Status of indoor air pollution (IAP) through particulate matter (PM) emissions and associated health concerns in South Asia.

Exposure to particulate emissions poses a variety of public health concerns worldwide, specifically in developing countries. This review summarized the documented studies on indoor particulate matter (PM) emissions and their major health concerns in South Asia. Reviewed literature illustrated the alarming levels of indoor air pollution (IAP) in India, Pakistan, Nepal, and Bangladesh, while Sri Lanka and Bhutan are confronted with relatively lower levels, albeit not safe. To our knowledge, data on this issue are absent from Afghanistan and Maldives. We found that the reported levels of PM10 and PM2.5 in Nepal, Pakistan, Bangladesh, and India were 2-65, 3-30, 4-22, 2-28 and 1-139, 2-180, 3-77, 1-40 fold higher than WHO standards for indoor PM10 (50 μg/m3) and PM2.5 (25 μg/m3), respectively. Regarding IAP-mediated health concerns, mortality rates and incidences of respiratory and non-respiratory diseases were increasing with alarming rates, specifically in India, Pakistan, Nepal, and Bangladesh. The major cause might be the reliance of approximately 80% population on conventional biomass burning in the region. Current review also highlighted the prospects of IAP reduction strategies, which in future can help to improve the status of indoor air quality and public health in South Asia.

[1]  Lidia Morawska,et al.  Combustion sources of particles. 1. Health relevance and source signatures. , 2002, Chemosphere.

[2]  C. Kolappan,et al.  Association between biomass fuel and pulmonary tuberculosis: a nested case–control study , 2009, Thorax.

[3]  Y. Ramesh Bhat,et al.  Association of indoor air pollution with acute lower respiratory tract infections in children under 5 years of age , 2012, Paediatrics and international child health.

[4]  P. Jha,et al.  Child mortality from solid-fuel use in India: a nationally-representative case-control study , 2010, BMC public health.

[5]  Digambar Behera,et al.  Domestic cooking fuel exposure and tuberculosis in Indian women. , 2010, The Indian journal of chest diseases & allied sciences.

[6]  Renuka Saini,et al.  Indoor Air Quality of Houses Located in the Urban Environment of Agra, India , 2008, Annals of the New York Academy of Sciences.

[7]  Ajay Taneja,et al.  Exposure of children studying in schools of India to PM levels and metal contamination: sources and their identification , 2013, Air Quality, Atmosphere & Health.

[8]  Muhammad Saleem,et al.  Comparative ambient and indoor particulate matter analysis of operation theatres of government and private (trust) Hospitals of Lahore, Pakistan , 2015 .

[9]  N. Bruce,et al.  Risk of low birth weight and stillbirth associated with indoor air pollution from solid fuel use in developing countries. , 2010, Epidemiologic reviews.

[10]  Z. Nasir,et al.  Characteristics of indoor/outdoor particulate pollution in urban and rural residential environment of Pakistan. , 2010, Indoor air.

[11]  Tasleem Akhtar,et al.  Chronic bronchitis in women using solid biomass fuel in rural Peshawar, Pakistan. , 2007, Chest.

[12]  M Kamijima,et al.  Indoor air pollution and its impact on children under five years old in Bangladesh. , 2007, Indoor air.

[13]  Z. Bhutta,et al.  Prenatal Exposure to Wood Fuel Smoke and Low Birth Weight , 2008, Environmental health perspectives.

[14]  Darby Jack,et al.  Impact of biomass fuels on pregnancy outcomes in central East India , 2014, Environmental Health.

[15]  L. Morawska,et al.  A pilot study of traditional indoor biomass cooking and heating in rural Bhutan: gas and particle concentrations and emission rates , 2017, Indoor air.

[16]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement , 2009, BMJ : British Medical Journal.

[17]  Robert D. Retherford,et al.  Biomass cooking fuels and prevalence of blindness in India. , 1999 .

