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HEALTH RISK ASSESSMENT DUE TO HOUSEHOLD AIR
POLLUTION IN INDIA : Case Study
By
Dr. J. K. MOITRA
Emtrc Consultants Pvt Ltd, Delhi
[email protected], [email protected], 9810032481
IAAPC Workshop on Household Air Pollution & Its Effect on Human Health
4th March 2014
INTRODUCTION TO A PECULIAR PROBLEM
o Indoor air pollution is widespread peculiar problem in Rural India. It is
due to domestic burning of biomass or coal in unscientific manner
(use of chulha / sigri inside house having inadequate ventilation).
o WHO estimated 3-4 lakhs deaths /year due to household air pollution.
o Even after 34 years of enactment of Air Act and declaring entire
country as air pollution control area, the problem remains / increasing.
o Even after 28 years of enactment of Environment Protection Act, the
issue did not get noticed as peculiar problem.
o India consumed 148.7 million tons of coal replacement worth of fuel
wood in 2011.
o Environmental Performance Index 2013: Rank of India 155/178
(Poor Index because of Indoor Air Pollution)
Condition of census house in India (2011)
Percentage
Total Rural Urban Total Rural Urban
1 Good 131019820 77041343 53978477 53.1 45.9 68.4
2 Livable 102470426 79855814 22614612 41.5 47.6 28.7
3 Dilapidated 13202421 10929573 2272848 5.4 0.5 2.9
4 Total
Households
246692667 167826730 78865937 100 100 100
Condition of Houses in Rural India lags behind Urban India
They do not have adequate ventilation, have dampness and overcrowded
They have roof predominantly made of thatch, bamboo, plastic, tin, tiles.
About 38% houses do not have separate kitchen for cooking
About 86% households use biomass as fuel.
Predominant Material of Roof (2011)
Absolute number Percentage
Total Rural Urban Total Rural Urban
1 Grass/thatch/bamboo/wood/
mud etc.
37123567 33484330 3639237 15.0 20 4.6
2 Plastic /Polyethylene 1557231 1054830 502401 0.6 0.6 0.6
3 Hand made tiles 35675903 30778543 4897360 14.5 18.3 6.2
4 Machine Made Tiles 22967460 17441452 5526008 9.3 10.4 7.0
5 Burnt bricks 16381118 12111943 4269175 6.6 7.2 5.4
6 Stone/ Slate 21127976 14860863 6267113 8.6 8.9 7.9
7 G.I./ Metal/ Asbestos sheets 39273252 26733862 12539390 15.9 15.9 15.9
8 Concrete 71659299 30746938 40912361 29.0 18.3 51.9
9 Any other material 926861 613969 312892 0.4 0.4 0.4
1 Total no. of Households 246692667 167826730 78865937 100 100 100
Households by Availability of Kitchen Facility (2011)
Absolute number Percentage
Total Rural Urban Total Rural Urban
1 Cooking inside house 215412336 139853780 75558556 87.3 83.3 95.8
(a) Has kitchen 137594123 76238077 61356046 55.8 45.4 77.8
(b) Does not have
kitchen
7781821 63615703 14202510 31.5 37.9 18.0
2 Cooking outside house 30483366 27578343 2905023 12.4 16.4 3.7
(a) Has kitchen 13597879 12302453 1295426 5.5 7.3 1.6
(b) Does not have
kitchen
16885487 15275890 1609597 6.8 9.1 2.0
3 No cooking 796965 394607 402358 0.3 0.2 0.5
Households by Fuel used for Cooking (2011)
Absolute number Percentage
Total Rural Urban Total Rural Urban
1 Fire wood 120834388 104963972 15870416 49.0 62.5 20.1
2 Crop Residue 21836915 20696938 1139977 8.9 12.3 1.4
3 Cow dung cake 19609328 18252466 1356862 7.9 10.9 1.7
4 Coal, Lignite etc. 3577035 1298968 2278067 1.4 0.8 2.9
5 Kerosene 7164589 1229476 5935113 2.9 0.7 7.5
6 LPG/PNG 70422883 19137351 51285532 28.5 11.4 65.0
7 Electricity 235527 118030 117497 0.1 0.1 0.1
8 Biogas 1018978 694384 324594 0.4 0.4 0.4
9 Any other 1196059 1040538 155521 0.5 0.6 0.2
10 No Cooking 796965 394607 402358 0.3 0.2 0.5
Study done by Researchers from CPCB (Dr. Nandita & Dr. Trivedi) found
that SPM level in indoor air of middle class household (n=1200, East Delhi)
was 3-5 times more than outdoor air (Published by TERI)
Time activity pattern: Women, elderly and child: more than 22 hours indoor.
