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Household Air Pollution Commission – The Lancet, Sept 3, 2014

18 September 2014 11:31 (America/New_York)

Household Air Pollution Commission – The Lancet, Sept 3, 2014 Executive Summary Nearly 3 billion people worldwide are exposed to the threat of household air pollution (HAP) every day from the use of solid fuel for cooking, heating, and lighting. HAP is a major contributor to global figures for morbidity and mortality, with major effects on respiratory symptoms and disease. This first Commission of The Lancet Respiratory Medicine discusses the toxic effects of HAP in low-income and middle-income countries, ways to measure pollution, and solutions to tackle the problem. While a linked Comment reminds readers that HAP can also occur in high-income countries. Comment Breaking new ground to promote change Emma Grainger, Louise Rishton, Jane Godsland, Diana Stanley

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Household air quality in high-income countries: forgotten but not gone Neil Schluger

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Commission Respiratory risks from household air pollution in low and middle income countries Stephen B Gordon, Nigel G Bruce, Jonathan Grigg, Patricia L Hibberd, Om P Kurmi, Kin-bong Hubert Lam, Kevin Mortimer, Kwaku Poku Asante, Kalpana Balakrishnan, John Balmes, Naor Bar-Zeev, Michael N Bates, Patrick N Breysse, Sonia Buist, Zhengming Chen, Deborah Havens, Darby Jack, Surinder Jindal, Haidong Kan, Sumi Mehta, Peter Moschovis, Luke Naeher, Archana Patel, Rogelio Perez-Padilla, Daniel Pope, Jamie Rylance, Sean Semple, William J Martin II

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Children’s Respiratory Health After an Efficient Biomass Stove (Patsari) Intervention

18 September 2014 11:24 (America/New_York)

Children’s Respiratory Health After an Efficient Biomass Stove (Patsari) Intervention. Ecohealth. 2014 Sep 9.

Authors: Schilmann A1, Riojas-Rodríguez H, Ramírez-Sedeño K, Berrueta VM, Pérez-Padilla R, Romieu I.
1Environmental Health Department, National Institute of Public Health (INSP), Av. Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.

Household use of fuelwood represents a socio-ecological condition with important health effects mainly in rural areas from developing countries. One approach to tackle this problem has been the introduction of efficient wood-burning chimney stoves. The aim of this study was to assess the impact of the introduction of Patsari stoves on the respiratory health of young children in highlands Michoacán, Mexico. A total of 668 households in six rural communities in a fuelwood using region were selected and randomized to receive an improved stove (Patsari) or rely entirely on the traditional wood fire until the end of the follow-up including 10 monthly visits.

Adherence to the intervention was variable over the follow-up time. The actual use of the Patsari stove as reported by the mother showed a protective effect mainly on the upper and lower respiratory infection duration (IRR URI 0.79, 95% CI 0.70-0.89, and LRI 0.41, 95% CI 0.21-0.80) compared to households that used only an open fire. Fewer days of child’s ill health represents saved time for the woman and avoided disease treatment costs for the family, as well as a decrease in public health costs due to a reduction in the frequency of patient visits.

Results of Laboratory Testing of 15 Cookstove Designs in Accordance with the ISO/IWA Tiers of Performance

18 September 2014 11:21 (America/New_York)

Results of Laboratory Testing of 15 Cookstove Designs in Accordance with the ISO/IWA Tiers of Performance. Ecohealth. 2014 Sep 12.

Authors: Still D1, Bentson S, Li H.
1 – Aprovecho Research Center, 76132 Blue Mountain School Rd, Cottage Grove, OR, 97424, USA,

The widespread adoption and sustained use of modern cookstoves has the potential to reduce harmful effects to climate, health, and the well-being of approximately one-third of the world’s population that currently rely on biomass fuel for cooking and heating. In an effort to understand and develop cleaner burning and more efficient cookstoves, 15 stove design and fuel/loading combinations were evaluated in the laboratory using the International Workshop Agreement’s five-tiered (0-4) rating system for fuel use and emissions.

The designs evaluated include rocket-type combustion chamber models including reduced firepower, sunken pots, and chimneys (three stoves); gasifier-type combustion chambers using prepared fuels in the form of wood pellets (four stoves); forced draft stoves with a small electric fan (five stoves); and a single insulated charcoal stove with preheated secondary air.