[18]  Moshtaq Ahmed,et al.  Household‐level risk factors for influenza among young children in Dhaka, Bangladesh: a case–control study , 2015, Tropical medicine & international health : TM & IH.

[19]  B. Padhi,et al.  Assessment of intra-urban variability in indoor air quality and its impact on children’s health , 2010 .

[20]  Use of biomass fuel and acute respiratory infections in rural Pakistan. , 2012, Public health.

[21]  A. Costello,et al.  Biomass fuel use and the exposure of children to particulate air pollution in southern Nepal , 2014, Environment international.

[22]  Bernadette A. Thomas,et al.  Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 , 2012, The Lancet.

[23]  S. Agrawal,et al.  Effect of Indoor air pollution from biomass and solid fuel combustion on symptoms of preeclampsia/eclampsia in Indian women , 2014, Indoor air.

[24]  Ashutosh Kumar Singh,et al.  Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 , 2016, Lancet.

[25]  Sumi Mehta,et al.  The Burden of Disease from Indoor Air Pollution in Developing Countries: Comparison of Estimates , 2002 .

[26]  Z. Nasir,et al.  Seasonal variation of fine particulate matter in residential micro- environments of Lahore, Pakistan , 2015 .

[27]  Sumi Mehta,et al.  Exposure assessment for respirable particulates associated with household fuel use in rural districts of Andhra Pradesh, India , 2004, Journal of Exposure Analysis and Environmental Epidemiology.

[28]  D Behera,et al.  Respiratory symptoms in Indian women using domestic cooking fuels. , 1991, Chest.

[29]  S. Roychoudhury,et al.  Activation of protein kinase B (PKB/Akt) and risk of lung cancer among rural women in India who cook with biomass fuel. , 2012, Toxicology and applied pharmacology.

[30]  Z. Nasir,et al.  The state of ambient air quality in Pakistan—a review , 2010, Environmental science and pollution research international.

[31]  N. Fatima,et al.  Urban air pollution & its assessment in Lucknow City--the second largest city of North India. , 2014, The Science of the total environment.

[32]  Kirk R. Smith,et al.  Cooking smoke and tobacco smoke as risk factors for stillbirth , 2005, International journal of environmental health research.

[33]  M. Bates,et al.  PM2.5 in household kitchens of Bhaktapur, Nepal, using four different cooking fuels , 2015 .

[34]  W. Hung,et al.  Exploratory study of the indoor and outdoor relationships and chemical compositions of particulate matter in urban households in Colombo , 2015 .

[35]  Dan J Stein,et al.  Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 , 2015, BDJ.

[36]  D Behera,et al.  Indoor air pollution as a risk factor for lung cancer in women. , 2005, The Journal of the Association of Physicians of India.

[37]  N. K. Mondal,et al.  Micronucleus formation, DNA damage and repair in premenopausal women chronically exposed to high level of indoor air pollution from biomass fuel use in rural India. , 2010, Mutation research.

[38]  A. Díaz,et al.  Chimney Stove Intervention to Reduce Long-term Wood Smoke Exposure Lowers Blood Pressure among Guatemalan Women , 2007, Environmental health perspectives.

[39]  Bernadette A. Thomas,et al.  Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 , 2012, The Lancet.

[40]  N. Mondal,et al.  Indoor pollution from solid biomass fuel and rural health damage: A micro-environmental study in rural area of Burdwan, West Bengal , 2014 .

[41]  P. Simkhada,et al.  The effect of exposure to biomass smoke on respiratory symptoms in adult rural and urban Nepalese populations , 2014, Environmental Health.

[42]  S. M. Shiva Nagendra,et al.  Indoor air quality investigations in a naturally ventilated school building located close to an urban roadway in Chennai, India , 2012 .

[43]  A. Elkamel,et al.  A review of standards and guidelines set by international bodies for the parameters of indoor air quality , 2015 .

