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Last edited: 28 September 2022      
Smoke in kitchen

Household cooking smoke kills more people each year than malaria. - Practical Action: June, 2006

GACC 2016 progress report fig

Adoption of clean cookstoves between 2013 and 2015. Photo credit: Clean Cooking Alliance

Women and children the world over, are exposed daily to a quiet killer: household smoke. The World Health Organization (WHO) reports that in 23 countries, 10% of deaths are due to just two environmental risk factors: unsafe water, including poor sanitation and hygiene; and household air pollution due to solid fuel use for cooking.[1] A WHO report from June 2015 states that "seven million deaths every year are attributable to air pollution. This makes it one of the deadliest health risk factors globally, comparable to tobacco smoking, and the greatest cause of death in some countries.

Globally, 88% of the world’s population breathes air that does not meet WHO’s air quality guidelines".[2] While much of this pollution comes from transportation and power generation emissions, household sources are a significant contributor to global air pollution. For example, a December 2016 publication from the Global Alliance for Clean Cookstoves reports that researchers in India found that 30% of outdoor particulate matter pollution can be attributed to household emissions. A separate study, conducted in China, found "efforts to reduce household air pollution have been considerably more effective at reducing overall pollution than efforts to regulate emissions from the transportation and power sectors."[3] Although curbing emissions from these sources is a critical step in reducing global air pollution, expanding the use of clean cookstoves can often lead to the most rapid benefits for individuals and their families as clean cookstoves greatly reduce or eliminate the dangerous health impacts of household air pollution. The good news is that the adoption of tier 4 (non-biomass) stoves, which have lowest emissions of all available stoves and includes solar cookers, increased from ~30% in 2013 to almost 50% in 2015.[4]

The World Health Organization has reports "household air pollution from solid fuel use, is responsible for more than 1.6 million annual deaths and 2.7% of the global burden of disease... Household air pollution was responsible for an estimated 3.2 million deaths per year in 2020, including over 237 000 deaths of children under the age of 5. [5] This makes this risk factor the second biggest environmental contributor to ill health, behind unsafe water and sanitation. Dependence on polluting solid fuels to meet basic energy needs represents one of the biggest threats to children’s health. Acute lower respiratory infections, in particular pneumonia, continue to be the biggest killer of young children and cause more than four million annual deaths. This toll almost exclusively falls on children in developing countries.” Scarce fuel also often means, unsafe drinking water is not heated to control water-borne diseases, and slow-cooking nutritious foods such as beans are dropped from family diets. In Kenya, water and smoke related diseases are among the top five major causes of mortality in children under age five years. According to PSI, current estimates show that the country has an annual incidence of between 3.5 and 4.6 severe diarrhea episodes per child. Poor nutrition, smoke and unsafe drinking water are also a health threat for people with AIDS.

Background[]

Indoor Air Polution map-deaths

Map of world deaths attributed to household air pollution from using solid fuels

Only recently has the magnitude of this issue come to the forefront of international concern. Two publications―a 2004 briefing by the Intermediate Technology Development Group (ITDG) titled "Smoke: the killer in the kitchen," and the Spring 2003 magazine Public Health from the School of Public Health at the University of California, Berkeley―attempt to quantify the negative health effects of exposure to indoor smoke on people in the developing world, especially women and children.

Approximately 2.4 billion people―over one-third of all humanity and two-thirds of the developing world―cook over biomass-fueled fires. Common biomass fuels include wood, charcoal, dung and crop residues. [6] And though the percentage of the population that cooks with these fuels is expected to go down over time, the total numbers are expected to rise by as many as 200 million people over the next quarter century. Not only is this environmentally unsustainable at the global level, the health ramifications are devastating at the community and family levels. According to the Berkeley report, indoor smoke poses serious health threats. "In homes without ventilation, exposures to particulate matter, along with carbon monoxide, formaldehyde, benzene, nitrogen dioxide, and other gases, can reach 1000 µg/m3 over a 24-hour period―more than 20 times higher than standards set by the U.S. Environmental Protection Agency." Exposure to these pollutants can lead to a number of serious illnesses, including acute lower respiratory infection (ALRI), chronic obstructive pulmonary disease (COPD) and pulmonary tuberculosis. Evidence is mounting that other illnesses, such as lung cancer, asthma and cataracts, as well as low infant birth weight, may also be caused or exacerbated by indoor smoke.

