In the Comparative Risk Assessment (CRA) done as part of the Global Burden of Disease project (GBD-2010), the global and regional burdens of household air pollution (HAP) due to the use of solid cookfuels, were estimated along with 60+ other risk factors. This article describes how the HAP CRA was framed; how global HAP exposures were modeled; how diseases were judged to have sufficient evidence for inclusion; and how meta-analyses and exposure-response modeling were done to estimate relative risks. We explore relationships with the other air pollution risk factors: ambient air pollution, smoking, and secondhand smoke. We conclude with sensitivity analyses to illustrate some of the major uncertainties and recommendations for future work. We estimate that in 2010 HAP was responsible for 3.9 million premature deaths and ∼4.8% of lost healthy life years (DALYs), ranking it highest among environmental risk factors examined and one of the major risk factors of any type globally.

Review from JAMA Internal Medicine — Risk of Tuberculosis From Exposure to Tobacco Smoke — A Systematic Review and Meta-analysis

Background: Approximately 2.8 billion people cook with solid fuels. Research has focused on the health impacts of indoor exposure to fine particulate pollution. Here, for the 2010 Global Burden of Disease project (GBD 2010), we evaluated the impact of household cooking with solid fuels on regional population-weighted ambient PM2.5 (particulate matter ≤ 2.5 μm) pollution (APM2.5). Objectives: We estimated the proportion and concentrations of APM2.5 attributable to household cooking with solid fuels (PM2.5-cook) for the years 1990, 2005, and 2010 in 170 countries, and associated ill health. Methods: We used an energy supply–driven emissions model (GAINS; Greenhouse Gas and Air Pollution Interactions and Synergies) and source-receptor model (TM5-FASST) to estimate the proportion of APM2.5 produced by households and the proportion of household PM2.5 emissions from cooking with solid fuels. We estimated health effects using GBD 2010 data on ill health from APM2.5 exposure. Results: In 2010, household cooking with solid fuels accounted for 12% of APM2.5 globally, varying from 0% of APM2.5 in five higher-income regions to 37% (2.8 μg/m3 of 6.9 μg/m3 total) in southern sub-Saharan Africa. PM2.5-cook constituted > 10% of APM2.5 in seven regions housing 4.4 billion people. South Asia showed the highest regional concentration of APM2.5 from household cooking (8.6 μg/m3). On the basis of GBD 2010, we estimate that exposure to APM2.5 from cooking with solid fuels caused the loss of 370,000 lives and 9.9 million disability-adjusted life years globally in 2010. Conclusions: PM2.5 emissions from household cooking constitute an important portion of APM2.5 concentrations in many places, including India and China. Efforts to improve ambient air quality will be hindered if household cooking conditions are not addressed. Citation: Chafe ZA, Brauer M, Klimont Z, Van Dingenen R, Mehta S, Rao S, Riahi K, Dentener F, Smith KR. 2014. Household cooking with solid fuels contributes to ambient PM2.5 air pollution and the burden of disease. Environ Health Perspect 122:1314–1320; http://dx.doi.org/10.1289/ehp.1206340

As part of the 12th Five-Year Plan, the Chinese government has developed air pollution prevention and control plans for key regions with a focus on the power, transport, and industrial sectors. Here, we investigate the contribution of residential emissions to regional air pollution in highly polluted eastern China during the heating season, and find that dramatic improvements in air quality would also result from reduction in residential emissions. We use the Weather Research and Forecasting model coupled with Chemistry to evaluate potential residential emission controls in Beijing and in the Beijing, Tianjin, and Hebei (BTH) region. In January and February 2010, relative to the base case, eliminating residential emissions in Beijing reduced daily average surface PM_2.5 (particulate mater with aerodynamic diameter equal or smaller than 2.5 micrometer) concentrations by 14 ± 7 μg⋅m⁻³ (22 ± 6% of a baseline concentration of 67 ± 41 μg⋅m⁻³; mean ± SD). Eliminating residential emissions in the BTH region reduced concentrations by 28 ± 19 μg⋅m⁻³ (40 ± 9% of 67 ± 41 μg⋅m⁻³), 44 ± 27 μg⋅m⁻³ (43 ± 10% of 99 ± 54 μg⋅m⁻³), and 25 ± 14 μg⋅m⁻³ (35 ± 8% of 70 ± 35 μg⋅m⁻³) in Beijing, Tianjin, and Hebei provinces, respectively. Annually, elimination of residential sources in the BTH region reduced emissions of primary PM_2.5 by 32%, compared with 5%, 6%, and 58% achieved by eliminating emissions from the transportation, power, and industry sectors, respectively. We also find air quality in Beijing would benefit substantially from reductions in residential emissions from regional controls in Tianjin and Hebei, indicating the value of policies at the regional level. Significance China suffers from severe outdoor air pollution and associated public health impacts. In response, the government has imposed restrictions on major pollution sources such as vehicles and power plants. We show that due to uncontrolled and inefficient combustion of solid fuels in household devices, emission reductions from the residential sector may have greater air quality benefits in the North China Plain, including Beijing than reductions from other sectors. These benefits would be largest in the winter heating season when severe air pollution occurs. Household emissions, mostly from space heating and cooking with solid fuels, are an important and generally unrecognized source of ambient air pollution in China and other developing countries. Alternative fuels and other ways of reducing emissions would have large benefits.