It was found that a charcoal burning stove was the only stove to meet all the Tier 4 levels of performance. Achieving over 40% thermal efficiency at high power was made possible by reducing firepower and gaps around the pot, although batch-fed stoves generally do not “turn down” for optimal low power performance. While all stoves met Tier 4 for carbon monoxide, only stoves equipped with electrical fans reduced respirable particulate matter to Tier 4 levels. Finally, stoves with chimneys and integrated pots were fuel efficient and virtually eliminated indoor emissions. It is hoped that these design techniques will be useful in further development and evolution of high-performance cookstove designs.

The Critical Importance of Cleaner Fuels

11 September 2014 11:33 (America/New_York)

The Critical Importance of Cleaner Fuels | Source: S Patel and S Mehta, Global Alliance for Clean Cookstoves, Aug 2014.

Preliminary exposure results from Alliance-supported child survival research studies in Ghana, Nigeria, and Nepal were unveiled at a special symposium held in Seattle at the annual meeting of the International Society for Environmental Epidemiology (ISEE), the premier technical conference for environmental health researchers.  Results indicate substantial reductions in exposure associated with the adoption of cleaner cookstoves and fuels.  Moreover, researchers reported high rates of study compliance, and solid evidence that study participants were actively using the intervention stoves.  There were also discussions on the implication of these results for achieving the World Health Organizations (WHO) indoor air quality guidelines for household fuel combustion, with a special emphasis on estimating the impact of ‘stove stacking’, or continued use of traditional cookstoves, on the ability to meet air quality guidelines.

These study results will have far reaching implications for Alliance focus countries such as Ghana, Kenya, China, and India, where policy makers and health professionals are well-positioned to increase awareness of the links between household air pollution, fuel switching, and health.  For example, given Ghana’s commitment to scaling adoption of clean cookstoves, and providing 50% of the population with access to clean fuels by 2020, the study will provide policy-relevant information for Ghana and the broader global public health community.

Respiratory risks from household air pollution in low and middle income countries

11 September 2014 11:23 (America/New_York)

Respiratory risks from household air pollution in low and middle income countries. Lancet Respir Med. 2014 Sep 2. pii: S2213-2600(14)70168-7. doi: 10.1016/S2213-2600(14)70168-7.

Authors: Gordon SB, Bruce NG, et al.

A third of the world’s population uses solid fuel derived from plant material (biomass) or coal for cooking, heating, or lighting. These fuels are smoky, often used in an open fire or simple stove with incomplete combustion, and result in a large amount of household air pollution when smoke is poorly vented. Air pollution is the biggest environmental cause of death worldwide, with household air pollution accounting for about 3·5-4 million deaths every year. Women and children living in severe poverty have the greatest exposures to household air pollution.

In this Commission, we review evidence for the association between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases. Respiratory infections (comprising both upper and lower respiratory tract infections with viruses, bacteria, and mycobacteria) have all been associated with exposure to household air pollution. Respiratory tract cancers, including both nasopharyngeal cancer and lung cancer, are strongly associated with pollution from coal burning and further data are needed about other solid fuels. Chronic lung diseases, including chronic obstructive pulmonary disease and bronchiectasis in women, are associated with solid fuel use for cooking, and the damaging effects of exposure to household air pollution in early life on lung development are yet to be fully described.

We also review appropriate ways to measure exposure to household air pollution, as well as study design issues and potential effective interventions to prevent these disease burdens. Measurement of household air pollution needs individual, rather than fixed in place, monitoring because exposure varies by age, gender, location, and household role. Women and children are particularly susceptible to the toxic effects of pollution and are exposed to the highest concentrations. Interventions should target these high-risk groups and be of sufficient quality to make the air clean. To make clean energy available to all people is the long-term goal, with an intermediate solution being to make available energy that is clean enough to have a health impact.

Household Cooking with Solid Fuels Contributes to Ambient PM2.5 Air Pollution and the Burden of Disease

11 September 2014 11:15 (America/New_York)

Household Cooking with Solid Fuels Contributes to Ambient PM2.5 Air Pollution and the Burden of Disease. Environ Health Perspect. 2014 Sep 5.

