Indoor solid fuel use and tuberculosis in China

July 21, 2011 · 0 comments

BMC Public Health 2011, 11:498

Indoor solid fuel use and tuberculosis in China: a matched case-control study

Full-text: http://www.biomedcentral.com/1471-2458/11/498/abstract

Xiaohong Kan , Chen-Yuan Chiang , Donald A Enarson , Wenhua Chen , Jianan Yang and Genwang Chen

Background – China ranks second among the 22 high burden countries for tuberculosis. A modeling exercise showed that reduction of indoor air pollution could help advance tuberculosis control in China. However, the association between indoor air pollution and tuberculosis is not yet well established. A case control study was conducted in Anhui, China to investigate whether use of solid fuel is associated with tuberculosis.

Methods – Cases were new sputum smear positive tuberculosis patients. Two controls were selected from the neighborhood of each case matched by age and sex using a pre-determined procedure. A questionnaire containing demographic information, smoking habits and use of solid fuel for cooking or heating was used for interview. Solid fuel (coal and biomass) included coal/lignite, charcoal, wood, straw/shrubs/grass, animal dung, and agricultural crop residue. A household that used solid fuel either for cooking and (/or) heating was classified as exposure to combustion of solid fuel (indoor air pollution). Odds ratios and their corresponding 95% confidence limits for categorical variables were determined by Mantel-Haenszel estimate and multivariate conditional logistic regression.

Results – There were 202 new smear positive tuberculosis cases and 404 neighborhood controls enrolled in this study. The proportion of participants who used solid fuels for cooking was high (73.8% among cases and 72.5% among controls). The majority reported using a griddle stove (85.2% among cases and 86.7% among controls), had smoke removed by a hood or chimney (92.0% among cases and 92.8% among controls), and cooked in a separate room (24.8% among cases and 28.0% among controls) or a separate building (67.8% among cases and 67.6% among controls). Neither using solid fuel for cooking (odds ratio (OR) 1.08, 95% CI 0.62-1.87) nor using solid fuel for heating (OR 1.04, 95% CI 0.54-2.02) was significantly associated with tuberculosis. Determinants significantly associated with tuberculosis were household tuberculosis contact (adjusted OR, 27.23, 95% CI 8.19-90.58) and ever smoking tobacco (adjusted OR 1.64, 96% CI 1.01-2.66).

Conclusion – In a population where the majority had proper ventilation in cooking places, the association between use of solid fuel for cooking or for heating and tuberculosis was not statistically significant.

HHI Survey on Cookstoves

July 21, 2011 · 0 comments

The Harvard Humanitarian Initiative is working to understand if/how improved biomass cookstoves can be better supported in humanitarian settings. To inform this work we would like to hear from individuals/organisations who currently work in humanitarian settings, whether or not they are currently working on cookstoves/indoor fuel. 

We have produced a short survey which should take 10-20minutes to be completed, depending on your responses. Our aim is to identify what supports successful programming alongside priorities for research and other supporting activities.

  • How do I complete the survey?
  • Please click on this link to complete the web-based survey:

Evaluate the toxicity of the biomass fuel cow dung (kanda) smoke

July 21, 2011 · 0 comments

Ecotoxicol Environ Saf. 2011 Jun 28

Multiple approaches to evaluate the toxicity of the biomass fuel cow dung (kanda) smoke.

Lal K, Mani U, Pandey R, Singh N, Singh AK, Patel DK, Singh MP, Murthy RC.

Inhalation Toxicology Division, Indian Institute of Toxicology Research, Mahatma Gandhi Marg, PO Box No. 80, Lucknow 226001, U.P, India.

Cow dung (Kanda) is a major source of energy in rural and urban population of developing countries and is burnt in traditional open stoves in confined space of kitchen without proper ventilation. In epidemiological studies, biomass fuel smoke has been reported to be responsible for several respiratory disorders in exposed population.

In a laboratory experiment, female wistar rats were exposed to kanda smoke for 60min/day over a period of 12 weeks. Chemical analysis of smoke showed the presence of PAHs. The increase in CYP1A1, GST-ya, GST-yc expression was found in 12 week exposed lung tissues as compared with controls. The exposure to smoke resulted in significant alteration in the BALF cells in the form of clustering of alveolar macrophages and giant cell formation with vacuolated cytoplasm. The macrophages also showed thickness and villi like projections on the cell surface thus reducing their phagocytic activities.

Histopathological changes in lung tissue were manifested in the form of damage to bronchiolar epithelium, edema and thickening of alveolar septa and emphysema after 4 and 8 week of exposure. These findings suggest that exposure to kanda smoke increases pulmonary tissue damage and may result in various forms ofrespiratory infections in the exposed popultion.

Variation in indoor levels of polycyclic aromatic hydrocarbons

July 21, 2011 · 0 comments

Environ Pollut. 2011 Jul;159(7):1810-5.

Variation in indoor levels of polycyclic aromatic hydrocarbons from burning various biomass types in the traditional grass-roofed households in Western Kenya.

