Respiratory risks from household air pollution in low and middle income countries.
Respiratory risks from household air pollution in low and middle income countries.
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DOI：
10.1016/s2213-2600(14)70168-7
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发表时间：
2014-10
影响因子：
76.2
通讯作者：
Martin, William J., II
中科院分区：
文献类型：
--
作者：
Gordon, Stephen B.;Bruce, Nigel G.;Grigg, Jonathan;Hibberd, Patricia L.;Kurmi, Om P.;Lam, Kin-bong Hubert;Mortimer, Kevin;Asante, Kwaku Poku;Balakrishnan, Kalpana;Balmes, John;Bar-Zeev, Naor;Bates, Michael N.;Breysse, Patrick N.;Buist, Sonia;Chen, Zhengming;Havens, Deborah;Jack, Darby;Jindal, Surinder;Kan, Haidong;Mehta, Sumi;Moschovis, Peter;Naeher, Luke;Patel, Archana;Perez-Padilla, Rogelio;Pope, Daniel;Rylance, Jamie;Semple, Sean;Martin, William J., II
世界上三分之一的人口使用源自植物材料（生物质）或煤炭的固体燃料来烹饪、取暖或照明。这些燃料冒烟，常用于明火或简易炉灶，燃烧不完全，排烟不畅时会造成大量家庭空气污染。空气污染是全球最大的环境死亡原因，家庭空气污染每年导致约 3·5-400 万人死亡。生活在严重贫困中的妇女和儿童受到家庭空气污染的影响最大。在该委员会中，我们审查了家庭空气污染与呼吸道感染、呼吸道癌症和慢性肺部疾病之间关联的证据。呼吸道感染（包括病毒、细菌和分枝杆菌引起的上呼吸道和下呼吸道感染）都与接触家庭空气污染有关。呼吸道癌症，包括鼻咽癌和肺癌，与燃煤污染密切相关，需要有关其他固体燃料的进一步数据。慢性肺部疾病，包括女性慢性阻塞性肺病和支气管扩张，与烹饪时使用固体燃料有关，而早年接触家庭空气污染对肺部发育的破坏性影响尚未得到充分描述。我们还审查了衡量家庭空气污染暴露的适当方法，以及研究设计问题和预防这些疾病负担的潜在有效干预措施。家庭空气污染的测量需要个人监测，而不是固定地点监测，因为接触情况因年龄、性别、地点和家庭角色而异。妇女和儿童特别容易受到污染的毒性影响，并且接触的浓度最高。干预措施应针对这些高风险群体，并具有足够的质量以保持空气清洁。为所有人提供清洁能源是长期目标，中间解决方案是提供足够清洁的能源以对健康产生影响。
A third of the world’s population uses solid fuel derived from plant material (biomass) or coal for cooking, heating, or lighting. These fuels are smoky, often used in an open fire or simple stove with incomplete combustion, and result in a large amount of household air pollution when smoke is poorly vented. Air pollution is the biggest environmental cause of death worldwide, with household air pollution accounting for about 3·5–4 million deaths every year. Women and children living in severe poverty have the greatest exposures to household air pollution. In this Commission, we review evidence for the association between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases. Respiratory infections (comprising both upper and lower respiratory tract infections with viruses, bacteria, and mycobacteria) have all been associated with exposure to household air pollution. Respiratory tract cancers, including both nasopharyngeal cancer and lung cancer, are strongly associated with pollution from coal burning and further data are needed about other solid fuels. Chronic lung diseases, including chronic obstructive pulmonary disease and bronchiectasis in women, are associated with solid fuel use for cooking, and the damaging effects of exposure to household air pollution in early life on lung development are yet to be fully described. We also review appropriate ways to measure exposure to household air pollution, as well as study design issues and potential effective interventions to prevent these disease burdens. 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 being to make available energy that is clean enough to have a health impact.