Association between indoor air pollution measurements and respiratory health in women and children in Lao PDR

Abstract

This article presents the results of a study on the association between measured air pollutants and the respiratory health of resident women and children in Lao PDR, one of the least developed countries in Southeast Asia. The study, commissioned by the World Health Organisation, included PM(10), CO and NO(2) measurements made inside 181 dwellings in nine districts within two provinces in Lao PDR over a 5-month period (12/05-04/06), and respiratory health information (via questionnaires and peak expiratory flow rate (PEFR) measurements) for all residents in the same dwellings. Adjusted odds ratios were calculated separately for each health outcome using binary logistic regression. There was a strong and consistent positive association between NO(2) and CO for almost all questionnaire-based health outcomes for both women and children. Women in dwellings with higher measured NO(2) had more than triple of the odds of almost all of the health outcomes, and higher concentrations of NO(2) and CO were significantly associated with lower PEFR. This study supports a growing literature confirming the role of indoor air pollution in the burden of respiratory disease in developing countries. The results will directly support changes in health and housing policy in Lao PDR.

Practical implications: This is the first study that investigated indoor air quality and its impact within residential dwellings in Lao PDR, which is one of the poorest and least developed countries in south-east Asia, with a life-expectancy of 56 years in 2008. While there have been other studies published on indoor air quality in other developing countries, the situation in Laos is different because the majority of houses in Laos used wood stoves, and therefore, emissions from wood burning are the dominant sources of indoor air pollution. In other countries, and studies, while emission from wood burning was investigated, wood was rarely the main or the only fuel used, as the houses used in addition (or solely) dung, kerosene or coal. The study quantified, for the first time, concentrations in houses two provinces in Laos PDR and shed light on the impact of human activities and urban design on pollutant concentrations and respiratory health. This study contributes to the accumulation of evidence to provide more reliable estimates of risk and a more informed basis for decision-making by concerned governments and communities.