Lisouza FA, Owuor OP, Lalah JO. Department of Chemistry, Maseno University, P.O. Box 333, Maseno 40105, Kenya. lisouzafred@yahoo.com

Biomass burning as fuel in the traditional grass-roofed rural households of Western Province of Kenya in open fire places, in poorly ventilated conditions, lead to accumulation of soot under the roofs. This study characterized and quantified the polycyclic aromatic hydrocarbons (PAHs) in accumulated soot in these households and determined the variation in PAHs concentrations with fuel biomass type. Soot samples collected from the households were extracted, cleaned and analysed by gas chromatography. The PAHs were identified using retention times, verified by gas chromatographic mass spectral analysis and quantified from peak area responses using the internal standard method. The PAHs levels significantly varied (P ≤ 0.05) with biomass type in the order: dung ≥ indigenous trees ≥ exotic trees ≥ shrubs and crop residues. Use of dung and wood from indigenous trees as fuel should be discouraged since they are higher emitters (P ≤ 0.05) of carcinogenic PAHs.

Integrated Assessment of Black Carbon and Tropospheric Ozone

June 16, 2011 · 0 comments

Integrated Assessment of Black Carbon and Tropospheric Ozone:  Summary for Decision Makers, 2011.

Download full-text (pdf)

UNEP/WMO

Scientific evidence and new analyses demonstrate that control of black carbon particles and tropospheric ozone through rapid implementation of proven emission reduction measures would have immediate and multiple benefits for human well-being.

Black carbon exists as particles in the atmosphere and is a major component of soot, it has significant human health and climate impacts. At ground level, ozone is an air pollutant harmful to human health and ecosystems, and throughout the troposphere, or lower atmosphere, is also a significant greenhouse gas. Ozone is not directly emitted, but is produced from emissions of precursors of which methane and carbon monoxide are of particular interest here.

Seven Additional African Nations to Join the Global Alliance for Clean Cookstoves

June 16, 2011 · 0 comments

Secretary Clinton Helps Secure Seven Additional African Nations to Join the Global Alliance for Clean Cookstoves

June 16, 2011 – On the heels of Secretary of State Hillary Rodham Clinton’s visit to Africa, seven African nations have joined the Global Alliance for Clean Cookstoves. The governments of Burkina Faso, Ethiopia, Kenya, Lesotho, Rwanda and Tanzania, together with the Nigerian Alliance for Clean Cookstoves, committed to join the public-private partnership to help save lives around the world.

These new Alliance partners have set goals to collectively reach nearly 20 million African homes with clean stoves and fuels by 2020, and ultimately help achieve the Alliance’s 100 by 20 goal, which calls for 100 million homes to adopt clean and efficient stoves and fuels by 2020.

The new African members join the nearly 100 partners which include national governments, UN agencies, private companies and non-governmental organizations already mobilized to overcome market barriers and achieve global-scale production, deployment, and use of clean cookstoves in the developing world.

Encouraging the development and use of clean cooking solutions in cultures, communities, and countries throughout the developing world is consistent with the core principles of U.S. foreign policy and development efforts, which focus on improving the lives of the world’s most vulnerable populations. The U.S. government has committed more than $50 million to the Alliance over five years. With the help of more than six federal agencies, the U.S. government is mobilizing financial resources, providing top-level U.S. experts, and leveraging research and development tools to help the Alliance achieve its 100 by 20 target.

On September 21, 2010, Secretary Clinton announced the Global Alliance for Clean Cookstoves, a public-private partnership led by the UN Foundation, to save lives, improve livelihoods, empower women, and combat climate change by creating a thriving global market for clean and efficient household cooking solutions. In May 2011, academy-award winning actress Julia Roberts became Global Ambassador of the Alliance.

To learn more about the Global Alliance for Clean Cookstoves, visit www.cleancookstoves.org or http://www.state.gov/s/partnerships/cleancookstoves/.

Indoor Air Pollution From Coal Combustion and the Risk of Neural Tube Defects

June 16, 2011 · 0 comments

Am J Epidemiol. 2011 Jun 9.

Indoor Air Pollution From Coal Combustion and the Risk of Neural Tube Defects in a Rural Population in Shanxi Province, China.

Li Z, Zhang L, Ye R, Pei L, Liu J, Zheng X, Ren A.

The authors evaluated indoor air pollution from coal combustion (IAPCC) as a potential risk factor for neural tube defects (NTDs) in a rural population in Shanxi Province, China. The studied rural population has both high IAPCC exposure and a high prevalence of NTDs. A population-based case-control study was used to identify 610 NTD cases and 837 normal controls between November 2002 and December 2007. Information was collected within 1 week following delivery or pregnancy termination due to prenatal NTD diagnosis.

The authors derived an exposure index by integrating a series of IAPCC-related characteristics concerning dwelling and lifestyle. Compared with women with no IAPCC exposure, women with any exposure at all had a 60% increased risk of having a child with an NTD (adjusted odds ratio (OR) = 1.6, 95% confidence interval (CI): 1.1, 2.1). An increased NTD risk was linked to both residential heating (adjusted OR = 1.7, 95% CI: 1.1, 2.4) and cooking (adjusted OR = 1.5, 95% CI: 1.1, 2.1). The risk increased with increases in the exposure index, showing a dose-response trend (P < 0.001). This is the first known study to link IAPCC to NTDs. Additional studies are needed to confirm the link between IAPCC and NTDs.

