Estimating the burden of disease attributable to household air pollution from cooking with solid fuels in South Africa for 2000, 2006 and 2012

Authors

  • R A Roomaney Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
  • C Y Wright Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa; Department of Geography, Geoinformatics and Meteorology, Faculty of Natural and Agricultural Sciences, University of Pretoria, South Africa
  • E Cairncross Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
  • N Abdelatif Biostatistics Research Unit, South African Medical Research Council, Cape Town, South Africa
  • A Cois Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
  • E B Turawa Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
  • O F Owotiwon Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
  • I Neethling Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; Institute for Lifecourse Development, University of Greenwich, London, UK
  • B Nojilana Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
  • R Pacella Institute for Lifecourse Development, University of Greenwich, London, UK
  • D Bradshaw Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
  • V Pillay-van Wyk Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa

DOI:

https://doi.org/10.7196/SAMJ.2022.v112i8b.16474

Keywords:

Environment, Gas, heart disease

Abstract

Background. Household air pollution (HAP) due to the use of solid fuels for cooking is a global problem with significant impacts on human health, especially in low- and middle-income countries. HAP remains problematic in South Africa (SA). While electrification rates have improved over the past two decades, many people still use solid fuels for cooking owing to energy poverty.
Objectives. To estimate the disease burden attributable to HAP for cooking in SA over three time points: 2000, 2006 and 2012.
Methods. Comparative risk assessment methodology was used. The proportion of South Africans exposed to HAP was assessed and assigned the estimated concentration of particulate matter with a diameter <2.5 μg/m3
(PM2.5) associated with HAP exposure. Health outcomes and relative risks associated with HAP exposure were identified. Population-attributable fractions and the attributable burden of disease due to HAP exposure (deaths, years of life lost, years lived with disability and disability-adjusted life years (DALYs)) for SA were calculated. Attributable burden was estimated for 2000, 2006 and 2012. For the year 2012, we estimated the attributable burden at provincial level.
Results. An estimated 17.6% of the SA population was exposed to HAP in 2012. In 2012, HAP exposure was estimated to have caused 8 862 deaths (95% uncertainty interval (UI) 8 413 - 9 251) and 1.7% (95% UI 1.6% - 1.8%) of all deaths in SA, respectively. Loss of healthy life years comprised 208 816 DALYs (95% UI 195 648 - 221 007) and 1.0% of all DALYs (95% UI 0.95% - 1.0%) in 2012, respectively. Lower respiratory infections and cardiovascular disease contributed to the largest proportion of deaths and DALYs. HAP exposure due to cooking varied across provinces, and was highest in Limpopo (50.0%), Mpumalanga (27.4%) and KwaZulu-Natal (26.4%) provinces in 2012. Age standardised burden measures showed that these three provinces had the highest rates of death and DALY burden attributable to HAP.
Conclusion. The burden of disease from HAP due to cooking in SA is of significant concern. Effective interventions supported by
legislation and policy, together with awareness campaigns, are needed to ensure access to clean household fuels and improved cook stoves. Continued and enhanced efforts in this regard are required to ensure the burden of disease from HAP is curbed in SA.

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2022-09-30

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Roomaney RA, Wright CY, Cairncross E, Abdelatif N, Cois A, Turawa EB, et al. Estimating the burden of disease attributable to household air pollution from cooking with solid fuels in South Africa for 2000, 2006 and 2012. S Afr Med J [Internet]. 2022 Sep. 30 [cited 2024 Dec. 10];112(8B):718-2. Available from: https://samajournals.co.za/index.php/samj/article/view/207

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