y-axis rugs indicate the gradient of background LRTI mortality rates for 2000 (left) and 2018 (right), illustrating the correlation between LRTI rates and the fraction attributable to total ambient air pollution. The lines connect a district to its preceding timepoint across the series. (B) Countries with the highest LRTI mortality in 2000 for each Global Burden of Disease subregion. The grey contours represent district-level distributions in 2000, whereas the navy represents distributions in 2018. In Thailand and South Africa, for example, reductions in household air pollution have resulted in less than a quarter of LRTIs being attributable to air pollution, whereas in China and India, similar reductions have been counteracted by rising ambient air pollution concentrations, which means that a larger share of LRTI deaths in children younger than 5 years continue to be attributable to total air pollution. LRTI=lower respiratory tract infection.
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References

    1. WHO . World Health Organization; Geneva: 2014. WHO guidelines for indoor air quality: household fuel combustion. - PubMed
    1. Anderson HR. Respiratory abnormalities in Papua New Guinea children: the effects of locality and domestic wood smoke pollution. Int J Epidemiol. 1978;7:63–72. - PubMed
    1. Smith KR, Samet JM, Romieu I, Bruce N. Indoor air pollution in developing countries and acute lower respiratory infections in children. Thorax. 2000;55:518–532. - PMC - PubMed
    1. Landrigan PJ, Fuller R, Acosta NJR, et al. The Lancet Commission on pollution and health. Lancet. 2018;391:462–512. - PubMed
    1. Zhao B, Zheng H, Wang S, et al. Change in household fuels dominates the decrease in PM2·5 exposure and premature mortality in China in 2005–2015. Proc Natl Acad Sci USA. 2018;115:12401–12406. - PMC - PubMed

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