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Millions Dead: How Do We Know and What Does It Mean? Methods Used in the Comparative Risk Assessment of Household Air Pollution

Kirk R. SmithSchool of Public Health, University of California, Berkeley, California 94720-7360;,Nigel BruceDepartment of Public Health and Policy, University of Liverpool, Liverpool, L69 3GB, United Kingdom;, ,Kalpana BalakrishnanDepartment of Environmental Health Engineering, Sri Ramachandra University (SRU), Chennai 600116, India;Heather Adair‐RohaniSchool of Public Health, University of California, Berkeley, California 94720-7360;,John R. BalmesPulmonary Medicine, University of California, San Francisco, California 94143;Zoë ChafeEnergy and Resources Group, University of California, Berkeley, California 94720-3050;Mukesh DheraniDepartment of Public Health and Policy, University of Liverpool, Liverpool, L69 3GB, United Kingdom;, ,H. Dean HosgoodDivision of Epidemiology, Albert Einstein College of Medicine, Bronx, New York 10461;Sumi MehtaDaniel PopeDepartment of Public Health and Policy, University of Liverpool, Liverpool, L69 3GB, United Kingdom;, ,Eva RehfuessDepartment of Medical Informatics, Biometry and Epidemiology, University of Munich, Munich 81377, Germany;
2014en
ABI

Аннотация

In the Comparative Risk Assessment (CRA) done as part of the Global Burden of Disease project (GBD-2010), the global and regional burdens of household air pollution (HAP) due to the use of solid cookfuels, were estimated along with 60+ other risk factors. This article describes how the HAP CRA was framed; how global HAP exposures were modeled; how diseases were judged to have sufficient evidence for inclusion; and how meta-analyses and exposure-response modeling were done to estimate relative risks. We explore relationships with the other air pollution risk factors: ambient air pollution, smoking, and secondhand smoke. We conclude with sensitivity analyses to illustrate some of the major uncertainties and recommendations for future work. We estimate that in 2010 HAP was responsible for 3.9 million premature deaths and ∼4.8% of lost healthy life years (DALYs), ranking it highest among environmental risk factors examined and one of the major risk factors of any type globally.

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