Solar Oven Society - Cooking Air Pollution chart 3-11

Household air pollution is the fourth-leading cause of premature death in the developing world. According to the ITDG briefing, women typically spend "three to seven hours per day by the fire, exposed to smoke, often with young children nearby." The briefing summarizes, as follows, the combined effect of these smoke-related illnesses on the population as a whole: "Indoor air pollution from the burning of solid fuels kills over 1.6 million people, predominately women and children, each year. This is more than three people per minute. It is a death toll almost as great a that caused by unsafe water and sanitation, and greater than that caused by malaria." [7] Women, as the briefing points out, are two to four times more likely to suffer COPD when exposed to indoor smoke pollution. Some studies suggest that women who cook over indoor wood fires are 2.5 times more likely to have active tuberculosis.

The ITDG briefing goes on to quantify the effect of indoor smoke on children. "Smoke in the home is one of the world's leading child killers, claiming nearly one million lives each year." In fact, according to the Berkeley report, ALRIs such as pneumonia and bronchitis are the leading cause of death among children in developing countries. Children exposed to indoor smoke are two to three times more likely to contract an ALRI. Children under the age of five, account for over 50% of all indoor-smoke related deaths. According to ITDG, the physiology of children makes them "absorb pollutants more readily than adults and also retain them in their system for longer." So, what can be done about this severe global health issue? People can't very well stop cooking, given that almost all staple foods need to be cooked before they can be eaten. As Dr. E. Bates put it, "If people do not have fuel for lighting, they must sit in the dark; if they do not have fuel for cooking, quite simply, they starve." Suggested solutions include better ventilation for existing cooking devices and the use of cleaner-burning fuels. High costs and limited access greatly reduce the chance that cleaner-burning fuels will be adopted by those most affected. Better ventilation will undoubtedly be incorporated when feasible, but the burning of biomass still negatively affects the environment in numerous ways. Solar cookers are the only competitively priced, smoke-free solution. Household smoke pollution disproportionately affects people living in regions that are conducive to solar cooking: India, China and sub-Saharan African, where the highest proportion of people cook with biomass fuels. The solar cooking community must take action to insure that public health officials are aware of the boon solar cookers are to the health of our women and children.

Statistics from the World Health Organization[]

Among these 3.2 million deaths from household air pollution exposure:

  • 32% are from ischaemic heart disease: 12% of all deaths due to ischaemic heart disease, accounting for over a million premature deaths annually, can be attributed to exposure to household air pollution;
  • 23% are from stroke: approximately 12% of all deaths due to stroke can be attributed to the daily exposure to household air pollution arising from using solid fuels and kerosene at home;
  • 21% are due to lower respiratory infection: exposure to household air pollution almost doubles the risk for childhood LRI and is responsible for 44% of all pneumonia deaths in children less than 5 years old.  Household air pollution is a risk for acute lower respiratory infections in adults and contributes to 22% of all adult deaths due to pneumonia;
  • 19% are from chronic obstructive pulmonary disease (COPD): 23% of all deaths from chronic obstructive pulmonary disease (COPD) in adults in low- and middle-income countries are due to exposure to household air pollution; and
  • 6% are from lung cancer: approximately 11% of lung cancer deaths in adults are attributable to exposure to carcinogens from household air pollution caused by using kerosene or solid fuels like wood, charcoal or coal for household energy needs.[8]

Extracts from an interview with Dr. Kirk R. Smith in 2009[]

Kirk R. Smith is among the world’s leading authorities on the problem of household air pollution (HAP). A professor of global environmental health at the University of California, Berkeley, Smith has been researching the problem since 1981. In 2007, the World Health Organization found that HAP was killing about 400,000 people in India every year, most of them women and children. The agency found that pollution levels in some kitchens in rural India were some 20 times higher than recommended and that the pollution was several times as bad as that found in New Delhi. Globally, more than 1.6 million people per year die premature deaths due to HAP caused by burning biomass – wood, dung, roots, straw, and coal in households. HAP is receiving more attention than it used to. It’s being ranked up there with poor water and sanitation as an environmental risk factor… Since 2002, we’ve come to understand even more about how household combustion contributes to climate change. And one of the more interesting and important pollutants now is realized to be black carbon — small soot particles which are extremely warming in the atmosphere and also contribute to the melting of glaciers when deposited on them. About one-third of human-caused black carbon emissions in the world are from poor household combustion. So you can’t have a black carbon program without considering combustion in households. [Source: Worldpress.com 7/23/09]