Authors: Chafe ZA1, Brauer M2, Klimont Z3, Van Dingenen R4, Mehta S5, Rao S3, Riahi K3, Dentener F4, Smith KR6.
Author information
1Energy and Resources Group; and Environmental Health Sciences, University of California, Berkeley, California, USA.
2School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
3International Institute for Applied Systems Analysis, Laxenburg, Austria.
4European Commission Joint Research Centre, Institute for Environment and Sustainability, Air and Climate Unit, Ispra, Italy.
5Global Alliance for Clean Cookstoves, Washington, DC, USA.
6Environmental Health Sciences, University of California, Berkeley, California, USA.

Background: Approximately 2.8 billion people cook with solid fuels. Research has focused on the health impacts of indoor exposure to fine particulate pollution. Here, for the 2010 Global Burden of Disease project (GBD 2010), we evaluate the impact of household cooking with solid fuels on regional population-weighted ambient PM2.5 pollution (APM2.5).

Objectives: We estimated the proportion and concentrations of APM2.5 attributable to household cooking with solid fuels (PM2.5-cook) for the years 1990, 2005, and 2010 in 170 countries; and associated ill-health.

Methods: We used an energy supply-driven emissions model (GAINS) and source-receptor model (TM5-FASST) to estimate the proportion of APM2.5 produced by households and the proportion of household PM2.5 emissions from cooking with solid fuels. We estimated health effects using GBD 2010 data on ill-health from APM2.5 exposure.

Results: In 2010, household cooking with solid fuels accounted for 12% of APM2.5 globally, varying from 0% of APM2.5 in five higher-income regions to 37% (2.8 µg/m3 of 6.9 µg/m3 total) in Southern sub-Saharan Africa. PM2.5-cook constituted >10% of APM2.5 in seven regions housing 4.4 billion people. South Asia showed the highest regional concentration of APM2.5 from household cooking (8.6 µg/m3). Based on GBD 2010, we estimate that exposure to APM2.5 from cooking with solid fuels caused the loss of 370,000 lives and 9.9 million disability-adjusted life years globally in 2010.

Conclusions: PM2.5 emissions from household cooking constitute an important portion of APM2.5 concentrations in many places, including India and China. Efforts to improve ambient air quality will be hindered if household cooking conditions are not addressed.

WHO Indoor air quality guidelines on household fuel combustion: Strategy implications of new evidence on interventions and exposure-risk functions

27 August 2014 11:56 (America/New_York)

WHO Indoor air quality guidelines on household fuel combustion: Strategy implications of new evidence on interventions and exposure-risk functions. Atmospheric Environment, 27 August 2014, In Press.

Nigel Brucea, b, , , Dan Popea, Eva Rehfuessc, Kalpana Balakrishnand, Heather Adair-Rohanib, Carlos Dorab
a Department of Public Health and Policy, University of Liverpool, UK
b Department of Public Health, Environmental and Social Determinants of Health, World Health Organisation, Geneva
c Institute for Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
d Department of Environmental Health Engineering, Sri Ramachandra University, Chennai, India

• New WHO air quality guidelines will address household air pollution (HAP).
• Action on HAP could lower risk of multiple child and adult diseases by 20-50%.
• New evidence shows levels at or below 35 μg/m3 PM2.5 (WHO IT-1) are needed.
• Most improved solid fuel stoves result in PM2.5 levels well above IT-1.
• Intervention strategy must shift towards accelerating access to clean fuels.

Background - 2.8 billion people use solid fuels as their primary cooking fuel; the resulting high levels of household air pollution (HAP) were estimated to cause more than 4 million premature deaths in 2012. The people most affected are among the world’s poorest, and past experience has shown that securing adoption and sustained use of effective, low-emission stove technologies and fuels in such populations is not easy. Among the questions raised by these challenges are (i) to what levels does HAP exposure need to be reduced in order to ensure that substantial health benefits are achieved, and (ii) what intervention technologies and fuels can achieve the required levels of HAP in practice? New WHO air quality guidelines are being developed to address these issues.

Aims – To address the above questions drawing on evidence from new evidence reviews conducted for the WHO guidelines.

Methods – Discussion of key findings from reviews covering (i) systematic reviews of health risks from HAP exposure, (ii) newly developed exposure-response functions which combine combustion pollution risk evidence from ambient air pollution, second-hand smoke, HAP and active smoking, and (iii) a systematic review of the impacts of solid fuel and clean fuel interventions on kitchen levels of, and personal exposure to, PM2.5 and carbon monoxide (CO).

