J Trop Pediatr. 2012 Dec;58(6):457-66.

Indoor Air Pollution-related Acute Lower Respiratory Infections and Low Birthweight: A Systematic Review.

Misra P, Srivastava R, Krishnan A, Sreenivaas V, Pandav CS. Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.

Background: Present study is a systematic review conducted to establish a quantitative association between acute lower respiratory infection (ALRI) and low birthweight (LBW) attributable to Indoor air pollution (IAP) in under-5 children.

Materials and Methods: Total of 24 articles for ALRI in under-5 and seven articles for LBW were included in this review. Meta-analysis was done on nine and six articles on ALRI and LBW children, respectively.

Results: Sixteen studies reported significantly elevated odds ratio (range: 1.38-6.0) of ALRI exposed to IAP. Similarly, significantly increased risk of LBW due to IAP was reported in the studies (range: 1.1-1.86). The risk of ALRI increased by 2.51 times, while the risk of LBW increased by 1.45 times due to IAP exposure.

Conclusions: This review of ALRI and LBW attributable by IAP confirms and strengthens the findings of previous reviews and provides further strong evidence of associations of ALRI and LBW with IAP.

TURBOCOCINA Field Assessments in Schools, San Lorenzo, Guatemala. 2012.

A Northcross, K Smith, MT Hernandez. Household Energy, Health & Climate Change Research Group. School of Public Health, UC Berkeley.

This study measured changes in kitchen concentrations and personal exposures to fine particles (PM2.5) and carbon monoxide (CO), two important health-related pollutants in woodsmoke, and fuel use after introduction of the school Turbococina™ (TC) cookstove in school kitchens currently using the Plancha chimney woodstove.

Compared to the Plancha, the TC reduced the fuel used in all of the schools, with statistical significance in all but one.  The small woodfuel pieces needed by the TC require the cook to spend more time in close proximity to the stove in comparison to the Plancha, which can hold large pieces of wood that take more time to burn.

 

Global Health, Sept 2012.

Conditions That Predispose to Pulmonary Hypertension and Right Heart Failure in Persons Exposed to Household Air Pollution in LMIC

G Bloomfield, et al.

Emerging evidence and research based on ambient air pollution also implicates HAP in the development of cardiovascular diseases such as myocardial ischemia, high blood pressure, and congestive heart failure, as well as with elevated right heart pressures 7, 8, 9. Cardiopulmonary diseases such as pulmonary hypertension (PH) and right heart failure (RHF) are common in LMIC and are often associated with human immunodeficiency virus (HIV), schistosomiasis, parenchymal destruction from tuberculosis, COPD, and other conditions common in LMIC 5, 10. Little is known, however, about the interplay between HAP, right heart function, and these common comorbidities in LMIC. Understanding these relationships is important so that the magnitude of the effect of HAP on PH and right heart function is understood and appropriate measures are taken to reduce the associated morbidity.

This review begins by highlighting what is known about the common causes of PH in LMIC using the international PH classification framework and highlighting conditions specific to LMIC. We then discuss HAP and its relationship to PH and RHF. Based on the disproportionate distribution of PH and RHF worldwide, we propose that the presence of certain comorbidities specific to LMIC may predispose individuals exposed to HAP to developing PH and RHF (Fig. 1). Where data are available, we review the literature regarding the effects of pre-existing comorbidities on the impact of exposure to HAP on PH and subsequent RHF in LMIC. Where data are lacking, we present a conceptual framework of the unique comorbid factors in LMIC that may predispose people to developing PH and RHF when exposed to HAP. Lastly, we suggest that a small proportion of patients exposed to HAP who develop isolated RHF may have no other predisposing factors and this group of patients deserves further study. By offering this conceptual framework on conditions specific to LMIC, HAP, PH, and RHF, our ultimate aim is to highlight the multifactorial nature of these complex relationships and suggest ripe avenues for further investigation.

Environmental Health Perspectives, Nov 2012

Research Opportunities for Cancer Associated with Indoor Air Pollution from Solid-Fuel Combustion

Britt C.  et al.

Background: Indoor air pollution (IAP) derived largely from the use of solid fuels for cooking and heating affects about 3 billion people worldwide, resulting in substantial adverse health outcomes, including cancer. Women and children from developing countries are the most exposed populations. A workshop was held in Arlington, Virginia, 9–11 May 2011, to better understand women’s and children’s potential health effects from IAP in developing countries. Workshop participants included international scientists, manufacturers, policy and regulatory officials, community leaders, and advocates who held extensive discussions to help identify future research needs.

Objectives: Our objective was to identify research opportunities regarding IAP and cancer, including research questions that could be incorporated into studies of interventions to reduce IAP exposure. In this commentary, we describe the state of the science in understanding IAP and its associations with cancer and suggest research opportunities for improving our understanding of the issues.

