[Stoves] Solid fuels and death - another academic fakery (Was: Norbert Senf - "new health study")

Mon Sep 24 20:13:54 CDT 2018

 Norbert:

I could attribute my premature near-death to the intellectual air pollution
of "solid fuels and health impacts" and stay away from reading any more of
such stuff. But this was an example of reporting on specific populations
over a specific period, so I decided to read it.

If the WHO/IHME numbers on HAP DALYs are fake, here at least the numbers
are real, but only one one side - hospital admissions and deaths associated
with ALRI. There is nothing on the other side of purported causation -
meaning the fuels.

Put another way, the WHO/IHME computations have NEITHER dose NOR disease
outcome data. Assumptions based on estimates based on assumptions in the
cited literature on estimates based on.. you get the idea.

Here they have "response", howsoever ridiculously defined. But they do not
have "dose".

This is ideological babble paraded a study.

It's no news that "Burning wood or coal to cook increases risk of
respiratory illness." The question is, what is the evidence, and what is it
about burning, how the alleged "increase" can be quantified, against what
baseline, for whom. (Yes, "whom" cannot just be personal identifiers;
unless you presume that human physiology is identical over respective life
times, the contexts of genetic, dietary, climatic, medicinal influences,
etc. matter. "Who" is a political question.)

The press release says flat out " Burning wood or coal to cook food is
associated with higher risk of being hospitalised or dying from respiratory
diseases."

May be, but the prescription pill suggests an advance bias -“Although we
cannot infer a causal relationship from these observational findings, this
still makes a compelling case to speed up the global implementation of
universal access to affordable clean energy, one of the United Nations’
Sustainable Development Goals.”

In other words, "We don't know the hack we are doing, but we will join the
musical chorus - G I U A A C E (jee, eye, you, eh, eh, see, ee). Global
Implementation of Universal Access.. blah, blah. Based on this pathetic
non-study? Gimme a break.

I am not going to bother purchasing the "study." Let's just look at the
Abstract:

a. " Little evidence from large-scale cohort study exists about the
relationship of solid fuel use with hospitalization and mortality from
major respiratory diseases. "

Ah. Happy to see a confirmation of my gripes for 20 years now - there is no
large-scale cohort study that provides any meaningful, if tentative,
quantitative information about solid fuel use and major respiratory
diseases. WHO and GBD 2012 claims are baseless. (Or, to put it politely,
experts agreed that this is the best science can do, no matter how bad it
is.)

b. " Cox regression yielded adjusted hazard ratios (HRs) for disease risks
associated with self-reported primary cooking fuel use."

Ah. Another confirmation of another one of my gripes - "primary cooking
fuel use" means nothing unless you presume all solid fuels to be
"polluting", without regard to fuel chemistry, combustion chemistry, or
even biochemistry, or any and all confounding factors. I forget my
statistical inference theory, and can't tell what use Cox regressions are
in weeding out irrelevant independent variables and serious violations of
OLS assumptions. But then, I do know public health people use statistical
inference in ways that statisticians would cringe at. Just how the "disease
risks" baseline is developed is one question; "clean fuel" cannot be the
baseline for disease risks because that begs the question.

c. " Overall 91% of participants reported regular cooking, with 52% using
solid fuels. "

Ah. Over a nine-year period, what changed in cooking, in fuels, in other
sources of same pollutants (if anybody had bothered, instead of assuming
equitoxicity of PM), and how did the "baseline" change - people got older,
moved in or out, building shells changed.

They do suggest that some people switched - " Compared with clean fuels
users, solid fuel users had adjusted HR of 1.36 (95%CI 1.32-1.40) for major
respiratory diseases, whereas those who switched from solid to clean fuels
had weaker HR (1.14, 1.10-1.17). "

I am suspicious of the UI ranges, but in any event, the difference in HR of
1.36 and 1.14 may not be statistically significant or even if it is, may
not hold for other contexts and cohorts. (This is the age old problem of
population health; non-generalizable inane findings.)

