IISection
4.5 IndooR aIR pollutIon ContRol
more than 20 Chinese studies: 3–5. Premature deaths: 400–800. Blindness is linked with the use of biomass fuels by women in India, which has the largest burden of blindness of any region of the world. Odds ratio for this group: 1.15–1.3. Blindness does not cause premature deaths, but puts a significant burden of disability.
Tuberculosis is responsible for 5% of the Indian burden of disease, a larger percent- age than in any other region. It causes premature deaths: 50,000–130,000. Perinatal effects (stillbirth; low birth weight; and death or illness during the first two weeks after birth) are responsible for 8.8% of the Indian burden of disease. But there is little evidence available to make estimates about premature deaths. Cardiovascular diseases (CVDs) and asthma are known to be related to outdoor air pollution and passive smoking in industrial countries but do not seem to have been studied in developing-country households (Smith, 1998).
The health bulletin of WHO has reported the results of studies conducted by Smith and Schwela on the number of deaths in developing and developed countries caused by indoor particle pollution for both the rural as well as urban population;
the results show that in rural households the particle pollution is responsible for 67–68% of the total deaths due to indoor particle pollution. This is due to the use of biomass fuel for cooking and heating purposes. A limited number of such studies has been done till now on the rural population of developing countries. Their results are shown in Table 4.9.
specific pollutants must be met. Furthermore, satisfying guidelines that do not have the force of law may still be legally prudent as a defense against negligence in poten- tial lawsuits. The underlying purpose in all control procedures is to ensure that the indoor air maintains the quality needed for safety and health; satisfies comfort and productivity needs; and is as cost effective and energy effective as possible. There are six ways to control indoor air pollution:
1. Removal or substitution at the source 2. Filtration and purification of contaminants
3. Dilution or ventilation of the indoor air with the outside air or filtered recy- cled air
4. Encapsulation or otherwise interfering with materials’ ability to give off pollutants
5. Time of use of a possible contaminant
6. Education and training of building occupants, especially operation and maintenance personnel
The EPA has consistently stated that source control is the most direct and depend- able control option and is the only effective one when strong pollutant sources are present. Ventilation is a preferred way of control when the contaminant/source is unknown, when source treatment is too costly, or when the source is localized. The IAQ management may also wish to seek the advice and counsel of medical experts as a control support through medical surveillance or treatment.
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5 Effects of Indoor Air Pollution from Biomass Fuel Use on Women’s Health in India
Twisha Lahiri and Manas Ranjan Ray
Contents
5.1 Introduction ... 136 5.1.1 Biomass Use in Indian Subcontinent ... 136 5.1.2 IAP from Biomass Burning ... 138 5.1.3 Health Impact of Biomass Smoke Exposure: Excess
Morbidity and Mortality ... 139 5.1.4 Scope of the Work and Objective of the Study ... 139 5.2 Study Protocol ... 140 5.2.1 Subjects ... 140 5.2.2 Evaluation of Respiratory Health ... 140 5.2.3 Measurement of IAP ... 140 5.2.4 Hematological Assays ... 140 5.2.5 Reproductive Toxicity of Biomass Smoke Exposures ... 140 5.2.6 Genotoxicity and Antioxidant Defense... 141 5.2.7 Questionnaire Survey for Neurobehavioral Problems ... 141 5.3 Salient Findings ... 141 5.3.1 Particulate Pollution in Cooking Areas ... 141 5.3.2 Effects on Respiratory Health ... 141 5.3.2.1 Rise in Respiratory Symptoms ... 141 5.3.2.2 Asthma ... 142 5.3.2.3 Reduction in Lung Function ... 143 5.3.2.4 Adverse Cellular Lung Reaction ... 144 5.3.2.5 Rise in COPD ... 146 5.3.3 Hematological, Immunological, and Cardiovascular Changes ... 147 5.3.4 Adverse Effects on Female Reproductive System ... 149 5.3.4.1 Alterations in Menstrual Cycle Length ... 149 5.3.4.2 Spontaneous Abortion ... 151 5.3.4.3 Low Birth Weight and Stillbirth ... 151 5.3.5 Depletion of Antioxidant Defense ... 152