Interventions to mitigate indoor air pollution: A cost-benefit analysis.
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ABSTRACT:
SUBMITTER: Irfan M
PROVIDER: S-EPMC8462720 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Recent intervention studies targeted at reducing indoor air pollution have demonstrated both the ability to improve respiratory health outcomes and to reduce particulate matter (PM) levels in the home. However, these studies generally do not address whether it is the reduction of PM levels specifically that improves respiratory health. In this paper we apply the method of principal stratification to data from a randomized air cleaner intervention designed to reduce indoor PM in homes of children with asthma. We estimate the health benefit of the intervention amongst study subjects who would experience a substantial reduction in PM in response to the intervention. For those subjects we find an increase in symptom-free days that is almost three times as large as the overall intention-to-treat effect. We also explore the presence of treatment effects amongst those subjects whose PM levels would not respond to the air cleaner. This analysis demonstrates the usefulness of principal stratification for environmental intervention trials and its potential for much broader application in this area.
| S-EPMC5042208 | biostudies-literature
Project description:BackgroundIndoor air quality represents a modifiable exposure to Chronic Obstructive Pulmonary Disease (COPD) health. In a randomized controlled trial (CLEAN AIR study), air cleaner assignment had causal effect in improving COPD outcomes. It is unclear, however, what is the treatment effect among those for whom intervention reduced air pollution and whether it was reduction in fine particulate matter (PM2.5) or nitrogen dioxide (NO2) that contributed to such improvement. Because pollution is a posttreatment variable, treatment effect cannot be assessed while controlling for pollution using intention-to-treat (ITT) analysis.ObjectiveUsing principal stratification method, we assess indoor pollutants as the intermediate variable, and determine the causal effect of reducing indoor air pollution on COPD health.MethodIn randomized controlled trial, former smokers with COPD received either active or placebo HEPA air cleaners and were followed for 6 months. Saint George's Respiratory Questionnaire (SGRQ) was the primary outcome and secondary measures included SGRQ subscales, COPD assessment test (CAT), dyspnea (mMRC), and breathlessness, cough, and sputum scale (BCSS). Indoor PM2.5 and NO2 were measured. Principal stratification analysis was performed to assess the treatment effect while controlling for pollution reduction.ResultsAmong those showing at least 40 % PM2.5 reduction through air cleaners, the intervention showed improvement in respiratory symptoms for the active (vs. placebo), and the size of treatment effect shown for this subgroup was larger than that for the overall sample. In this subgroup, those with active air cleaners (vs. placebo) showed 7.7 points better SGRQ (95%CI: -14.3, -1.1), better CAT (β = -5.5; 95%CI: -9.8, -1.2), mMRC (β = -0.6; 95%CI: -1.1, -0.1), and BCSS (β = -1.8; 95%CI: -3.0, -0.5). Among those showing at least 40 % NO2 reduction through air cleaners, there was no intervention difference in outcomes.ConclusionAir cleaners caused clinically significant improvement in respiratory health for individuals with COPD through reduction in indoor PM2.5.Trial registrationClinicalTrials.gov: NCT02236858.
| S-EPMC9975085 | biostudies-literature
Project description:BackgroundTobacco smoking, passive smoking, and indoor air pollution from biomass fuels have been implicated as risk factors for tuberculosis (TB) infection, disease, and death. Tobacco smoking and indoor air pollution are persistent or growing exposures in regions where TB poses a major health risk. We undertook a systematic review and meta-analysis to quantitatively assess the association between these exposures and the risk of infection, disease, and death from TB.Methods and findingsWe conducted a systematic review and meta-analysis of observational studies reporting effect estimates and 95% confidence intervals on how tobacco smoking, passive smoke exposure, and indoor air pollution are associated with TB. We identified 33 papers on tobacco smoking and TB, five papers on passive smoking and TB, and five on indoor air pollution and TB. We found substantial evidence that tobacco smoking is positively associated with TB, regardless of the specific TB outcomes. Compared with people who do not smoke, smokers have an increased risk of having a positive tuberculin skin test, of having active TB, and of dying from TB. Although we also found evidence that passive smoking and indoor air pollution increased the risk of TB disease, these associations are less strongly supported by the available evidence.ConclusionsThere is consistent evidence that tobacco smoking is associated with an increased risk of TB. The finding that passive smoking and biomass fuel combustion also increase TB risk should be substantiated with larger studies in future. TB control programs might benefit from a focus on interventions aimed at reducing tobacco and indoor air pollution exposures, especially among those at high risk for exposure to TB.
