INDOOR AIR QUALITY: Wood-Burning Stoves Get Help from HEPA Filters

The total role that the environment plays in contributing to premature death and disability remains sketchy, but researchers working with the World Health Organization (WHO) continue to flesh out the details. Now four WHO researchers have estimated the global burden of certain toxic substances for which adequate data are available. They have calculated that in 2004 2 at least 8.3% of all preventable deaths and 5.7% of the preventable portion of the metric known as disability-adjusted life years (DALYs, which address a blend of death and disease impacts) were caused by the toxics analyzed. Their estimates include health end points such as cardiovascular disease, cancers, neuropsychiatric disorders, asthma, chronic obstructive pulmonary disease, respiratory infections, and birth defects. 3 The leading contributors to premature death and DALYs were indoor solid fuel com-Other toxics included in the global totals were asbestos, lead, arsenic in drinking water (but only in Bangladesh), and a few other chemicals, including some typically encountered in occupational settings. Children under age 15 years were a highly susceptible group, suffering 54% of the total DALY burden. That includes 80% of the burden imposed by lead, 75% of that of indoor solid fuel use, 61% of that of SHS, 19% of that of acute accidental poisonings, and 10% of that of outdoor air pollution. The estimates include only a small fraction of all plausible chemical actors, says lead author Annette Prüss-Ustün. Among the thousands of toxics and pathways not included were mercury, dioxins, cadmium, radioactive substances, chronic pesticide exposures, active tobacco smoking, nonurban outdoor air pollutants , site-specific pollution hot spots, and chemicals whose actions are altered by climate change. Nevertheless, Prüss-Ustün and colleagues think their analysis covers a high percentage of all acute impacts and a moderately high portion of all elevated chronic occupational exposures, although only a modest fraction of all chronic exposures in the general population , and almost none of the impacts such as developmental damage, degradation of specific organs or body systems, or harm caused by the extensive synthetic chemical body burden documented to occur in many people. The ultimate test of man's conscience may be his willingness to sacrifice something today for future generations whose words of thanks will not be heard.