Findings – Evidence on health risks from HAP suggest that controlling this exposure could reduce the risk of multiple child and adult health outcomes by 20-50%. The new integrated exposure-response functions (IERs) indicate that in order to secure these benefits, HAP levels require to be reduced to the WHO IT-1 annual average level (35 μg/m3 PM2.5), or below. The second review found that, in practice, solid fuel ‘improved stoves’ led to large percentage and absolute reductions, but post-intervention kitchen levels were still very high, at several hundreds of μg/m3 of PM2.5, although most solid fuel stove types met the WHO 24-hr average guideline for CO of 7 mg/m3 Clean fuel user studies were few, but also did not meet IT-1 forPM2.5, likely due to a combination of continuing multiple stove and fuel use, other sources in the home (e.g. kerosene lamps), and pollution from neighbours and other outdoor sources.

Conclusions – Together, this evidence implies there needs to be a strategic shift towards more rapid and widespread promotion of clean fuels, along with efforts to encourage more exclusive use and control other sources in and around the home. For households continuing to rely on solid fuels, the best possible low-emission solid fuel stoves should be promoted, backed up by testing and in-field evaluation.

Highway proximity and black carbon from cookstoves as a risk factor for higher blood pressure in rural China

27 August 2014 11:18 (America/New_York)

Highway proximity and black carbon from cookstoves as a risk factor for higher blood pressure in rural China. Proc Natl Acad Sci U S A. 2014 Aug 25.

Baumgartner J1, Zhang Y2, Schauer JJ3, Huang W2, Wang Y2, Ezzati M4.
1Institute for Health and Social Policy and Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada H3A 1A3; Institute on the Environment, University of Minnesota, St. Paul, MN 55108;
2College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China;
3Environmental Chemistry and Technology Program, Department of Civil and Environmental Engineering, University of Wisconsin-Madison, Madison, WI 53706; and.
4MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, United Kingdom.

Air pollution in China and other parts of Asia poses large health risks and is an important contributor to global climate change. Almost half of Chinese homes use biomass and coal fuels for cooking and heating. China’s economic growth and infrastructure development has led to increased emissions from coal-fired power plants and an expanding fleet of motor vehicles. Black carbon (BC) from incomplete biomass and fossil fuel combustion is the most strongly light-absorbing component of particulate matter (PM) air pollution and the second most important climate-forcing human emission. PM composition and sources may also be related to its human health impact. We enrolled 280 women living in a rural area of northwestern Yunnan where biomass fuels are commonly used. We measured their blood pressure, distance from major traffic routes, and daily exposure to BC (pyrolytic biomass combustion), water-soluble organic aerosol (organic aerosol from biomass combustion), and, in a subset, hopane markers (motor vehicle emissions) in winter and summer. BC had the strongest association with systolic blood pressure (SBP) (4.3 mmHg; P < 0.001), followed by PM mass and water-soluble organic mass. The effect of BC on SBP was almost three times greater in women living near the highway [6.2 mmHg; 95% confidence interval (CI), 3.6 to 8.9 vs. 2.6 mmHg; 95% CI, 0.1 to 5.2]. Our findings suggest that BC from combustion emissions is more strongly associated with blood pressure than PM mass, and that BC’s health effects may be larger among women living near a highway and with greater exposure to motor vehicle emissions.

Sustained high incidence of injuries from burns in a densely populated urban slum in Kenya: An emerging public health priority.

27 August 2014 11:13 (America/New_York)

Sustained high incidence of injuries from burns in a densely populated urban slum in Kenya: An emerging public health priority. Burns. 2014 Sep;40(6):1194-200.

Authors: Wong JM1, Nyachieo DO1, Benzekri NA1, Cosmas L1, Ondari D1, Yekta S2, Montgomery JM1, Williamson JM1, Breiman RF3.
1Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Nairobi, Kenya and the Kenya Medical Research Institute (KEMRI)-CDC Research Collaboration.
2Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, ON, Canada.
3Global Disease Detection Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Nairobi, Kenya and the Kenya Medical Research Institute (KEMRI)-CDC Research Collaboration. Electronic address:

INTRODUCTION: Ninety-five percent of burn deaths occur in low- and middle-income countries (LMICs); however, longitudinal household-level studies have not been done in urban slum settings, where overcrowding and unsafe cook stoves may increase likelihood of injury.

