5. Burden of Disease from Indoor Air Pollution

Indoor air pollution has evolved into a high-priority risk across the globe, with various organizations ranking indoor air pollution in the top category of environmental risks. Indoor air pollutant concentrations are a function of indoor source emissions, the infiltration of ambient pollution via building leakage, and the air exchange rate (ventilation) in the building. Health effects range from acute conditions such as sensory irritation to chronic, potentially life-threatening conditions such as cancer and cardiovascular disease. The three primary factors that affect indoor air quality are the nature of indoor pollutant sources, ventilation of the building, and occupant behaviors. This initial modeling effort focuses on the residential environment because people spend the majority of their time indoors in residential dwellings. Deficient air quality can exist in all types of enclosed buildings and structures. In the future, the methods and models developed here could be applied to other indoor environments. The burden of disease due to a particular pollutant was calculated by multiplying the attributable fraction by the observed number of cases of the relevant health outcome in the population. The leading source of indoor air pollution contributing to excess cases of illness is environmental tobacco smoke. Altogether, it appears to cause more than 80% of the health-care facility visits attributed to indoor air pollution. The leading health outcomes attributed to indoor air pollution are cardiovascular disease and lower respiratory tract infections. An estimated 280 deaths result from those diseases, with approximately 88% of those deaths attributed to cardiovascular disease caused by environmental tobacco smoke. Our analyses suggest that indoor air pollution is a considerable risk to public health in the United Arab Emirates (UAE), accounting for at least 77,000 excess visits to health-care facilities in 2008 in addition to the 280 excess deaths. In terms of mortality, indoor air quality ranks second only to outdoor air pollution as a cause of environmentally related diseases in the UAE.