Indoor air pollution in developing countries: recommendations for research

Available studies indicate that indoor air pollution (IAP) from household cooking and space heating apparently causes substantial ill-health in developing countries where the majority of households rely on solid fuels (coal or biomass as wood, crop residues, and dung), but there are many remaining uncertainties. To pin down impacts in order to effectively target interventions, research is particularly needed in three areas: (1) epidemiology: case-control studies for tuberculosis (TB) and cardiovascular disease in women and randomized intervention trials for childhood acute respiratory diseases and adverse pregnancy outcomes; (2) exposure assessment: techniques and equipment for inexpensive exposure assessment at large scale, including national level surveys; (3) interventions: engineering and dissemination approaches for improved stoves, fuels, ventilation, and behavior that reliably and economically reduce exposure. There are also important potential synergisms between efforts to reduce greenhouse gas emissions and those to reduce health-damaging emissions from solid-fuel stoves. The substitution of biomass by coal being considered in some countries should be pursued with caution because of the known serious health effects of household coal use.