These limitations aside, the large attributable burden documented in our analysis represents a major shift in our understanding of disease burden arising from particulate matter and emphasises the need to design alternative fuels for household cooking and heating,163 implement more stringent regulation of vehicle and industrial emissions,164–166 reduce agricultural burning or land clearing by fire,167 and curb and reverse deforestation and desertification to reduce ambient particulate matter from dust.168–171 A large share of ambient particulate matter in Asia and sub-Saharan Africa originates from solid fuel.172,173 Therefore the two exposures are related, and alternative cooking and heating fuels would have benefits for people who currently use solid fuels as well as those who do not, but live in the same community.173
