CDC – Improving Indoor Air Quality in Rural Kenya

February 5, 2013 · 1 comment

Improving Indoor Air Quality in Rural Kenya | Source: CDC/Kenya Blog, Jan 25, 2013

Secretary Clinton launched the Global Alliance for Clean Cookstoves in 2010 with the aim of saving lives, improving livelihoods, empowering women, and combating climate change by creating a viable commercial market for clean and efficient cookstoves and fuel. The Centers for Disease Control and Prevention (CDC) has joined the Alliance, which aims to help 100 million households adopt cleaner cookstove alternatives by 2020 through scientific validation of health benefits—CDC’s role—and novel marketing initiatives that will aid local economies to help make clean-burning cookstoves available to all who need them.

Martha Gembo lights a cookstove fire in her home in rural western Kenya. She kneels on the dirt floor next to the stove’s clay foundation, pushing thin sticks of wood into a side opening. She lights a match, places it on sticks visible from inside an embedded ceramic cylinder and a fire begins to grow. The smoke curls up and out a small window cut above the stove. Martha’s ceramic cookstove looks very different from the 3-stone fire pits traditionally used in this area of rural Kenya. This upesi jiko(Swahili for ‘quick stove’) is one of many improved cooking technologies being tested in impoverished communities throughout Africa, Asia, and Latin America.

New stove technologies being tested by KEMRI/CDC, SWAP, and Berkeley Air in 50 households

The Kenya Medical Research Institute/Centers for Disease Control and Prevention (KEMRI/CDC), in partnership with theSafe Water and AIDS Project (SWAP) and Berkeley Air Monitoring Group, is currently evaluating six improved cookstoves with the potential of lowering indoor air pollution in 50 households in two villages in Nyanza Province. The study will identify stoves with high acceptability and investigate the short term effects of these stoves on indoor, outdoor, and personal air pollution exposure reduction through structured interviews, focus groups, and kitchen performance tests. Although the health impact of these new stoves have not been fully evaluated yet, Martha, a field officer for SWAP, attests that community members have reported improved household air quality and fewer burn injuries. Martha also says that the many of the new stoves consume much less wood than an open fire pit, translating to less time spent collecting firewood.

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Burns in Tanzania: morbidity and mortality, causes and risk factors

February 5, 2013 · 0 comments

Burns in Tanzania: morbidity and mortality, causes and risk factors: a review. Int J Burn Trauma 2013;3(1):18-29

Anne H Outwater, et al.

Burn injuries in low and middle income countries still remain a significant health problem, even though numbers of burn injuries in high income countries have decreased showing that such events are not “accidents” but are usually preventable. WHO states that the vast majority (over 95%) of fire-related burns occur in low and middle income countries. Burn injuries are a major cause of prolonged hospital stays, disfigurement, disability, and death in Africa Region. Evidence shows that prevention strategies can work.

However prevention strategies need to be tailored to the specific environment taking into account local risk factors and available resources. An examination of the patterns and causes of burns should allow site specific recommendations for interventions. This literature review, specific to the United Republic of Tanzania, was conducted by researching PubMed, SafetyLit, and African Journals on Line data bases for primary sources using key words plus . Two sets of student data collected as part of Bachelor’s degree final dissertations at Muhimbili University of Health and Allied Sciences were used. In all, twenty two primary sources were found.

Risk factors for burn morbidity in Tanzania are: 1/ a young age, especially years 1-3, 2/ home environment, especially around cooking fires, 3/ epilepsy, during seizures, and 4/ perceived inevitability of the incident. It was expected that ground level cooking fires would be found to be a risk factor, but several studies have shown non-significant results about raised cooking fires, types of fuel used, and cooking appliances.

Risk factors for burn mortality are: being male, between 20-30 years of age, and being punished for alleged thieving by community mobs. An important factor in reducing burn morbidity, especially in children, is to educate people that burns are preventable in most cases and that most burns occur in the home around cooking fires. Children need to be kept away from fires. Epileptics should be monitored for medication and kept away from cooking fires as well. Community members need to be encouraged to bring wrong doers to the police.

Household air pollution and stillbirths in India: Analysis of the DLHS-II National Survey

February 5, 2013 · 0 comments

Household air pollution and stillbirths in India: Analysis of the DLHS-II National Survey. Environmental Research, Available online 31 January 2013.

P.V.M. Lakshmia, et al.

Background – Several studies have linked biomass cooking fuel with adverse pregnancy outcomes such as preterm births, low birth weight and post-neonatal infant mortality, but very few have studied the associations with cooking fuel independent of other factors associated with stillbirths.

