Indoor air pollution and its health effects in China ‐ a review

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Abstract
Indoor air pollution in cities in China is mainly from domestic coal combustion, and from coal and biomass fuel combustion in rural areas. Factors affecting indoor air pollutant concentrations include fuel, ventilation, floor plan of house, and season, etc. Pollutants emitted from coal combustion are significantly higher than those from gas or liquefied petroleum gas. Among biofuels used in China, biogas is the least, firewood the second, and cow/sheep dung the most polluting biofuel in terms of indoor pollution levels. Adverse health effects of indoor air pollution due to fuel combustion in China are diverse in nature and vary in severity, ranging from pre‐clinical decrease in local non‐specific immune function and pulmonary function, to elevated prevalence of respiratory diseases and symptoms, lung cancer, especially female lung cancer, birth defects and fluorosis. In most of the epidemiologic studies cited below, due precaution was taken to stratify for the effect of smoking and passive smoking. Indoor air pollution is particularly harmful to the health of women and children, especially aged women and young children. Intervention measures have been taken to ameliorate indoor air pollution and need to be strengthened.