9. Harmful indoor air pollution, such as 2 points
tobacco and cooking smoke, has been
estimated to be up to what percent
greater than outdoor pollution?
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#Covid-19
Answers
Answer:
The principal sources of indoor air pollution are: Combustion, building material, and bioaerosols.(2) While radon, asbestos, pesticides, heavy metals, volatile organic matter, and environmental tobacco smoke are considered major indoor pollutants in developed countries, the combustion products of biomass fuels contribute most to indoor air pollution in developing nations. In India, out of 0.2 billion people using fuel for cooking; 49% use firewood; 8.9% cow dung cake; 1.5% coal, lignite, or charcoal; 2.9% kerosene; 28.6% liquefied petroleum gas (LPG); 0.1% electricity; 0.4% biogas; and 0.5% any other means.(3)
The incomplete combustion products of biomass fuels include suspended particulate matter, carbon monoxide, polyaromatic hydrocarbons, polyorganic matter, formaldehyde, etc., which have adverse effects on health. The combustion of coal results in production of oxides of sulfur, arsenic, and fluorine. Pollutants such as aldehydes, volatile, and semivolatile organic compounds are produced from resins, waxes, polishing materials, cosmetics, and binders. Lastly; biological pollutants like dust mites, molds, pollen, and infectious agents produced in stagnant water, mattresses, carpets, and humidifiers too pollute indoor air.(4)
A study on quantifying exposures to respiratory particulate matter found concentrations of particulate matter ranging from 500 to 2,000 mg/m3 during cooking in biomass-using households. Average 24-h exposures ranged from 82 ± 39 mg/m3 for those using clean fuels, to 231 ± 109 mg/m3 for those who used biomass fuel for cooking.(5) In indoor air, carbon monoxide levels during cooking by dung, wood, coal, kerosene, and LPG were found to be 144, 156, 94, 108, and 14 mg/m3, respectively. The indoor levels of total polyaromatic hydrocarbons during use of dung, wood, coal, kerosene, and LPG were 3.56, 2.01, 0.55, 0.23, and 0.13 mg/m3 of air, respectively.(6) The formaldehyde mean levels were 670, 652, 109, 112, and 68 mg/m3, respectively, for dung, wood, coal, kerosene, and LPG.(7)
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Effects of Indoor Air Pollution on Health
The ill-effects of indoor air pollution result in about 2 million premature deaths per year, wherein 44% are due to pneumonia, 54% from chronic obstructive pulmonary disease (COPD), and 2% from lung cancer.(8) The most affected groups are women and younger children, as they spend maximum time at home.(8) The morbidities associated with indoor air pollution are respiratory illnesses, viz., acute respiratory tract infection(9) and COPD,(10) poor perinatal outcomes like low birth weight(11) and still birth, cancer of nasopharynx, larynx, lung,(12) and leukemia. The harmful health effects of formaldehyde range from being an acute irritant, reducing vital capacity, causing bronchitis, to being a carcinogen causing leukemia and lung cancer.(13,14) There are few studies done so far to show the effect of wood smoke on cardiovascular health. A study from Guatemala reported that reduction in wood smoke exposure by use of improved chimney stove resulted in lowering of systolic blood pressure by 3.7 mmHg (95% confidence interval (CI): -8.1, 0.6) and diastolic blood pressure by 3.0 mmHg (95% CI: -5.7, -0.4).(15) Another study reported reduction in ST-segment depression (odds ratio (OR) 0.26, 95% CI: 0.08, 0.90) on electrocardiogram after stove intervention.(16)
The indoor air pollutants have potential health effects.(17) The particulates cause respiratory infections, chronic bronchitis, COPD, and also lead to exacerbation of COPD. Sulfur dioxide and nitrogen dioxide cause wheezing and exacerbation of asthma. In addition to this, nitrogen dioxide causes respiratory infections and deteriorates lung functions. Sulfur dioxide has an additional etiological role in exacerbation of COPD and cardiovascular disease. The risk of poor perinatal outcomes, viz., low birth weight and perinatal death increases from exposure to carbon monoxide. Biomass smoke, especially metal ions and polycyclic aromatics, leads to development of cataract. Polycyclic aromatic hydrocarbons lead to development of cancers of lungs, mouth, nasopharynx, and larynx. As a consequence of poverty, factors such as living conditions, sanitation, and access to water are associated with solid fuel use, and should be considered while measuring impact of solid fuel on child survival.(17)
Various studies in India have reported harmful effects of indoor air pollution. In a large case-control study, after adjustment for demographic factors and living conditions, solid-fuel use significantly increased child deaths at ages 1-4 years (prevalence ratio boys: 1.30, 95% CI: 1.08-1.56; girls: 1.33, 95% CI: 1.12-1.58). More girls than boys died from exposure to solid fuels. Solid fuel use was also associated with nonfatal pneumonia (boys: Prevalence ratio 1.54; 95% CI: 1.01-2.35; girls: Prevalence ratio 1.94; 95% CI: 1.13-3.33).(18)
Explanation:
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