[Stoves] Global household pollution exposures and impacts: a house of cards (Re: Crispin on (Uganda): Government official (aDALYs next?)

Tue Oct 17 11:58:56 CDT 2017

This is in the thread News (Uganda): Government official cautions on
standards for cookstoves (aDALYs next?)

Crispin:

A delayed response to your post below two weeks ago. First, I take back my
insistence on separating cooking stoves from heating stoves; I think
utilization rates vary and that biomass is used for space heating oudoor
(sitting around) and indoor (some of the time) for a few months a year in
many parts of the world.

1. Cooking and heating:

Space heating in very cold regions is a qualitatively different problem
than cooking in less severe environs. Indian urban folks prefer induction
stoves because they make cooking in summers bearable - no flame heat from
gas stoves.

I shouldn't have to hammer "context, cost, and convergence (of politics,
culture, timing, etc." into you. High stove utilization rates make heating
stoves saving on high volumes of fuel use worth the investment in changing.

The combined heating and cooking stove innovations ARE indeed a great
contribution to the stove science and to taking another look at the very
definition of "cookstove" from a poor person's perspective. In India,
relatively cold winters of the desert and some mountainous/valley regions
get night time temperatures to 5-6 degrees C.

I have seen wood and charcoal stoves as well as bon fires "outside" all
over New Delhi for keeping warm at nights and in mornings. Why, even during
cloudy mid-days when some people have to work outside the homes.

2. Emission rates and concentrations:

The statement  in the Rosenthal et al. (2017) paper (with 21 co-authors for
fewer than frive pages) Implementation Science to AccelerateClean Cooking
for Public Health
<https://ehp.niehs.nih.gov/wp-content/uploads/125/1/EHP1018.alt.pdf>  -
"One of the key conclusions from the IAQG was that, despite impressive
exposure reductions of 50–80% in the best stove programs, in absolute terms
average post-intervention concentrations remained well above the WHO
interim target (35 μg/m3 annual mean)" - is suspect. The diseases
associated with HAP are often of adult onset, chronic, medically treatable,
with multiple risk factors. To associate in a linear fashion, with a few
short-term concentration measures (where non-HAP PM2.5 exposures can be
excluded), is scientifically ludicrous. It is also irrelevant for judging
stoves and fuels choices unless actual emission rates with specific
chemistry of fuels are measured and a model of HAP emissions and exposures
for each household is constructed.

In short, any claim that none of the solid fuel, in particular biomass,
stoves are "healthy enough" or "health protective" cannot stand. Yes, smoke
is unhealthy; we have known it for millennia. But quantification of
specific ill effects over lifetimes, especially for chronic diseases,
computed by extending irrelevant Relative Risk ratios from rich country
studies (some of which quite controversial) amounts to demeaning science.

What has happened is that WHO and UNDP - by taking rather convoluted logic
of Kirk Smith papers on building an inventory of "household cookstoves fuel
use" from Census data and Demographic and Health Surveys - have created a
global "dataset" where "number of households reporting solid fuels as
principal source of cooking or heating energy" is elevated as a proxy for
exposures. What WHO has for a "global HAP database" is a smattering of
studies with different or no protocols and rarely any dose-response studies
(until Kirk Smith's Guatemala highlands report, a pioneering study but not
without its own interpretation problems). See Global database of household
air pollution measurements: Background
<http://www.who.int/entity/indoorair/health_impacts/Background_Global_HAP_Db_v3_2011.pdf?ua=1>
.

More on this concentration=exposure and concentration->relative risks some
other time.

3. Is PM2.5 the main culprit?

A 2011 expert conference concluded, " Although the type and extent of
exposure assessment will necessarily depend on the goal and design of the
cookstove study, without improved understanding of exposure–response
relationships, the level of air pollution reduction necessary to meet the
health targets of cookstove interventions will remain uncertain."Health and
Household Air Pollution from Solid Fuel Use: The Need for Improved Exposure
Assessment
<https://ehp.niehs.nih.gov/wp-content/uploads/121/10/ehp.1206429.pdf> (Clark,
et al. http://dx.doi.org/10.1289/ehp.1206429).

