[Stoves] [stove and climate] The newest review of HAP health impacts

Ronal W. Larson rongretlarson at comcast.net
Wed Aug 1 10:32:48 CDT 2018


List:

	There is a great deal more useful information in the full document at 
https://www.healtheffects.org/system/files/Comm18-HAP-NCD.pdf <https://www.healtheffects.org/system/files/Comm18-HAP-NCD.pdf>

	A bit on Tiers in and near Figure 16 (p44).

	So far, I've only skimmed.

Ron

> On Jul 31, 2018, at 10:39 PM, Ronal W. Larson <rongretlarson at comcast.net> wrote:
> 
> List
> 
> 	1.  I'll be reading this (a relatively short paper attached below) tonight.  Looks well done so far.  If Professor Smith recommends it - I want to read it and hope most of you will also.  There is more at:  https://www.healtheffects.org/publication/household-air-pollution-and-noncommunicable-disease <https://www.healtheffects.org/publication/household-air-pollution-and-noncommunicable-disease>
> 
> 	2.  I presume Nikhil is still preparing a response to the question posed to him by Professor Gadgil a few days ago - for citations.  I'd be satisfied if Nikhil simply told us what he sees wrong with this paper. 
> 
> 	3.  On Nikhil's behalf, Crispin gave a lengthy response to Professor Gadgil,  but again - contained none of the cites that Professor Gadgil requested.  So I hope Crispin also will refute this one (which I believe supports Prof. Gadget's belief in WHO and similar data like in this new report).
> 
> 	4.  I have finished the short book by Professor Doug Brugge - and now can recommend it.   The chapter on stove health impacts is the shortest - and mostly (and appropriately) credits Kirk Smith.  But I learned a lot much more on PM2.5 and epidemiology in later chapters. Maybe more later on this.
> 
> 	5.    We are working in an area (biomass stoves) where way too little health-related science has been performed - compared say to cigarette smoking.  While Crispin and Nihil are preparing a rebuttal to this new report above, I also hope they will include data on the relative validity of health statistics for cigarette smoke (a much less serious problem than the one this list is addressing - but one that seems to have been settled scientifically).
> 
> Ron
> 
>> Begin forwarded message:
>> 
>> From: "Kirk R. SMITH" <krksmith at berkeley.edu <mailto:krksmith at berkeley.edu>>
>> Subject: [stove and climate] The newest review of HAP health impacts
>> Date: July 31, 2018 at 9:49:55 PM MDT
>> To: "Kirk R. SMITH" <krksmith at berkeley.edu <mailto:krksmith at berkeley.edu>>
>> 
>> New study out of the Health Effects Institute in Boston – press release below. Great job by excellent authors and highly competent reviewers and published by a reputable source.  (I might add that it is about time in that for 20 years at least some of us have been trying to push HEI to take on this issue.  Better late than never, I suppose.  Or perhaps, better said as smart people can change their mind once they see the facts.)
>>  
>> Interesting that it is framed under a “noncommunicable disease” framework.  This is due to the growing interest in NCDs to be sure, but also because the impacts on pneumonia in children, the major accepted non-NCD impact, is dropping rapidly worldwide.  This came about not to great improvements in pollution levels, but to great improvements in child health due to better nutrition, primary health care and vaccines.  Thus, kids may still be getting respiratory infections from smoke, but they die from such infections much less frequently than the past.    On the other hand, there are range of other impacts on children that are not included yet in the official categories of diseases (from the global burden of disease projects) associated with household pollution, including a range of adverse pregnancy outcomes and associated child morbidity/mortality, plus probably stunting and cognitive impacts.    Thus, children are not off the hook from being beneficiaries of clean household environments.
>>  
>> Unfortunately, the summary press release below fails to note the importance of household fuels in creating ambient air pollution exposures in many countries.    Indeed, in both India and China, studies have shown that households are probably the first (India) or second (China) most important source of ambient pollution, measured as PM2.5, the best indicator for health impacts.  To be clear, this point is made in the policy summary, attached, and in the main report (see link).  As we are seeing in China, however, it probably ought to have been one of the main points being made since cleaning up households is making big progress as a means to control ambient levels, rather than for the benefit of the households themselves.  Perhaps backwards, but nevertheless this realization has triggered healthful policy changes that otherwise  likely might not have happened soon.  
>>  
>> The point now, at least from my perspective, is perhaps not so much improving impact estimates, worthy scientific exercises as they are although always changing and subject to uncertainty, but finding ways to motivate policy.  The ambient air pollution link is clearly one of them
