Indoor Air Quality at Rural and Urban Sites in Pakistan

Household energy stacking and structures in Pakistan - Results from a multiple-energy study in Azad Kashmir and Punjab

Solid fuel use (SFU) is common in most developing countries and would release many hazardous air pollutants posing high risks on human health. The Global Burden of Disease (GBD) study highlighted risks associated with household SFU in Pakistan, however, high uncertainties prevail because of scanty data on SFU and unaccounted energy stacking. This study conducted a field campaign aiming at collecting first-hand data on household energy mix in Pakistan. The first survey was in Punjab and Azad Kashmir, and revealed that stacked energy use was pervasive, especially for cooking. The stacking was found to be much more obvious in SFU households (defined as those using SFU dominantly) compared to those non-SFU. There were significantly substantial differences between Azad Kashmir and Punjab because of distinct resources available and economic conditions. Woody materials comprised up to nearly 70% in Azad Kashmir, but in Punjab, gas was frequently used for cooking. Only investigating primary household energy would probably overestimate main energy types that being used for a longer time but underestimated other supplements, suggesting the preference of multiple-energy surveys in household energy studies.

Average Hourly Concentrations of Air Contaminants in Selected Urban, Town, and Rural Sites

The inhabitants of cities, towns, and villages are exposed to different levels of air pollution, which also vary throughout the day. Information regarding episodes of poor and good air quality enables planning to mitigate the risks and maximize the benefits of spending time outdoors. In this work, an analysis was made of the state of air quality 2012-2016, using data gathered from automatic measuring stations located in five cities (> 50,000 inhabitants), five towns (5000-50,000 inhabitants), and five villages (< 5000 inhabitants) in five neighboring provinces in central Poland, in Central Europe. The monitoring stations were designated as "city background", "town background", and "rural background". More than 3 million pieces of data were collected from 15 monitoring stations. This allowed the average daily changes in the concentration of air pollutants (NO2 and NOx, O3, SO2, CO, PM10, PM2.5, C6H6) to be determined, depending on the type of station and the size of the settlement unit in both winter periods and summer periods. As a result, the most and least favorable hours in terms of levels of air pollution were identified. This information could help to inform air quality management in modern cities, towns, and villages and to improve the quality of life, particularly among those most susceptible to the negative effects of air pollution, such as the elderly and children.

Household air pollution from cooking fuel and respiratory health risks for children in Pakistan

Around 2.7 billion people in the world cook with polluting fuels, such as wood, crop residue, animal dung, charcoal, coal, and kerosene. Household air pollution from cooking with polluting fuels is recognized as a major risk factor for the disease burden. In this study, we examine the effect of using polluting fuels for cooking on the respiratory health of children in Pakistan. This study uses cross-sectional data from Pakistan Demographic and Health Survey 2012-13, with the sample size of 11,040 children under 5 years of age. Using logistic regression model, we control for factors such as averting activities, child characteristics, household characteristics, mother characteristics, and the unobserved factors using fixed effects. The results show that children in households using polluting fuels are 1.5 times more likely to have symptoms of acute respiratory infection (ARI) than children in households using cleaner fuels.

Health Risk Assessment of Indoor Air Quality, Socioeconomic and House Characteristics on Respiratory Health among Women and Children of Tirupur, South India

Background: Indoor air pollution is still considered as one of the leading causes of morbidity and mortality worldwide and especially in developing countries, including India. This study aims to assess social, housing, and indoor environmental factors associated with respiratory health among mothers and children. Methods: The study was conducted in the city of Tirupur, South India. We quantitatively assessed the indoor exposure to fine particulate matter (PM_2.5) and carbon monoxide in relation to respiratory health among women and children. Information on health status, household characteristics and socioeconomic factors was collected using a modified standardised questionnaire. Results: This study demonstrates the significant health impact of housing and socioeconomic characteristics on the burden of respiratory illness among women and children in urban South India. Increased respiratory symptoms were recorded among women and children from low income households, and those who allowed smoking inside. The mean PM_2.5 concentration measured in this study was 3.8 mg/m³ which exceeded the World Health Organization (WHO) 24 h guideline value of 0.025 mg/m³. Conclusions: This study is the first to our knowledge carried out in urban South India and the findings can be used for future intervention studies.

