Millions dead: How do we know and what does it mean? Methods used in the comparative risk assessment of household air pollution

Kirk R. Smith, Nigel Bruce, Kalpana Balakrishnan, Heather Adair-Rohani, John Balmes, Zoë Chafe, Mukesh Dherani, H. Dean Hosgood, Sumi Mehta, Daniel Pope, Eva Rehfuess

Research output: Contribution to journalArticle

287 Scopus citations

Abstract

In the Comparative Risk Assessment (CRA) done as part of the Global Burden of Disease project (GBD-2010), the global and regional burdens of household air pollution (HAP) due to the use of solid cookfuels, were estimated along with 60+ other risk factors. This article describes how the HAP CRA was framed; how global HAP exposures were modeled; how diseases were judged to have sufficient evidence for inclusion; and how meta-Analyses and exposure-response modeling were done to estimate relative risks. We explore relationships with the other air pollution risk factors: Ambient air pollution, smoking, and secondhand smoke. We conclude with sensitivity analyses to illustrate some of the major uncertainties and recommendations for future work. We estimate that in 2010 HAP was responsible for 3.9 million premature deaths and ∼4.8% of lost healthy life years (DALYs), ranking it highest among environmental risk factors examined and one of the major risk factors of any type globally.

Original languageEnglish (US)
Pages (from-to)185-206
Number of pages22
JournalAnnual Review of Public Health
Volume35
DOIs
StatePublished - Jan 1 2014

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Keywords

  • DALY
  • Global Burden of Disease
  • Household fuels
  • IER
  • Indoor air pollution
  • Integrated exposure-response
  • Solid cookfuels

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Smith, K. R., Bruce, N., Balakrishnan, K., Adair-Rohani, H., Balmes, J., Chafe, Z., Dherani, M., Hosgood, H. D., Mehta, S., Pope, D., & Rehfuess, E. (2014). Millions dead: How do we know and what does it mean? Methods used in the comparative risk assessment of household air pollution. Annual Review of Public Health, 35, 185-206. https://doi.org/10.1146/annurev-publhealth-032013-182356