[Stoves] How are DALYs and GBD numbers created?

Tom Miles tmiles at trmiles.com
Sat May 20 12:16:09 CDT 2017


Nikhil,

 

If you disagree with the health metrics used to justify stoves development and dissemination then propose tangible alternatives. Don’t just complain. 

 

Health risk is a good reason for implementing improved household energy solutions including improved cooking stoves. Fuels, stoves, and the way they are used clearly contribute to improved health. We see it in practice. We see improved health and safety as positive and immediate outcomes of our projects. Reduce smoke and trauma and you improve health. At the same time you probably improve habits and change other behaviors (eg. food, clean water) that improve health. 

 

So how do we measure health improvements from reduced smoke and trauma and how do we use that data to promote funding for further research, development and dissemination? Can alternative metrics be more effective in attracting funding? Who will fund the development of the alternative metrics? What’s your plan?        

 

Tom   

 

From: Stoves [mailto:stoves-bounces at lists.bioenergylists.org] On Behalf Of Frank Shields
Sent: Saturday, May 20, 2017 8:34 AM
To: Nikhil Desai <ndesai at alum.mit.edu>; Discussion of biomass cooking stoves <stoves at lists.bioenergylists.org>
Subject: Re: [Stoves] How are DALYs and GBD numbers created?

 

Nikhil,

Yes - the goal is to get more money for research. 

When is the goal going to change from research to fixing a problem?

 

This Stoves group is not wanting to stall for time and spend money until the LPG people do our job for us. Stovers need help in producing stoves that burn the fuel they use, doing the task they want done and produce the least polluted air. Thats lab work that is now being accomplished behind closed doors.- we wait!. Then the stoves need help in disseminating them to the users as Paul is asking for.

 

Frank  

 

 

 

 

On May 19, 2017, at 10:59 PM, Nikhil Desai <pienergy2008 at gmail.com <mailto:pienergy2008 at gmail.com> > wrote:

 

Frank: 

Sorry. We do not know what all causes each and every death. That's why we have doctors' certificates, though not for all. And even when there are doctors' certificates listing a cause, it is debatable and debated. The IHME super-humans do in fact assign a single cause to every death record they have, NO MATTER what the listed cause of death was. 

Besides, a death is a death, with medical definition. A "premature death" is an emotional term or IHME fiat. It used to be that a death at an age lower than the national life expectancy at birth was called "premature death". As infant and maternal mortality declined, the mean and the median of deaths in sufficiently homogeneous large cohorts came close, implying that "premature death" and "postmature death" numbered about the same. 

Then too, is a national population a homogeneous cohort? And how does one go about getting life tables and computing life expectancy at birth, at age 5 and so on to age 95? (The US now has 70,000 people over the age 100. All will die a premature death. Or a post-mature one.) 

Beginning 2012 or so, the pompous priesthood of public piety - I mean, of public health - declared that every death before the age 86 was a premature death. 

Was every premature death caused by x, y, or z? What does one need to know in order to assign such causes?

Don't even think of medicine. Medicine is about treating a disease. Health and medicine are not the same thing. 

I won't presume to talk about HIV or knife wounds to vital organs, but no, we don't know what causes premature deaths. There are correlations of this kind of that. 

Killing by assumptions is euphemistically called attributability to risk factors. 

I am still waiting to understand what my post-mature mortality will be attributed to. Surely not absence of dirty air. Have inhaled enough dirty air from WHO. 


Fixing a problem requires determining what the problem is. Except in extreme cases - such as being caught in fires - PM2.5 exposures are not known to actually kill anybody. I invite Kirk Smith and WHO to produce a list of 7,000 people whose PM2.5 exposures have been measured over a sufficiently long period to have caused identified diseases with no other risk factor but such exposures. 

But WHO and IHME cannot identify a problem other than that they can't persuade enough skeptics that transition to LPG and electricity will eliminate 4 million premature deaths. 

That's why money is the best medicine. Throw money around, buy some media time and conferences, and use hundreds of millions of dollars to put out mind-numbing, prematurely-killing research in the hands of gullible media and public. 

Why? So you get more money for more research.

Why? So you get more money for more research.

 

ditto. 

This is an old debate. Back in 2001 July-September (ending on 9/11), there was online debate under the Shell Foundation Household Energy and Health initiative. One participant on this list wanted money for stove design. Several others wanted money for epidemiological research. 

Not one premature death has been averted. 

No surprise. There is not an iota of quantitative evidence that the 20th Century modern energy revolution - minus fires in wars - averted premature deaths.

Research on premature mortality has one sole purpose - to cook the dead. 

Nikhil












------------------------------------------------------------------------
Nikhil Desai

(India +91) 909 995 2080
Skype: nikhildesai888

 

On Sat, May 20, 2017 at 2:10 AM, Frank Shields <franke at cruzio.com <mailto:franke at cruzio.com> > wrote:

We all know what causes premature death: 1) contaminated water, 2) dirty air and 3) spoiled food. 

