Health effects of household air pollution related to biomass cook stoves in resource limited countries and its mitigation by improved cookstoves

Environ Res. 2020 Jul:186:109574. doi: 10.1016/j.envres.2020.109574. Epub 2020 Apr 28.


Background: Household air pollution (HAP) related to cooking is associated with significant global morbidity and mortality. An estimated three billion people worldwide are exposed to cooking related HAP caused by solid fuel combustion. This exposure is highest for the vulnerable population of women and children resulting in significant cumulative health effects.

Methods: A literature review was conducted for health effects of household air pollution related to biomass cookstoves in resource limited countries and to evaluate the effect of improved cookstoves on these health effects. We searched PubMed, Embase and Cochrane Library. We conducted searches in January 2018 with a repeat in February 2020. We included only studies conducted in resource limited countries, published in English, irrespective of publication year and studies that examined the health effects of HAP and/or studied the effects of improved cookstove (IC). Two authors independently screened journal article titles, abstracts and full-text articles to identify those that included the following search term: biomass cookstoves and health risks. We also assessed the limitations of IC with barriers to their uptake.

Results: Health effects associated with HAP mostly include increased blood pressure (BP), dyspnea, childhood pneumonia, lung cancer, low birthweight and cardiovascular diseases. Being a global problem with divergent environmental factors including wide variety of fuel used, housing condition, foods prepared, climatic condition and social factors; most solutions though efficient seems inadequate. Improved cookstove (IC) mitigates emissions and improves short term health, though few randomized long-term studies could substantiate its long-standing continuance and health benefits.

Conclusion: There is ample data about the health effects of HAP, with some benefit with IC intervention for elevated blood pressure, dyspnea symptoms, mutagenicity and cardiovascular diseases. IC does not have any benefit in pregnancy outcomes or children health.

Keywords: Blood pressure; Cookstove; Indoor air pollution; Particulate matter; Polycyclic aromatic hydrocarbons.

Publication types

  • Review

MeSH terms

  • Air Pollution*
  • Air Pollution, Indoor* / analysis
  • Biomass
  • Child
  • Cooking
  • Female
  • Household Articles*
  • Humans
  • Pregnancy