Now let me turn back to the press release, the common tool of universities
and publishers to twist the findings to make it seem like they are doing
something meaningful, not wasting time and money: (my response between ***)

d. "The CKB is a prospective study of 0.5 million adults aged from 30 to 79
years who were recruited from 10 different areas of China during 2004-08.
The participants included in the present report were never smokers and were
free of respiratory and other major chronic disease upon enrolment. Their
health status was monitored for 9 years through linkages to death
registries and hospital records. During that time, 19,823 participants were
either hospitalised or died from a major respiratory disease. Of these
events, 10,553 were due to chronic lower respiratory disease (asthma or
chronic obstructive pulmonary disease [COPD]), and 7,324 were due to acute
lower respiratory infections, most often pneumonia."

*** How reliable is the base-year information about 0.5 million people
being never smokers and free of respiratory AND other major chronic
disease? Over nine years, roughly 4 million person-years were under
observation (say, 0.5 m person-years were lost to death, considering the
tail end of age at the beginning). Mixing "hospitalized" and "died from a
major respiratory disease" is a questionable definition of a "disease
risk", and also begs the question how many hospitalizations and deaths
occurred due to diseases other than "a major respiratory disease". Ignore
also locational/climatic differences across "10 different areas of China",
the changes in the access to, and cost/quality of medical care, or
life-style factors (including mobility, with exposures to environmental
risk factors for respiratory diseases). With all those qualifications, what
does it mean that 7,324 hospitalizations OR deaths occurred due to ALRI? As
a % of 4 or 4.5 million person-years, some hospitalization due to ALRI may
be independent of fuel choice (leave alone methods of cooking or actual
concentrations of pollutants in the air breathed). They don't have
exposure/dosage data for fuel-origin smoke, or for all other pollutants. I
don't see the equation specified, but I suppose they are using a "dummy
variable" for fuel type - say, 1 if the fuel is claimed to be "solid fuel"
and 0 if "clean fuel). Ignore ventilation, stacking, time and duration of
use. Mortgage common sense, for that's what wins research grants and press
releases for GIUAACE. ***

e. "The researchers found that the risk for chronic and acute respiratory
disease hospitalisations or deaths was 36% higher among those who used wood
or coal for cooking compared to those who used a clean-burning fuel (such
as electricity or gas), after taking account of the effects of age, sex,
socio-economic status, passive smoking, alcohol drinking, diet, physical
activity, and adiposity. The study also showed clearly that the longer
people used solid fuels, the higher the risk of hospitalisation or death
from a respiratory disease; the risk was 54% higher among those who used
either wood or coal for 40 years or longer compared to clean-fuel users."
*** Ok to throw around such numbers but they really mean nothing conclusive
in terms of predicting ALRI incidence.  This is nonsense, not science. No
inference warranted.***

f. Pollution arising from domestic burning of coal and wood for cooking and
heating has been consistently shown to contribute to deaths from
cardiovascular disease and lung cancer. While many previous studies have
suggested a link between solid fuel use and COPD, most of them focused on
changes in lung function rather than hospital admissions or deaths. The
associations with other respiratory diseases have not been well described.
*** Ah, again. A lie repeated a thousand times - "Pollution arising from
domestic burning of coal and wood for cooking and heating has been
consistently shown to contribute to deaths from" CVD and lung cancer." This
is inane cite-o-logy of generalizing evidence from iffy, spotty studies.
That anything may "contribute to" deaths and hospitalization is a matter of
pre-conceived biases. Why some people think there are uses of medicinal
smoke, while the EPA/WHO see in every molecule of CO2 and every PM2.5
particle a WMD. It's like the ideological rant against "capitalism" or
"climate"; I can find or invent any theory of property rights under any
definition of property and rights, and blame everything that happens in the
world as a consequence of capitalism, or because we know anything and
everything is affected by climate, I can find or invent any definition of
climate and health and blame all incremental disease on climate change.
Here, these people claim that somehow "hospital admissions or deaths" are
superior indicators of respiratory health than lung function tests. As
someone who has suffered both COPD confirmed by lung tests as well as
hospitalizations due to shortness of breath, I find such claims ludicrous.
The tragedy is, these researchers may well have picked indicators that gave
some "stronger" numbers for HR, not necessarily stronger statistical power
for predictability, replicability. If so, I repeat - this is nonsense, not
science. ***
----
In sum,
1. There is no mention of quantified exposures of any particular pollutant.
It is silly to quantify everything else when you don't quantify the source
of the risk. Self-reported use of a fuel type is taken as a proxy for
exposure, which essentially means, "You tell me you use solid fuel, I tell
you you are at risk."