Men and school going children: about 12 hours indoors
Study done by EMTRC in 10 houses of carpet weavers in Rampur village
and Ramnagar village of Bhadohi / Jaunpur district (UP) found that SPM,
CO, SO2, NO2 level in indoor air was 3-4 times more than the national
standard. The weavers were using biomass as cooking fuel inside houses
and using dibris (kerosene lanterns) in till late night (where carpets are
woven). Winrock International used the findings to distribute 1000+ solar
lanterns to the weavers.
Time activity pattern: Women, elderly and child: more than 22 hours indoor.
Men and children: about 20 hours indoors
Initial Case Studies
Raigarh: Industrialised area, AAQ - Very High to Critical
Domestic fuel of low SEG: Coal in chulha / sigri
Ventilation of houses of low SEG: Poor
Time activity pattern: Women, elderly and child: more than 22 hours
indoor. Men and school going children: about 12 hours indoors
EMTRC engaged CNCI –Kolkata to do the health study.
Sample size: 252 (Rural)
Tightness of chest, chest pain, chest discomfort symptom more
prevalent in women than in men (30% Vs 22%)
Recurrent head ache symptom more prevalent in women than in
men (68% Vs 46.5%);
63% in low SEG, 39% in medium SEG, 28% in high SEG (Raigarh)
Case Study 1 (Raigarh)
Case Study (Raigarh)
Prevalence of LRS in
adults
Low SEG (%)
Medium SEG (%) High SEG (%)
Dry cough 43 26 34.5
Cough with phlegm 34 26 24
Breathlessness 47 26 41
Wheeze 15 4.3 10.3
Chest discomfort 28 26 7.0
Prevalence of URS in
adults
Low SEG
Medium SEG High SEG
URS 69.5% 65.2% 65.5%
URS: Sinusitis, runny or stuffy nose, sore throat, common cold with fever
Lung function by spirometry; n=234
Reduced lung function: 63.4% adults (64% women, 62% men)
Restrictive type: 45.6% female, 36.7% male
Reduced lung function was more prevalent in low SEG
Mean FVC was 74.8% of predicted value in low SEG
FEV1 was 81.5% of predicted value in low SEG (against 94% of
predicted value in medium and high SEG)
Case Study (Raigarh)
Structured HHRA
study conducted at
3 locations
1. Singrauli (UP)
2. Seepat (CG)
3. Anta (Rajasthan)
Case Study 2
(Comparative)
Singrauli: Heavily Industrialised area, AAQ-Very High to Severe
Coal is available in plenty
Domestic fuel of low and medium SEG: Coal in chulha / sigri.
Ventilation of houses of low SEG: Poor
Time activity pattern: Women, elderly and child: more than 22 hours
indoor. Men and school going children: about 12 hours indoors
EMTRC engaged NSCB Medical College (Dept of Community
Medicine) –Jabalpur to do the health study.
Sample size: 200 (Rural)
Case Study (Singrauli-UP)
Seepat: Rural Area, AQI-Pollution within NAAQS
Domestic fuel of low and medium SEG: Biomass in chulha / sigri.
Ventilation of houses of low SEG: Poor
Time activity pattern: Women, elderly and child: more than 22 hours
indoor. Men and school going children: about 12 hours indoors
EMTRC engaged Maulana Azad Medical College (COEH) –Delhi to do
the health study.
Sample size: 160 (Rural)
Case Study (Seepat-CG)
Anta: Rural Area, AQI- Low Pollution
Domestic fuel of low and medium SEG: Biomass in chulha / sigri.
