Review
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World J Clin Pediatr. May 8, 2013; 2(2): 6-15
Published online May 8, 2013. doi: 10.5409/wjcp.v2.i2.6
Indoor air pollution and respiratory health of children in the developing world
Sumal Nandasena, Ananda Rajitha Wickremasinghe, Nalini Sathiakumar
Sumal Nandasena, National Institute of Health Sciences, Ministry of Health, Kalutara, KT 12000, Sri Lanka
Ananda Rajitha Wickremasinghe, Department of Public Health, Faculty of Medicine, University of Kelaniya, Kelaniya, GQ 11010, Sri Lanka
Nalini Sathiakumar, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, United States
Author contributions: Nandasena S completed the initial literature survey; Nandasena S, Wickremasinghe AR contributed to summarize all eligible papers, synthesized the findings and drafted the manuscript; Sathiakumar N helped in drafting the final manuscript, and Nandasena S is the guarantor of the work; All authors read and approved the final manuscript.
Correspondence to: Dr. Sumal Nandasena, National Institute of Health Sciences, Ministry of Health, No. 28, Mathugama Road, Kalutara, KT 12000, Sri Lanka. sumalnandasena@gmail.com
Telephone: +94-71-8289349 Fax: +94-34-2226319
Received: February 18, 2013
Revised: April 4, 2013
Accepted: April 17, 2013
Published online: May 8, 2013
Processing time: 67 Days and 2.9 Hours
Abstract

Indoor air pollution (IAP) is a key contributor to the global burden of disease mainly in developing countries. The use of solid fuel for cooking and heating is the main source of IAP in developing countries, accounting for an estimated 3.5 million deaths and 4.5% of Disability-Adjusted Life Years in 2010. Other sources of IAP include indoor smoking, infiltration of pollutants from outdoor sources and substances emitted from an array of human utilities and biological materials. Children are among the most vulnerable groups for adverse effects of IAP. The respiratory system is a primary target of air pollutants resulting in a wide range of acute and chronic effects. The spectrum of respiratory adverse effects ranges from mild subclinical changes and mild symptoms to life threatening conditions and even death. However, IAP is a modifiable risk factor having potential mitigating interventions. Possible interventions range from simple behavior change to structural changes and from shifting of unclean cooking fuel to clean cooking fuel. Shifting from use of solid fuel to clean fuel invariably reduces household air pollution in developing countries, but such a change is challenging. This review aims to summarize the available information on IAP exposure during childhood and its effects on respiratory health in developing countries. It specifically discusses the common sources of IAP, susceptibility of children to air pollution, mechanisms of action, common respiratory conditions, preventive and mitigating strategies.

Keywords: Indoor air pollution; Air pollution; Respiratory health; Children; Developing countries

Core tip: Indoor air pollution (IAP) is a key contributor to the burden of disease in developing countries; use of solid fuel for cooking and heating is the main source of IAP. Children are among the most vulnerable groups for adverse effects of IAP. The respiratory system is a primary target of air pollutants resulting in a wide range of acute and chronic effects. The spectrum of respiratory adverse effects ranges from mild subclinical changes and mild symptoms to life threatening conditions, and even death. This review summarizes the available information on IAP exposure during childhood and its effects on respiratory health in developing countries.