| S-EPMC1769410 | biostudies-literature
Project description:Infants spend most of their indoor time at home; however, residential air quality is poorly understood. We investigated the air quality of infants' homes in the New England area of the U.S. Participants (N = 53) were parents of infants (0-6 months) who completed telephone surveys to identify potential pollutant sources in their residence. Carbon monoxide (CO), carbon dioxide (CO(2)), particulate matter with aerodynamic diameter ≤0.5 µm (PM(0.5)), and total volatile organic compounds (TVOCs) were measured in 10 homes over 4-7 days, and levels were compared with health-based guidelines. Pollutant levels varied substantially across homes and within homes with overall levels for some homes up to 20 times higher than for other homes. Average levels were 0.85 ppm, 663.2 ppm, 18.7 µg/m(3), and 1626 µg/m(3) for CO, CO(2), PM(0.5), and TVOCs, respectively. CO(2), TVOCs, and PM(0.5) levels exceeded health-based indoor air quality guidelines. Survey results suggest that nursery renovations and related potential pollutant sources may be associated with differences in urbanicity, income, and presence of older children with respiratory ailments, which could potentially confound health studies. While there are no standards for indoor residential air quality, our findings suggest that additional research is needed to assess indoor pollution exposure for infants, which may be a vulnerable population.
| S-EPMC3290986 | biostudies-literature
Project description:Because most people spend the majority of their time in microenvironments, indoor air pollution (IAP) has gained more attention than outdoor air pollution recently. It is indeed crucial to understand IAP sources and the factors that influence human exposure. We synthesized evidence on IAP levels and contributing factors in Ethiopia from available literature, utilizing findings from 19 studies to retrieve 66 relevant values. Particulate matters (PM2.5, PM4, PM10, and TSP), as well as gaseous pollutants such as carbon monoxide (CO), nitrogen dioxide (NO2), polyaromatic hydrocarbons (PAHs), and total volatile organic compounds (TVOCs), were analyzed. The calculated mean concentrations for PM2.5, PM10, NO2, TVOCs, and CO were 477.47 μg/m3, 228.38 μg/m3, 63.84 μg/m3, 1361.79 μg/m3, and 18.82 ppm, respectively, all of which exceeded the annual WHO exposure guidelines. Geographical location, stove type, and household activities showed a variation in pollutants concentration. The higher levels of pollutants were attributed to emissions from biomass fuel used for baking injera, wot preparation, and conducting a coffee ceremony, as well as poor ventilation, season, cooking time, and tobacco smoke. The health risk assessments for exposure to various domestic activities were found to be acceptable, except for PM10, with the highest correlation with an acute respiratory infection. Although improved cookstove technology has been proposed as a sustainable energy source, investigations in Ethiopia have revealed that there is still room for public health protection. There is a paucity of research on the relationship between indoor and outdoor air pollution. Future research should prioritize these issues, with a focus on the link between IAP exposure and health effects. In conclusion, there is a higher IAP concentration in Ethiopia so the community should be made aware of it as well as related health effects, and immediate mitigation measures are needed to achieve a reduction in exposure.
| S-EPMC9674910 | biostudies-literature
Project description:Indoor air pollution (IAP) is a serious threat to human health, causing millions of deaths each year. A plethora of pollutants can result in IAP; therefore, it is very important to identify their main sources and concentrations and to devise strategies for the control and enhancement of indoor air quality (IAQ). Herein, we provide a critical review and evaluation of the major sources of major pollutant emissions, their health effects, and issues related to IAP-based illnesses, including sick building syndrome (SBS) and building-related illness (BRI). In addition, the strategies and approaches for control and reduction of pollutant concentrations are pointed out, and the recent trends in efforts to resolve and improve IAQ, with their respective advantages and potentials, are summarized. It is predicted that the development of novel materials for sensors, IAQ-monitoring systems, and smart homes is a promising strategy for control and enhancement of IAQ in the future.
| S-EPMC7215772 | biostudies-literature
Project description:This study examines characteristics of atmospheric methylsiloxane pollution in indoor settings where interior renovation/redecoration is being undertaken, in addition to ordinary family homes and inside family cars. Concentrations of atmospheric methylsiloxane in these locations were approximately one order of magnitude higher than that in outdoor areas. The average indoor concentration of methylsiloxane where renovation was being undertaken was 9.4 ?g/m3, which is slightly higher than that in an ordinary family home (7.88 ?g/m3), while samples from family cars showed lower concentration (3.10 ?g/m3). The indoor atmospheric concentration during renovation/redecoration work was significantly positively correlated with the duration of the work. The structure of atmospheric methylsiloxane pollution is basically the same in these three venues. The concentration of annulus siloxane was much higher than that of linear compounds (85% of the total methylsiloxane concentrations). Household dust in average family homes showed total methylsiloxane concentration of 9.5 ?g/m3 (average); the structure mainly consisted of linear siloxane (approximately 98% of total concentration), thereby differing from that of atmospheric methylsiloxane pollution. The comparatively high concentration of methylsiloxane in these three venues indicates that interior renovation and decoration work, and even travelling in cars, can involve exposure to more serious siloxane contamination during everyday activities.
| S-EPMC4539186 | biostudies-literature
Project description:Chinese cooking features several unique processes, e.g., stir-frying and pan-frying, which represent important sources of household air pollution. However, factors affecting household air pollution and the vertical variations of indoor pollutants during Chinese cooking are less clear. Here, using low-cost sensors with high time resolutions, we measured concentrations of five gas species and particulate matter (PM) in three different sizes at multiple heights in a kitchen during eighteen different Chinese cooking events. We found indoor gas species were elevated by 21%-106% during cooking, compared to the background, and PMs were elevated by 44%-159%. Vertically, the pollutants concentrations were highly variable during cooking periods. Gas species generally showed a monotonic increase with height, while PMs changed more diversely depending on the cooking activity's intensity. Intense cooking, e.g., stir-frying, pan-frying, or cooking on high heat, tended to shoot PMs to the upper layers, while moderate ones left PMs within the breathing zone. Individuals with different heights would be subject to different levels of household air pollution exposure during cooking. The high vertical variability challenges the current indoor standard that presumes a uniform pollution level within the breathing zone and thus has important implications for public health and policy making.
| S-EPMC9500372 | biostudies-literature
Project description:BackgroundA growing body of research suggests exposure to high levels of outdoor air pollution may negatively affect cognitive functioning in older adults, but less is known about the link between indoor sources of air pollution and cognitive functioning. We examine the association between exposure to indoor air pollution and cognitive function among older adults in Mexico, a developing country where combustion of biomass for domestic energy remains common.MethodData come from the 2012 Wave of the Mexican Health and Aging Study. The analytic sample consists of 13 023 Mexican adults over age 50. Indoor air pollution is assessed by the reported use of wood or coal as the household's primary cooking fuel. Cognitive function is measured with assessments of verbal learning, verbal recall, attention, orientation and verbal fluency. Ordinary least squares regression is used to examine cross-sectional differences in cognitive function according to indoor air pollution exposure while accounting for demographic, household, health and economic characteristics.ResultsApproximately 16% of the sample reported using wood or coal as their primary cooking fuel, but this was far more common among those residing in the most rural areas (53%). Exposure to indoor air pollution was associated with poorer cognitive performance across all assessments, with the exception of verbal recall, even in fully adjusted models.ConclusionsIndoor air pollution may be an important factor for the cognitive health of older Mexican adults. Public health efforts should continue to develop interventions to reduce exposure to indoor air pollution in rural Mexico.
| S-EPMC5796803 | biostudies-literature
Project description:In the last decade, a number of quantitative epidemiological studies of specific diseases have been done in developing countries that for the first time allow estimation of the total burden of disease (mortality and morbidity) attributable to use of solid fuels in adult women and young children, who jointly receive the highest exposures because of their household roles. Few such studies are available as yet for adult men or children over 5 years. This paper evaluates the existing epidemiological studies and applies the resulting risks to the more than three-quarters of all Indian households dependent on such fuels. Allowance is made for the existence of improved stoves with chimneys and other factors that may lower exposures. Attributable risks are calculated in reference to the demographic conditions and patterns of each disease in India. Sufficient evidence is available to estimate risks most confidently for acute respiratory infections (ARI), chronic obstructive pulmonary disease (COPD), and lung cancer. Estimates for tuberculosis (TB), asthma, and blindness are of intermediate confidence. Estimates for heart disease have the lowest confidence. Insufficient quantitative evidence is currently available to estimate the impact of adverse pregnancy outcomes (e.g., low birthweight and stillbirth). The resulting conservative estimates indicate that some 400-550 thousand premature deaths can be attributed annually to use of biomass fuels in these population groups. Using a disability-adjusted lost life-year approach, the total is 4-6% of the Indian national burden of disease, placing indoor air pollution as a major risk factor in the country.
| S-EPMC27217 | biostudies-literature