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Indoor Air Pollution - Silent Killer of Women
T V Padma

NEW DELHI, Jan 3, 2007 (IPS) - Women and young girls coughing and choking as they cook food over traditional stoves that burn wood, leaves or dung is a common a sight in poor homes across Asia, Africa and Latin America. But no one notices the deleterious effects.

Over 1.5 million females die prematurely every year by inhaling poisonous fumes as they cook or heat their homes with these organic fuels but catch little attention from governments, policy experts, scientists and medical experts.

Almost three billion people burn traditional fuels indoors for cooking and heating and their numbers are expected to "rise substantially by 2020," John Mitchell, coordinator of the partnership for clean indoor air at the United States Environmental Protection Agency told IPS at an international meeting on better air quality held in Yogyakarta, in December.

Of these, more than 1.6 million persons, mainly women and children, die prematurely each year from breathing high levels of indoor smoke. This is twice as many deaths as estimated due to outdoor pollution.

Indoor air pollution could lead to an epidemic of breathing problems that could kill faster than SARS or the bird flu, warned Kirk Smith, professor of public health at the University of California, Berkeley.

"Will there be a massive emergency meeting in Geneva of international agencies and donors with unlimited authority and funds to take action?" Smith asked participants at the meeting. "The answer is no -- indeed nothing will be done."

Ironically, the conference itself focused on outdoor air pollution and the final statement issued on Dec. 15 did not refer to it.

‘Biomass' or traditional fuels of biological origin, such as wood, twigs and leaves, account for 9.3 percent of the global energy consumed, according to the 2004 World Energy Assessment report. The reason they are so dangerous is that they do not burn completely --or in scientific parlance, their combustion efficiency is less than 100 percent.

"A traditional wood-fired Indian cooking stove can be a toxic waste factory," said Smith. According to him, typical biomass cook stoves convert 6-20 percent of the carbon to toxic substances.

Globally, indoor smoke ranks tenth as a risk factor for global burden of disease, according to a 2002 World Health Organisation report. But it ranks third for the Indian burden of disease.

Typical poisonous pollutants in fuel smoke produced by poor burning include small particles of carbon monoxide and nitrogen dioxide, and substances containing carbon and hydrogen (hydrocarbons) and sometimes chlorine.

In fact, about 5 percent of outdoor air pollution is due to smoke from indoors escaping, said Mitchell.

"Indoor air pollution is a cross-cutting issue" said Mitchell. Cutting down trees for fuel leads to deforestation and desertification and is linked to greenhouse gas emissions and climate change. But it is also a gender issue as it affects the health of women who are most exposed to the indoor smoke and are often the last in the family to avail of medical treatment; and it affects children's health causing respiratory problems.

Yet, indoor air pollution has been largely ignored by scientists. There have been too few measurements worldwide to determine exact levels of exposures or link to specific disease patterns, said Smith

For example, of the 2-3 million deaths in children under five years due to infections in the lower breathing tract, there are estimates of percent deaths due to malnutrition, diarrhoea, genetic susceptibility to diseases, non-immunisation against vaccine-preventable diseases. But there are no estimates of how many deaths were due to burning solid fuels in homes.

Preliminary data from an ongoing trial on 530 households using open fire stoves for cooking and with a pregnant women or child under four months in Guatemala were revealing. Young children in households cooking over open wood fires had serious respiratory ailments compared to those in homes that used improved woodstoves with chimneys, Smith reported at the workshop.

Once a chimney was fitted to the stove, polluting fine particles reduced by 90 percent, Smith said.

An ongoing series of studies at four locations in India, funded by Fogarty International, is addressing the question of whether exposure to indoor smoke from solid fuels aggravates tuberculosis. It is expected to complete collecting data by the end of next year.

More encouraging news came from the Partnership for Clean Indoor Air (PCIA) that was launched at the World Summit on Sustainable Development in Johannesburg in 2002. Over 120 partners from public and private sector are now working under it in 67 countries.

PCIA tries to improve health, livelihood and the quality of life through reduced exposure to air pollution, primarily among women and children, in developing countries. This is through an increase in the use of clean, reliable, affordable, efficient and safe cooking and heating practices at homes.

PCIA said its 10 pilot projects in Africa, Asia and Latin America have educated 1.3 million households. The result is 70,000 homes using clean and fuel-efficient practices and 700 new, small businesses producing and marketing improved technologies.

Another success story came from China, where The Nature Conservancy (TNC), a biodiversity conservation non-profit organisation based in Yunan province, which works on conservation and community development issues, has taken a lead in using alternative energy to improve indoor air quality.

The north-west corner of Yunan has the headwaters for Yangtze, Mekong, Salween and Irrawady rivers and is one of the world's 10 biodiversity hotspots.

Most people in the region rely on firewood for cooking and heating, but this not only destroys the local forest but also causes serious health problems due to indoor air pollution. TNC initiated an alternative energy programme in 2001 to protect the rich biodiversity in northwest Yunan and use energy strategies.

The project developed more efficient stoves and expanded renewable energy sources such as biogas digesters, solar water heaters and micro hydropower generators, said Xia Zuzhang, director of operations at the TNC programme.