Journal club

Household air pollution has been estimated to be responsible for 3.2 million preventable deaths every year globally. With biomass exposure and environmental pollution linked to exacerbations of airways disease, this health impact disproportionately affects low and middle income countries. Puzzolo et al ( Lancet Resp Med 2024;12(4):281–293) undertook a systematic review and included 116 studies in the subsequent meta-analyses, to compare use of gaseous fuels in the domestic environment with more polluting fuels (wood/charcoal/kerosene) and cleaner fuels (electricity/solar) with no point of use pollution. Use of gas significantly decreased the risk of COPD (OR 0·37, 95%CI 0·23–0·60; p<0·0001), pneumonia (OR 0·54, 0·38–0·77; p=0·0008), deficits in lung function (OR 0·27, 0·17–0·44; p<0·0001), severe respiratory illness or death (OR 0·27, 0·11–0·63; p=0·0024) compared with more polluting fuels. Preterm births (OR 0·66, 0·45–0·97; p=0·033), and low birth weights were similarly reduced (OR 0·70, 0·53–0·93; p=0·015). Risk of asthma did not reach statistical significance. Gas compared with electricity did increase risk of COPD (OR 1·15, 1·06–1·25; p=0·0011) and pneumonia (OR 1·26, 1·03–1·53; p=0·025) but this was not significant in all studies. While having its own health and environmental impacts, switching to gas from more polluting fuels may reduce the burden of health risk in countries without …