METHODS: Using a prospective, population-based disease surveillance system in the urban slum of Kibera in Kenya, we examined the incidence of household-level burns of all severities from 2006-2011.

RESULTS: Of approximately 28,500 enrolled individuals (6000 households), we identified 3072 burns. The overall incidence was 27.9/1000 person-years-of-observation. Children <5 years old sustained burns at 3.8-fold greater rate compared to (p<0.001) those ≥5 years old. Females ≥5 years old sustained burns at a rate that was 1.35-fold (p<0.001) greater than males within the same age distribution. Hospitalizations were uncommon (0.65% of all burns).

CONCLUSIONS: The incidence of burns, 10-fold greater than in most published reports from Africa and Asia, suggests that such injuries may contribute more significantly than previously thought to morbidity in LMICs, and may be increased by urbanization. As migration from rural areas into urban slums rapidly increases in many African countries, characterizing and addressing the rising burden of burns is likely to become a public health priority.

Factors Influencing Household Uptake of Improved Solid Fuel Stoves in Low- and Middle-Income Countries: A Qualitative Systematic Review

19 August 2014 10:37 (America/New_York)

Factors Influencing Household Uptake of Improved Solid Fuel Stoves in Low- and Middle-Income Countries: A Qualitative Systematic Review. Int. J. Environ. Res. Public Health, Aug 2014.

Authors: Stanistreet Debbi 1,*, Puzzolo Elisa 1, Bruce Nigel 1, Pope Dan 1 and Rehfuess Eva 2
1 Department of Public Health and Policy, Institute of Psychology, Health and Society, Whelan Building, University of Liverpool, Liverpool L69 3GB, UK; E-Mails: (P.E.); (B.N.); (P.D.)
2 Institute for Medical Informatics, Biometry and Epidemiology, University of Munich, Marchioninistr. 15, Munich 81377, Germany; E-Mail:
* Author to whom correspondence should be addressed; E-Mail:; Tel.: +44-151-794-5583.

Abstract: Household burning of solid fuels in traditional stoves is detrimental to health, the environment and development. A range of improved solid fuel stoves (IS) are available but little is known about successful approaches to dissemination. This qualitative systematic review aimed to identify factors that influence household uptake of IS in low- and middle-income countries. Extensive searches were carried out and studies were screened and extracted using established systematic review methods. Fourteen qualitative studies from Asia, Africa and Latin-America met the inclusion criteria. Thematic synthesis was used to synthesise data and findings are presented under seven framework domains.

Findings relate to user and stakeholder perceptions and highlight the importance of cost, good stove design, fuel and time savings, health benefits, being able to cook traditional dishes and cleanliness in relation to uptake. Creating demand, appropriate approaches to business, and community involvement, are also discussed. Achieving and sustaining uptake is complex and requires consideration of a broad range of factors, which operate at household, community, regional and national levels. Initiatives aimed at IS scale up should include quantitative evaluations of effectiveness, supplemented with qualitative studies to assess factors affecting uptake, with an equity focus.

CAPS Study – An advanced cookstove intervention to prevent pneumonia in children under 5 years old in Malawi: a cluster randomised controlled trial

19 August 2014 10:32 (America/New_York)

Liverpool School of Tropical Medicine - CAPS Study: An advanced cookstove intervention to prevent pneumonia in children under 5 years old in Malawi: a cluster randomised controlled trial.


  • Malawi has one of the highest rates of death among infants and the under fives (69 and 110 per 1000 live births respectively in 2009) despite having made progress towards meeting the Millennium Development Goal of reducing child mortality.
  • Pneumonia is the leading cause of death and one of the commonest causes of morbidity: around 300 per 1000 children under the age of 5 are diagnosed with pneumonia every year.
  • Exposure to smoke produced when biomass fuels (animal or plant material) are burned in open fires is a major avoidable risk factor for pneumonia.
  • In Malawi, where at least 95% of households depend on biomass as their main source of fuel, biomass smoke exposure is likely to be responsible for a substantial burden of this disease.
  • Smoke from burning biomass in open fires also causes other health problems including chronic lung disease, lung cancer, heart disease, stillbirth and low birth weight; it is also thought to be an important driver of global climate change.
  • The problem of biomass smoke exposure is seen across Africa where around 700 million people burn biomass fuels to provide energy for cooking, heating and lighting.
  • The problem extends right around the globe where around half the worlds population are dependent on biomass fuels for their day-to-day energy requirements.
  • Around 4 million people die every year around the world from the effects of biomass smoke.


