2011 Articles

Targeting of household air pollution: interpretation of RESPIRE

Miller, Rachel L.; Agerstrand, Cara Lyn

An estimated 3 million infants and children younger than 5 years die every year from pneumonia in developing countries.1 Exposure to household air pollution emitted from biomass fuels has been implicated in about a third of these cases.2 Observational and case-control studies have reported an association between exposure to household air pollution and lower respiratory tract infections.3 However, until now, no randomised controlled intervention trials had been done in children.

In The Lancet, Kirk R Smith and colleagues of the Randomised Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) report a randomised trial that aimed to reduce household air pollution and its subsequent effects on early childhood pneumonia. 4 The RESPIRE trial, which was undertaken in the Guatemalan highlands from 2002–04, introduced chimney stoves (planchas) in homes using traditional wood fires for cooking. 534 homes with pregnant women or infants younger than 4 months were randomly assigned to either planchas or control (traditional wood fires); the primary outcome was the reduction of physician-diagnosed pneumonia in children with use of standardised criteria. Study participants were followed up until 18 months of age, with weekly visits by fieldworkers, and subsequent referral to local physicians who were masked to intervention status for the assessment and diagnosis of pneumonia.