Article Text

Download PDFPDF
Household air pollution-related lung disease: protecting the children
  1. Peter P Moschovis1,
  2. Patricia L Hibberd2
  1. 1 Divisions of Pulmonary Medicine and Global Health, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
  2. 2 Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to Dr Peter P Moschovis, Massachusetts General Hospital, Boston, MA 02114, USA; pmoschovis{at}

Statistics from

Nearly 3 billion people worldwide cook and heat their homes using biomass fuels, primarily in low and middle-income countries.1 Smoke from biomass fuel combustion contains a combination of gases, particulate matter and volatile organic compounds that is particularly harmful to the developing lungs of children.2 Over time, chronic exposure to household air pollution results in mucus hypersecretion, emphysema and bronchiolar fibrosis,3 and exposure to household air pollution is a well-described risk factor for both acute and chronic respiratory disease.4–6

The settings in which biomass smoke exposure is most common are also settings in which there is a high prevalence of reduced lung function.7 8 A recent study of 2000 primarily non-smokers in urban Malawi found a >40% rate of abnormal lung function (primarily reduced forced vital capacity (FVC)),9 and the largest published spirometry study in Uganda reported that 16% of adults over age 30 years had spirometry-confirmed chronic obstructive pulmonary disease (COPD).10 There is increasing evidence that reduced lung function begins early in life11–15; therefore, efforts to understand and prevent chronic respiratory disease must focus on modifiable risk factors that affect lung development in infancy and early childhood.16 17 Several studies have previously measured lung function among children in sub-Saharan Africa,18–21 but no prior study has reported the effect of a cookstove intervention on lung function in African children. Despite a number of cookstove intervention trials, there remains a lack of conclusive evidence regarding the benefit of cookstove interventions on lung health.22

In this issue of Thorax, Rylance et al report the results of …

View Full Text


  • Contributors PPM drafted and revised the manuscript, and PLH made substantial contributions to the initial draft and revision. Both approved the final version.

  • Funding PPM and PLH have received funding for research relevant to this topic (Moschovis K23ES030399, Hibberd UG1HD078439 and R21AI140258).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles