Most of the diseases responsible for high mortality in the country have been termed preventable, meaning preventative actions and early intervention can save lives. The leading causes of death in Sierra Leone are malaria, respiratory infections and diarrhoea, and they all have two things in common. First, they have strong connections with the environment and, second, they are preventable at minimal costs. Failure to prevent them puts people at risk, resulting in dire consequences (disease burden, medical cost and loss of human capacity) for families and the state.

Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of morbidity and mortality worldwide and its development is influenced by environmental factors. Lifestyle factors, such as smoking, and occupational hazards, like continuous exposure to harmful dust, fumes, vapours and gases, are significant risk factors for COPD (Kim & Lee 2017) Environmental exposures and chronic obstructive pulmonary disease, Molecular and Cellular Toxicology, 13 (3).

The air quality in houses is affected by the type of fuel used for heating, and cooking can also be a major contributor to the development of COPD. The cleaner the fuel, the lower the risk. However, in a low or middle income country like Sierra Leone where  biomass fuels are used widely in most homes, the risk of contracting COPD and/or Asthma is often higher.

In Sierra Leone, it is estimated that some 95% of households use wood, charcoal and other forms of biomass for cooking. This is because cleaner forms of fuel are expensive and very few people can afford them for household use. Research conducted in Sierra Leone found that exposure to smoke from wood and charcoal is a major health risk and this exposure has been associated with acute respiratory infection (ARI) in children and adults. The study further mentioned that homes using wood stoves had 32% of ARI compared to 24% in homes using charcoal stoves. This study is a confirmation that exposure to smoke from biomass exposes household members to respiratory problems and that continuous exposure could lead to more serious conditions like COPD.

E Taylor & S Nakai (2012) Prevalence of Acute Respiratory Infection in Women and Children in Western Sierra Leone due to smoke from wood and charcoal stoves, International journal of Environmental Research and Public Health, No 9 June 2012.