[44]  Ajay Taneja,et al.  Source Characterization of Trace Elements in Indoor Environments at Urban, Rural and Roadside Sites in a Semi Arid Region of India , 2014 .

[45]  David Wheeler,et al.  Who Suffers from Indoor Air Pollution? Evidence from Bangladesh , 2004, Health policy and planning.

[46]  H. Bush,et al.  The Impact of Emotional Intelligence on Conditions of Trust among Leaders at the Kentucky Department for Public Health , 2015, Front. Public Health.

[47]  Mukesh Khare,et al.  Indoor air quality modeling for PM10, PM2.5, and PM1.0 in naturally ventilated classrooms of an urban Indian school building , 2011, Environmental monitoring and assessment.

[48]  Peter Vickerman,et al.  A dose-response relationship between exposure to a large-scale HIV preventive intervention and consistent condom use with different sexual partners of female sex workers in southern India , 2011, BMC public health.

[49]  Chen Chen,et al.  Estimating Indoor PM2.5 and CO Concentrations in Households in Southern Nepal: The Nepal Cookstove Intervention Trials , 2016, PloS one.

[50]  R. Neupane,et al.  Domestic smoke pollution and acute respiratory infections in a rural community of the hill region of Nepal , 1989 .

[51]  A. Taneja,et al.  Personal and ambient PM2.5 exposure assessment in the city of Agra , 2016, Data in brief.

[52]  S. Zaidi,et al.  Second-hand smoke in indoor hospitality venues in Pakistan. , 2011, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[53]  S. Datta,et al.  Determinants of low birth weight in rural Wardha , 2012 .

[54]  C. Sharma,et al.  Indian aerosols: present status. , 2002, Chemosphere.

[55]  Rajesh Kumar,et al.  Household air pollution and stillbirths in India: analysis of the DLHS-II National Survey. , 2013, Environmental research.

[56]  T Myran,et al.  Mineral and/or metal content as critical determinants of particle-induced release of IL-6 and IL-8 from A549 cells. , 2000, Journal of toxicology and environmental health. Part A.

[57]  D. Alam,et al.  Adult cardiopulmonary mortality and indoor air pollution: a 10-year retrospective cohort study in a low-income rural setting. , 2012, Global heart.

[58]  W. Petri,et al.  Impact of neighborhood biomass cooking patterns on episodic high indoor particulate matter concentrations in clean fuel homes in Dhaka, Bangladesh. , 2014, Indoor air.

[59]  S. Shrestha,et al.  Indoor Air Pollution from Biomass Fuels and Respiratory Health of the Exposed Population in Nepalese Households , 2005, International journal of occupational and environmental health.

[60]  S. Guttikunda,et al.  Exposure to particulate matter in India: A synthesis of findings and future directions. , 2016, Environmental research.

[61]  N. Kolstrup,et al.  Asthma and indoor environment in Nepal , 2001, Thorax.

[62]  Hiroshi Yamato,et al.  Secondhand smoke exposures in indoor public places in seven Asian countries. , 2010, International journal of hygiene and environmental health.

[63]  Z. Mahmood,et al.  Adoption of improved cookstoves in Pakistan: A logit analysis , 2017 .

[64]  Rufus Edwards,et al.  Impact of improved cookstoves on indoor air quality in the Bundelkhand region in India , 2007 .

[65]  L. Brown,et al.  Sri Lanka Pilot Study to Examine Respiratory Health Effects and Personal PM2.5 Exposures from Cooking Indoors , 2016, International journal of environmental research and public health.

[66]  J. Benichou,et al.  Choice of time‐scale in Cox's model analysis of epidemiologic cohort data: a simulation study , 2004, Statistics in medicine.

[67]  A. Patankar,et al.  Monetary burden of health impacts of air pollution in Mumbai, India: implications for public health policy. , 2011, Public health.