2. While some apparently relevant factors - age, sex, ... adiposity - have
been "taken into account," the question is, how they are taken into account
(dummy variables in a regression?) and what other variables have been
ignored, consciously or inadvertently. Take for example the finding
that " Those
who burned wood or coal in ventilated stoves had a slightly lower risk of
hospitalisation or death from respiratory disease, particularly for the
milder conditions, than those who used stoves that were not ventilated."

>From what little I have known of "population health" and "global health",
it is an industry fueled by mindless grants leading to mindless claims,
turning around to say, "But more research is warranted at the national,
sub-national, group levels." Of, in this instance, to actually survey fuel
use patterns and exposures to all air pollution over a long enough period.
(They can, like Ajay Pillarisetti, assume away the duration by asserting
that instantaneous relative risk is all that is needed for any gibberish
level of PM2.5 concentration. But that s a different type of fakery.)

It is of course easier to pay to generate claims than to pay to keep quiet
and avoid intellectual pollution. The classical tradition of epidemiology
would demand precise definitions, measurement protocols, and rigorous
design of experiments and testing. "Anything goes" is the motto in "global
health". I think even Kirk Smith would be happy to identify claims that he
does not agree with.

These "studies" are of dubious value for predictive purposes or insight
into engineering and design. If you assume "solid fuels kill," why bother
how much and when? Why pretend expertise?

WHO HAP DALYs and BAMG HAPIT aDALYs have a) no respectable theory (just the
nonsense of PM2.5 equitoxicity and of the Integrated Exposure Response),
and b) no credible data -  on emission rates, concentrations, ingestions,
or disease incidence. I happen to think that this China "study" is less
transparent, outright deceit in service of official dogma.

Health is a social science. GBD is economics - third rate theories of
"expected" burdens of disease, and of expenditure priorities in terms of
$/aDALYs (both relying on fake indices of "well-being" (GDP per capita or
household monthly expenditures per capita, any of which can be cooked up as
mindlessly as "smoke inhalation", and fake unit cost information).

On that, some other time. I don't particularly enjoy fighting satanic
cults.

Nikhil

On some types of allegedly beneficial biomass smoke: “Fill your heart full
of good things” – smudging is the ceremonial tradition of Indigenous people
across North America, it cleanses your mind, body and soul.
<https://educateinspirechange.org/spirituality/smudging-does-a-lot-more-than-clear-evil-spirits-new-research-reveals/>

Medicinal smokes. Mohagheghzadeh A1, Faridi P, Shams-Ardakani M, Ghasemi
Y.J Ethnopharmacol. 2006 Nov 24;108(2):161-84. Epub 2006 Sep 9.
<https://www.ncbi.nlm.nih.gov/pubmed/17030480#>
https://www.ndph.ox.ac.uk/news/burning-wood-or-coal-to-cook-
increases-risk-of-respiratory-illness.

------------------------------------------------------------------------
Nikhil Desai
(US +1) 202 568 5831
*Skype: nikhildesai888*

On Sat, Sep 22, 2018 at 10:48 AM, Norbert Senf <norbert.senf at gmail.com>
wrote:

> Hate to stir the pot again in the ongoing health effects vs cause
> discussion regarding wood smoke.
> However, this study jointly conducted by the China and Oxford and
> published yesterday looks pretty solid:
> https://www.ndph.ox.ac.uk/news/burning-wood-or-coal-to-cook-
> increases-risk-of-respiratory-illness.
>
> Norbert
> --
> Norbert Senf
> Masonry Stove Builders
> 25 Brouse Road, RR 5
> Shawville Québec J0X 2Y0
> 819.647.5092
> www.heatkit.com
>
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