Review
Author: Abu-Zaid, Ahmed ; Sergindo, Mihretu Tagesse ; Salami, Afeez Abolarinwa ; Afzal, Saira ; Bhaskar, Sonu ; Singh, Surjit ; Pawar, Shrikant ; Almustanyir, Sami ; Zyoud, Sa'ed H ; Rana, Kritika ; Belay, Sefealem Assefa ; Ahmad, Danish ; Malhotra, Kashish ; Mohammadian-Hafshejani, Abdollah ; Rahman, Mohammad Hifz Ur ; Bhat, Ajay Nagesh ; Misganaw, Awoke ; Raghav, Pankaja ; Lahariya, Chandrakant ; Al Hamad, Hanadi ; Dadras, Omid ; Rodriguez, Jefferson Antonio Buendia ; Ghith, Nermin ; Ahmadi, Ali ; Omar Bali, Ahmed ; Patel, Jay ; Straif, Kurt ; Malik, Ahmad Azam ; Bennett, Derrick A ; Odo, Daniel Bogale ; J, Vinothini ; Gebremeskel, Teferi Gebru ; Jairoun, Ammar Abdulrahman ; Shamsi, Anas ; Anyabolo, Ekenedilichukwu Emmanuel ; Poluru, Ramesh ; Chimoriya, Ritesh ; Knibbs, Luke D ; Rezaei, Nazila ; Sethi, Yashendra ; Yonemoto, Naohiro ; Tumurkhuu, Munkhtuya ; Do, Thanh Chi ; Chaudhary, Anis Ahmad ; Garcia, Vanessa ; Gebregergis, Miglas Welay ; Stockfelt, Leo ; Chaurasia, Akhilanand ; Chen, Yifan ; Ahmad, Sajjad ; Adepoju, Abiola Victor ; Athari, Seyyed Shamsadin ; Hoan, Nguyen Quoc ; Yadav, Mukesh Kumar ; Nguyen, Hien Quang ; Motappa, Rohith ; Halwani, Rabih ; Xu, Suowen ; Sahoo, Pragyan Monalisa ; Lim, Stephen S ; Boppana, Sri Harsha ; Xiao, Hong ; Kansal, Sushil Kumar ; Zaki, Leila ; Verma, Madhur ; Janodia, Manthan Dilipkumar ; Cao, Fan ; Abubakar, Bilyaminu ; Feizkhah, Alireza ; Guan, Shi-Yang ; Saya, Ganesh Kumar ; Adegboye, Oyelola A ; Hwang, Bing-Fang ; Chanie, Gashaw Sisay ; Samy, Abdallah M ; Mhlanga, Laurette ; Noubiap, Jean Jacques ; Bhattacharjee, Priyadarshini ; Huynh, Hong-Han ; Karaye, Ibraheem M ; Vidale, Simone ; Parikh, Romil R ; Emeto, Theophilus I ; Nguyen, Dang ; Apostol, Geminn Louis Carace ; Barteit, Sandra ; Yiğit, Arzu ; Ahmed, Haroon ; Morawska, Lidia ; Chandika, Rama Mohan ; Gao, Xiang ; Mirrakhimov, Erkin M ; Mohamed, Nouh Saad ; Khalaji, Amirmohammad ; Kumar, Ashish ; Perianayagam, Arokiasamy ; Stanaway, Jeffrey D ; Salihu, Dauda ; Chong, Bryan ; Lee, Munjae ; Khatab, Khaled ; Lan, Tuo ; Gadanya, Muktar A ; Bam, Kiran ; Owolabi, Mayowa O ; Inok, Arit ; Areda, Demelash ; Nzoputam, Ogochukwu Janet ; Ebrahimi, Alireza ; Pham, Hoang Tran ; Olagunju, Andrew T ; Brauer, Michael ; Yin, Dehui ; Edinur, Hisham Atan ; López-Gil, José Francisco ; Gupta, Lalit ; Adeyeoluwa, Temitayo Esther ; Beloukas, Apostolos ; Tsatsakis, Aristidis ; Rana, Juwel ; Meles, Hadush Negash ; Khosla, Atulya Aman ; Ramadan, Mahmoud Mohammed ; Tampa, Mircea ; Yiğit, Vahit ; Mekene Meto, Tesfahun ; Heyi, Demisu Zenbaba ; Yu, Chuanhua ; Hasnain, Md Saquib ; Kulkarni, Vishnutheertha ; Zhu, Bin ; Mereta, Seid Tiku ; Boampong, Mary Sefa ; Rauniyar, Santosh Kumar ; Mattiello, Rita ; Mondal, Himel ; Pantazopoulos, Ioannis ; Siraj, Md Shahjahan ; Ghasemzadeh, Afsaneh ; Jha, Ravi Prakash ; Alif, Sheikh Mohammad ; Dey, Sagnik ; Sayeed, Md Abu ; Ommati, Mohammad Mehdi ; Menezes, Ritesh G ; Zhang, Zhiqiang ; Naveed, Muhammad ; Liu, Wei ; Thakur, Ramna ; Shittu, Aminu ; Azadnajafabad, Sina ; Mokdad, Ali H ; Rajaa, Sathish ; Ahmed, Ayman ; Jayaram, Shubha ; Meretoja, Tuomo J ; Rahim, Fakher ; Mestrovic, Tomislav ; Temsah, Reem Mohamad Hani ; Zhang, Haijun ; Baran, Mehmet Firat ; Amusa, Ganiyu Adeniyi ; Tefera, Yibekal Manaye ; Hezam, Kamal ; Ashraf, Tahira ; Peprah, Prince ; Sheikh, Aziz ; Abeldaño Zuñiga, Roberto Ariel ; Bilgin, Cem ; Ahmad, Aqeel ; Sahebkar, Amirhossein ; Afzal, Muhammad Sohail ; Hosseinzadeh, Hassan ; KM, Shivakumar ; Prates, Elton Junio Sady ; Ndejjo, Rawlance ; Vos, Theo ; Abedi, Armita ; Nair, Sanjeev ; Kuddus, Mohammed ; Al Awaidy, Salah ; Mirza, Moonis ; Asgedom, Akeza Awealom ; Golinelli, Davide ; Ondayo, Maureene Auma ; Odetokun, Ismail A ; Cruz-Martins, Natalia ; Islam, Sheikh Mohammed Shariful ; Schumacher, Austin E ; Aregawi, Brhane Berhe ; Tanwar, Manoj ; Ahmed, Anisuddin ; Alajlani, Muaaz M ; Oluwatunase, Gideon Olamilekan ; Parija, Pragyan Paramita ; Vahdati, Sanaz ; Bennitt, Fiona B ; Werkneh, Adhena Ayaliew ; Olasehinde, Tosin Abiola ; Malinga, Lesibana Anthony ; Khajuria, Himanshu ; Udoakang, Aniefiok John ; Bhagat, Devidas S ; Rasali, Drona Prakash ; Alvis-Zakzuk, Nelson J ; Jema, Alelign Tasew ; Eftekharimehrabad, Aziz ; Santric-Milicevic, Milena M ; Anagaw, Tadele Fentabel ; Noman, Efaq Ali ; Puvvula, Jagadeesh ; Bhatti, Manpreet S Singh ; El Bayoumy, Ibrahim Farahat ; Christopher, Devasahayam J ; Boudalia, Sofiane ; Bahramian, Saeed ; Banik, Biswajit ; Jakovljevic, Mihajlo ; Pati, Siddhartha ; Nikolouzakis, Taxiarchis Konstantinos ; Immurana, Mustapha ; Bhandari, Dinesh ; Emdadul Haque, Syed ; Wonde, Tewodros Eshete ; Zhai, Chunxia ; Lusk, Jay B ; Liu, Gang ; Mathioudakis, Alexander G ; Ahmad, Muayyad M ; Shamim, Muhammad Aaqib ; Wozniak, Sarah ; Folayan, Morenike Oluwatoyin ; Ashbaugh, Charlie ; Ullah, Sana ; Basu, Saurav ; Liu, Shuke ; Nguyen, Van Thanh ; Fischer, Florian ; Otoiu, Adrian ; Bhatti, Gurjit Kaur ; Pradhan, Jalandhar ; Kumar, Dewesh ; Jalilzadeh Yengejeh, Reza ; Rahmani, Amir Masoud ; Wojewodzic, Marcin W ; Belayneh, Melesse ; Kumar, Nithin ; Ajami, Marjan ; Darcho, Samuel Demissie ; Mohammed, Mustapha ; Lauriola, Paolo ; Hasaballah, Ahmed I ; Mohammed, Shafiu ; Baskaran, Pritish ; Yaya, Sanni ; Swami Vetha, Berwin Singh ; Bhardwaj, Pankaj ; Zeng, Youjie ; Fazylov, Timur ; Momani, Shaher ; Ofakunrin, Akinyemi O D ; Kulimbet, Mukhtar ; Chattu, Vijay Kumar ; Fahim, Ayesha ; Munjal, Kavita ; Satpathy, Maheswar ; Lai, Hanpeng ; Vaziri, Siavash ; Rahman, Mosiur ; Bosoka, Samuel Adolf ; Jonas, Jost B ; Padubidri, Jagadish Rao ; Kanmodi, Kehinde Kazeem ; Iqhrammullah, Muhammad ; Russo, Michele ; G, Sridevi ; Islam, Rakibul M ; Zyoud, Samer H ; Basu, Sanjay ; Gebrehiwot, Mesfin ; Kheirallah, Khalid A ; Seylani, Allen ; Murray, Christopher J L ; Kayode, Gbenga A ; Yahoo Syed, Saba ; Rahman, Muhammad Aziz ; Wassie, Gizachew Tadesse ; Aboagye, Richard Gyan ; Agide, Feleke Doyore ; Adekanmbi, Victor ; Koren, Gerbrand ; Ali, Waad ; Myung, Woojae ; Khanal, Vishnu ; Tabatabaei, Seyyed Mohammad ; Idowu, Oluwatope Olaniyi ; Hay, Simon I ; Wu, Zenghong ; Mithra, Prasanna ; Rafiee, Ata ; Causey, Kate ; Parthasarathi, Ashwaghosha ; Akinyemi, Rufus Olusola ; Desye, Belay ; Le, Nhi Huu Hanh ; Lee, Seung Won ; Siddig, Emmanuel Edwar ; Sarkar, Tanmay ; Roy, Priyanka ; Weldetinsaa, Haftom Legese ; Dhimal, Meghnath ; Babu, Giridhara