The extent of exposure and health effects of household coal burning in urban residential areas in South Africa.

Household coal burning is one of the major sources of total suspended particulate matter (TSP) in African urban residential areas in South Africa. The coal stoves used are usually poorly vented or unvented, consequently resulting in high levels of indoor air pollution. The effects of household fuels used in two Townships in the Vaal Triangle (central South Africa) on the health of 8-12 year old children living in these households, were investigated. Personal exposures of 45 children to TSP, resulting from mainly coal burning, determined over 12 hour periods during the summer and winter of 1991 and 1992, indicated extremely high exposures. The health questionnaire data indicated that 59.9% of the population uses coal for space heating and cooking purposes. Most of the population perceived coal burning as the major source of air pollution in their area. The respiratory illness prevalence rates for the populations living respectively in three exposure areas: a coal burning area, a partially electrified area and an electrified area, were relative low with no statistical significantly difference in prevalence rates for the different exposure areas. However, children living in an area where only coal was burned had a respectively 170% and 120% higher risk of developing Upper Respiratory Tract Illnesses (URI) than children living in a partially electrified and a totally electrified area. The health data were collected during the summer period which is the period of lowest exposure to air pollution. Crowding and environmental tobacco smoking (ETS) did not have a marked effect on the risk to develop URI and LRI. Exposure measurements taken during the winter period indicated higher levels of TSP than during the summer period. It is expected that the prevalence rate of respiratory symptoms will be significantly higher during the winter period.