According to the WHO global health observatory, living or working in an unhealthy environment was associated, in 2016, with 12.6 million deaths representing 23% of all deaths. Of these, about 4.3 million deaths every year were estimated to result from exposure to ambient air pollution (fine particulate matter) and 3.8 million from exposure to household air pollution (caused by burning biomass fuel for domestic cooking and heating). The Lancet Commission on Pollution and Health 2017 stressed that people from low- and middle-income countries (LMICs) disproportionately experience the burden of adverse effects due air pollution.
Current evidence strongly links air pollution to respiratory illnesses, with estimated environment-related yearly deaths due to chronic respiratory diseases and respiratory infections amounting to 1.4 million and 567,000, respectively. The WHO 2017 report highlighted a status quo in low-income countries for lower respiratory illnesses as first cause of death in 2015, as compared to 2012, with tuberculosis (TB) being the leading cause among adults. Besides respiratory health effects, the Forum for International Respiratory Societies’ Environmental Committee has summarized the evidence linking air pollution with many other non-communicable diseases.
We conducted a systematic review (including 60 studies) to map the impact of ambient air pollution (AAP) on health effects in sub-Saharan Africa (SSA). Our findings suggested that:
- Continuous air quality monitoring coverages are scarce in Sub-Saharan
- SSA exhibited 10 to 20 fold higher levels of AAP than WHO standards
- Most health studies relied on questionnaires to estimate health effects due to AAP
- Very few longitudinal studies were conducted in SSA in relation to AAP
- Children and the elderly were found to be more susceptible to AAP.
Gordon and colleagues extensively reviewed the health risks associated with exposure to household air pollution in LMICs and concluded that:
- Measurement of household air pollution needs individual, rather than fixed in place, monitoring because exposure varies by age, gender, location, and household role.
- Women and children are particularly susceptible to the toxic effects of pollution and are exposed to the highest concentrations.
- Interventions should target these high-risk groups and be of sufficient quality to make the air clean.
- To make clean energy available to all people is the long-term goal, with an intermediate solution consisting of making available energy that is clean enough to have a health impact.
In this module, we will discuss (with a focus on Africa)
- State-of-the-art about air pollution and health effects
- Past and current interventional studies to reduce household air pollution
- Implications of the available evidence, identification of research gaps and formulation of policy recommendations for a practical mitigation plan for both ambient and household air pollution across SSA.