>>  
>> Undoubtedly, however, the contents of the press release were not under direct control of the authors themselves/k
>>  
>> Policy summary attached and on my website below.  Main report available at
>>  
>> https://www.healtheffects.org/publication/household-air-pollution-and-noncommunicable-disease <https://www.healtheffects.org/publication/household-air-pollution-and-noncommunicable-disease>
>>  
>> NEW REPORT: One in Three Households Worldwide Exposed to Household Air Pollution;
>> Growing Evidence Links Their Exposure to 2.6 Million Deaths from Heart, Lung,
>> and Other Diseases -- 
>>  
>> (BOSTON July 26, 2018) A total of 2.5 billion people — a third of the global population —
>> were exposed to household air pollution (HAP) in 2016 from the use of solid fuels for cooking
>> and heating, according to a new report, Household Air Pollution and Noncommunicable Disease,
>> issued today by the Health Effects Institute1 (HEI) at www.healtheffects.org <http://www.healtheffects.org/>.
>>  
>> That enormous population, exposed to high levels of particulate matter from HAP, faces a
>> significant health risk. HEI’s synthesis of the latest scientific evidence found a growing number
>> of epidemiological studies and systematic science reviews with evidence that HAP exposures
>> increase the risk of many noncommunicable diseases, including lung and heart disease, cataracts,
>> and lung cancer.
>>  
>> All told, this translates into HAP exposure contributing substantially to the global burden of
>> disease, an estimated 2.6 million deaths in 2016. The economic consequences of the HAP-attributable
>> health burden are also large: the best available estimate from the World Bank
>> suggests an annual global welfare loss in 2013 of about $1.5 trillion in 2011 U.S. dollars from
>> HAP exposures alone.
>>  
>> Most of those affected live in low- and middle-income countries in Asia and Africa. These
>> populations — and especially the women and children inside the homes — face a double burden:
>> from the air they breathe indoors as well as from outdoor air pollution from the full range of
>> industrial, transport, and other sources. (Detailed estimates of these double burdens in each
>> country in the world are available at www.stateofglobalair.org <http://www.stateofglobalair.org/>.)
>>  
>> Clean energy solutions are necessary to reduce disease burden substantially. The report
>> found the traditional interventions to reduce exposure — introducing improved solid fuel
>> cookstoves — have had mixed effects, with some reductions in exposure but relatively few
>> health benefits. Cost of the alternatives, cultural attachment to the older stoves, and challenges
>> in operating the new stoves all likely contribute to lower than expected improvements in
>> exposure and health. These findings suggest that more extensive clean energy solutions, such as
>> bringing natural gas and electricity to rural homes, are needed to significantly reduce health
>> burden.
>>  
>> Introducing those new solutions has the potential for substantial public health benefits.
>> HEI’s Global Burden of Disease from Major Air Pollution Sources (GBD MAPS) project
>> estimates that, in China and India alone, policies that shift to reliance on clean fuels could
>> decrease the future burden of disease from ambient air pollution attributable to residential
>> burning of solid fuels by at least 30% and possibly by more than 95%, depending on the policy.
>> In India, for example, a policy that would virtually eliminate use of biomass cookstoves by 2050
>> could avoid 500,000 early deaths from outdoor air pollution annually relative to a business-as-usual
>> scenario; eliminating these stoves would have substantial benefits indoors as well.
>>  
>> This new HEI Report, Household Air Pollution and Noncommunicable Disease, which was
>> intensively peer reviewed prior to HEI publication by leading global experts on disease and
>> household air pollution, is available at www.healtheffects.org <http://www.healtheffects.org/> as HEI Communication 18, and in
>> a special Summary for Policy Makers. For further information on the report, please contact:
>> Katy Walker, Principal Scientist, HEI (kwalker at healtheffects.org <mailto:kwalker at healtheffects.org>; +1 617 488 2310
>>  
>> Kirk R. Smith, MPH, PhD <krksmith at berkeley.edu <mailto:krksmith at berkeley.edu>>
>> Professor of Global Environmental Health
>> University of California Berkeley, 94720-7360 USA
>> Director, Collaborative Clean Air Policy Centre, Delhi;  https://ccapc.org.in/ <https://ccapc.org.in/>
>> Darbari Seth Block, India Habitat Centre, Lodhi Road, New Delhi, 110003
>> Delhi cell: (91) 99587 38713
>> http://www.kirkrsmith.org/ <http://www.kirkrsmith.org/>
>>  
>>  
>> 
>> -- 
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> <Comm18-SummaryForPolicyMakers.pdf>
> 

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