tailieunhanh - Indoor air pollution in developing countries: a major environmental and public health challenge

In this paper we provide a comprehensive characterization ofmodel choice andmodel uncer- tainty in time series studies of air pollution and mortality, focusing on confounding adjustment for seasonal and long-term trends. We first identify analytical approaches that are used com- monly in air pollution epidemiology formodelling the smooth function of time and for selecting its degrees of freedom. We then introduce a statistical framework that allows us to compare and evaluate critically the statistical properties of each modelling approach by illustrating its theoretical properties and by simulation studies. Finally, we apply the different approaches for confounding adjustment to the NMMAPS database containing daily mortality, pollution and weather data. | Special Theme - Environment and Health Indoor air pollution in developing countries a major environmental and public health challenge Nigel Bruce 1 Rogelio Perez-Padilla 2 Rachel Albalak3 Around 50 of people almost all in developing countries rely on coal and biomass in the form ofwood dung and crop residues for domestic energy. These materials are typically burnt in simple stoves with very incomplete combustion. Consequently women and young children are exposed to high levelsof indoor air pollution everyday. There is consistent evidence that indoor air pollution increases the risk of chronic obstructive pulmonary disease and of acute respiratory infections in childhood the most important cause of death among children under 5 years of age in developing countries. Evidence also exists of associations with low birth weight increased infant and perinatal mortality pulmonary tuberculosis nasopharyngeal and laryngeal cancer cataract and specifically in respect of the use of coal with lung cancer. Conflicting evidence exists with regard to asthma. All studies are observational and very few have measured exposure directly while a substantial proportion have not dealt with confounding. As a result risk estimates are poorly quantified and may be biased. Exposure to indoor air pollution may be responsiblefor nearly 2 million excess deaths in developing countries and for some 4 of the global burden of disease. Indoor air pollution is a major global public health threat requiring greatly increased efforts in the areas of research and policy-making. Research on its health effects should be strengthened particularly in relation to tuberculosis and acute lower respiratory infections. A more systematic approach to the development and evaluation of interventions is desirable with clearer recognition of the interrelationships between poverty and dependence on polluting fuels. Keywords air pollution indoor - adverse effects fossil fuels - toxicity lung diseases smoke inhalation .