Since the middle of the 20th century, fighting air pollution has been a primary goal of the growing environmental movement in the United States and around the world. Encounters with smog and toxic gases inspired waves of public anger and protest that led to Clean Air Acts being passed in several countries and a steady progression toward tighter standards. But most of these efforts have concentrated on pollutants in the air outside the home produced by factories, automobiles, and other industrial sources. Meanwhile, another source of air pollution closer to home has gone unnoticed, even as it causes potentially millions of death in the developing world.
The main cause of indoor air pollution, explains Sola Olopade, professor of medicine at the University of Chicago Medical Center, is the burning of biomass for cooking food. In impoverished areas without access to electricity, people resort to using firewood, agricultural residue, and even cow dung as fuel for their kitchen stoves. In structures with poor ventilation, the burning of these items can create a high concentration of toxic fumes with serious health effects for those exposed.
“The problem is when you use firewood to cook, the smoke from it contains a lot of polluted dust that is carcinogenic and can also lead to airway damage and infection,” said Olopade, who is also clinical director of the University of Chicago Global Health Initiative. “When you look at it globally, there are about 3 billion people, mostly women and children, who are exposed to indoor pollution from using firewood to cook.”
The World Health Organization estimates that indoor air pollution is responsible for roughly 1.6 million deaths each year, from acute lower respiratory infections, chronic obstructive pulmonary disease, lung cancer, and other diseases. Half of those deaths are children, and nearly a third are children under the age of five, Olopade said.
“To put it in the right context, indoor pollution from biomass contributes to about 2.6 percent of the global burden of disease, actually kills more people every year than HIV and maybe even malaria, and yet nobody knows about it,” Olopade said. “So if we can accomplish bringing sensitivity or attention to this problem, and use it to influence policy and help people who are poor and would otherwise have no opportunity to have more efficient stoves, I think we will be very delighted.”
Just such an effort is currently underway thanks to a grant awarded to Olopade by the CHEST Foundation, an organization of American pulmonologists. Olopade has traveled back to his birth country of Nigeria to launch an effort against indoor air pollution in three rural communities named Eruwa, Igo-Ora, and Abanla. While doing a previous study on asthma in Nigeria, Olopade said he found that an overwhelming number of asthmatic children experienced high concentrations of toxic fumes at home.
“Growing up in Nigeria, I was aware that people used firewood to cook, but usually in open spaces outside. I really had no idea of the ill effect,” Olopade said. “But as a pulmonologist now, I guess I’m more sensitized to some of the problems related to lungs.”
The grant will fund the purchase of new stoves with better ventilation for many of the households in the community. Olopade and colleagues will also begin a campaign of education and information for residents and village leaders, hoping to inspire safer practices through word of mouth. Simultaneously, data on exposure levels and health issues will be collected to enable research on the damage caused by indoor air pollution.
“The goal is that we can do it in a scientific way with an intervention phase where we, over a 2-year period, give people clean stoves and then come back and look at some of those biomarkers of exposure and damage and be able to see whether improving air quality itself can lead to less damage,” Olopade said.
Ultimately, the best way to prevent indoor air pollution is to expand access to electricity and cleaner gases in poor, rural communities, Olopade said. But in the interim, he hopes that simple local measures can help reduce the disease burden of this invisible killer, in Eruwa, in Nigeria, and in other developing nations, such as Bangladesh and China, plagued by the problem. Ultimately, reducing the negative effects of indoor air pollution can make significant progress towards the WHO Millennium Development Goals, which seek to cut worldwide child mortality rates, he said.
“If you can eliminate mortality which is preventable from exposure to indoor pollution from biomass, most of these countries will be ahead in terms of meeting some of these Millennium Development Goals,” Olopade said. “The implications of improving or minimizing exposure to indoor pollution from biomass are really, really substantial and we hope through this effort we can improve the awareness of the dangers of this exposure.”
Photos courtesy of Sola Olopade