  • There are now particularly efficient biomass-burning cookstoves that substantially reduce smoke emissions and exposures.
  • Some of the more advanced biomass-burning cookstoves reduce emissions by as much as 90% by incorporating technologies (e.g. fans) that improve combustion efficiency.
  • Other ways of reducing biomass fuel use and smoke exposure include cleaner fuels, better ventilation and changes in cooking behavior.
  • Access to smoke exposure reduction technologies is limited by poverty in much of the developing world.
  • The Global Alliance for Clean Cookstoves (GACC) was launched in 2010 to tackle the lack of access to clean affordable energy through public-private partnerships.
  • A central aim of the alliance is for 100 million homes to adopt clean and efficient stoves and fuels by 2020.


  • The trial will be conducted in rural Malawi.
  • 150 villages will be randomly assigned to an intervention or control group.
  • In the intervention villages, all households with a child up to the age of 4.5 years will receive two Philips fan-assisted stoves to fully replace their traditional cooking methods (mainly open fires).
  • In the control villages, all households with a child up to the age of 4.5 years will continue with their traditional cooking methods. Included villages will stay in the study for 2 years.
  • The main outcome of interest is pneumonias in children under 5 years of age.
  • Other outcomes include measures of air pollution and economic and social impacts of the stoves.


EPA/Winrock Webinar – Results from CCT Studies and Stove Design and Performance Testing Workshops in Vietnam, Mexico, and Nepal

19 August 2014 10:26 (America/New_York)

EPA/Winrock Webinar – Results from CCT Studies and Stove Design and Performance Testing Workshops in Vietnam, Mexico, and Nepal, July 29, 2014.

In 2012 and 2013 Aprovecho Research Center, with support from the U.S. EPA and Winrock International, conducted Controlled Cooking Test (CCT) field studies and provided technical training for organizations working to promote cleaner, more efficient cooking technologies in Vietnam (2012), Mexico (2013), and Nepal (2013). On July 2, 2014 Winrock and the U.S. EPA hosted a webinar to present results and lessons learned from the studies and information about how these results can inform and improve cookstove design, performance and use. The webinar also provided context and outcomes from the regional technical capacity building workshops that complemented each field study. Mike Hatfield presented on behalf of Aprovecho Research Center.

Perspectives in Household Air Pollution Research: Who Will Benefit from Interventions?

12 August 2014 12:21 (America/New_York)

Perspectives in Household Air Pollution Research: Who Will Benefit from Interventions? Curr Envir Health Rpt, July 2014.

Authors: Maggie L. Clark & Jennifer L. Peel

Despite increasing recognition surrounding this global environmental health problem, much remains to be elucidated regarding exposure response relationships, particularly among potentially susceptible population subgroups. Given that many of the communities most affected by household air pollution exposures also experience elevated exposures to poverty, psychosocial stressors, other environmental pollutants, and comorbid conditions, research needs to correctly specify risks due to these potentially interacting risk factors. Although suggestive evidence exists for differential improvements in health following reductions in ambient air pollution concentrations among specific subgroups, the question remains as to who will benefit and to what extent from efforts to reduce exposures to emissions from household solid fuel combustion. The ability to know what to expect from cookstove interventions and to accurately describe the presence of distinct subgroup responses is crucial to reduce uncertainty and to encourage policy makers to enact change.

Study delves into Nepal’s kitchen hazards

12 August 2014 12:12 (America/New_York)

Study delves into Nepal’s household hazardsNic White, Medical Press, Aug 8, 2014

A pilot study of Nepalese kitchens aims to improve public health and reduce burn injuries in the poorest neighbourhoods of South Asia, a UWA burn researcher says.

Burn Injury Research Unit Assistant Professor Hilary Wallace says 75 per cent of burns in South Asia occur in the home, mostly in the kitchen, and targeted education and financial support interventions could help save many lives.

“What happens in the kitchen can improve or undermine public health,” she says.

“In many of these poverty-stricken areas, burns are more common than AIDS or tuberculosis.”

Dr Wallace says the study will use community volunteers to locate the most at-risk households, interview them to identify potential hazards in their homes and then deliver tailor-made interventions.

