Quantifying the Effects of Exposure to Indoor Air Pollution from Biomass
Acute respiratory infections (ARI) are the leading cause of burden of disease worldwide and have
been causally linked with exposure to pollutants from domestic biomass fuels in developing countries.
We used longitudinal health data coupled with detailed monitoring and estimation of personal
exposure from more than 2 years of field measurements in rural Kenya to estimate the
exposure–response relationship for particulates < 10 μm diameter (PM10) generated from biomass
combustion. Acute respiratory infections and acute lower respiratory infections are concave,
increasing functions of average daily exposure to PM10, with the rate of increase declining for
exposures above approximately 1,000–2,000 μg/m3. This first estimation of the exposure–response
relationship for the high-exposure levels characteristic of developing countries has immediate and
important consequences for international public health policies, energy and combustion research,
and technology transfer efforts that affect more than 2 billion people worldwide.