Indoor coal use and early childhood growth

June 16, 2011 · 0 comments

Arch Pediatr Adolesc Med. 2011 Jun;165(6):492-7.

Indoor coal use and early childhood growth.

Ghosh R, Amirian E, Dostal M, Sram RJ, Hertz-Picciotto I.

OBJECTIVE:
To examine whether indoor coal combustion for heating, which releases pollutants into the air, affects early childhood growth.

DESIGN:
A prospective longitudinal study, with growth measurements extracted from medical records of the children’s well-child care visits at age 36 months. Data were compiled from self-administered questionnaires and medical records, both completed at 2 time points: delivery and follow-up.

SETTING:
Teplice and Prachatice districts in the Czech Republic.

PARTICIPANTS:
A total of 1133 children followed from birth to age 36 months. Main Exposure Maternally reported use of coal for heating. Main Outcome Measure The z score for height for age and sex at age 36 months.

RESULTS:
Adjusted for covariates, indoor coal use was significantly associated with a lower z score for height for age and sex at age 36 months (z score = -0.37; 95% confidence interval, -0.60 to -0.14). This finding translates into a reduction in height of about 1.34 cm (95% confidence interval, 0.51 to 2.16) for boys and 1.30 cm (95% confidence interval, 0.50 to 2.10) for girls raised in homes that used coal. The association between coal use and height was modified by postnatal cigarette smoke exposure.

CONCLUSIONS:
Pollution from indoor coal use may impair early childhood skeletal growth to age 36 months. Because a significant proportion of the world population still uses coal indoors, the finding has public health consequences.

Intervention to Lower Household Woodsmoke Exposure in Guatemala

June 16, 2011 · 0 comments

Environ Health Perspect. 2011 Jun 13.

Intervention to Lower Household Woodsmoke Exposure in Guatemala Reduces ST-segment Depression on Electrocardiograms.

McCracken J, Smith KR, Stone P, Díaz A, Arana B, Schwartz J.

BACKGROUND:
A large body of evidence suggests that fine particulate air pollution is a cause of cardiovascular disease, but little is known in particular about the cardiovascular effects of indoor air pollution from household use of solid fuels in developing countries. RESPIRE was a randomized trial of a chimney woodstove that reduces woodsmoke exposure.

OBJECTIVES:
Test the hypotheses that the stove intervention, as compared to open fire use, would reduce ST-segment depression and increase heart rate variability (HRV).

METHODS:
We used two complementary study designs: (a) between-groups comparisons based on randomized stove assignment, and (b) before-and-after comparisons within control subjects, who used open fires during the trial and received chimney stoves after the trial. Electrocardiogram sessions lasting 20 hours were repeated up to three times among 49 intervention and 70 control women 38 to 84 years of age, and 55 control subjects were also assessed after receiving stoves. HRV and ST-segment values were assessed for each 30-minute period. ST-segment depression was defined as an average value below -1.00 mm. Personal fine particle (PM2.5) exposures were measured during 24 hours before each electrocardiogram.

RESULTS:
PM2.5 exposure means were 266 and 102 μg/m3 during the trial period in the control and intervention groups, respectively. During the trial, the stove intervention was associated with an odds ratio of 0.26 (95% CI: 0.08, 0.90) for ST-segment depression. We found similar associations with the before-and-after comparison. The intervention was not significantly associated with HRV.

CONCLUSIONS:
The stove intervention was associated with reduced occurrence of nonspecific ST-segment depression, suggesting that household woodsmoke exposures affect ventricular repolarization and potentially cardiovascular health.

Health effects of an efficient vented stove in the highlands of Guatemala.

June 16, 2011 · 0 comments

Glob Public Health. 2011 Jun;6(4):421-32.

Health effects of an efficient vented stove in the highlands of Guatemala.

Harris SA, Weeks JB, Chen JP, Layde P.

In Guatemala, as in many places throughout the world, millions of indigenous people cook over non-ventilated indoor open fires. Indoor air pollution and accidental burns are well-known problems attributed to such fires. Efforts have been made to improve health outcomes by placing more efficient vented stoves in homes to decrease such exposure.

The purpose of this study is to see if there are any measurable improvements in health outcomes after placement of such stoves within a community. Specifically, this study is designed to evaluate the health effects of placement of the ONIL stove, a rocket-style stove that has been shown to decrease household carbon monoxide (CO) levels and wood-fuel use. The ONIL stove was installed in more than 90% of the homes in Santa Avelina, Quiche, Guatemala between 2002 and 2006.

The number of clinic visits per year for acute upper- and lower-respiratory illnesses in this village was compared for the years 2002 and 2006. Clinic visits for upper- and lower-respiratory illnesses combined decreased by 26%, and for acute lower respiratory solely, by 45% between 2002 and 2006. This study suggests that the placement of an improved vented stove may be associated with a corresponding decrease in acute respiratory illnesses.

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