Two Million Deaths Attributed To Indoor Air Pollution, Say Experts

Eranga Isaac, CNS Correspondent, Nigeria
It has been established by health experts in Nigeria that indoor and outdoor environments are usually polluted by multifarious mixtures of gases and particles that are produced by combustion of various types of fuels. Sources of indoor pollution include cooking stoves, cigarettes smoking, burning of various fuels for indoor heating, burning of mosquito coils and burning of incense for religious purposes and defecating in the living room.

All these are major promoters of indoor air pollution and they pose great threat to the survival of humans. Indoor air pollution is a major environmental and public health challenge in developing countries, where according to the World Health Organisation (WHO), exposure to indoor air pollution may be responsible for over two million deaths and about 4% of the global burden of diseases such as asthma, heart and lung ailments.

But the degree to which an individual is harmed by air pollution usually depends on the period of exposure and the concentration of the harmful chemicals. Unfortunately, different groups of individuals are affected by air pollution in different ways. Some individuals are much more sensitive to pollutants than are others. For instance, young children and elderly people often suffer more from the effects of air pollution. Children take in more air per unit body weight than do adults because they have a higher breathing rate.

In many tropical and sub-tropical countries, the use of mosquito coils is a key stratagem for reducing mosquito bites. While effective at combating mosquitoes, chemical-emitting coils may pose unintended hazards to respiratory health, thereby causing respiratory tract infection. For instance, tiny particles from a smoldering mosquito coil are small enough to be inhaled deeply into the lungs and present a real danger for those already sick, as well as for the healthy. Exposure to mosquito coil smoke is strongly associated with asthma. This was contained in a 1994 study on home environment risk factors for asthma, which was published in the journal, Annals of Tropical Paediatrics. It involved 140 children with a mean age of 66 months in Nigeria.

However, smoke from any source, be it mosquito coil, firewood or cigarette is bad for health due to exposure to potentially harmful substances. According to Dr Soji Ige, a chest physician at the University College Hospital (UCH), Ibadan, Oyo State, Nigeria, smoke from fireworks, vehicular exhaust, cigarette smoking, crackers, cooking wood and kerosene stoves are all airway irritants, which could cause airway narrowing and subsequently symptoms of asthma in the individual.

“The fact that smoke from mosquito coil can be equated to about that from 100 cigarettes has being established. It is a real fact. Unfortunately, even the light amount of smoke that is inhaled in a room where mosquito coil is smoldering can prone a person to many diseases such as asthma, lung cancer and emphysema,” he said.

According to Professor Sola Olapade, a lung specialist at the University of Chicago, “Almost 60% of the homes, in which persons with asthma live, use firewood and other agricultural residues for cooking; especially in kitchens or places where there is poor ventilation.”

He continues, “When people cook in closed environment and get exposed to smoke from burning firewood, it causes a lot of damage to their lungs. The smoke from burning firewood contains volatile organic compounds, some of which can cause cancer. In addition, the other irritants present in the smoke damage the lung by destroying the protective system and also cause lower respiratory infections such as pneumonia. It also contains carbon monoxide, which could lead to carbon monoxide poisoning. Currently, it contributes about 2 million deaths every year.”

He declared that the effect of indoor smoke in poor people is worse because of their poor nutritional status. “If you eat a balanced diet, you will have what is called antioxidants which to some degree protect against these oxidants in smoke,” he added.

Speaking on ways of responding to the growing burden of non-communicable diseases (NCDs), Dr Gan Quan of The International Union Against Tuberculosis and Lung Disease (The Union), said that tobacco use is one the main contributors to NCDs and tobacco control is an effective measure to curb the NCD epidemic. The tobacco industry has had its eyes on Africa, where the smoking rate in many countries remains low, which means much room for growth for the cigarette market. “One piece of advice I would offer is that measures should be put into place to restrict the advertising, promotion, and sponsorship of the tobacco companies. As a tobacco-growing nation, people generally might be more sympathetic to the tobacco industry and are more likely to take tobacco advertising, promotion, and sponsorship for granted. The other piece of advice is that the tobacco companies should be distanced from public health policy making especially related to tobacco control. The necessity is clearly outlined in Article 5.3 of the FCTC and its guidelines.”

Dr Quan added that owners of public premises would never be willing to maintain a smoke free environment in their businesses unless forced to do so because telling smokers to stop smoking or to go outside to smoke can potentially insult some customers. “On the other hand, the owners of public premises do have the responsibility to keep their venues safe and healthy for all who have access to them. Therefore, it becomes necessary to require owners/managers of public premises to maintain a smoke free environment to protect the health of non-smokers through legal measures. The government too has the responsibility to ensure that its citizens (non-smokers in this case) live in a healthy environment through enforcement actions of the smoke free laws”, he added.

Dr. Young Onakponyan, a leading physician at Wilbon Hospital, Urubi, Benin City, Nigeria, said that the effect of exposure to smoke are both long and short term. Examples of short-term effects include irritation to the eyes, nose and throat, and upper respiratory infections such as bronchitis and pneumonia. Other symptoms can include headaches, nausea, and allergic reactions. Long-term health effects can include chronic respiratory disease, lung cancer, heart disease, and even damage to the brain, nerves, liver, or kidneys.   

Dr Young added that many Nigerians, particularly women, engage in cooking indoors with hazardous materials because of their poverty level. According to him the Clean Cook Stove being promoted by the United Nations Secretary General – Ban Ki Moon, cannot be purchased by the majority of Nigerian women because of the high cost attached to it. He called on the Government of Nigeria to subsidize the clean cooking stove so as to encourage its usage.

Eranga Isaac, Citizen News Service - CNS 
13 September 2014