Smokers Dying Younger - What If Non-smokers Are Also Dying Younger?

By Ram Charitra Sah (Posted: November 21, 2008) 

Approximately half the world’s population and up to 90% of rural households in developing countries still rely on unprocessed biomass fuels in the form of wood, dung and crop residues. These are typically burnt indoors in open fires or poorly functioning stoves. As a result, there are high levels of air pollution to which women, responsible for cooking, and their young children, who mostly stay with their mother during the cooking hours, are most heavily exposed.

The extent, to which such a large mass of population is continuously exposed to heavy indoor air pollution, in the absence of harnessing technologies of alternative energy readily available in most rural areas of Nepal, is severe. Poverty is one of the main barriers to the adoption of cleaner fuels. These days, the affordability and accessibility of cleaner fuels is getting harder and harder. The standard family possesses at least two to three gas cylinders: one under use, one in the queue at a gas station, and one as a reserve. The slow pace of development in many countries suggests that biomass fuels will continue to be used by the poor for many decades.

There is consistent evidence that indoor air pollution increases the risks of chronic obstructive pulmonary disease and of acute respiratory infections in childhood, the most important cause of death among children less than 5 years of age in developing countries, including Nepal. The lung is the most common site of injury by airborne pollutants. In the case of Nepal, the problem is not limited to only direct exposure related problem to indoor air pollution. It is an integrated problem with daily drudgery of women who collect the fuel wood from the ever-increasing distance of forest. Nepalese women suffer a high incidence of uterine prolapse that is likely due to carrying heavy wood loads soon after delivery. In rural India, women are engaged for six hours daily in collection of fuel wood & fodder and cooking. (Issue No. 3, December 2000).

Fuel wood constitutes 78% of the total fuel consumption, and it is one of the main causes of forest depletion. This is basically due to the absence of alternative energy harnessing technology. Most of the rural people have to depend on forest fuel wood, agricultural residues, and dung for cooking. As a result, distances from the villages to the forest have increased.

The government has so far been focusing on urban outdoor air pollution, to which only 15 % of the total country’s population is exposed. Thus, if we consider the value of life in the rural area and the urban area to be the same, there is an even more serious situation of the health hazards caused by indoor air pollution in the rural areas, which is inhabited by 85 % of the total population. Women, who are considered responsible for the cooking and collecting the fuel wood, share half of this total population. Moreover, 12 % of the child population below 5 years of age mostly stays with their mothers while cooking. Thus more than 60 % of the total populations are heavily exposed to the indoor air pollution, with poorly ventilated houses as well as inefficient cooking stoves. There is a high health impact - sickness and forest reduction is enough for the government attention to focus and address the indoor air pollution problem. It calls for greater policy reforms and will be significant for a large percentage of the population. It is also equally important in terms of gender equity and the right to live in a healthy environment, especially for children. There is a need to prioritise government policy to focus on indoor air pollution in a similar manner that it has given to urban air pollution.

The story of Kanchhi Maya Nepali began just to represent the early demise of small kids with the continuous exposure to the heavy indoor air pollution, who cannot afford processed fuel and do not have enough food to sustain the daily caloric intake recommended to remain healthy. Acute effects, however, may also include non-respiratory signs and symptoms, which may depend upon toxicological characteristics of the substances and host-related factors. Key Signs/Symptoms of the indoor air pollution are dizziness or headache, confusion, nausea/emesis, fatigue, tachycardia, eye and upper respiratory tract irritation, wheezing/bronchial constriction, persistent cough, elevated blood, carboxyhemoglobin levels, increased frequency of angina in persons with coronary heart disease. So not only are people like Kanchhi Maya Nepali, who lost her beloved son affected by this problem, but it is also the history of most rural Nepalese - non-smokers dying earlier

Ram Charitra Sah