Universidade Eduardo Mondlane, Maputo, Mozambique.
Instituto Nacional de Saúde, Maputo, Mozambique.
Curr Environ Health Rep. 2019 Sep;6(3):116-126. doi: 10.1007/s40572-019-00234-8.
This research aims to summarize evidence on the cardiovascular effects of indoor air pollution (IAP) from solid fuel and identify areas for research and policy for low- and middle-income countries.
IAP affects people from low socioeconomic status in Latin America, Asia, and Africa, who depend upon biomass as a fuel for cooking, heating, and lighting. In these settings, IAP disproportionately affects women, children, the elderly, and people with cardiopulmonary disease. The health effects of IAP include acute respiratory infections, chronic obstructive pulmonary disease, pneumoconiosis, cataract and blindness, pulmonary tuberculosis, adverse effects to pregnancy, cancer, and cardiovascular and cerebrovascular disease. New methods for assessing individual IAP exposure, exposing pathways of IAP-related cardiovascular disease, and performing qualitative research focusing on population preferences regarding strategies to reduce IAP exposure have been the most important developments in tackling the burden of IAP. Unfortunately, major disparities exist regarding research into the cardiovascular effects of IAP, with only few studies coming from sub-Saharan Africa, despite this region having the highest proportion of households using solid fuels. Premature cardiovascular deaths and disability can be averted in low-middle income countries by addressing biomass fuel usage by the most disadvantaged settings. While research is needed to uncover the mechanisms involved in cardiovascular outcomes linked to IAP, immediate action is needed to educate the most affected populations on IAP health hazards and to reduce their exposure to this environmental risk through promoting improved housing and better ventilation, as well as increasing access to affordable clean cooking energy.
本研究旨在总结固体燃料导致的室内空气污染(IAP)对心血管影响的证据,并确定针对中低收入国家的研究和政策领域。
IAP 影响拉丁美洲、亚洲和非洲社会经济地位较低的人群,这些人依靠生物质作为烹饪、取暖和照明燃料。在这些环境中,IAP 对妇女、儿童、老年人以及患有心肺疾病的人造成的影响更大。IAP 的健康影响包括急性呼吸道感染、慢性阻塞性肺疾病、尘肺、白内障和失明、肺结核、对妊娠的不良影响、癌症以及心血管和脑血管疾病。评估个体 IAP 暴露的新方法、暴露于与 IAP 相关的心血管疾病的途径,以及进行针对减少 IAP 暴露的人群偏好的定性研究,是应对 IAP 负担的最重要进展。不幸的是,IAP 对心血管影响的研究存在很大差异,只有少数研究来自撒哈拉以南非洲,尽管该地区使用固体燃料的家庭比例最高。通过解决最弱势群体的生物质燃料使用问题,可以避免中低收入国家发生过早的心血管死亡和残疾。虽然需要研究来揭示与 IAP 相关的心血管结果涉及的机制,但需要立即采取行动,通过宣传改善住房和更好的通风条件,以及增加获得负担得起的清洁能源烹饪的机会,来教育受影响最严重的人群了解 IAP 对健康的危害,并减少他们接触这种环境风险。