Indoor Air Pollution and Mortality in Belgium: A 30-Year Retrospective Population Study (1991–2021)

Patrick Deboosere , VUB
Lise Bevernaegie, Vrije Universiteit Brussel, BRISPO

Air pollution remains the largest environmental health risk in Europe, with indoor air quality representing a significant component. This study investigates one key source of indoor pollution: residential heating systems. We linked the 1991 Belgian census population to individual cause-specific mortality data from 2001–2021 to analyze mortality risks from Chronic Obstructive Pulmonary Disease (COPD) and Ischemic Heart Disease (IHD). Households were categorized by heating type: central heating, wood burning, coal stoves, and other systems. Using a Cox regression model controlled for sex, age, and educational level (a proxy for socio-economic status), we found that all non-central heating systems were associated with a significantly higher risk of respiratory and cardiovascular mortality. Specifically, indoor coal heating was associated with an 85% higher risk of COPD mortality and a 50% higher risk of IHD mortality compared to central heating. While controlling for socio-economic status attenuated these associations, the elevated risks remained statistically significant. Our findings also indicate that the use of coal stoves is an intermediate factor explaining how regional socio-economic inequalities translate into geographical disparities in mortality. This research reinforces the substantial health impact of indoor air pollution and provides compelling evidence to support policies phasing out indoor solid-fuel heating systems.

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 Presented in Session 102. Flash Session Seasonal, Climate- and COVID-19-Related Mortality