Method – We analyzed the data from 188,917 ever-married women aged 15–49 included in India’s 2003–2004 District Level Household Survey-II to investigate the association between household use of cooking fuels (liquid petroleum gas/electricity, kerosene, biomass) and risk of stillbirth. Prevalence ratios (PRs) were obtained using Poisson regression with robust standard errors after controlling for several potentially confounding factors (socio-demographic and maternal health characteristics).

Results – Risk factors significantly associated with occurrence of stillbirth in the Poisson regression with robust standard errors model were: literacy status of the mother and father, lighting fuel and cooking fuel used, gravida status, history of previous abortion, whether the woman had an antenatal check up, age at last pregnancy >35 years, labor complications, bleeding complications, fetal and other complications, prematurity and home delivery. After controlling the effect of these factors, women who cook with firewood (PR 1.24; 95% CI: 1.08–1.41, p=0.003) or kerosene (PR 1.36; 95% CI: 1.10–1.67, p=0.004) were more likely to have experienced a stillbirth than those who cook with LPG/electricity. Kerosene lamp use was also associated with stillbirths compared to electric lighting (PR 1.15; 95% CI: 1.06–1.25, p=0.001). The population attributable risk of firewood as cooking fuel for stillbirths in India was 11% and 1% for kerosene cooking.

Conclusion – Biomass and kerosene cooking fuels are associated with stillbirth occurrence in this population sample. Assuming these associations are causal, about 12% of stillbirths in India could be prevented by providing access to cleaner cooking fuel.

Jacob Moss – State Dept Flagship Partnership Reaches Key Milestones

January 30, 2013 · 0 comments

Flagship Partnerships Reach Key Milestones | Source: DIPNOTE, US State Dept blog, Jan 14, 2013 |

Jacob Moss serves as Director of the U.S. Cookstoves Initiative.

Global Alliance for Clean Cookstoves

Since Secretary Clinton launched the Global Alliance for Clean Cookstoves in 2010, it has become a leading platform for addressing the challenge that almost three billion people face every day as they cook their food over open fires or crude stoves. In 2012, a definitive new study reinforced the urgency of addressing these practices, doubling the estimate of mortality associated with exposure to cookstove smoke from two to four million deaths per year. The Alliance’s interim goal is to help 100 million homes adopt clean cooking solutions by 2020.

In 2012, the Alliance reached several key milestones, including: more than doubling its size to over 500 partners, including 38 countries; publishing a groundbreaking strategy for universal adoption of clean cookstoves and fuels; establishing the first-ever set ofinternational cookstove standards; setting six initial priority countries for Alliance operations; developing a comprehensive stove performance inventory containing data from over 600 unique tests to compare lab and field results and set credible standards; commissioning over $4 million in research and stove testing centers; and catalyzing over $150 million in investments — over $30 million for the Alliance and its grant programs, and over $120 million in parallel funding to spur advances in clean cooking.

The U.S. commitment under the Alliance is now up to $114 million, mostly in applied research and financing. And with the Secretary of State’s support, we’ve led a wide range of diplomatic activities to support the Alliance, including reaching out to engage new nations such as China, South Africa, Sweden, Afghanistan, and Mexico.

As Executive Director Radha Muthiah moves the Alliance to full-scale implementation in its priority countries and more broadly launches several major financing tools for the sector, I am confident that this momentum will continue in 2013.

USAID/Bangladesh Cookstove Activities-2012

January 30, 2013 · 1 comment

USAID/Bangladesh Cookstove Activities, May 2012.

Richard Greene, Mission Director, USAID/Bangladesh.

Excerpt from presentation – Assessment of Improved Cookstove Market Southwest Bangladesh May 2012

  • Fuel use: most households used mixed fuels- dung, leaves and agricultural bi-products, little wood (limited potential carbon finance)
  • Fuel expenditure: range of expenditures, many prioritize free fuels first, high dependency on collected dung, leaves, agricultural waste. Reported spending ranged from BDT 400-1200 for traditional and ICS.
  • Cooking location: most traditional cooking in semi-enclosed or open spaces (in dry season). Adoption of ICS drove some cooking indoors
  • Hardware: observed design, quality control, performance and maintenance issues with current ICS/chimneys
  • Stove use: multiple stoves in parallel, specific needs for certain foods, ICS needs more constant tending (e.g. Can’t put on rice and go do other chores)
  • Financing: multiple promising partners; proven finance models using installments (e.g. Grameen Shakti solar home systems)

Biochar Cookstoves Boost Health for People and Crops

January 30, 2013 · 0 comments

Biochar Cookstoves Boost Health for People and Crops | Source: Stacey Schultz, National Geographic Daily News, Jan 29, 2013.

