Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.
Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa; Department of Geography, Geoinformatics and Meteorology, Faculty of Natural and Agricultural Sciences, University of Pretoria, South Africa.
S Afr Med J. 2022 Sep 30;112(8b):718-728. doi: 10.7196/SAMJ.2022.v112i8b.16474.
Household air pollution (HAP) due to the use of solid fuels for cooking is a global problem with significant impacts on human health, especially in low- and middle-income countries. HAP remains problematic in South Africa (SA). While electrification rates have improved over the past two decades, many people still use solid fuels for cooking owing to energy poverty.
To estimate the disease burden attributable to HAP for cooking in SA over three time points: 2000, 2006 and 2012.
Comparative risk assessment methodology was used. The proportion of South Africans exposed to HAP was assessed and assigned the estimated concentration of particulate matter with a diameter <2.5 μg/m3 (PM2.5) associated with HAP exposure. Health outcomes and relative risks associated with HAP exposure were identified. Population-attributable fractions and the attributable burden of disease due to HAP exposure (deaths, years of life lost, years lived with disability and disability-adjusted life years (DALYs)) for SA were calculated. Attributable burden was estimated for 2000, 2006 and 2012. For the year 2012, we estimated the attributable burden at provincial level.
An estimated 17.6% of the SA population was exposed to HAP in 2012. In 2012, HAP exposure was estimated to have caused 8 862 deaths (95% uncertainty interval (UI) 8 413 - 9 251) and 1.7% (95% UI 1.6% - 1.8%) of all deaths in SA, respectively. Loss of healthy life years comprised 208 816 DALYs (95% UI 195 648 - 221 007) and 1.0% of all DALYs (95% UI 0.95% - 1.0%) in 2012, respectively. Lower respiratory infections and cardiovascular disease contributed to the largest proportion of deaths and DALYs. HAP exposure due to cooking varied across provinces, and was highest in Limpopo (50.0%), Mpumalanga (27.4%) and KwaZulu-Natal (26.4%) provinces in 2012. Age standardised burden measures showed that these three provinces had the highest rates of death and DALY burden attributable to HAP.
The burden of disease from HAP due to cooking in SA is of significant concern. Effective interventions supported by legislation and policy, together with awareness campaigns, are needed to ensure access to clean household fuels and improved cook stoves. Continued and enhanced efforts in this regard are required to ensure the burden of disease from HAP is curbed in SA.
因烹饪而使用固体燃料导致的户内空气污染（HAP）是一个全球性问题，对人类健康造成重大影响，尤其是在低收入和中等收入国家。南非（SA）的 HAP 仍然是一个问题。尽管在过去二十年里，电气化率有所提高，但由于能源贫困，许多人仍然使用固体燃料做饭。
针对 2000 年、2006 年和 2012 年三个时间点，估算因烹饪而导致的 HAP 在南非的疾病负担。
采用比较风险评估方法。评估南非接触 HAP 的人群比例，并根据与 HAP 暴露相关的估计浓度分配直径<2.5μg/m3（PM2.5）的颗粒物。确定与 HAP 暴露相关的健康结果和相对风险。计算 HAP 暴露导致的南非人口归因分数（死亡、生命损失年、残疾生存年和残疾调整生命年（DALY））和疾病负担。估算了 2000 年、2006 年和 2012 年的归因负担。对于 2012 年，我们在省级层面估算了归因负担。
2012 年，估计有 17.6%的南非人口接触 HAP。2012 年，HAP 暴露估计导致 8862 人死亡（95%置信区间（UI）8413-9251）和 1.7%（95% UI 1.6%-1.8%）的所有南非死亡人数，分别。健康生命年损失包括 208816 DALY（95% UI 195648-221007）和 1.0%的所有 DALY（95% UI 0.95%-1.0%），分别。2012 年，下呼吸道感染和心血管疾病导致的死亡和 DALY 比例最大。各省烹饪引起的 HAP 暴露量不同，2012 年林波波省（50.0%）、姆普马兰加省（27.4%）和夸祖鲁-纳塔尔省（26.4%）最高。年龄标准化负担指标显示，这三个省 HAP 导致的死亡和 DALY 负担率最高。
南非因烹饪导致的 HAP 疾病负担令人严重关切。需要通过立法和政策支持有效的干预措施，以及宣传运动，以确保获得清洁的家用燃料和改进的炉灶。在这方面需要继续加强努力，以遏制南非因 HAP 导致的疾病负担。
