Implementing the recommendations of the WHO Indoor air quality guidelines to address household air pollution: a country perspective from India

Abstract

Background: The WHO Indoor Air Quality Guidelines (IAQGs) developed in 2013, provide for the first time, technology specific guidance to meet the interim and guideline targets for specific criteria air pollutants associated with household cookfuel use. This will allow many developing countries including India, to evaluate alternative intervention options to reduce household air pollution exposure against the interim targets and develop plans to reach guideline values in the long-term. Aim: To highlight special considerations in the application of the WHO IAQGs to address air pollution exposures from household cookfuel use in India. Methods: We provide an overview of the household air pollution status in India from a systematic literature review and a India specific modeling exercise executed as part of the GBD 2010 exercise. We describe implications of household cookfuel use on ambient air quality (currently estimated to account for 25% of the outdoor particulate matter load). We also track important new evaluations of cleaner combustion (biomass) cookstoves and cleaner fuel options and provide comparative analyses of factors influencing their adoption from case studies in multiple states. Results &Conclusion: The new estimates for the burden of disease attributable to household air pollution in India includes contributions from indoor and outdoor exposures. The use of the WHO IAQGs with the previously provided pollutant specific AQGs affords a unique opportunity to include household air pollution under the ambit of existing standards. We highlight the need to initiate intervention efforts beyond small scale programs covering individual households in select communities to include large scale and high density efforts involving cleaner technologies at the state or national levels. Substantive reorganization of current programs is imminently needed to make progress towards achieving air quality standards described by WHO AQGs in India.