[68]  A. Wickremasinghe,et al.  Respiratory health status of children from two different air pollution exposure settings of Sri Lanka: a cross-sectional study. , 2012, American journal of industrial medicine.

[69]  R. Haque,et al.  Seasonal concentrations and determinants of indoor particulate matter in a low-income community in Dhaka, Bangladesh. , 2013, Environmental research.

[70]  B. P. Shukla,et al.  Effects of Particulate Air Pollution on the Respiratory Health of Subjects Who Live in Three Areas in Kanpur, India , 2004, Archives of environmental health.

[71]  Michael G. Apte,et al.  Air pollution and the energy ladder in asian cities , 1994 .

[72]  J. Samet,et al.  Indoor air pollution in developing countries and acute lower respiratory infections in children , 2000, Thorax.

[73]  H. Saiyed,et al.  Ocular morbidity and fuel use: an experience from India , 2004, Occupational and Environmental Medicine.

[74]  S. Roychoudhury,et al.  Adverse reproductive health outcomes in pre-menopausal Indian women chronically exposed to biomass smoke , 2015, Journal of Public Health.

[75]  Rajesh Kumar,et al.  Biomass fuel and risk of tuberculosis: a case–control study from Northern India , 2010, Journal of Epidemiology & Community Health.

[76]  M. Travers,et al.  Indoor air quality due to secondhand smoke: Signals from selected hospitality locations in rural and urban areas of Bangalore and Dharwad districts in Karnataka, India. , 2015, Indian journal of cancer.

[77]  K. R. Smith National burden of disease in India from indoor air pollution. , 2000, Proceedings of the National Academy of Sciences of the United States of America.

[78]  F. Kelly,et al.  Air pollution and the elderly: oxidant/antioxidant issues worth consideration , 2003, European Respiratory Journal.

[79]  M. Kadir,et al.  Situational Analysis of Household Energy and Biomass Use and Associated Health Burden of Indoor Air Pollution and Mitigation Efforts in Pakistan , 2010, International journal of environmental research and public health.

[80]  Nowarat Coowanitwong,et al.  Ambient PM10 and respiratory illnesses in Colombo City, Sri Lanka , 2008, Journal of environmental science and health. Part A, Toxic/hazardous substances & environmental engineering.

[81]  Mohammad Alauddin,et al.  Quantification of Indoor Air Pollution from Using Cookstoves and Estimation of Its Health Effects on Adult Women in Northwest Bangladesh , 2012 .

[82]  Amod K Pokhrel,et al.  Case-control study of indoor cooking smoke exposure and cataract in Nepal and India. , 2005, International journal of epidemiology.

[83]  A. Gharaibeh,et al.  Determination of selected heavy metals in air samples from the northern part of Jordan , 2010, Environmental monitoring and assessment.

[84]  H. Groote,et al.  Determinants of household energy use in Bhutan , 2014 .

[85]  B. R. Gurjar,et al.  Air Pollution : Health and Environmental Impacts , 2010 .

[86]  Alexander Baklanov,et al.  Megacities, air quality and climate , 2016 .

[87]  Philip K. Hopke,et al.  Indoor air pollution from particulate matter emissions in different households in rural areas of Bangladesh , 2009 .

[88]  M. Pandey Prevalence of chronic bronchitis in a rural community of the Hill Region of Nepal. , 1984, Thorax.

[89]  A. Nafees,et al.  Indoor air pollution (PM2.5) due to secondhand smoke in selected hospitality and entertainment venues of Karachi, Pakistan , 2011, Tobacco Control.

[90]  J. Chow,et al.  Study of carbonaceous fractions associated with indoor PM2.5/PM10 during Asian cultural and ritual burning practices , 2016 .

[91]  C. Dimitroulopoulou,et al.  Personal exposure of children to air pollution , 2009 .

[92]  Ajay Taneja,et al.  Seasonal trends of PM10, PM5.0, PM2.5 & PM1.0 in indoor and outdoor environments of residential homes located in North-Central India , 2012 .