Ventilation of houses of low SEG: Poor
Time activity pattern: Women, elderly and child: more than 22 hours
indoor. Men and school going children: about 12 hours indoors
EMTRC engaged Maulana Azad Medical College (COEH) – Delhi to
do the health study.
Sample size: 160 (Rural)
Case Study (Anta-Rajasthan)
House condition, fuel use and dietary intake
Case Study
Location Pollution
Status
Poor
Ventilation
Domestic fuel
use
Dietary Habits
Singrauli Severe
exposure
83%
household
Coal (95%
household)
Low BMI, BMR: Inadequate
Addictions: Very High
Diet quality: Poor
Rice and vegetables only
Seepat Moderate
Exposure
92%
household
Cow dung
& Wood
(97% household)
Low BMI, BMR: Inadequate
Addictions: Low
Diet quality: poor
Rice and vegetables only
Anta Low
exposure
41%
household
Cow dung
& Wood
(75% household)
Good BMI, BMR: Adequate
Addictions: Low
Diet quality: good
Wheat, pulses, maize, fruits,
milk, vegetables
Prevalence of disease
Case Study
Location Prevalence of disease
Singrauli Incidence of TB, asthma, bronchitis, skin disease very
common. Women suffer more from TB & PSOD
Seepat Cough and expectoration : prevalent in approx 15% children.
Cough, breathlessness, wheeze & chest pain: prevalent in
approx 20% adults
Anta COPD, Hypertension, Asthma: Less than 1%
Pulmonary Function Test: OK in 99% subjects
Urine status: OK in all subjects
Common Sufferers in above three location
Women suffer more due to URS & LRS, Reduced Lung Function
People from low SEG suffer more from above diseases
Considering following Ambient Air Quality, impact predictions
done for Indoor and Outdoor Health Risk using RISC5 Model
Health Risk Impact Assessment
Sr.
No
Parameters Unit Results National Standard
Date of Sampling 09-10-2012 10-10-2012
1 PM10 µg/m3 84 80 100(24-hours average)
2 PM2.5 µg/m3 42 41 60(24-hours average)
3 NO2 µg/m3 17.2 15.8 80(24-hours average)
4 SO2 µg/m3 8.9 8.2 80(24-hours average)
5 Carbon Monoxide (CO) mg/m3 0.75 0.68 4 (1-hours average)
6 Ozone (O3) g/m3 52 47 180 (1-hours average)
7 Benzene g/m3 0.33 0.32 05(Annual Basis)
8 Benzo(a)Pyrene, BaP ng/m3 0.22 0.25 01(Annual Basis)
9 Arsenic (As) ng/m3 0.22 0.19 06(Annual Basis)
10 Mercury(Hg) ng/m3 0.14 0.15 -------
11 Nickel (Ni) ng/m3 1.9 1.8 20(Annual Basis)
12 Lead (Pb) g/m3 0.24 0.22 1(24-hours average)
13 Ammonia (NH3) g/m3 26 24 400(24-hours average)
Inference: Health Risk is more in Indoor than Outdoor
Risk Assessment using RISC5 Model
NON CARCINOGENIC RISK DUE TO INDOOR AIR QUALITY
Category of Risk Adult Population Child Population Acceptable Limit
Maximum Risk 0.049 0.049 1
Mean Risk 0.028 0.030 1
CARCINOGENIC RISK DUE TO INDOOR AIR QUALITY
Category of Risk Adult Population Child Population Acceptable Limit
Maximum Risk 0.0000013 0.0000015 0.0001
Mean Risk 0.00000029 0.00000044 0.0001
CARCINOGENIC RISK DUE TO OUTDOOR AIR QUALITY
Category of Risk Adult Population Child Population Acceptable Limit
Maximum Risk 0.00000035 0.0000029 0.0001
Mean Risk 0.00000000529 0.000000058 0.0001
NON CARCINOGENIC RISK DUE TO OUTDOOR AIR QUALITY
Category of Risk Adult Population Child Population Acceptable Limit
Maximum Risk 0.0051 0.049 1
Mean Risk 0.00019 0.001 1
IMPACT ASSESSMENT
o People of low Socio Economic Group in Rural Area burn biomass or
coal as fuel in sigris or chulhas, that gives rise to household air pollution
o Burning ROM coal in sigris or chulhas give rise to serious pollution
o Due to absence of separate kitchen and proper ventilation, the air
pollutants gets trapped inside the house, circulates within and dissipates
at low rate. The concentration of pollutants is therefore more than outdoor
o Women, infants and child spend almost all the time indoor.
