Millions Dead: How Do We Know and What Does it Mean? Methods Used in the Comparative Risk Assessment of Household Air Pollution

Posted: 22 Mar 2014

See all articles by Kirk R. Smith

Kirk R. Smith

University of California, Berkeley - School of Public Health

Nigel Bruce

University of Liverpool - Department of Public Health, Policy and Systems

Kalpana Balakrishnan

Sri Ramakrishna Engineering College (SREC)

Heather Adair-Rohani

University of California, Berkeley - School of Public Health

John Balmes

University of California, San Francisco (UCSF) - Division of Pulmonary, Critical Care, Allergy and Sleep Medicine

Zoë A. Chafe

University of California, Berkeley

Mukesh Dherani

University of Liverpool - Department of Public Health, Policy and Systems

H. Dean Hosgood

Yeshiva University - Department of Epidemiology & Population Health

Sumi Mehta

Global Alliance for Clean Cookstoves

Daniel Pope

University of Liverpool - Department of Public Health, Policy and Systems

Eva Rehfuess

Technische Universität München (TUM) - Department of Medical Informatics, Biometry and Epidemiology

HAP CRA Risk Expert Group

Independent

Date Written: March 2014

Abstract

In the Comparative Risk Assessment (CRA) done as part of the Global Burden of Disease project (GBD-2010), the global and regional burdens of household air pollution (HAP) due to the use of solid cookfuels, were estimated along with 60+ other risk factors. This article describes how the HAP CRA was framed; how global HAP exposures were modeled; how diseases were judged to have sufficient evidence for inclusion; and how meta-analyses and exposure-response modeling were done to estimate relative risks. We explore relationships with the other air pollution risk factors: ambient air pollution, smoking, and secondhand smoke. We conclude with sensitivity analyses to illustrate some of the major uncertainties and recommendations for future work. We estimate that in 2010 HAP was responsible for 3.9 million premature deaths and ∼4.8% of lost healthy life years (DALYs), ranking it highest among environmental risk factors examined and one of the major risk factors of any type globally.

Suggested Citation

Smith, Kirk R. and Bruce, Nigel and Balakrishnan, Kalpana and Adair-Rohani, Heather and Balmes, John and Chafe, Zoë A. and Dherani, Mukesh and Hosgood, H. Dean and Mehta, Sumi and Pope, Daniel and Rehfuess, Eva and Expert Group, HAP CRA Risk, Millions Dead: How Do We Know and What Does it Mean? Methods Used in the Comparative Risk Assessment of Household Air Pollution (March 2014). Annual Review of Public Health, Vol. 35, pp. 185-206, 2014, Available at SSRN: https://ssrn.com/abstract=2412877 or http://dx.doi.org/10.1146/annurev-publhealth-032013-182356

Kirk R. Smith (Contact Author)

University of California, Berkeley - School of Public Health ( email )

50 University Hall #7360
Berkeley, CA 94720-7360
United States

Nigel Bruce

University of Liverpool - Department of Public Health, Policy and Systems ( email )

Liverpool, L69 3GB
United Kingdom

Kalpana Balakrishnan

Sri Ramakrishna Engineering College (SREC) ( email )

Warangal
India

Heather Adair-Rohani

University of California, Berkeley - School of Public Health ( email )

50 University Hall #7360
Berkeley, CA 94720-7360
United States

John Balmes

University of California, San Francisco (UCSF) - Division of Pulmonary, Critical Care, Allergy and Sleep Medicine ( email )

San Francisco General Hospital
Box 2911
San Francisco, CA
United States

Zoë A. Chafe

University of California, Berkeley ( email )

310 Barrows Hall
Berkeley, CA 94720
United States

Mukesh Dherani

University of Liverpool - Department of Public Health, Policy and Systems ( email )

Liverpool, L69 3GB
United Kingdom

H. Dean Hosgood

Yeshiva University - Department of Epidemiology & Population Health ( email )

Jack and Pearl Resnick Campus
1300 Morris Park Avenue
Bronx, NY 10461
United States

Sumi Mehta

Global Alliance for Clean Cookstoves ( email )

Washington, DC 20006
United States

Daniel Pope

University of Liverpool - Department of Public Health, Policy and Systems ( email )

Liverpool, L69 3GB
United Kingdom

Eva Rehfuess

Technische Universität München (TUM) - Department of Medical Informatics, Biometry and Epidemiology ( email )

Munich, 81377
Germany

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