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Energy, Air Pollution and Health Research


Evidence base for household air pollution and health

The Global Burden of Disease

This study estimated that, in 2010, 2.8 billion people used traditional solid fuels (wood, dung, coal, etc) and simple stoves as their primary means of cooking worldwide, leading to levels of HAP (particulate matter-PM2.5) in homes some 20 to 40 times the WHO ‘safe’ air quality guideline level. This contributed to 4.3% of the global burden of disease in 2010, and 4 million premature deaths from childhood pneumonia and a range of adult diseases (IHD, stroke, COPD, lung cancer and cataracts).

Contributions of emissions from household fuel combustion released to ambient air were also found to account for around 400,000 deaths from outdoor air pollution. Systematic reviews conducted by the research group and the RESPIRE trial, provided important data on exposure and health risk estimates for this project.

As part of this work, our group contributed to the innovative work in developing integrated exposure response functions, which were used as the basis for estimating the additional risk associated with exposure to HAP for several of the disease conditions included in the burden calculations.

Building on the experience gained through the GBD-2010 study, our team is contributing to the development by Public Health England (in partnership with IHME) of the 2013 disease burden study for England.


GBD-2010: Professor Nigel Bruce (co-chair for HAP expert group), Dr Daniel Pope (member expert group and lead reviewer), Dr Mukesh Dherani (member of expert group)

GBD-2013: Professor Nigel Bruce, Dr Daniel Pope, Dr Mukesh Dherani (members of expert committee)


Bill and Melinda Gates Foundation (HAP Comparative Risk Assessment)

Publications/ dissemination

Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS & Pope D (senior author Lozano R). Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet 2014; 384: 980-1004.

Wang H, Liddell CA, Coates MM & Bruce N, Dherani M, Pope D (senior author Murray CJL). Global, regional, and national levels of neonatal, infant, and under-5 mortality 1990-2013: a systematic analysis. The Lancet 2014; 384: 957-97.

Burnett RT, Pope A III, Ezzati M, Olives C, Lim SS, Mehta S, Shin HH, Singh G, Hubbell B, Brauer M, Anderson HR, Smith KR, Balmes JR, Bruce NG, Kan H, Laden F, Pruss-Ustun A, Turner MC, Gapstur SM, Diver WR, Cohen A. An Integrated Risk Function for Estimating the Global Burden of Disease Attributable to Ambient Fine Particulate Matter Exposure. Environ Health Perspectives; 2014: DOI:10.1289/ehp.1307049

Kirk R. Smith, Nigel Bruce, Kalpana Balakrishnan, Heather Adair-Rohani, John Balmes, Zoe Chafe, Mukesh Dherani, H. Dean Hosgood, Sumi Mehta, Daniel Pope, Eva Rehfuess and others in the HAP CRA Risk Expert Group. (2014) Millions Dead: How Do We Know and What Does It Mean? Methods Used in the Comparative Risk Assessment of Household Air Pollution. Annu Rev Public Health 2014; 35:1-27

Dherani M, Turner L, Johnstone F, Sharples T, Pope D, Bruce N. Body-mass-index-related disease burden in northwest UK - Global Burden of Disease methods in a subnational cross-sectional study: opportunities and challenges. The Lancet 2013; 381: S36

Murray CJL, Richards MA, Newton JN, Fenton KA, Anderson HR & Bruce N, Dherani M, Pope D (senior author Davies A). UK health performance: findings of the Global Burden of Disease Study 2010. The Lancet 2013; 381: 997-1020.

Murray CJL, Aboyans V & Bruce N, Dherani M, Pope D (senior author Lopez LD). GBD 2010 country results: a global public good. The Lancet 2013; 381: 965-970.

Lim M, Voss T, Flaxman AD & Bruce N, Dherani M, Pope D (senior author Memish ZA). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet 2012; 380: 2224-2260.