[Stoves] Off-topic: PM2.5 toxicity according to reviews (Was Crispin, Ron re: Ghana news on Second Lady)

Nikhil Desai pienergy2008 at gmail.com
Wed Oct 25 15:04:55 CDT 2017


Crispin:

I agree " Anyone who claims that wood smoke is as toxic as cigarette smoke
and asbestos particles is not reading the literature."

To clarify, toxicity is a unit measure - relative risk (RR) per dosage.
Tobacco smoking has a higher RR because the mass ingestion is higher.
Ambient air has a lower RR because the dosage is lower.

The IERs in GBD are based on active smoking data and relative risks at one
end and ambient air PM2.5 and relative risk at the other. When it comes to
HAP, there is no data, no theory, just an interpolation along the IER and
the assumption that PM2.5 from smoking, ambient air, and HAP has uniform
unit toxicity.

According to Kirk Smith and Jennifer Peel in 2010, the range of estimated
average inhaled dose of PM2.5 varies by three orders of magnitude. (These
are lumped from different studies with no consistent protocol or
measurement metric, over different cohorts not comparable, and assuming 18
m3/day breathing rate.) Their problem then was that "as yet there are no
published studies of CVD" from HAP. ("Mind the Gap," EHP December 2010, p.
1643-5).

So what does Kirk Smith do, after arguing in 1999 in a World Bank paper
that data paucity and non-comparability, confounding factors, did not
permit quantification of health damage from cooking fuel IAP?

As economists do when they don't know something, environmental health
enthusiasts make convenient assumptions that give the desired results to
grab headlines and more research funds; namely, to forget that PAHs are
different from fine dusts or mites, and declare every PM2.5 as a weapon of
mass destruction.

Which is now meeting some resistance.

Back on 26 July, I had posted the following about PM2.5 and predictability
of premature mortality -

*"The fundamental premise that [concentration-response] curves exist that
can predict the public health effects caused by reductions in pollutant
concentrations needs to be carefully reexamined and tested, as it does not
appear to hold in general." *Do causal concentration–response functions
exist? A critical review of associational and causal relations between fine
particulate matter and mortality, Louis Anthony (Tony) Cox Jr, Critical
Reviews in Toxicology, Pages 1-29 | Received 12 Oct 2016, Accepted 23 Mar
2017, Published online: 28 Jun 2017 http://dx.doi.org/10.1080
/10408444.2017.1311838.

I have been waiting for Ron's review of that paper and can submit some
excerpts later, but let me quote a little more from it (Table 1). Cox
quotes


"“Ambient fine particulate matter (PM2.5) has a large and well-documented
global burden of disease. Our analysis uses high-resolution (10 km,
global-coverage) concentration data and cause-specific integrated exposure
response (IER) functions developed for the Global Burden of Disease 2010 to
assess how regional and global improvements in ambient air quality could
reduce attributable mortality from PM2.5. Overall, an aggressive global
program of PM2.5 mitigation in line with WHO interim guidelines could avoid
750 000 (23%) of the 3.2 million deaths per year currently (ca. 2010)
attributable to ambient PM2.5.” Apte et al. (2015)" Apte JS et al., 2015
July 7 Addressing global mortality from ambient PM2.5 mortality from
ambient PM2.5 Environ. Sci. Technol. 49:8057-8066

Cox's response to which is,

"The Global Burden of Disease IER functions are based on relative risk
measures of association. They do not allow prediction or assessment of
“how… improvements on ambient air quality could reduce attributable
mortality” or avoid deaths unless the underlying relative risks represent
(manipulative) causal relations."


This is a polite version of my saying that DALYs are for the cohorts dead,
and have zero predictive value and that aDALYs are fiction manufactured for
Goldman Sachs by Gold Standard and GACC.

There is no there there, except for those who want to show and sell pies in
the skies.

Cox further argues,

Attributable risk and burden-of-disease studies, as previously discussed,
assume that if responses are greater among people with higher exposures,
then this difference is caused by the difference in exposures, and could be
reduced by reducing it. Typically, this assumption is made without any
careful justification: it simply confuses association with causation.
Examples are widespread, e.g. Fann et al. (2012), Lepeule et al. (2012),
Schwartz et al. (2017), and Lo et al. (2016)."


The Fann et al. paper is Estimated Changes in Life Expectancy and Adult
Mortality Resulting from Declining PM2:5 Exposures in the Contiguous United
States:1980–2010. Env. Health Perspectives https://doi.org/10.1289/EHP507.

They conclude, "Our estimates suggest that declines in PM2.5 exposures
between 1980 and 2010 have benefitted public health. " However, they do
recognize that PM2.5 data "were not regularly collected on an extensive
spatial scale until the late 1990s", just that "concentrations of monitored
pollutants that are precursors to PM2.5, including SO2 in particular, have
declined by approximately 80% during the period from 1980 to 2010."

Duh! With SO2 and other precursors down so much, the natural question for
our discussion here should be a) What do SOx and NOx have to do with
biomass cookstove emissions and b) What does US experience in PM2.5
reductions have to do with WHO PM2.5 emission reduction targets and Kirk
Smith's theology of "truly health protective" based on IERs? (Hint: the
answer is very simple.)

WHO is out to sell the world's poor short for the sake of advancing
bureaucratic careers, venturing outside its jurisdiction. It is fooling us
all to the point that the bureaucrats will pass on, and WHO of coming years
would be more laughable than it was last week appointing Bob Mugabe as a
goodwill ambassador.

Cox's view based on critical review is that

"*None of these papers demonstrates a manipulative causal C–R relationship
between changes in exposure concentrations and changes in total mortality
risks*. Some papers refute previous statistical causal claims (e.g. Dockery
et al. 2013). Thus, it *appears* that the literature on adverse public *health
effects that are solidly proved to be caused by PM2.5 exposure and to be
preventable by reducing PM2.5 exposure* is *still in its infancy despite
decades of association-based and assumption-based studies: sound studies
that address manipulative causality are still very much needed*." (emphasis
added).

