Indoor air a major cause of heart disease deaths in low income countries

Each year over 17 million people die due to cardiovascular diseases. Behavioural risk factors such as smoking and a poor diet are known to increase the risk of dying from CVD but air pollution is not considered such a risk because of uncertainty as to how exposure to air pollution can be modified. 

A new analysis of data from nearly all World Health Organization member states demonstrates a link between air pollution and CVD deaths and finds such mortality much more prevalent in low-income countries.

The study used WHO statistics for 183 countries with a population of more than 90,000 and World Bank Classification of countries by income level was used to analyse mortality in countries with different levels of income.

The proportion of the population with access to clean fuels for cooking was calculated as an indicator of household air pollution

It was found that in 2019, outdoor air pollution caused 70  heart disease-related deaths per 100,000 people in low-income countries compared with just 16 per 100,000 in high-income countries.

Also, in low-income countries, household air pollution due to cooking practices contributed to more than twice as many stroke-related deaths than outdoor air pollution.

The study concludes that without intervention, poor people in low and middle income countries will still lack access to clean fuels and technologies in 2030.

It is stressed that sub-Saharan Africa is in ‘critical need’ of action. Population growth has outpaced access to clean cooking, and 923 million people were still using polluting fuels in 2020.

Strategies should include policies to provide financial support to enable access to technologies and fuels, improved ventilation and housing design and communication campaigns to encourage clean energy use. 

Corresponding author Nikolai Khaltaev, MD, of the Global Alliance against Chronic Respiratory Diseases, in Switzerland. said: ‘Effective air pollution control along with the lifestyle modifications and disease management should be essential components of cardiovascular disease preventive strategies.’