Liverpool School of Tropical Medicine

The Liverpool School of Tropical Medicine has identified the health effects of indoor air pollution as an important area of research. 700 million people in Africa use burned animal or plant material, known as biomass fuel, to provide energy for cooking, heating and lighting. People using biomass fuel experience substantial smoke exposure, due to a) partial combustion of fuel and b) poor ventilation methods and indoor air pollution. Indoor air pollution is associated with both respiratory (COPD, lung infections, cancer) and non-respiratory (low birth weight and perinatal death, cataracts) health effects, particularly in women and children who are most exposed.

In addition, biomass fuel use also has economic effects on low-income families with even traditional fuels such as crop residues or dung being considered “commodities” with value and adverse environmental effects with climate change related to greenhouse emissions and degradation of forests due to clearing of trees for fuel. Change in the methods of cooking and the types of biomass fuel used could simultaneously result in major improvements in both health and the environment.

There are important obstacles to progress which are not only scientific, but also logistic, socio-economic and political. LSTM will help the BREATHE consortium to come together to offer a systems science approach to the use of biomass fuel in Africa. Systems approaches accept that multiple factors interact in complex problems and result in several simultaneous effects. Indoor air pollution was the focus of a recent NIH symposium on system science in September 2008. Single parameter isolated interventions cannot define practical solutions in these models but instead, a raft of interventions can combine to produce a beneficial health impact demonstrable using several parameters. The BREATHE consortium will describe the specific health effects of particular fuel use patterns and the underlying mechanisms by which they occur in Africa. The most effective interventions will be determined in terms of health impact, accessibility, affordability and acceptability, and biomarkers of efficacy validated to compare different interventions.

The BREATHE-Africa consortium will focus in 4 areas relevant to African biomass fuel use and air pollution which are (1) Exposure and biomarkers (2) Health effects (3) Mechanisms and (4)Interventions.