Over one lakh children die in India annually because of household air pollution, says study. Outdoor air pollution has received much-required attention in popular media. What is missing though in conversations is indoor air pollution, which causes 3.5 million-4 million global deaths annually, according to a recent report published in The Lancet, one of the oldest and best-known peer-reviewed weekly on general medicine. Contrary to popular perception, closing the windows cannot guard one against air pollution. Indoor air pollution is also lethal like outdoor pollution and considering that many studies say that we spend most of our time indoors, improper ventilation and disposal of household pollutants may actually be worse. Indoor air pollution can have several types of pollutants and sources. Some of them are: Carbon monoxide Radon Nitrogen dioxide Secondhand smoke Lead particles Asbestos Mould, Pollen, Dander Formaldehyde Volatile organic compounds (VOCs) found in household products found like pesticides, coatings, printing inks, adhesives, cleaning agents, and personal care products. Some of these pollutants were and are still hard to detect. Until the term, Sick Building Syndrome (SBS) was coined to explain a condition where patients complained of symptoms such as a headache, eye, nose, and throat irritation, fatigue, and dizziness and nausea, most thought that they had acquired some type of mysterious-undiagnosable illnesses. But as they found that their symptoms seemed to be linked to the amount of time they spent in a closed building. The causes were found to be flaws in the heating, ventilation, and air conditioning systems, or the presence of pollutants in building materials or household items. However rather than SBS, most indoor air pollution deaths occur because of Household Air Pollution (HAP) in low-income households due to their use of biomass for cooking and heating. According to a study conducted by the Centre for Health and Environment last year, HAP was responsible for an estimated 9,77,094 deaths in 2015 in India, a significant chunk of which were women and children. “An estimated 4,00,000 deaths in India happen as a result of acute lower respiratory infection in children below five years of age, with a third of the risk attributable to HAP exposures,” adds the report. HAP is responsible for the following three main health issues: acute lower respiratory infections in children under five years of age chronic obstructive pulmonary disease in women lung cancer (especially in users of coal) Other outcomes such as such as pre-term births, low birth weight, cataracts, asthma and tuberculosis are also linked to HAP. The study also emphasises that exposure to air pollution, both indoors and outdoors, is more severe for those individuals belonging to a lower socioeconomic status. “A majority of urban slums in India are located close to factories and highways. Therefore, people residing in slums are more prone to higher exposures from industrial and vehicular emissions. Densely populated localities with absent exhaust vents, coupled with the use of low-quality domestic fuels (such as biomass, dung etc.), and the presence of unpaved roads further deteriorates indoor air in slums. A study carried out by Kulshreshtha et al. (2008) identified differences of 110-175 µg/m3 in indoor PM concentrations between low and high-income houses. Another study carried out in Mumbai also reported higher indoor pollutant concentrations in low-income houses than affluent ones,” the report adds. Solutions and the way forward While reports have pointed out that even basic solutions(whose efficacy has been under question) such as purchasing of air purifiers and good quality pollution masks are beyond the means of the public at large, the answers for the way forward, like the vast majority of the public already believes, has to come from the government. This includes funding of more evidence-based studies, better and more air monitoring stations, more awareness drives, subsidizing of equipment to combat air pollution and expanding schemes relating to this such as the Prime Minister’s rural LPG scheme etc.