Mind you, this is when the quality of exposure and response data is not in
question and associations are well-established, though over disparate
cohorts in time and space.

When it comes to Kirk Smith's concoction of Millions Dead, there are direct
exposure data that could even remotely be implicated in chronic adult
diseases. All he does is take the IERs of dubious value - forced into a
shape without any data except at the two end points of active smoking and
rich-country ambient air - and then slaps assumed concentrations by sex and
"child". Voila! Put 300 mcg/m3 exposure based on -- nothing but 617 Indian
households for six months in 2004/5 (it seems I was mistaken in earlier
reporting that these were from 2011/12) - and you get Relative Risks by
interpolation.

What theory? Who knows? When you don't have data, you better stay away from
theory!

By the way, the Dockery et al. 2013 paper is about refuting the "Dublin
study" on benefits of banning coal burning in Dublin County, Ireland.
According to Cox, "the updated study using control groups concluded that
the bans had produced no detectable reductions in total or cardiovascular
mortality rates."

So much for our friend Ron's trying to lump me with Big Tobacco, and
reminders of the ghoulish air of US cities and towns in 1950s or 1980s. We
got cleaner air to breathe, just that EPA brought us ghoulish airs of HAP
cult murders by assumption.

In 20 years, PM2.5 from non-HAP sources would have taken over in exposures
(as they probably have in many developing countries, but why bother with
facts when assumptions are enough?). People will still die, if faster or
earlier; fossil fuels or malnutrition or religious/ethnic intolerance will
be blamed. (Oh why not? One can do regressions with made up data.)

Nikhil



On Sat, Oct 14, 2017 at 8:09 PM, Crispin Pemberton-Pigott <
crispinpigott at outlook.com> wrote:

> Dear Ron
>
> The difference is that there is a great deal of research on the nature and
> effect of cigarette smoke and as all of it is PM2.5, we have clear proof
> that the concept of equitoxicity is false. In fact the banning of smoking
> is based on this conclusion.
>
> No similar studies exist ‎for other PM2.5 types save perhaps asbestos.
> Anyone who claims that wood smoke is as toxic as cigarette smoke and
> asbestos particles is not reading the literature.
>
> As Nikhil points out, there are many more assumptions being made
> 'heroically' in the leap from cooking stoves to attributions of
> life-shortening inhalations. In this case the BAMG have induced the WHO
> committee to make exhalations ‎which are speculative and supported by
> opinion, not arguable facts and studies.
>
> The lesson from Kyrgyzstan is ‎that a strong case can be made for certain
> fuels (dung, wood and coal) together with chronic under-heating being very
> unhealthy combinations. To disaggregate the conditions and effects of fuels
> is going to take a lot more time and work.
>
> The demonstration that the medical and living environmental influences can
> be overcome without changing fuels serves to add support to the claims by
> stove designers that this is a solvable problem. This is made in opposition
> to the baseless claim that solid fuels cannot be burned cleanly enough to
> confer 'health benefits'.
>
> That silly assertion is like the old lady who asked, in opposition to air
> travel, "If God had intended man to fly, why would He have given us such
> lovely trains?"
>
> If God had intended women to burn solid fuels, why would He have given us
> LPG and Electricity? Is that the deal?
>
> Regards
> Crispin
>
> On Oct 14, 2017, at 12:09 AM, Nikhil Desai <pienergy2008 at gmail.com> wrote:
>
> Crispin:
>
> Just a coincidence that your post reminded me of a case connecting
> workplace sexual harassment of young women and cookstove emissions.
>
> Why of course, I am thinking of the economist R. K. Pachauri, formerly of
> Teri, The Energy Research Institute in New Delhi and of the IPCC. It was
> via Teri that the first formal study of Indian indoor air pollution from
> solid fuel cookstoves began, in early 1983.  Clean Cooking Forum 2017 is
> being held not too far from where it all started then.
>
> Thinking of your grotesque analogy, I guess physical violence leads to
> long-term trauma for the survivors, a mental health issue. A co-damage if
> you will.
>
> In the WHO claims on HAP, there is a mental violence done by abuse of
> science.
>
> In each case, what happens behind the doors is kept unspoken. That is a
> societal cost of putting up with conceit and deceit of the violators.
>
> Please let us know which document of WHO says that HAP "kills". I will
> post two very short WHO statements (3-4 pages each) on HAP BOD methods and
> results, and also quote from a Kirk Smith paper about how the GBD
> attributable deaths rose in numbers. (I quoted from GBD 2016 that HAP
> attributable deaths have now gone down from 2000 to 2016).
>
> On claims like "kills" or the 2014 WHO document on HFC "guidelines"
> interfering with stove performance metrics and protocols, you could request
> your national government to take the matter to WHO Director General to
> complain that WHO has exceeded its remit and it has issued misleading
> public health statements.
>
> Nikhil
>
> PS: There is a WSJ front page story about a startup making false claims - Outcome,
> a Hot Tech Startup, Misled Advertisers With Manipulated Information,
> Sources Say
> <https://www.wsj.com/articles/outcome-a-hot-tech-startup-misled-advertisers-with-manipulated-information-sources-say-1507834627> Rolfe
> Winkler 13 October 2017. Arguendo, the technology was aimed to "nudge"
> (term from the new Nobel economist Richard Thaler) patients waiting in
> doctors' offices to a the drug that pharma companies paid Outcome to market
> via televisions in selected doctors' offices.  I wonder if Outcome should
> have instead sold aDALYs from nudging.
>
>
>
>
>
>
>
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