LAUSR

Abstract Background Lighting sources have been overlooked in previous estimates of the health burden attributable to household air pollution (HAP). However, lighting sources can be an important predictor of personal exposure to HAP in countries with limited access to electricity. We modeled the health and environmental impacts of hypothetical intervention scenarios that replace kerosene-based lighting with renewable electricity in East Africa. Methods We used comparative risk assessment methods to quantify the ischemic heart disease-, stroke-, lung cancer-, chronic obstructive pulmonary disease- and lower respiratory infection-related morbidity and mortality attributable to personal fine particulate matter (PM2.5) exposure due to kerosene-based lighting for residents of East Africa in 2015. We used health and demographic data from the Global Burden of Disease; PM2.5 exposure estimates from a previous study replacing kerosene-based lighting with solar lighting; and exposure-response functions from the literature to estimate the number of deaths and DALYs that could be avoided with increased scaling-up of the lighting source intervention. We estimated avoided black carbon emissions using emission factors from published literature. Results We estimated that 6218, 10,092, 12,723 deaths and 409, 654, 814 hundred thousand DALYs could be avoided if 33%, 66%, and 100% respectively of households using kerosene-based lighting replaced it with electricity in East Africa in 2015. Including lighting fuel in estimates of deaths due to PM2.5 from household air pollution in the region would add a further 9% in addition to those from cooking with solid fuel. Full replacement of kerosene-based lighting with renewable electricity would have reduced black carbon emissions by 4.4 Gg/year or 3957 CO2eq Gg in 2015, with the largest emission reductions in Uganda and Kenya. Conclusion Kerosene-based lighting is a non-negligible source of HAP in the region and should be included in assessments of the health burden attributable to HAP.