Despite progress towards the electrification of households, indoor air pollution remains one of the biggest health risks in South Africa.

According to environmental health experts, most low-income households cannot afford to rely exclusively on electricity for cooking and heating and so continue to use cheaper, “dirty” fuels.

“More than 50 percent of South African households still use paraffin, coal and wood as their main energy source. By far the biggest cause of illness and death is from indoor pollution and not outside air pollution,” says Angela Mathee, Senior Specialist Scientist for Environmental Health, Medical Research Council.

According to Mathee, there is an unseen and largely undocumented epidemic of respiratory disease resulting from indoor air pollution exposure in South Africa. This includes acute respiratory infections, pneumonia and chronic obstructive lung disease.

“We have one of the most impressive electrification programmes in the world,” says Mathee. “Around 1 000 new households have received electricity every day in South Africa for the past couple of years but many don’€™t necessarily use it. In winter months especially, many households find it cheaper to use a coal stove for multiple purposes such as cooking, boiling water, heating the home, and ironing, making it cheaper overall, than electricity.”

According to the World Health Organisation, respiratory infection is the largest single-category cause of mortality and morbidity worldwide, accounting for nine percent of the entire global burden of disease, 80 percent of which occurs in the Third World among children under the age of five years.

The World Health Organisation also estimates that worldwide, as many as 2,5 million people die prematurely each year from exposure to indoor air pollution. This approximates the annual death toll from other diseases like malaria and tuberculosis.

“Coal combustion causes the most serious indoor pollution. And the level of exposure to airborne particles in Soweto exceeds the maximum allowance permitted by the World Health Organisation by 96 percent. It costs South Africa’€™s Department of Health about R360 million a year to treat respiratory diseases caused by coal combustion,” says Mongameli Mehlwana from the Energy and Development Research Centre of the University of Cape Town.

According to Mehlwana, The Department of Minerals and Energy is investigating strategies that take these realities into account.

Current plans to replace coal-generated electricity with gas power by building a station powered by gas in the Cape Town area by the year 2005 could also help those without electricity.

Gas is a much cleaner and more environmentally-friendly fuel than either coal or paraffin, and is cheaper than electricity.

Having a gas-fired power station in Cape Town would enable you to take gas off directly for other applications, including heating and cooking in domestic homes, says Tony Stott, Generation Environmental Manager of Eskom.

Plans like this are encouraging, but short-term strategies to reduce indoor pollution are also needed, says Mehlwana.

Such strategies would include large-scale education about averting the dangers of indoor pollution, the monitoring of paraffin quality, distribution and storage, and the introduction of quality control for appliances such as wick and coal stoves.

Apart from causing indoor pollution, low-cost fuels are a common cause of residential fires and the fatal poisoning of young children.

“Fires that involve energy sources such as wood or paraffin account for 75 percent of serious injuries in childhood occurring in informal settlements, and are responsible for 21 percent of child deaths,” says Mehlwana.

“Of the 173 cases of poisoning admitted to the Tygerberg Hospital children’€™s emergency ward last year, 32 percent were related to volatile exposures, of which by far the most common is paraffin,” says Dr Gerbus Müller from the Department of Pharmacology, University of Stellenbosch. -Health-e News Service.