[93]  Anindita Dutta,et al.  Cooking with biomass increases the risk of depression in pre-menopausal women in India. , 2012, Social science & medicine.

[94]  Joellen Lewtas,et al.  Air pollution combustion emissions: characterization of causative agents and mechanisms associated with cancer, reproductive, and cardiovascular effects. , 2007, Mutation research.

[95]  S. Saleem,et al.  Exposure of pregnant women to indoor air pollution: a study from nine low and middle income countries , 2010, Acta obstetricia et gynecologica Scandinavica.

[96]  R. Dikshit,et al.  Indoor air pollution from solid fuels and risk of hypopharyngeal/laryngeal and lung cancers: a multicentric case-control study from India. , 2008, International journal of epidemiology.

[97]  Z. Bhutta,et al.  Indoor carbon monoxide and PM2.5 concentrations by cooking fuels in Pakistan. , 2009, Indoor air.

[98]  S. Roychoudhury,et al.  Changes in sputum cytology, airway inflammation and oxidative stress due to chronic inhalation of biomass smoke during cooking in premenopausal rural Indian women. , 2013, International journal of hygiene and environmental health.

[99]  C. Sreeramareddy,et al.  Association between biomass fuel use and maternal report of child size at birth - an analysis of 2005-06 India Demographic Health Survey data , 2011, BMC public health.

[100]  H. S. Joshi,et al.  Tuberculosis and Indoor Biomass and Kerosene Use in Nepal: A Case–Control Study , 2009, Environmental health perspectives.

[101]  Anindita Dutta,et al.  Hypertension with elevated levels of oxidized low-density lipoprotein and anticardiolipin antibody in the circulation of premenopausal Indian women chronically exposed to biomass smoke during cooking. , 2011, Indoor air.

[102]  R. Nazir,et al.  Indoor/outdoor relationship of trace metals in the atmospheric particulate matter of an industrial area , 2011 .

[103]  V. Gaborieau,et al.  Risk factors of lung cancer in Chandigarh, India. , 2001, The Indian journal of medical research.

[104]  Gurumurthy Ramachandran,et al.  Women's personal and indoor exposures to PM2.5 in Mysore, India : Impact of domestic fuel usage , 2005 .

[105]  H. Glick,et al.  Effect of cooking fuels on respiratory diseases in preschool children in Lucknow, India. , 1996, The American journal of tropical medicine and hygiene.

[106]  Keywan Riahi,et al.  Household Cooking with Solid Fuels Contributes to Ambient PM2.5 Air Pollution and the Burden of Disease , 2014, Environmental health perspectives.

[107]  J. Marshall,et al.  Spatiotemporal aspects of real-time PM(2.5): low- and middle-income neighborhoods in Bangalore, India. , 2011, Environmental science & technology.

[108]  R. Phalkey,et al.  A systematic review of air pollution as a risk factor for cardiovascular disease in South Asia: limited evidence from India and Pakistan. , 2014, International journal of hygiene and environmental health.

[109]  V. Mishra Effect of indoor air pollution from biomass combustion on prevalence of asthma in the elderly. , 2002, Environmental health perspectives.

[110]  R. Vecchi,et al.  Characterisation of PM10 and PM2.5 particulate matter in the ambient air of Milan (Italy) , 2001 .

[111]  Z. Bhutta,et al.  Eye and respiratory symptoms among women exposed to wood smoke emitted from indoor cooking: a study from southern Pakistan , 2005 .

[112]  C. Ranabhat,et al.  Consequence of Indoor Air Pollution in Rural Area of Nepal: A Simplified Measurement Approach , 2015, Front. Public Health.

[113]  Nigel Bruce,et al.  Eye discomfort, headache and back pain among Mayan Guatemalan women taking part in a randomised stove intervention trial , 2005, Journal of Epidemiology and Community Health.