Discussion: Opportunities for research on IAP and cancer include studies of the effect of IAP on cancers other than lung cancer; studies of genetic factors that modify susceptibility; studies to determine whether the effects of IAP are mediated via germline, somatic, and/or epigenetic changes; and studies of the effects of IAP exposure via dermal and/or oral routes.

Conclusions: IAP from indoor coal use increases the risk of lung cancer. Installing chimneys can reduce risk, and some genotypes, including GSTM1-null, can increase risk. Additional research is needed regarding the effects of IAP on other cancers and the effects of different types of solid fuels, oral and dermal routes of IAP exposure, genetic and epigenetic mechanisms, and genetic susceptibility.

Solar Cooker Review

November 26, 2012 · 0 comments

Solar Cooker Review, November 2012   Volume 18 Number 2

Solar Cookers International

Contents

  • Solar Cooking in Afghanistan’s Wakhan Corridor
  • George Clooney and Solar Cookers
  • The Case for the Integrated Cooking Method
  • International Union for Conservation of Nature votes to Support Solar Cooking
  • And more

Stove Performance Inventory Report, Prepared for the Global Alliance for Clean Cookstoves, 2012.

Berkeley Air Monitoring Group

The inventory currently contains data from over 600 unique sets of performance tests, which represent more than 3500 individual samples collected using a range of laboratory and field methods. It was compiled through a systematic review of published and gray literature using search terms related to cookstove testing and performance. The inventory has also been designed to facilitate continuous updates, so that additional sources, including new studies and foreign-language publications, may be included.

The purpose of this report is to present key information about the current inventory, breaking down the numbers by type of test, data source, region, and stove and fuel type.  The bulk of the current inventory data is from laboratory tests, especially from North America and Asia, where a handful of large testing programs have been the main contributors. Although there is much less field data to present, the largest contribution of field data comes from Africa. Traditional and simple non-traditional stoves have been the most commonly tested stove types, with more testing now being done on newer stove technologies and fuels. Finally, the inventory substantiates the expectation that liquid and gas fuels burn more cleanly than solid fuels, whereas unprocessed crop residues and dung are generally the least clean household energy sources.

The stove performance inventory also provides an opportunity to map and compare stove performance against standards or benchmarks, the most relevant of which is the recently approved  ISO International Workshop Agreement on Clean and Efficient Cookstoves (February 2012).  The IWA, which is a preliminary step towards a formal ISO standard, uses “Tiers of Performance” to categorize stove performance levels for efficiency, safety, and emissions. The majority of non-traditional solid-fuel stove performance results place them in Tiers 1 and 2 for emissions and efficiency, with only liquid and gas stoves (e.g. ethanol and LPG) meeting the ambitious health and environmental-related targets associated with Tier 4.  By and large, the best biomass stove performers – fan stoves and gasifiers – fit into Tier 3, although more data is needed to understand if these technologies can obtain similar levels of performance in the field.

Moreover, the comparison of laboratory and field data where both exist for specific stove/fuel combinations, which is generally for traditional (Tier 0) and Tier 1 stoves, indicates that laboratory testing overestimates the field performance for most stove types. The factors identified in the literature as having the greatest impact on the lab/field performance gap for biomass stoves are fuel quality and cooking as well as fire tending practices. This finding underscores the need for further field testing of advanced biomass stoves that fit into Tier 3 based on laboratory tests, to investigate whether this performance gap continues to exist in the higher tiers and if so, how it might be mitigated.

Although this first iteration of the inventory was compiled through the application of systematic search criteria and no doubt captures a great deal of the available work, there are some sources that are not represented and some topics that still need to be explored. Foreign language sources are missing, especially many Chinese papers, as are many proprietary data sets. Also missing are adoption-related metrics, as these are not yet well characterized. Finally, efforts still need to be done for mapping results from different water boiling-based protocols into a unified comparative framework, as well as the protocol development that would allow us to better include technologies not designed for typical water boiling testing, such as those for intended for cooking flatbreads (plancha) and indoor heating.

Measurement and modeling of indoor air pollution in rural households with multiple stove interventions in Yunnan, China. Atmospheric Environment, 14 November 2012

Zohir Chowdhury, Luke Campanella, Christen Gray, Abdullah Al Masud, Jessica Marter-Kenyon, David Pennise, Dana Charron, Xia Zuzhang

In the developing world, indoor air pollution (IAP) created from solid fuel used in traditional biomass cook stoves is a leading contributor of poor respiratory health, global burden of disease, and greenhouse pollutant emissions. In the present study, we piloted an experimental cross-sectional monitoring and evaluation design with 30 households in rural Lijiang and Deqin counties in northwest Yunnan province, China. This approach offers the ability to examine the effectiveness of improved cook stove (ICS) programs with a much smaller sample size than the typical population based pre- and post-intervention study that requires a large sample representative of the population. Continuous PM2.5 was measured with the UCB (currenly known as UCB-PATS) and the TSI DustTrak and continuous CO was measured with the HOBO CO logger.

