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A systematic review assessing the impact of improved cookstove technology interventions on household air pollution on human health in sub-Saharan Africa
Citation:
Weaver, A., D. Dillon, S. Reigh, K. Rappazzo, AND Tom Luben. A systematic review assessing the impact of improved cookstove technology interventions on household air pollution on human health in sub-Saharan Africa. International Society for Environmental Epidemiology North America Chapter Conference, Corvallis, OR, June 19 - 21, 2023.
Impact/Purpose:
Exposure to household air pollution, mainly from cooking, is a major health concern in sub-Saharan Africa. Improved cookstoves, that use a cleaner fuel or are more fuel efficient than traditional cookstoves, have been proposed as a possible solution. In this study, we reviewed the academic literature of trials that consider health impacts of improved cookstoves, either as a before/after comparison or as a randomized trial in sub-Saharan Africa.
Description:
Background and aims: A major contributor to household air pollution (HAP) in sub-Saharan Africa is reliance on unclean fuel sources. Improved cookstove technology (ICT) interventions have been promoted as a potential solution, but their impacts on health are unclear. Our aim is to conduct a systematic review to explore impacts of ICT interventions on health outcomes in sub-Saharan Africa. Methods: We conducted a systematic review, following PRISMA guidelines, focused on ICT interventions carried out in sub-Saharan Africa from 2000-present. We performed this search in MEDLINE, PubMed, Web of Science, Web of Science CABI, and EMBASE via ProQuest using comprehensive search terms. Two reviewers assessed each study using predefined inclusion/exclusion criteria and extracted data. We evaluated each study on participant selection, exposure assessment, control comparability, outcomes, analyses, and biases. Results: From 4,461 articles, a total of k = 23 articles described results of an ICT intervention on health outcomes. These took place in seven countries. Pooled mean exposure estimates for PM2.5 in control and interventions groups were 102.88 µg/m3 (95%CI: 52.63, 153.14; I2 96.9%) and 101.76 µg/m3 (95%CI: 57.47, 146.06; I2 98.2%) respectively. Estimates for pooled mean CO were 2.40 ppm (95%CI: 0, 8.33; I2 99.0%) and 1.66 ppm (0, 4.91; I2 98.5%)abs for control and intervention groups. Most study outcomes focused on respiratory and pregnancy-related endpoints. Fewer studies focused on cardiovascular endpoints, functional limitations, burns, eye issues, or other endpoints. Of all health outcomes reported, 49/252 (19.44%) endpoints were reported as significantly different between control and intervention groups. Significant associations between interventions and improved health outcomes were most common for respiratory endpoints, specifically lung function or incident infectious diseases. Conclusion: There is mixed evidence that ICT interventions influenced health outcomes. ICT interventions may decrease HAP, other sources/routes of air pollutant exposure are not addressed by improved cookstoves.