“This holistic approach doesn’t just focus on one problem, it looks at domains like the cooking process instead—which might be harmful for lungs as well as risky for burns,” she says.

Dr Wallace says risk factors could include open biomass fires, uncovered drinking water, hazardous electrical wiring, children playing close to cooking stoves and fires, storage of food, sanitation and hygiene, and cooking and diet practices.

“Cooking is often done on the floor—flames and pots of boiling liquid easily accessible. Flames catch the edge of women’s saris and children knock pots over,” she says.

Exploding kerosene and gas cylinders are particularly devastating but are routinely stored inside because of the likelihood of theft if stored outside.

Cheap and effective anti-theft devices could help this issue, but cylinders may also be bad quality or reused.

Dr Wallace says some 20 per cent of burns, particularly to women, are self inflicted.

“In South Asia there is a lack of social safety nets or other means to cope with crises, and people can find themselves in a situation they feel is unbearable,” she says.

Dr Wallace says the interventions could range from simple advice about better cooking, lighting and heating practices to financial assistance through community-based savings and credit organisations to buy safer technology like improved cookstoves.

“There will be other domains around food preparation, sanitation, water quality, heating and lighting, electricity and storage of flammable liquids and poisons,” she says.

The volunteers will return at regular intervals to support the women to implement the changes.

Dr Wallace says the interventions will be followed up with larger randomised controlled trials to see what approaches improve issues like respiratory disease, diarrhoea and burn injury.


Adherence to reduced-polluting biomass fuel stoves improves respiratory and sleep symptoms in children

12 August 2014 12:07 (America/New_York)

Adherence to reduced-polluting biomass fuel stoves improves respiratory and sleep symptoms in children. BMC Pediatrics 2014, 14:12.

Roberto A Accinelli, et al. Corresponding authors: Roberto A Accinelli

Background – Symptoms of sleep apnea are markedly increased in children exposed to smoke from biomass fuels and are reduced by kitchen stoves that improve indoor biomass pollution. However, the impact of adherence to the use of improved stoves has not been critically examined.

Methods – Sleep-related symptom questionnaires were obtained from children <15 years of age in 56 families residing in the communities of Lliupapuquio, Andahuaylas province in Peru before and 2 years after installation of less-polluting Inkawasi cooking stoves.

Results – 82 children with lifetime exposures to indoor fuel pollution were included. When compared to those alternating between both types of stoves or those using traditional stoves only, those children who exclusively used Inkawasi cooking stoves showed significant improvements in sleep and respiratory related symptoms, but some minor albeit significant improvements occurred when both stoves were concomitantly used.

Conclusions- Improvements in respiratory and sleep-related symptoms associated with elevated indoor biomass pollution occur only following implementation and exclusive utilization of improved kitchen stoves.

World Bank – Tracking Access to Nonsolid Fuel for Cooking

12 August 2014 12:02 (America/New_York)

Tracking Access to Nonsolid Fuel for Cooking, 2014.

Ghosh Banerjee, Sudeshna; Portale, Elisa; Adair-Rohani, Heather; Bonjour, Sophie. World Bank.

The World Health Organization estimates that in 2012 about 4.3 million deaths occurred because of exposure to household air pollution caused by smoke from the incomplete combustion of fuels such as wood, coal, and kerosene. Inefficient energy use in the home also poses substantial risks to safety, causing burns and injuries across the developing world. To support the achievement of these goals, a starting point must be set, indicators developed, and a framework established to track those indicators until 2030.

The World Bank and International Energy Agency have led a consortium of 15 international agencies to produce data on access to nonsolid fuel for the SE4ALL Global Tracking Framework. Launched in 2013, the framework defines access to modern cooking solutions is as the use of nonsolid fuels for the primary method of cooking. Nonsolid fuels include (i) liquid fuels (for example, kerosene, ethanol, or other biofuels), (ii) gaseous fuels (such as natural gas, LPG, and biogas), and (iii) electricity. These are in contrast to solid fuels such as (i) traditional biomass (wood, charcoal, agricultural residues, and dung), (ii) processed biomass (pellets, briquettes); and (iii) other solid fuels (such as coal and lignite).

Experimental Evidence on Improved Cooking Stoves in Rural Senegal

8 August 2014 12:19 (America/New_York)

The Intensive Margin of Technology Adoption: Experimental Evidence on Improved Cooking Stoves in Rural Senegal, 2014.

