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Sep 19, 2007Article Details
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Main Article Content
Estimating the burden of disease attributable to indoor air pollution from household use of solid fuels in South Africa in 2000
Abstract
Objectives. To estimate the burden of respiratory ill health in
South African children and adults in 2000 from exposure to
indoor air pollution associated with household use of solid
fuels.
Design. World Health Organization comparative risk assessment
(CRA) methodology was followed. The South African Census
2001 was used to derive the proportion of households using
solid fuels for cooking and heating by population group.
Exposure estimates were adjusted by a ventilation factor taking
into account the general level of ventilation in the households.
Population-attributable fractions were calculated and applied to
revised burden of disease estimates for each population group.
Monte Carlo simulation-modelling techniques were used for
uncertainty analysis.
Setting. South Africa.
Subjects. Black African, coloured, white and Indian children
under 5 years of age and adults aged 30 years and older.
Outcome measures. Mortality and disability-adjusted life years
(DALYs) from acute lower respiratory infections in children
under 5 years, and chronic obstructive pulmonary disease and
lung cancer in adults 30 years and older.
Results. An estimated 20% of South African households were
exposed to indoor smoke from solid fuels, with marked
variation by population group. This exposure was estimated to
have caused 2 489 deaths (95% uncertainty interval 1 672 -
3 324) or 0.5% (95% uncertainty interval 0.3 - 0.6%) of all deaths
in South Africa in 2000. The loss of healthy life years comprised
a slightly smaller proportion of the total: 60 934 DALYs (95%
uncertainty interval 41 170 - 81 246) or 0.4% of all DALYs (95%
uncertainty interval 0.3 - 0.5%) in South Africa in 2000. Almost
99% of this burden occurred in the black African population.
Conclusions. The most important interventions to reduce this
impact include access to cleaner household fuels, improved
stoves, and better ventilation.
South African Medical Journal Vol. 97 (8) Part 2 2007: pp. 764-771
