Energy technology, indoor air pollution, and respiratory infections in developing countries: A field study from Central Kenya.

摘要

Globally, more than two billion people rely on biofuels as the primary source of domestic energy. Exposure to indoor air pollution, especially to particulate matter, from biomass combustion, is a causal agent of respiratory and eye diseases. Acute respiratory infections (ARI) and chronic respiratory diseases lead the causes of disease and mortality worldwide, and account for more than 10% of the global burden of disease, mostly in developing countries.; In this dissertation, I consider the linkages among household energy technology, indoor environment, and health. I provide quantitative analysis of (1) patterns of human exposure to indoor air pollution, (2) the exposure-response relationship for particulate matter and ARI, and (3) the pollution reducing performance of an array of stove-fuel combinations. Data are from three years (1996--1999) of field research in Central Kenya. I also briefly discuss the important issues in successful dissemination of household level technologies.; I construct Profiles of exposure using continuous real-time monitoring of pollution concentration and the location and activities of household members, supplemented by data on the spatial dispersion of pollution and interviews. Exposure during brief high-intensity emission episodes accounts for 31%--61% of the total exposure of household members who participate in cooking and 0%--11% for those who do not. Simple models that neglect the spatial distribution of pollution within the home, intense emission episodes, and activity patterns underestimate exposure by 3%--71% for different demographic sub-groups, resulting in inaccurate and biased estimations.; ARI and acute lower respiratory infections (ALRI) are increasing, concave functions of average daily exposure to PM10. The rate of increase declines for exposures above approximately 2000 mug·m -3. Consequently, programs aiming to reduce the adverse health impacts of indoor air pollution in developing countries should focus on measures that result in larger reductions in pollution, especially those that bring average exposure below 2000 mug·m-3.; Improved wood stoves provide an overall reduction in the emission concentration compared to 3-stone fire. The largest reduction of emission concentrations and human exposure, however, is achieved through a transition from wood to charcoal. I discuss the implications for public health and technology transfer.