o Women of low SEG therefore suffer from URS and LRS.
o Confounding factors are poor nutrition and unhygienic surroundings
o Health Risk Impact due to indoor air pollution is > outdoor air pollution.
REASONS FOR THE PROBLEM
o In industrialized areas, all adult family members work. They have little
time to collect firewood & depend upon coal from black market for fuel.
o Developed nations do not face such problem. Otherwise they would
have solved the problem, which India could emulate sooner or later.
o Indoor air quality market is not lucrative for developed nations (because
stakeholders are all poor illiterate people without any voice)
o Indian decision makers and scientific researchers are skewed towards
Urban Pollution that gives them more credit and rewards.
o Agency established by Indian law did nothing even after 34 years of
enactment of Air Act. (business as usual scenario).
o Awareness campaign highlighting “Indoor Air Pollution” never appeared
in any newspaper / Electronic Media.
IS THERE A SOLUTION
o Scientist like Prof Kirk Smith, TERI, CSE, etc did outstanding work to
highlight the problem of indoor air pollution in India. The decision
makers know that indoor air pollution due to coal or biomass burning
is an issue pertaining to health of rural people.
o Decision makers are aware that indoor air pollution is directly
proportional to expenditure incurred on health program.
o The fuel giving rise to indoor air pollution or clean fuel is owned,
regulated and run by the Government.
o Indian public or Scientific organizations have very little role to play to
prevent, control or abate such pollution.
DO WE NEED NEW LAW
o Legal framework is in place:
o Air Act 1981: Act to provide for the preservation, control and abatement
of air pollution. Objective : Preservation of the quality of air and control
of air pollution.
o Environment Protection Act 1986: Enacted with the objective of
providing for the protection and improvement of the environment.
Preventing environmental pollution in all its forms and tackle specific
environmental problems that are peculiar to different parts of the
country.
o Solution exists because: we understand the peculiar issue, we have
legal framework, we have enforcement institutions.
o Prioritization and Concrete Action by Government is lacking.
Long Term Action
MSW Rules and Regulations, Vehicular Standards, Fuel Quality Standards
are framed by CPCB but implemented by other government agencies.
CPCB may formulate Guidelines for prevention, control and abatement of
Indoor (Household) Air Pollution
Implementing agencies: Rural Development, Urban Development, Social
Development Ministry
Short Term Action: Creating awareness among rural population about
health impacts of indoor air pollution
RECOMMENDATIONS
Separate kitchen or kitchen outside house where biomass is used
(distinctly separating the living room and bed room)
Switch over to improved / scientifically designed chulhas/ sigris
Improving the ventilation / air circulation in rural houses
Stop use of ROM coal in sigris / chulhas. (Coal after removing the volatile
matter could be used [in places where coal is plenty])
Stop black marketing ROM coal
Make available subsidized LPG, PNG, electricity in rural areas
Make available Solar Lanterns, Solar Cookers in rural areas
Maximize the use of Biogas Plants in rural areas
Apply true SEIA study and need based development CSR plans for rural
areas
RECOMMENDATIONS
EMTRC Team:
G.K.Mendiratta, Ratnesh Kotiyal, Mukesh Kumar, Ashok Kumar, sandeep
Shukla
Dr. Nandita Moitra, Dr. R.C.Trivedi
Prof. T.K.Joshi, MAMC, Ms. Pallavi, Ms. Deepika
Prof. Toppo, Prof. Tiwari, Dr. Jyoti (Medical College – JBP)
Prof. T. Lahiri (Chittaranjan National Cancer Institute-Kolkata
ACKNOWLEDGEMENT