Environmental versus health safety considerations for fuelwood-burning stoves[]

The team of Rob Balis, Majid Ezzati, and Daniel Kammen have done extensive research into the pollution generated from wood-burning cookstoves in Africa. Daniel Kammen, a professor of public policy at the University of California at Berkeley, reports that their findings show the levels of greenhouse gas emissions (GHG) from charcoal burning and production, are significantly higher than previously believed. He estimates that 250 million people use charcoal for their domestic energy at least once a week, mainly in Africa, parts of Asia, and Brazil. Their findings were first published in the March 2003 issue of Environmental Science and Technology. Read their report at Greenhouse Gas Implications of Household Energy Technology in Kenya The charcoal-fueled stoves do however, produce 75−95% less carbon particulate compared to wood-fueled alternatives. This fact immediately points to a benefit of burning charcoal to reduce the incidence of particulate related respiratory disease. If large scale charcoal production is able to be done in a sustainable fashion, charcoal can be promoted to significantly help reduce respiratory disease. However, often charcoal production is done illegally, using very inefficient techniques, creating additional environmental problems. The use of an efficient, well-maintained wood stove, like the improved combustion stoves variety, will reduce carbon emissions by approximately 50% over open fires. Limiting the air flow, or damping down the air intake of these stoves, will lower the stove temperature and extend cooking times, but will release more carbon particulate. Conversely, the use of charcoal increases the amount of other greenhouse gas emissions released into the atmosphere when compared to using wood or biomass fuels. Possibly 6-13 times as much GHG is released using charcoal fuel compared with bio-mass fuels. According to Kammen, this negative aspect is not significant compared to the respiratory health benefit of cooking with charcoal. The amount of GHG emissions generated by cooking activities is still a very small contributor to the total coming from all other emission sources. Improved combustion wood stoves will continue to be an important component of integrated cooking. Their use will be encouraged, when solar cooking is not possible. With either approach, heat-retention cooking can save time and fuel.

Reports[]

WHO HAP deaths by location 2012

Household air pollution deaths in 2012 by location[9]

  • March 2014: The World Health Organization (WHO) estimates that 4.3 million people die annually from household air pollution caused by cooking with biomass and coal.[9] It is the greatest health risk in the world after high blood pressure, tobacco and alcohol, with more people dying from the incremental, ongoing inhalation of smoke from fires they ignite in their own homes than from malaria, tuberculosis and HIV/AIDS combined. Read WHO report summary: Burden of disease from Household Air Pollution for 2012
  • December 2012: A new study estimates 4 million deaths globally from household cooking smoke each year - The recently released "Global Burden of Disease 2010", funded by the Gates Foundation and just published in The Lancet, comes to this conclusion, and is double the previous accepted estimate. The study isolated the effects of cooking smoke only. There appears to be a shift from communicable children's diseases to non-communicable disease in adult populations as the major health threat affecting developing countries. The cooking problem is compounded by the fact that achieving a fifty percent reduction in cooking smoke does not correlate to a fifty percent reduction in respiratory disease. Substantial smoke reduction is required to see significant improvement. Read more about the air quality findings from the Global Alliance for Clean Cookstoves press release.
  • September 2011: Around three billion people cook and heat their homes using open fires and leaky stoves burning biomass (wood, animal dung and crop waste) and coal. Nearly two million people die prematurely from illness attributable to household air pollution from household solid fuel use. Read more...Indoor air pollution and health - World Health Organization
  • February 2005: Smoke in the Kitchen: Health Impacts of Indoor Air Pollution in Developing Countries - UNDP

Articles in the media[]

Audio and video[]

  • January 2017:
Solar_Cookers_International_All_About_Access

Solar Cookers International All About Access

Household air pollution: causes and solutions

  • March 2013:
CEDESOL_-_Changing_Lives_In_Rural_Bolivia

CEDESOL - Changing Lives In Rural Bolivia

David Whitfield explains the challenges and successes CEDESOL has faced in the past, and their methods of educating the rural population about the integrated cooking approach in 2013.

  • September 2011:
From_the_Mara_Soil_-_a_Film_About_Simple_and_Natural_Solutions_to_Poverty,_Hunger_and_Disease-0

From the Mara Soil - a Film About Simple and Natural Solutions to Poverty, Hunger and Disease-0

Permaculture is discussed, and in part, how solar cooking can help relieve the constant exposure to smoky cooking fires.

See also[]

External links[]

References[]