Johns Hopkins University, School of Medicine, Baltimore, Md.
University of New Mexico School of Medicine, Albuquerque, NM; University of New Mexico Comprehensive Cancer Center, Albuquerque, NM.
J Allergy Clin Immunol Pract. 2022 Nov;10(11):2807-2819. doi: 10.1016/j.jaip.2022.08.031. Epub 2022 Sep 2.
Biomass fuel smoke, secondhand smoke, and oxides of nitrogen are common causes of household air pollution (HAP). Almost 2.4 billion people worldwide use solid fuels for cooking and heating, mostly in low- and middle-income countries. Wood combustion for household heating is also common in many areas of high-income countries, and minorities are particularly vulnerable. HAP in low- and middle-income countries is associated with asthma, acute respiratory tract infections in adults and children, chronic obstructive pulmonary disease, lung cancer, tuberculosis, and respiratory mortality. Although wood smoke exposure levels in high-income countries are typically lower than in lower-income countries, it is similarly associated with accelerated lung function decline, higher prevalence of airflow obstruction and chronic bronchitis, and higher all-cause and respiratory cause-specific mortality. Household air cleaners with high-efficiency particle filters have mixed effects on asthma and chronic obstructive pulmonary disease outcomes. Biomass fuel interventions in low-income countries include adding chimneys to cookstoves, improving biomass fuel combustion stoves, and switching fuel to liquid petroleum gas. Still, the impact on health outcomes is inconsistent. In high-income countries, strategies for reducing biomass fuel-related HAP are centered on community-level woodstove changeout programs, although the results are again inconsistent. In addition, initiatives to encourage home smoking bans have mixed success in households with children. Environmental solutions to reduce HAP have varying success in reducing pollutants and health problems. Improved understanding of indoor air quality factors and actions that prevent degradation or improve polluted indoor air may lead to enhanced environmental health policies, but health outcomes must be rigorously examined.
生物质燃料烟雾、二手烟和氮氧化物是家庭空气污染（HAP）的常见原因。全球几乎有 24 亿人使用固体燃料做饭和取暖，主要是在中低收入国家。在许多高收入国家的地区，木材燃烧也被用于家庭取暖，少数民族尤其容易受到影响。在中低收入国家，HAP 与哮喘、成人和儿童急性呼吸道感染、慢性阻塞性肺疾病、肺癌、结核病和呼吸道死亡率有关。尽管高收入国家的木材烟雾暴露水平通常低于低收入国家，但它同样与加速肺功能下降、更高的气流阻塞和慢性支气管炎患病率以及全因和呼吸道特定原因死亡率增加有关。具有高效微粒过滤器的家用空气净化器对哮喘和慢性阻塞性肺疾病的结果有混合影响。在低收入国家，针对生物质燃料的干预措施包括在炉灶上增加烟囱、改进生物质燃料燃烧炉以及改用液化石油气。尽管如此，对健康结果的影响仍不一致。在高收入国家，减少生物质燃料相关 HAP 的策略集中在社区层面的火炉更换计划上，但结果同样不一致。此外，鼓励家庭禁烟的举措在有孩子的家庭中取得的成功不一。减少 HAP 的环境解决方案在减少污染物和健康问题方面取得了不同程度的成功。对室内空气质量因素和防止其恶化或改善污染室内空气的措施的更好理解可能会导致环境健康政策的加强，但必须严格审查健康结果。
