Household Air Pollution

Primary reference(s)

WHO, 2018. Household air pollution and health. World Health Organization (WHO). Accessed 20 October 2020.

Additional scientific description

Around 3 billion people still cook using solid fuels (such as wood, crop wastes, charcoal, coal, dung) and kerosene in open fires and inefficient stoves. Most of these people are poor and live in low- and middle-income countries. These cooking practices are inefficient and use fuels and technologies that produce high levels of household air pollution with a range of health-damaging pollutants, including small soot particles that penetrate deep into the lungs. In poorly ventilated dwellings, indoor smoke can be 100 times higher than acceptable levels for fine particles. Exposure is particularly high among women and young children, who spend the most time near the domestic hearth (WHO, 2018a).

Exposure to smoke from cooking fires causes 3.8 million people per year to die prematurely from illness attributable to the household air pollution caused by the inefficient use of solid fuels and kerosene for cooking. Among these 3.8 million deaths: 27% are due to pneumonia; 18% from stroke; 27% from ischaemic heart disease; 20% from chronic obstructive pulmonary disease (COPD); and 8% from lung cancer (WHO, 2018a).

Metrics and numeric limits

The WHO Air Quality guidelines offer recommended exposure levels for particulate matter (PM10 and PM2.5), ozone, nitrogen dioxide and sulphur dioxide, as well as a set of interim targets to encourage a progressive improvement in air quality (WHO, 2006). 

Examples of drivers, outcomes and risk management

The World Health Organization (WHO) provides technical support to countries in their own evaluations and scale-up of healthpromoting household fuels and technologies (WHO, 2018a). This is further complemented by the ongoing development of the Clean Household Energy Solutions Toolkit (CHEST) to support the implementation of WHO Guidelines for indoor air quality: household fuel combustion (WHO, 2014). CHEST is a suite of tools and information resources that help countries identify stakeholders working on household energy and/or public health to design, implement and monitor policies addressing household energy (WHO, 2018a). These are summarised below:

• Guidelines for indoor air quality: household fuel combustion: To ensure healthy air in and around the home, these guidelines provide health-based recommendations on the types of fuels and technologies to protect health as well as strategies for the effective dissemination and adoption of such home energy technologies (WHO, 2014).
• Household energy database: This database (WHO, no date a) is used to monitor global progress in the transition to cleaner fuels and stove combinations in households. It also supports assessments of disease burden from the household air pollution generated from the use of polluting fuel and technologies. As the custodial agency for Sustainable Development Goal Indicator 3.9.1 (mortality rate from the joint effects of household and ambient air pollution) and 7.1.2 (population with primary reliance on clean fuels and technologies) (WHO, 2018b), the WHO uses the Household energy database to derive estimates for tracking progress towards achieving universal clean energy access and related health impacts (WHO, 2018a).
• Research and programme evaluation: WHO is working with countries, researchers and other partners to harmonise methods of evaluation across settings so that health impacts are assessed consistently and rigorously and incorporate economic assessment of health benefits (WHO, 2018a).
• Leadership and advocacy in the health, energy and climate community: In May 2015, the World Health Assembly unanimously adopted a resolution on air pollution and health, calling for the integration of health concerns into national, regional and local air pollution-related policies. The following year, the World Health Assembly adopted a ‘Roadmap for Enhanced Action’ (WHO, no date b), calling for increased cross-sector cooperation to address the health risks of air pollution. WHO emphasises the compelling health arguments for cleaner household energy in a range of global forums addressing maternal and child health issues related to pneumonia as well as forums concerned with noncommunicable diseases (WHO, 2018a).
• Health and climate change: The WHO is a partner of the Climate and Clean Air Coalition to Reduce Short-Lived Climate Pollutants (CCAC). As a member of the CCAC’s health task force, the WHO is providing technical support for harnessing health benefits from actions to reduce short-lived climate pollutants and working to scale-up health sector engagement to address such pollutants and improve air quality (WHO, 2018a).
• Health, energy and sustainable development: Reductions in air pollution-related disease burden (both for household and outdoor) will be used to monitor the progress towards attaining the Sustainable Development Goal on Health (SDG 3). Achieving the Sustainable Development Goal on energy (SDG 7) (UN, 2015) could prevent millions of deaths and improve the health and well-being of the billions of people relying on polluting technologies and fuels for cooking, heating and lighting. To better assess the health risks of household energy use, as well as differentiated gender impacts from household energy practices, the WHO is leading an effort with countries and surveying agencies (e.g., the United States Agency for International Development Demographic and Health Surveys Program, the United Nations Children’s Emergency Fund Multiple Indicator Cluster Surveys, and the World Bank’s Living Standards Measurement Study) to better capture information on all the fuels and technologies used in the home for cooking, heating and lighting, as well as other impacts like time lost to fuel collection disaggregated by sex (WHO, 2018a).

The WHO also supports international initiatives to improve air pollution and related health impacts such as the Global Alliance for Clean Cookstoves and the Climate Clean Air Coalition (WHO, 2018a).