A Major Environmental Cause of Death
The World Health Organization (WHO) lists indoor air pollution (IAP) ( 1) from primitive household cooking fires as the leading environmental cause of death in the world, as it contributes to nearly 2.0 million deaths annually (2)—more deaths than are caused each year by malaria. Almost half of the planet lives in poverty, and those households generally use biomass (wood, crop residues, charcoal, or dung) or coal as fuel for cooking and heating. The primitive fires typically fill homes with dense smoke, blackening walls and ceilings and sickening those within.
Women and children living in extreme poverty are at highest risk for adverse health outcomes from IAP. Whereas men tend to be physically removed from household smoke exposures during the day, women and children suffer high exposures, which lead to many of the same disease risks as if they were lifelong smokers of tobacco. Mortality estimates from IAP are primarily based on risk for acute pneumonia in children under age 5 and chronic obstructive pulmonary disease (COPD) (3) (see the chart, page 181).
The consequences of primitive household cooking also extend to the global environment. For those at the bottom of the energy ladder, reliance on biomass fuels and coal contributes to local and regional environmental degradation and deforestation. A 2011 World Bank report underscores health benefits as a rationale for cookstove interventions but also emphasizes evidence for environment and climate benefits (4). Improved and efficient stoves reduce fuel use (reducing CO2 release) and, if sufficiently advanced, decrease black carbon emissions.