Gunther Bensch; Jörg Peters. Ruhr-Universität Bochum (RUB), Department of Economics.

This paper evaluates take-up and impacts of low-cost improved stoves through a randomized controlled trial. The randomized stove is primarily designed to curb fi rewood consumption but not smoke emissions. Nonetheless, we find considerable effects not only on firewood consumption, but also on smoke exposure and smoke-related disease symptoms – induced by behavioural changes at the intensive margin affecting outside cooking and cooking time due to the new stove.

Affordability for sustainable energy development products

8 August 2014 12:06 (America/New_York)

Affordability for sustainable energy development products. Applied Energy, Volume 132, 1 November 2014, Pages 308–316

Paul H. Riley. The University of Nottingham, Department of Electrical and Electronic Engineering, Nottingham NG7 2RD, UK

Clean burning products, for example cooking stoves, can reduce household air pollution (HAP), which prematurely kills 3.5 million people each year. By careful selection of components into a product package with micro-finance used for the capital payment, barriers to large-scale uptake of products that remove HAP are reduced. Such products reduce smoke from cooking and the lighting from electricity produced, eliminates smoke from kerosene lamps. A bottom-up financial model, that is cognisant of end user social needs, has been developed to compare different products for use in rural areas of developing countries. The model is freely available for use by researchers and has the ability to assist in the analysis of changing assumptions. Business views of an individual villager, the village itself and a country view are presented.

The model shows that affordability (defined as the effect on household expenses as a result of a product purchase) and recognition of end-user social needs are as important as product cost. The effects of large-scale deployment (greater that 10 million per year) are described together with level of subsidy required by the poorest people. With the assumptions given, the model shows that pico-hydro is the most cost effective, but not generally available, one thermo-acoustic technology option does not require subsidy, but it is only at technology readiness level 2 (NASA definition) therefore costs are predicted and very large investment in manufacturing capability is needed to meet the cost target. Thermo-electric is currently the only technology that can be used worldwide every day of the year and is available without research. However, it is not yet self-financing and therefore requires subsidy or diversion of more household income to be affordable. A combination of photovoltaic and clean cookstove may be suitable in areas where sufficient solar radiation is available on most days. Affordability is shown to be highly dependent on the income that can be derived from carbon credits.

Human urinary mutagenicity after wood smoke exposure during traditional temazcal use

8 August 2014 11:57 (America/New_York)

Human urinary mutagenicity after wood smoke exposure during traditional temazcal use. Mutagenesis, Advance Access published August 1, 2014.

Alexandra S. Long*, Christine L. Lemieux1, et al.

This study examined the urinary mutagenicity in 19 indigenous Mayan families from the highlands of Guatemala who regularly use temazcales (N = 32), as well as control (unexposed) individuals from the same population (N = 9). Urine samples collected before and after temazcal exposure were enzymatically deconjugated and extracted using solid-phase extraction. The creatinine-adjusted mutagenic potency of urine extracts was assessed using the plate incorporation version of the Salmonella mutagenicity assay with strain YG1041 in the presence of exogenous metabolic activation. The post-exposure mutagenic potency of urine
extracts were, on average, 1.7-fold higher than pre-exposure samples (P < 0.005) and also significantly more mutagenic than the control samples (P < 0.05). Exhaled carbon monoxide (CO) was ~10 times higher following temazcal use (P < 0.0001), and both CO level and time spent in temazcal were positively associated with urinary mutagenic potency (i.e. P < 0.0001 and P = 0.01, respectively). Thus, the wood smoke exposure associated with temazcal use contributes to increased excretion of conjugated mutagenic metabolites. Moreover, urinary mutagenic potency is correlated with other metrics of exposure (i.e. exhaled CO, duration of exposure). Since urinary mutagenicity is a biomarker associated with genetic damage, temazcal use may therefore be expected to contribute to an increased risk of DNA damage and mutation, effects associated with the initiation of cancer.

Duke University – Cleaning up the act of cooking (Video)

8 August 2014 11:47 (America/New_York)

Improved cook stoves (ICS) have the potential to deliver triple benefits: health and time savings, reduced deforestation, and reduced emissions of black carbon, a significant short-term contributor to global climate change. This video highlights a Duke University research study that aims to better understand the diffusion of ICS technologies in Uttarakhand, India.


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