Improving household air quality: The neglected cultural dimension

Household air pollution is now recognized as the single largest environmental health risk factor worldwide contributing to the global burden of disease, with the World Health Organization (WHO) estimating that close to 4million people per year die prematurely as a result(1,2).This form of pollution is widespread in resource-poor countries mainly due to the use of biomass fuels, derived from crop residues, animal dung, wood or charcoal, as a source of household energy. It has been linked with an increased frequency of lower respiratory infection, cataract, ischemic stroke, hemorrhagic stroke, hypertension, ischemic heart disease and chronic obstructive pulmonary disease, as well as tracheal, bronchial and lung cancer (2). Vulnerable groups, such as the rural poor or women and children, appear to be disproportionately affected, the former as they are forced by economic circumstances to use more polluting fuel sources and the latter as a consequence of carrying out common domestic tasks such as cooking. The substantial disease burden and its propensity to affect vulnerable populations have led to its identification as a major target for intervention to improve global health and it is specifically mentioned in the current Sustainable Development Goals (Goal 3 –which recommends implementation of the WHO indoor air quality guidelines on household fuel combustion)