Background: Well over a hundred studies over the last three decades have assessed levels of household air pollution (HAP) in developing countries. In view of this progress we updated the earlier version of WHO global IAP database through a systematic review of studies reported in peer-reviewed literature through 2011. Aim: This exercise was performed to generate pooled estimates of exposures for particulate matter and CO with solid fuel stoves (traditional, improved) and cleaner fuels, and inform the WHO HAP-IAQG (Indoor Air quality Guidelines) process. Methods: We initiated a search for articles indexed in PubMed, Web of Science and Bioscience databases with keywords and MeSH terms using PRISMA guidelines. A total of 161 articles were selected from over 6800 citations. 46 PM studies and 27 CO studies were included for generating pooled estimates for 24 h concentrations and/or exposures. Results: The pooled mean and pooled S.D. for 24 hr kitchen area concentrations of PM2.5 in solid fuel using households are estimated to be 972 μg/m3(S.D. 876 μg/m3) as compared to 148μg/m3 (S.D. 56 μg/m3 ), in households using gas, electricity or kerosene as primary fuels. The corresponding 24 hr personal exposures in solid fuel using households are estimated to be 267μg/m3 (S.D. 297 μg/m3) and 219μg/m3 for women and children respectively, with exposures in gas/electricity using households being comparable to the kitchen area concentrations. The pooled mean and pooled S.D for 24 hr kitchen CO concentrations amongst solid fuel users are estimated to be 8.60 ppm (S.D.6.21ppm) while personal exposures are estimated to be 3.63 ppm and 2.69 ppm for women and children respectively. Estimates of concentrations and exposures for multiple PM fractions and CO across multiple fuel, stove and household configurations have also been generated. Conclusions: The revised WHO-Global database provides a useful platform for comparative analyses of data from multiple studies using periodically updated information.
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