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Improved stove interventions to reduce household air pollution in low and middle income countries: a descriptive systematic review.

Thomas E, Wickramasinghe K, Mendis S, Roberts N, Foster C - BMC Public Health (2015)

Bottom Line: When well-designed, implemented and monitored, stove interventions can have positive effects.However, the impacts are unlikely to reduce pollutant levels to World Health Organization recommended levels.Future studies require greater process evaluation to improve knowledge of implementation barriers and facilitators.

View Article: PubMed Central - PubMed

Affiliation: British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK. emma.thomas@dph.ox.ac.uk.

ABSTRACT

Background: Household air pollution (HAP) resulting from the use of solid fuels presents a major public health hazard. Improved stoves have been offered as a potential tool to reduce exposure to HAP and improve health outcomes. Systematic information on stove interventions is limited.

Methods: We conducted a systematic review of the current evidence of improved stove interventions aimed at reducing HAP in real life settings. An extensive search of ten databases commenced in April 2014. In addition, we searched clinical trial registers and websites for unpublished studies and grey literature. Studies were included if they reported on an improved stove intervention aimed at reducing HAP resulting from solid fuel use in a low or middle-income country.

Results: The review identified 5,243 records. Of these, 258 abstracts and 57 full texts were reviewed and 36 studies identified which met the inclusion criteria. When well-designed, implemented and monitored, stove interventions can have positive effects. However, the impacts are unlikely to reduce pollutant levels to World Health Organization recommended levels. Additionally, many participants in the included studies continued to use traditional stoves either instead of, or in additional to, new improved options.

Conclusions: Current evidence suggests improved stove interventions can reduce exposure to HAP resulting from solid fuel smoke. Studies with longer follow-up periods are required to assess if pollutant reductions reported in the current literature are sustained over time. Adoption of new technologies is challenging and interventions must be tailored to the needs and preferences of the households of interest. Future studies require greater process evaluation to improve knowledge of implementation barriers and facilitators.

Review registration: The review was registered on Prospero (registration number CRD42014009796).

No MeSH data available.


Related in: MedlinePlus

Flow diagram of study selection
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Fig1: Flow diagram of study selection

Mentions: Our systematic review identified 5243 potential articles. After duplicates were removed, title screening occurred on 3772 studies of which 258 were further screened on abstract and 57 full texts retrieved. A total of 36 studies were found to meet the full inclusion criteria (see Fig. 1 for a flow chart of study selection). Studies were excluded on the grounds of: study type (only stove intervention or evaluation of stove intervention studies were included); source of air pollution (populations exposed to non-solid fuels only such as tobacco, radon or outdoor sources of air pollution were excluded), the study setting (intervention occurring in non-natural settings such as laboratory-based or non-residential settings such as occupational settings were excluded); the study country (only studies from LMIC were included).Fig. 1


Improved stove interventions to reduce household air pollution in low and middle income countries: a descriptive systematic review.

Thomas E, Wickramasinghe K, Mendis S, Roberts N, Foster C - BMC Public Health (2015)

Flow diagram of study selection
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4499941&req=5

Fig1: Flow diagram of study selection
Mentions: Our systematic review identified 5243 potential articles. After duplicates were removed, title screening occurred on 3772 studies of which 258 were further screened on abstract and 57 full texts retrieved. A total of 36 studies were found to meet the full inclusion criteria (see Fig. 1 for a flow chart of study selection). Studies were excluded on the grounds of: study type (only stove intervention or evaluation of stove intervention studies were included); source of air pollution (populations exposed to non-solid fuels only such as tobacco, radon or outdoor sources of air pollution were excluded), the study setting (intervention occurring in non-natural settings such as laboratory-based or non-residential settings such as occupational settings were excluded); the study country (only studies from LMIC were included).Fig. 1

Bottom Line: When well-designed, implemented and monitored, stove interventions can have positive effects.However, the impacts are unlikely to reduce pollutant levels to World Health Organization recommended levels.Future studies require greater process evaluation to improve knowledge of implementation barriers and facilitators.

View Article: PubMed Central - PubMed

Affiliation: British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK. emma.thomas@dph.ox.ac.uk.

ABSTRACT

Background: Household air pollution (HAP) resulting from the use of solid fuels presents a major public health hazard. Improved stoves have been offered as a potential tool to reduce exposure to HAP and improve health outcomes. Systematic information on stove interventions is limited.

Methods: We conducted a systematic review of the current evidence of improved stove interventions aimed at reducing HAP in real life settings. An extensive search of ten databases commenced in April 2014. In addition, we searched clinical trial registers and websites for unpublished studies and grey literature. Studies were included if they reported on an improved stove intervention aimed at reducing HAP resulting from solid fuel use in a low or middle-income country.

Results: The review identified 5,243 records. Of these, 258 abstracts and 57 full texts were reviewed and 36 studies identified which met the inclusion criteria. When well-designed, implemented and monitored, stove interventions can have positive effects. However, the impacts are unlikely to reduce pollutant levels to World Health Organization recommended levels. Additionally, many participants in the included studies continued to use traditional stoves either instead of, or in additional to, new improved options.

Conclusions: Current evidence suggests improved stove interventions can reduce exposure to HAP resulting from solid fuel smoke. Studies with longer follow-up periods are required to assess if pollutant reductions reported in the current literature are sustained over time. Adoption of new technologies is challenging and interventions must be tailored to the needs and preferences of the households of interest. Future studies require greater process evaluation to improve knowledge of implementation barriers and facilitators.

Review registration: The review was registered on Prospero (registration number CRD42014009796).

No MeSH data available.


Related in: MedlinePlus