 

If we have 10M dollars to spend we go into a village and test the water, air and food. If they test ok we then spend the money and do a study to determine the unknown cause. 

 

If any one of the three is determined to be suspect we spend the 10M to find a solution to fix that problem. We don’t need to do another study to determine the cause of the problem. That would only waste the money and nothing gets accomplished. The only benefit is the ones awarded the money to do the research that puts out a report stating something we already know.

 

 

Regards

 

Frank 

On May 19, 2017, at 1:24 PM, Crispin Pemberton-Pigott <crispinpigott at outlook.com <mailto:crispinpigott at outlook.com> > wrote:

 

Dear Nikhil

I felt that with that advice in hand (yours) people reading this list should familiarize themselves with the root documents to understand how model-based this is, and where the limitations lie.

One limitation is trying to take a population statistic and project onto an individual a specific ‘countable’ better outcome. If such a projection is not true for one person, it is also not true for a thousand people counted individually.  If we can understand that, we have a chance of seeing between other lines.

Independent investigation of truth. It is a founding principle.

Regards
Crispin



Crispin:

I repeat - DALYs and risk factors for household fuel use in developing countries are cooked.

Do not bother looking for emissions, concentrations, exposures, or for that matter even deaths and disability statistics with any physical counterparts -- THESE people, THIS area, THESE fuels and stoves, THIS moment.

Let me spell out simply - they are all lies.

Official lies. In officious publications.

Nikhil

------------------------------------------------------------------------
Nikhil Desai
(India +91) 909 995 2080 <tel:+91%2090999%2052080> 
Skype: nikhildesai888

On Sat, May 20, 2017 at 12:29 AM, Crispin Pemberton-Pigott < <mailto:crispinpigott at outlook.com> crispinpigott at outlook.com< <mailto:crispinpigott at outlook.com> mailto:crispinpigott at outlook.com>> wrote:
Dear Friends

If you have wondered how the GBD and DALY numbers are generated, have a look at these two documents linked below.

Note the clear distinction maintained between exposure and emissions. When it comes to cooking stoves there is a big difference. If the emissions go outside and do not result in exposure, the indoor exposure problem is solved. If emissions go outside and elevate an ambient level to a higher one, exposures increase a bit for everyone.

We have the interesting case of upland Kyrgyzstan where dung and wood are primarily burned for cooking and heating. If the current situation is heavily polluted indoor air (leaky stoves etc) and pristine outdoor air, is it enough to put 100% of the emissions outside (seal the stoves)? Is it enough to reduce emissions by ½ and put all the it outside where it is diluted into insignificance? When is ‘enough’ an adequate response?

How about in a crowded valley where it is 500 µg/m3 indoors and 100 µg/m3 outside? The indoor pollution goes outside anyway, sooner or later, so putting it up a chimney would make nearly no difference to anything. Not even 100.01.

My point is that reducing emissions is great, but that putting it in the right place is a Good Start, while working on absolute reductions. Thoughts, anyone?

Regards
Crispin

Models of death and disability:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30505-6/fulltext

Ambient PM2·5 was the fifth-ranking mortality risk factor in 2015. Exposure to PM2·5 caused 4·2 million (95% uncertainty interval [UI] 3·7 million to 4·8 million) deaths and 103·1 million (90·8 million 115·1 million) disability-adjusted life-years (DALYs) in 2015, representing 7·6% of total global deaths and 4·2% of global DALYs, 59% of these in east and south Asia. Deaths attributable to ambient PM2·5 increased from 3·5 million (95% UI 3·0 million to 4·0 million) in 1990 to 4·2 million (3·7 million to 4·8 million) in 2015. Exposure to ozone caused an additional 254 000 (95% UI 97 000–422 000) deaths and a loss of 4·1 million (1·6 million to 6·8 million) DALYs from chronic obstructive pulmonary disease in 2015.

And

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31012-1/fulltext

We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes…



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Thanks

 

Frank

Frank Shields

Gabilan Laboratory

Keith Day Company, Inc.

1091 Madison Lane

Salinas, CA  93907

(831) 246-0417 <tel:(831)%20246-0417>  cell

(831) 771-0126 <tel:(831)%20771-0126>  office

fShields at keithdaycompany.com <mailto:fShields at keithdaycompany.com> 

 

 

 

franke at cruzio.com <mailto:franke at cruzio.com> 

 

 

 

 

 

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Thanks

 

Frank

Frank Shields

Gabilan Laboratory

Keith Day Company, Inc.

1091 Madison Lane

Salinas, CA  93907

(831) 246-0417 cell

(831) 771-0126 office

fShields at keithdaycompany.com <mailto:fShields at keithdaycompany.com> 

 

 

 

franke at cruzio.com <mailto:franke at cruzio.com> 

 

 

 

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