Health Impacts of Fuel-based Lighting

The challenges of sustainability often intertwine with those of public health, revealing opportunities in both arenas for disenfranchised populations. A fifth of the world’s population earns on the order of $1 per day and lacks access to grid electricity. They pay a far higher proportion of their income for illumination than those in wealthy countries, obtaining light with fuel-based sources, primarily kerosene lanterns. The same population experiences adverse health and safety risks from these same lighting fuels.

Beyond the well-known benefits of reducing lighting energy use, costs, and pollution (which has its own health consequences), off-grid electric light can yield substantial health and safety benefits and save lives. While knowledge of these benefits can enhance the business case for conversion to more efficient and less dangerous technologies such as LED lighting, proponents often lack accurate information.  Statements confusing lighting with the more widely known health impacts of cooking are a particularly common problem.

A large but specialized medical literature identifies an array of risks associated with fuel-based lighting, including: burns caused by a wide variety of factors, indoor air pollution, non-intentional ingestion of kerosene fuel by children, suppressed visual health, and compromised health services and outcomes in facilities lit with fuel-based light. Each risk factor results in illness, and most in mortalities. Lighting is the dominant and sometimes only use of kerosene (referred to as paraffin in some parts of the world) in rural areas, although kerosene plays a large role for cooking in urban areas or areas without solid fuel supplies. Lighting-only statistics are provided in this report whenever possible.

There are few national-level assessments of health impacts associated with off-grid lighting.  A survey of 3,315 users of kerosene lighting across five sub-Saharan Africa countries found 26% to have health concerns related to the kerosene lighting. Many sudies report that accidental ingestion of kerosene is the primary case of child poisoning in the developing world. In South Africa alone, over 200,000 people are injured or lose property each year due to kerosene-related fires, in addition to 79,750 very young children unintentionally ingesting kerosene (in 3.6% of all households), of which 60% develop a chemically induced pneumonia. In Bangladesh, kerosene lamps are responsible for 23% of infant burns. Three multi-year reviews of admissions to Nigerian hospitals attributed ~30% of all burn cases to kerosene.  Even higher burn rates (~40%) are attributed to kerosene lamps in Sri Lankan homes, with 150-200 lives lost and an associated cost of $1M each year to for medical care.

Most studies are based on hospital admissions, which vastly underestimate incident rates in the broader population, particularly among the poorest segments and other groups less likely to have access to or seek hospital care. This report’s review of 85 published reports spanning 27 countries indicates the pervasiveness of impacts and potential solutions: