Research on household air pollution must be a global health priority

(Press-News.org) Addressing the burden of household air pollution from solid fuel combustion— the leading environmental cause of death and disability in the world—has led to the implementation of many important interventions to promote access to improved stoves and clean fuels, but there is little demonstrated evidence of health benefits from most of these programs or technologies. Such are the conclusions of a new Policy Forum article published in this week's PLOS Medicine by authors who also outline a set of research priorities for addressing household air pollution.

A group of international researchers, led by William J. Martin II from the National Institutes of Health in the US and funded by several US government sponsors, identified research gaps and priorities related to the health effects of household air pollution and unsafe stoves in seven areas: cancer; infections; cardiovascular disease; maternal, neonatal, and child health; respiratory disease; burns; and ocular disorders and gaps in four cross-cutting areas that are relevant to research on HAP (exposure and biomarker assessment, women's empowerment, behavioral approaches, and program evaluation).

The authors conclude: "It is vital that researchers partner with implementing organizations and governments to evaluate the impacts of improved stove and fuel programs to identify and share evidence regarding the outcomes of the many implementation programs underway, including the socio-behavioral aspects of household energy use."

### Funding: We wish to thank the following for their support of the May 2011 workshop, ''Health Burden of Indoor Air Pollution on Women and Children in Developing Countries,'' and a subsequent workshop for members of the writing team: the U.S. Department of State, the U.S. Department of Health and Human Services, the U.S. National Institutes of Health (Eunice Kennedy Shriver National Institute of Child Health and Human Development; National Cancer Institute; National Eye Institute; National Heart, Lung, and Blood Institute; National Institute of Environmental Health Sciences; John E. Fogarty International Center; and Office of Behavioral and Social Sciences Research), the Environmental Protection Agency, the Centers for Disease Control and Prevention, the U.S. Agency for International Development, and the World Health Organization. While several of the authors are employees of these organizations, we can confirm that the funders of the workshop did not have any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Comments and views of the authors do not necessarily represent the views of the U.S. Department of State, the U.S. Department of Health and Human Services, U.S. National Institutes of Health, the Centers for Disease Control and Prevention, the Environmental Protection Agency, the United States Agency for International Development, or the World Health Organization.

Competing Interests: WE is an at-large member of the Gender Coordinating Committee of the Global Alliance for Clean Cookstoves/UN Foundation. This is an unpaid position that provides intellectual input on gender/sex issues to the Global Alliance; however, WE has no involvement with the Alliance's publications or with its funding calls. All other authors have declared that no competing interests exist.

Citation: Martin WJ II, Glass RI, Araj H, Balbus J, Collins FS, et al. (2013) Household Air Pollution in Low- and Middle-Income Countries: Health Risks and Research Priorities. PLoS Med 10(6): e1001455. doi:10.1371/journal.pmed.1001455

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Contact:

William Martin II
Associate Director
National Institutes of Health
Eunice Kennedy Shriver National Institute of Child Health and Human Development
31 Center Drive
Building 31, Room 2A31
Bethesda, Maryland 20892-2425
UNITED STATES
301-451-1749
wjmartin@mail.nih.gov END