Using the traditional method of cooking and heating, mean 24-h PM2.5 and CO concentrations in the kitchen were measured in the range of 0.15 to 0.71 mg/m3 for PM2.5 and 3.0 to 11 ppm for CO. These concentrations were compared to using a combination of improved stoves in the kitchen where PM2.5 and CO concentrations were measured in the range of 0.08 to 0.18 mg/m3 for PM2.5 and 0.7 to 5.5 ppm for CO. These concentrations yielded statistically significant reduction in IAP when replacing the traditional fireplace or traditional stove with an improved stove combination. Finally, we show a strong correlation between CO and PM2.5 (R2 = 0.72 to 0.76). The combination of this experimental design along with the monitoring and evaluation protocol presented here may provide a robust framework to rapidly assess the effectiveness of ICS interventions in progress.

Household Light Makes Global Heat: High Black Carbon Emissions From Kerosene Wick Lamps. Environ. Sci. Technol., November 19, 2012.

Nicholas Lam , Yanju Chen , Cheryl Weyant , Chandra Venkataraman , Pankaj Sadavarte , Michael Johnson , Kirk R. Smith , Benjamin Brem , Joseph Arineitwe , Justin Ellis , and Tami Bond

Kerosene-fueled wick lamps used in millions of developing-country households are a significant but overlooked source of black carbon (BC) emissions. We present new laboratory and field measurements showing that 7-9% of kerosene consumed by widely used simple wick lamps is converted to carbonaceous particulate matter that is nearly pure BC. These high emission factors increase previous BC emission estimates from kerosene by 20-fold, to 270 Gg/year (90% uncertainty bounds: 110, 590 Gg/year).

Aerosol climate forcing on atmosphere and snow from this source is estimated at 22 mW/m2 (8, 48 mW/m2 ), or 7% of BC forcing by all other energy-related sources. Kerosene lamps have affordable alternatives that pose few clear adoption barriers and would provide immediate benefit to user welfare. The net effect on climate is definitively positive forcing as co-emitted organic carbon is low. No other major BC source has such readily available alternatives, definitive climate forcing effects, and co-benefits. Replacement of kerosene-fueled wick lamps deserves strong consideration for programs that target short-lived climate forcers.

Tuberculosis and Poverty: Why Are the Poor at Greater Risk in India? PLoS ONE 7(11) 2012

Olivia Oxlade, et al.

Background – Although poverty is widely recognized as an important risk factor for tuberculosis (TB) disease, the specific proximal risk factors that mediate this association are less clear. The objective of our study was to investigate the mechanisms by which poverty increases the risk of TB.

Methods – Using individual level data from 198,754 people from the 2006 Demographic Health Survey (DHS) for India, we assessed self-reported TB status, TB determinants and household socioeconomic status. We used these data to calculate the population attributable fractions (PAF) for each key TB risk factor based on the prevalence of determinants and estimates of the effect of these risk factors derived from published sources. We conducted a mediation analysis using principal components analysis (PCA) and regression to demonstrate how the association between poverty and TB prevalence is mediated.

Results – The prevalence of self-reported TB in the 2006 DHS for India was 545 per 100,000 and ranged from 201 in the highest quintile to 1100 in the lowest quintile. Among those in the poorest population, the PAFs for low body mass index (BMI) and indoor air pollution were 34.2% and 28.5% respectively. The PCA analysis also showed that low BMI had the strongest mediating effect on the association between poverty and prevalent TB (12%, p = 0.019).

Conclusion – TB control strategies should be targeted to the poorest populations that are most at risk, and should address the most important determinants of disease—specifically low BMI and indoor air pollution.

The Enabling Environment: Policies and Guidelines for IAQ and Cookstove Programming in Developing Countries, 2012.

Myles F. Elledge. RTI International (Research Triangle Institute [RTI]), Research Triangle Park, North Carolina, USA

This paper examines the World Health Organization (WHO) initiative to develop new guidelines on indoor air quality (IAQ) for household energy consumption and reflects on the leading examples of national-level cookstove programs. New IAQ guidelines promise to be an important stimulus for practical policies to enable better household fuels programming. The guidelines provide benchmarking and support the advancement of the recent International Standards Organization (ISO) International Workshop Agreement on cookstoves emissions to the next level.

An overview of the leading examples of national cookstove programs shows a weak linkage to health because few programs have drivers associated with IAQ, and there is a general absence of national IAQ policies. The WHO IAQ guidelines fill a void in recognizing the public health impact of IAQ and cookstoves and compliments the cookstove standards movement to bring new rigor and evidence-based information on fuel use and stove
emissions.

The guidelines will provide evidence to support developing country governments to integrate the health dimension into stove interventions and strengthen the use of policy to enable IAQ awareness for enhanced cookstove programming.