diseases (NCDs) worldwide; it is responsible for 26% of deaths from ischaemic heart disease, 24% of those from strokes, 43% from chronic obstructive pulmonary disease and 29% from lung cancer.
The sectors that produce most GHGs – energy, transport, industry, agriculture, waste management and land use – are also the main sources of fine particulate matter and other important air pollutants. These include short‐lived climate pollutants such as black carbon, methane and ground‐level ozone, which also threaten human health.
Approximately 25% of urban ambient air pollution from fine particulate matter is contributed by traffic, 15% by industrial activities including electricity generation, 20% by domestic fuel burning, 22% from unspecified sources of human origin and 18% from natural sources.
Effectively all exposure to indoor air pollution, which causes almost four million deaths a year, is from use of solid fuels for cooking in poor households.
Source: WHO (2018, p. 16).
What is also significant to underscore is that the health impacts of air pollution are felt disproportionately within poorer communities and particularly amongst women and children from poorer households. The role of gender in determining activities that expose women and young girls to ill health and lack of access to education and employment for instance is important not just in terms of responding to HAP but also in terms of gender‐assigned household responsibilities and hours spent in terms of searching for the very forms of solid fuels that contribute to increased health risks. More than 25 years ago, Indian climate change and energy expert, Jyoti Parikh highlighted the need for greater attention and data collection on gender and energy policy: ‘The fact that there are no gender specific data available in the energy sector‐ which is one of the most quantified sectors is largely due to lack of concern and understanding about gender issues by energy policy makers and analysts’ (1995, p. 7). Parikh pointed out gender‐specific disparities lessen as economic development increases. However, growing health and economic disparities resulting from the COVID pandemic are a major future development concern in terms of gender and racial inequities. Key findings from a special report ‘Burning Opportunity: Clean Household Energy for Health, Sustainable Development, and Well Being of Women and Children’ show that little room for equivocation as to who bears the negative health impacts of exposure to HAP and include the following facts:
‘Household air pollution is the single most important environmental health risk factor worldwide.
Women and children are at a particularly high risk of disease from exposure to HAP. Sixty percent of all premature deaths attributed to household air pollution occur in women and children. Women experience higher personal exposure levels than men, owing to their greater involvement in daily cooking and other domestic activities. The single biggest killer of children aged under five years worldwide is pneumonia. This disease cuts short almost a million young lives each year. More than 50% of those pneumonia deaths are caused by exposure to HAP.
Improving health in urban environments depends in part on addressing pollution from household fuel burning. In India, for example, new research estimates that almost 30% of outdoor air pollution is from household sources.
Women and girls are the primary procurers and users of household energy services, and bear the largest share of the health and other burdens associated with reliance on polluting and inefficient energy systems. Owing to the considerable amount of time spent in proximity to polluting combustion sources, women and children are at particularly high risk of disease from exposure to HAP.
New analyses find that reliance on polluting fuels and technologies is associated with significant drudgery and time loss for children – especially girls. Data on wood and water gathering from 30 countries show that both boys and girls in clean fuel‐using households spent less time gathering wood or water than those from homes cooking mainly with polluting fuels. Girls living in households that cook mainly with polluting fuels bear the greatest time‐loss burden collecting wood or water’ (WHO 2016c, p. ix).
Exposure to air pollution was found to vary greatly by socio‐economic status according to a 2015 review of existing literature on air pollution funded by US National Institute of Environmental Health Sciences. ‘Socioeconomic Disparities and Air Pollution Exposures: A Global Review’ found that poorer communities tend to be exposed to higher concentrations of air pollution, compared to richer communities (Hajat et al. 2015). But there is an additional generational inequity that is being passed on to children from poorer households that was highlighted by the UN Children’s Fund (UNICEF) 2016 report entitled ‘Clear the Air for Children’. Based on satellite imagery of outdoor air pollution, this report provided for the first time the staggering scale and scope of the air pollution crisis faced by children. South Asia was found to have the largest number of children living with toxic air pollution – 620 million, followed by East Asia and Pacific region – 450 million children; West and Central Africa – 240 million; Eastern and Southern Africa – 200 million, and when taken together all the regions comprised a total of 2 billion children living in areas that exceed WHO guideline limits of 10 μg/m3 (2016, p. 63). Some of the report’s key findings regarding air pollution provide evidence of the costs and disproportionate burdens borne by children in low‐ and middle‐income countries and across regions (see Box 1.5).
Box 1.5 Burdens of air pollution on children: key findings related to disproportionate burdens.
Around 300 million children currently live in areas where the air is toxic – exceeding international limits by at least six times
In total, around 2 billion children live in areas that exceed the World Health Organization annual limit of 10 μg/m 3 (the amount of micrograms of ultra‐fine particulate matter per cubic metre of air that constitutes a long term hazard)
Globally, air pollution affects children in low‐ and middle income countries more. Up to 88 per cent of all deaths from illnesses associated with outdoor air pollution16 and over 99 per cent of all deaths from illnesses associated with indoor air pollution occur in low‐ and middle‐income countries.
Asia currently accounts for the vast bulk of total deaths attributable to air pollution. The proportions, however, are changing. In Africa, increasing industrial production, urbanization and traffic is causing the rapid rise of outdoor air pollution. As this happens, the number of African children exposed to outdoor air pollution is likely to increase, especially as the continent’s share of the global child population is set to increase markedly. By midcentury, more than one in three children globally is projected to be African.
Outdoor air pollution tends to be worse in lower‐income, urban communities. Lower‐income areas are often highly exposed to environmental pollutants such as waste and air pollution. Factories and industrial activity are also more common near lower‐income areas, and there is often less capacity to manage waste. This can result in burning, including of plastics, rubber and electronics, creating highly toxic airborne chemicals which are highly detrimental to children. Poorer families are also less likely to have resources for good quality ventilation, filtration and air conditioning to protect themselves from harmful air.
Indoor air pollution is most common in lower‐income, rural areas. Over 1 billion children live in homes where solid fuels are used in cooking and heating. While outdoor air pollution tends to be worse in poor urban communities, indoor air pollution tends to be worse in rural communities where biomass fuels are more frequently used in cooking and heating due to lack of access to other forms of energy.