Like many of her neighbors in Amubri, an indigenous community at the southern tip of Costa Rica, Gloria Torress Buitrago relied for years on a fogónfor cooking. The traditional open-fire stove is common in Amubri (map), and so are the dire health effects. “It was hard to look around and just breathe without feeling the smoke burning the eyes or throat,” Buitrago said. One cousin suffered from asthma, and everyone in her family was constantly tearing up from the wood fire’s smoke.

Buitrago was just one of 3 billion people worldwide who rely on such open-fire cookstoves. A recent global health study found that the fumes from those stoves was the largest environmental health threat in the world today, killing 3.5 million people a year—more deaths than caused by malaria and HIV/AIDS combined. (See related blog post: “Cookstove Smoke Is ‘Largest Environmental Threat,’ Global Health Study Finds.”) Cookstoves that burn cleaner can help fight this epidemic, but they can do even more than that when configured to produce biochar, a dark, fine-grained residue that can become a prized asset for rural communities.

Cookstoves that can produce biochar, like the one pictured above in western Kenya, can be a key tool in fighting respiratory disease and boosting agricultural production. Photograph courtesy ACON

In regions as diverse as the high mountain valleys of Costa Rica and the agricultural fields of western Kenya, biochar cookstoves are being used to simultaneously clear the air and enrich the soil. Biochar, a type of charcoal produced when biomass burns in an oxygen-free environment, can boost water and nutrients in dry, depleted soil while serving as a vehicle for burying the carbon that contributes to global warming.

Breathing Easier

Groups like Seattle, Washington-based SeaChar, the recipient of a $72,000grant from National Geographic’s Great Energy Challenge initiative, have been testing new variations on clean cookstoves. SeaChar’s Estufa Finca (“Farm Stove” in Spanish) burns biomass cleanly while turning it into biochar. It’s not a fancy apparatus: Fashioned from local materials, its components include a 5-gallon steel paint bucket, some corrugated steel roofing material, and half of a one-gallon tomato sauce can.

Gloria Torres Buitrago’s family is one of 110 households that acquired one of the stoves last year through SeaChar’s Estufa Finca program in Costa Rica’s Talamanca region. Buitrago says the stove has relieved not only the smoke problem in her home, but also the effort required to keep fires burning. “The time and money it takes to get wood has been reduced a lot,” Buitrago said in an interview with a SeaChar staff member, who then translated and emailed her responses. “This time can be used to share with family or just do other things in the garden.” (See related story: “Protecting Health and the Planet With Clean Cookstoves.”)

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Household fuels, low birth weight, and neonatal death in India: The separate impacts of biomass, kerosene, and coal

January 29, 2013 · 0 comments

Int J Hyg Environ Health. 2013 Jan 21.

Household fuels, low birth weight, and neonatal death in India: The separate impacts of biomass, kerosene, and coal.

Epstein MB, Bates MN, Arora NK, Balakrishnan K, Jack DW, Smith KR. School of Public Health, University of California, Berkeley, CA, USA.

We examined the impact of maternal use of different household cooking fuels in India on low birth weight (LBW<2500g), and neonatal mortality (death within 28 days of birth). Using cross-sectional data from India’s National Family Health Survey (NFHS-3), we separately analyzed the prevalence of these two outcomes in households utilizing three types of high-pollution fuels for cooking – biomass, coal, and kerosene – using low-pollution fuels (gas and biogas) as the comparison “control” group. Taking socioeconomic and child-specific factors into account, we employed logistic regression to examine the impact of fuel use on fetal and infant health.

The results indicate that household use of high-pollution fuels is significantly associated with increased odds of LBW and neonatal death. Compared to households using cleaner fuels (in which the mean birth weight is 2901g), the primary use of coal, kerosene, and biomass fuels is associated with significant decreases in mean birth weight (of -110g for coal, -107g for kerosene, and -78g for biomass). Kerosene and biomass fuel use are also associated with increased risk of LBW (p<0.05).

Results suggest that increased risk of neonatal death is strongly associated with household use of coal (OR 18.54; 95% CI: 6.31-54.45), and perhaps with kerosene (OR 2.30; 95% CI: 0.95-5.55). Biomass is associated with increased risk of neonatal death among infants born to women with no more than primary education (OR 7.56; 95% CI: 2.40-23.80). These results are consistent with a growing literature showing health impacts of household air pollution from these fuels.

Are rocket mud stoves associated with lower indoor carbon monoxide and personal exposure in rural Kenya?

January 29, 2013 · 0 comments

Indoor Air. 2013 Feb;23(1):14-24.

Are rocket mud stoves associated with lower indoor carbon monoxide and personal exposure in rural Kenya?

Ochieng CA, Vardoulakis S, Tonne C. Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency, Chilton, Oxon, UK.