Rathnaiah ; Okonji, Osaretin Christabel ; Barone-Adesi, Francesco ; Banach, Maciej ; Pereira, Gavin ; Cohen, Aaron J ; Rajput, Prashant ; Hu, Chengxi ; Malik, Iram ; Enyew, Habtamu Demelash ; Mirica, Andreea ; Pribadi, Dimas Ria Angga ; Swain, Chandan Kumar ; Bashiru, Hameed Akande ; Adha, Rishan ; Temsah, Mohamad-Hani ; Ashemo, Mubarek Yesse ; Meo, Sultan Ayoub ; Oancea, Bogdan ; Zeariya, Mohammed G M ; Mubarik, Sumaira ; Ali, Abid ; Aremu, Olatunde ; Nangia, Vinay ; Tripathy, Jaya Prasad ; Fakunle, Adekunle Gregory ; Doshi, Ojas Prakashbhai ; Aly, Hany ; Kurmi, Om P ; Amu, Hubert ; Ibitoye, Segun Emmanuel ; Jaiswal, Abhishek ; Mohamed, Jama ; Tovani-Palone, Marcos Roberto ; Oghenetega, Onome Bright ; Koul, Parvaiz A ; Tarkang, Elvis Enowbeyang ; Park, Eun-Kee ; Anuoluwa, Iyadunni Adesola ; Holla, Ramesh ; Krishan, Kewal ; Pourshams, Akram ; Abdoun, Meriem ; Ekundayo, Temitope Cyrus ; Bastan, Mohammad-Mahdi ; Pardhan, Shahina ; Aravkin, Aleksandr Y ; Shahid, Samiah ; Nawsherwan ; Azzam, Ahmed Y ; Alemayohu, Mulubirhan Assefa ; Shetty, Pavanchand H ; Saddik, Basema Ahmad ; Sham, Sunder ; Yon, Dong Keon ; Norouzian Baghani, Abbas ; Diaz, Daniel ; Adane, Mesafint Molla ; Chen, Guangjin ; Tang, Haosu ; Rout, Himanshu Sekhar ; Shiue, Ivy ; Chukwu, Isaac Sunday ; Hashmeh, Nadim ; Ikiroma, Adalia ; Ranabhat, Chhabi Lal ; Wu, Felicia ; Adeyomoye, Olorunsola Israel ; Guo, Zhifeng ; Olufadewa, Isaac Iyinoluwa ; Saeed, Umar ; Anuoluwa, Boluwatife Stephen ; Roshandel, Gholamreza ; Kuate Defo, Barthelemy ; Daikwo, Patience Unekwuojo ; Dai, Xiaochen ; E'mar, Abdel Rahman ; Alvis-Guzman, Nelson ; Tibebu, Nigusie Selomon ; Delgado-Saborit, Juana Maria ; Vohra, Karn ; Rawaf, Salman ; Rajabi, Rayan ; Saheb Sharif-Askari, Narjes ; P A, Mahesh Padukudru ; Niranjan, Vikram ; Munkhsaikhan, Yanjinlkham ; Tiwari, Krishna ; Maugeri, Andrea ; Spearman, Sandra ; Redwan, Elrashdy M Moustafa Mohamed ; Noor, Syed Toukir Ahmed ; Golechha, Mahaveer ; Maharaj, Sandeep B ; Rahmanian, Mohammad ; Anvari, Saeid ; Joseph, Nitin ; Faridi, Sasan ; Sabet, Cameron John ; Khosravi, Majid ; Das, Saswati ; Kadashetti, Vidya ; Omotayo, Abiodun Olusola ; Burkart, Katrin ; Thienemann, Friedrich ; Singh, Paramdeep ; Okereke, Chukwuma ; Röhr, Susanne ; Abdelkader, Atef ; Ahmadi, Sepideh ; Wickramasinghe, Nuwan Darshana ; Abdurebi, Muhammed Jemal ; Gupta, Bhawna ; Villani, Simona ; Al-Gheethi, Adel Ali Saeed ; Miller, Ted R
BACKGROUNDDespite a substantial reduction in the use of solid fuels for cooking worldwide, exposure to household air pollution (HAP) remains a leading global risk factor, contributing considerably to the burden of disease. We present a comprehensive analysis of spatial patterns and temporal trends in exposure and attributable disease from 1990 to 2021, featuring substantial methodological updates compared with previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study, including improved exposure estimations accounting for specific fuel types.METHODSWe estimated HAP exposure and trends and attributable burden for cataract, chronic obstructive pulmonary disease, ischaemic heart disease, lower respiratory infections, tracheal cancer, bronchus cancer, lung