This is a remarkable paper, and needs to be read between the lines, noting
as well what else could have been said given the state of knowledge -
including one co-author's (Balakrishnan) own concoction of WHO HAP database
- but note one assertion:

"PM2.5 mass *may be* the most relevant parameter of interest for health;
however, this is *not currently known given the lack of measurements of
pollutants other than PM2.5 and CO*. Much of the emphasis for health
effects has been on PM2.5 because it is *thought* to be the most relevant
size fraction for health. However, *limited evidence exists in the ambient
air pollution literature regarding the health effects of coarse and
ultrafine PM* (Brunekreef and Forsberg 2005; Health Effects Institute
2013). Furthermore, lung deposition varies by factors such as age, sex,
breathing rate, underlying disease state, and PM aerodynamic size fraction
(Chalupa et al. 2004; Goldberg and Lourenco 1973; Kim and Hu 2006; Kim and
Kang 1997; Ruzer and Harley 2013; Segal et al. 2002). *Little is known
about how cooking fuel and combustion characteristics change particle size
distribution and composition in real-world settings. Therefore, further
work is needed to elucidate the relevant pollutants from biomass and coal
combustion and their relative toxicity*"(emphasis added).

Read the rest of the paper to re-affirm my "There is no there there." WHO
and Kirk Smith have been on a propaganda campaign of killing by
assumptions, saving lives by HAPIT.

WHO/Smith claims rest on shifting sands.

Nikhil

On Mon, Oct 2, 2017 at 1:18 PM, Crispin Pemberton-Pigott <
crispinpigott at outlook.com> wrote:

> Dear Nikhil
>
>
>
> I am reversing the paragraphs:
>
>
>
> >Nobody NEEDS to meet the WHO PM2.5 guideline for anything, leave alone in
> poor people's homes; otherwise, the first thing to ban would be smoking,
> dust, organic pathogens. There is no control of PM2.5 for household or
> ambient air pollution anywhere in the developing world that I know of that
> meets the elitist fancies of WHO "guidelines".
>
>
>
> Understood. It is selective representation of the total problem.
>
>
>
> >"One of the key conclusions from the IAQG was that, despite impressive
> exposure reductions of 50–80% in the best stove programs, in absolute terms
> average post-intervention concentrations remained well above the WHO
> interim target (35 μg/m3 annual mean)—that is, levels estimated to be
> necessary to yield significant health improvements (WHO 2014). Based on the
> limited data available at the time, clean fuel technologies [e.g., liquid
> petroleum gas (LPG), biogas, electricity, ethanol] performed best overall,
> but households using them also fell short of the target. Stove stacking
> (using multiple stoves and fuels) and other pollution sources inside (e.g.,
> kerosene lamps) and outside the home were likely explanations. These
> findings suggest that* near exclusive, community-wide use of clean fuels
> is needed to meet the PM2.5 guideline and to maximize health benefits*
> (Johnson and Chiang 2015). " (emphasis added).
>
> The simple and necessary response is the demonstration in Kyrgyzstan this
> past winter (official results still pending the completion of studies
> conducted in the same set) that a reduction of more than 99% is possible by
> changing the stove alone.  That represents a mortal threat to the narrative
> that ‘solid fuels cannot be burned cleanly’.
>
>
>
> Even if the WGO target is valid, the claim to ‘only a 50-80% reduction’
> having been achieved is incorrect. It has been going on for a while, it is
> just that the Fresh Air in Kyrgyzstan provides documented proof of it. It
> is well known since 2014 that the cooking and heating stoves in Ulaanbaatar
> were more than 90% better than the baseline, often more than 98%. Kirk had
> to modify his usual copy-paste narrative in a report to the Minster about
> 90% being clean enough and unachievable, to more than 95% cleaner, but that
> had already been achieved. The latest appliances are better than 98% down
> on PM2.5 in terns of total emitted, and virtually 100% on the indoor air
> portion of that.
>
>
>
> The claims in Johnson-Chiang 2015 may be convenient but they are not
> correct, and were not at the time even if proof was not widely available,
> or ignored.
>
>
>
> Regards
>
> Crispin
>
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