Household use of biomass fuels is a major source of indoor air pollution and poor health in developing countries. We conducted a cross-sectional investigation in rural Kenya to assess household air pollution in homes with traditional three-stone stove and rocket mud stove (RMS), a low-cost unvented wood stove. We conducted continuous measurements of kitchen carbon monoxide (CO) concentrations and personal exposures in 102 households. Median 48-h kitchen and personal CO concentrations were 7.3 and 6.5 ppm, respectively, for three-stone stoves, while the corresponding concentrations for RMS were 5.8 and 4.4 ppm.

After adjusting for kitchen location, ventilation, socio-economic status, and fuel moisture content, the use of RMS was associated with 33% lower levels of kitchen CO [95% Confidence Interval (CI), 64.4-25.1%] and 42% lower levels of personal CO (95% CI, 66.0-1.1%) as compared to three-stone stoves. Differences in CO concentrations by stove type were more pronounced when averaged over the cooking periods, although they were attenuated after adjusting for confounding. In conclusion, RMS appear to lower kitchen and personal CO concentrations compared to the traditional three-stone stoves but overall, the CO concentrations remain high.

PRACTICAL IMPLICATIONS: The rocket mud stoves (RMS) were associated with lower CO concentrations compared to three-stone stoves. However, the difference in concentrations was modest and concentrations in both stove groups exceeded the WHO guideline of 7 μg/m(3) , suggesting the unvented RMSs on their own are unlikely to appreciably benefit health in this population. Greater air quality benefit could be realized if the stoves were complemented with behavior change, including education on extinguishing fire when not in use as well as fuel drying, and cooking in locations that are separate from the main house.

Proinflammatory effects of cookstove emissions on human bronchial epithelial cells

January 29, 2013 · 0 comments

Indoor Air. 2013 Feb;23(1):4-13. doi: 10.1111/j.1600-0668.2012.00790.x.

Proinflammatory effects of cookstove emissions on human bronchial epithelial cells.

Hawley B, Volckens J. Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.

Approximately half of the world’s population uses biomass fuel for indoor cooking and heating. This form of combustion typically occurs in open fires or primitive stoves. Human exposure to emissions from indoor biomass combustion is a global health concern, causing an estimated 1.5 million premature deaths each year. Many ‘improved’ stoves have been developed to address this concern; however, studies that examine exposure-response with cleaner-burning, more efficient stoves are few.

The objective of this research was to evaluate the effects of traditional and cleaner-burning stove emissions on an established model of the bronchial epithelium. We exposed well-differentiated, normal human bronchial epithelial cells to emissions from a single biomass combustion event using either a traditional three-stone fire or one of two energy-efficient stoves. Air-liquid interface cultures were exposed using a novel, aerosol-to-cell deposition system. Cellular expression of a panel of three pro-inflammatory markers was evaluated at 1 and 24 h following exposure. Cells exposed to emissions from the cleaner-burning stoves generated significantly fewer amounts of pro-inflammatory markers than cells exposed to emissions from a traditional three-stone fire. Particulate matter emissions from each cookstove were substantially different, with the three-stone fire producing the largest concentrations of particles (by both number and mass).

This study supports emerging evidence that more efficient cookstoves have the potential to reduce respiratory inflammation in settings where solid fuel combustion is used to meet basic domestic needs. PRACTICAL IMPLICATIONS: Emissions from more efficient, cleaner-burning cookstoves produced less inflammation in well-differentiated bronchial lung cells. The results support evidence that more efficient cookstoves can reduce the health burden associated with exposure to indoor pollution from the combustion of biomass.

Socio-cultural acceptability of improved cook stoves (ICS) in rural Malawi

January 29, 2013 · 0 comments

Socio-cultural acceptability of improved cook stoves (ICS) in rural Malawi, 2012.

Concern Universal

Concern Universal commissioned this study to assess the social cultural acceptability of improved cook stoves (ICS) in rural Malawian villages. The aim of the study is to learn lessons about efficiency, effectiveness, acceptance and usage of ICS in rural Malawi. The results aim to inform policy for project and programme design and implementation. ICS have faced a revival in recent years, after most programmes in the 1980s failed. Despite these earlier failures evidence suggests that certain stoves that have improved combustion properties might yield various health, environmental, economic and social benefits.

Given that there has been little research on the social-cultural issues surrounding cooking, the study used an inductive approach to allow the flexibility to add new and relevant questions throughout data gathering. Household data were collected in five villages in Mulanje, Dedza, and Balaka. Group interviews were conducted in five villages in the same districts but not always in the same villages. The villages were selected to cover different stove designs promoted by different organisations, and so provide a basis for comparison users perceptions and dissemination approaches.

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