cancer, stroke, type 2 diabetes, and causes mediated via adverse reproductive outcomes for 204 countries and territories from 1990 to 2021. We first estimated the mean fuel type-specific concentrations (in μg/m3) of fine particulate matter (PM2·5) pollution to which individuals using solid fuels for cooking were exposed, categorised by fuel type, location, year, age, and sex. Using a systematic review of the epidemiological literature and a newly developed meta-regression tool (meta-regression: Bayesian, regularised, trimmed), we derived disease-specific, non-parametric exposure-response curves to estimate relative risk as a function of PM2·5 concentration. We combined our exposure estimates and relative risks to estimate population attributable fractions and attributable burden for each cause by sex, age, location, and year.FINDINGSIn 2021, 2·67 billion (95% uncertainty interval [UI] 2·63-2·71) people, 33·8% (95% UI 33·2-34·3) of the global population, were exposed to HAP from all sources at a mean concentration of 84·2 μg/m3. Although these figures show a notable reduction in the percentage of the global population exposed in 1990 (56·7%, 56·4-57·1), in absolute terms, there has been only a decline of 0·35 billion (10%) from the 3·02 billion people exposed to HAP in 1990. In 2021, 111 million (95% UI 75·1-164) global disability-adjusted life-years (DALYs) were attributable to HAP, accounting for 3·9% (95% UI 2·6-5·7) of all DALYs. The rate of global, HAP-attributable DALYs in 2021 was 1500·3 (95% UI 1028·4-2195·6) age-standardised DALYs per 100 000 population, a decline of 63·8% since 1990, when HAP-attributable DALYs comprised 4147·7 (3101·4-5104·6) age-standardised DALYs per 100 000 population. HAP-attributable burden remained highest in sub-Saharan Africa and south Asia, with 4044·1 (3103·4-5219·7) and 3213·5 (2165·4-4409·4) age-standardised DALYs per 100 000 population, respectively. The rate of HAP-attributable DALYs was higher for males (1530·5, 1023·4-2263·6) than for females (1318·5, 866·1-1977·2). Approximately one-third of the HAP-attributable burden (518·1, 410·1-641·7) was mediated via short gestation and low birthweight. Decomposition of trends and drivers behind changes in the HAP-attributable burden highlighted that declines in exposures were counteracted by population growth in most regions of the world, especially sub-Saharan Africa.INTERPRETATIONAlthough the burden attributable to HAP has decreased considerably, HAP remains a substantial risk factor, especially in sub-Saharan Africa and south Asia. Our comprehensive estimates of HAP exposure and attributable burden offer a robust and reliable resource for health policy makers and practitioners to precisely target and tailor health interventions. Given the persistent and substantial impact of HAP in many regions and countries, it is imperative to accelerate efforts to transition under-resourced communities to cleaner household energy sources. Such initiatives are crucial for mitigating health risks and promoting sustainable development, ultimately improving the quality of life and health outcomes for millions of people.FUNDINGBill & Melinda Gates Foundation.