[Stoves] Randomized Trial of Interventions to Improve Childhood Asthma in Homes with Wood-burning Stoves

Fri Nov 3 09:21:45 CDT 2017

Dear Nikhil

The protocol is used by FRESH Air<http://www.theipcrg.org/display/DoResearch/2015/04/15/FRESH+AIR+in+Kyrgyzstan%3A+part+of+the+European+Lung+Foundation+%28ELF%29+Healthy+Lungs+for+Life+programme> and it is worth a visit to that little site to see what they are doing and why.

I have seen their outputs and they include 48 hr monitoring for PM and CO. The prevalence of COPD is high, approaching 100% for adults over 40 in the high areas like Naryn. That is why we were conducting stove swaps there.

What is not clear is a relationship between certain types of smoke and asthma. There is very little smoke in the USA and asthma is very common. As the air has become cleaner over 40 years, asthma cases have spiked. It is a good job correlation is not causation.

See the linked report. The guy on the left in photos 3 and 4 is Talant Sooronbaev who is leading the field investigations. The PM numbers are not prepared by them – the Micro-PEMS go back to the providers.

Regards
Crispin

Crispin:

Sorry to say, such studies produce nothing of value in design and promotion of household cookstoves for the masses in the developing countries.

Just because something gets published in EHP on "rural areas of Montana, Idaho, and Alaska, where residential wood combustion is a major source of ambient and indoor PM2:5 and the primary source of home heating during cold-temperature periods" and pays homage to Kirk Smith doesn't make it worth giving a dime for it. Fortunately this was free.

I was impressed by the description of tools for "two, 48-h observation periods during each of two winter periods, before and after intervention". Seems like this kind of stuff is acceptable in "epidemiology" studies in US. I kept scratching my head as I read the conclusion - "This trial was conducted across several rural communities in three states, but translation of these findings to other settings with similarly exposed child asthma populations would require further study and inquiry into the challenges associated with dissemination of in-home PM reduction strategies."

As an asthma sufferer, I don't see just what difference such studies would make when to whom. This was said to be the first RCT. In recent years, a lot of economic policy research is marketed in the name of  "first RCT on this subject. Why, there is this piece by a trio at Harvard-MIT-Chicago (now) about an RCT on "improved cookstoves" in Odisha, India published as an MIT e-con department Working Paper a little over five years ago. I think we should have Cecil get some money to do an RCT on rich theorists of stoves and health.

Unfortunately, I have not yet found any associational epidemiology study that has taught me anything but how poor rich science is.

Nikhil

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