Bioaerosols in residential micro-environments in low income countries: a case study from Pakistan

Our knowledge of the concentrations of bioaerosols in residential micro-environments in low income countries is scanty. The present investigation was conducted to assess the culturable concentration and size distribution of bacteria, gram negative bacteria and fungi in two rural and an urban site in Pakistan. The highest indoor culturable bacteria concentration was found at Rural Site II (14,650 CFU/m3) while the outdoor maximum occurred at the urban site (16,416 CFU/m3). With reference to fungi, both indoor and outdoor concentrations were considerably higher at Rural Site I than the other sites. The size distribution of culturable bacteria at all sites showed greater variability than that of culturable fungi. At all sites more than the half (55-93%) of the culturable bacterial and fungal counts were observed in the respirable fraction (<4.7 μm) and so had the potential to penetrate into lower respiratory system.

Monitoring and Respiratory Health Assessment of the Population Exposed to Cooking Fuel Emissions in a Rural Area of Jalgaon District, India

Indoor air pollution is an ongoing problem in developing countries. Respiratory diseases are common worldwide in rural communities. This study was undertaken to estimate the respirable particulate matter (PM10) concentrations emitted from cooking fuels and their effects on the respiratory health of the rural population of Jalgaon district. The respiratory status of the exposed population was assessed by conducting pulmonary function tests in the study area. The levels of forced vital capacity and forced expiratory volume in 1 second were lower, and difficulty in respiration and frequent coughing were more common with higher odds ratios (OR) of 2.53 (95% confidence interval [CI] = 1.1-2.83) and 1.84 (95% CI = 0.95-2.10) in agrowaste-user female subjects. Ventilatory impairment among the agrowaste-user subjects was higher than among users of gas and wood. Difficulty in respiration and frequent coughing were strongly associated in wood-user female subjects as well with ORs of 2.10 (95% CI = 0.85-2.49) and 1.79 (95% CI = 0.91-1.98), respectively. Chest pain was significantly associated in agrowaste- and wood-user female subjects. This study confirms an association between the reductions in lung efficiency with high PM10 exposure in the rural population. The result of this study reveals an association between respiratory diseases symptoms and indoor air quality in the biomass-using rural population of Jalgaon district.

The state of indoor air quality in Pakistan--a review

BACKGROUND AND PURPOSE

In Pakistan, almost 70% of the population lives in rural areas. Ninety-four percent of households in rural areas and 58% in urban areas depend on biomass fuels (wood, dung, and agricultural waste). These solid fuels have poor combustion efficiency. Due to incomplete combustion of the biomass fuels, the resulting smoke contains a range of health-deteriorating substances that, at varying concentrations, can pose a serious threat to human health. Indoor air pollution accounts for 28,000 deaths a year and 40 million cases of acute respiratory illness. It places a significant economic burden on Pakistan with an annual cost of 1% of GDP. Despite the mounting evidence of an association between indoor air pollution and ill health, policy makers have paid little attention to it. This review analyzes the existing information on levels of indoor air pollution in Pakistan and suggests suitable intervention methods.

METHODS

This review is focused on studies of indoor air pollution, due to biomass fuels, in Pakistan published in both scientific journals and by the Government and international organizations. In addition, the importance of environmental tobacco smoke as an indoor pollutant is highlighted.

RESULTS

Unlike many other developing countries, there are no long-term studies on the levels of indoor air pollution. The limited studies that have been undertaken indicate that indoor air pollution should be a public health concern. High levels of particulate matter and carbon monoxide have been reported, and generally, women and children are subject to the maximum exposure. There have been a few interventions, with improved stoves, in some areas since 1990. However, the effectiveness of these interventions has not been fully evaluated.

CONCLUSION

Indoor air pollution has a significant impact on the health of the population in Pakistan. The use of biomass fuel as an energy source is the biggest contributor to poor indoor air quality followed by smoking. In order to arrest the increasing levels of indoor pollution, there is a dire need to recognize it as a major health hazard and formulate a national policy to combat it. An integrated effort, with involvement of all stakeholders, could yield promising results. A countrywide public awareness campaign, on the association of indoor air pollution with ill health, followed by practical intervention would be an appropriate approach. Due to the current socioeconomic conditions in the country, development and adoption of improved cooking stoves for the population at large would be the most suitable choice. However, the potential of biogas as a fuel should be explored further, and modern fuels (natural gas and LPG) need to be accessible and economical. Smoking in closed public spaces should be banned, and knowledge of the effect of smoking on indoor air quality needs to be quantified.