[Stoves] ] Solid fuels and death - another academic fakery

[Peeters Frans]

Dear NIKHIL

       Your RISK INTERPRETATION is WRONG !
That is why in INDIA people daying as flies working in leather treating with Cr2O3 ,
And my family died from footsole canser , due CHROME 6 was 500x to high .
MPD CHROME 6 is 25 micogram/ day .
Bangladesh export fancy SHOES to FRANCE and 35% are to high in CHROME 6 dangerous cancerogen like is CADMIUM also MPD 25 ug .

      You like CANCER with GARANTI ?
I worked a lifetime with PLUTONIUM ,here we have PREDICTING MATH in the Pu AIROSOL MONITORS ! 120 bq/hour alpha  6 MeV  is ALARM .and run !
1 microgram Pu is 2200 Bq ,inplanted in a mice gives CANCER after 1 year .
THAT IS CANCER RISK WITH  WARANTI ……..!

   Back to CARBON FUEL .
CHEMISTRY is an EXACT SCIENSE !  
   Your INTELIGENT TALK HAS NO MEASUREMENTS and is POLITICS to run or ruen  the circus .
        The only best work done to interpret CARBON FUEL CANCER DANGER was done in East GERMANY ROSTOK in a COKE factory.
Someting like 50 hydrocarbons were extracted end given to 500 mices .
So the danger was determined per hydrocarbon .

The stovers speaking about PM10 and 2,5 without knowing the product .
For me pure carbon is not dangerous as is coagulated blood under the skin .
But a PM 9 micron carbon with 1 micron naftalene attached is a very dangerous cancerogen .
A PM 10 SiO2 sand is not cancerogen but silicosis disturbs lung functions .

       You better learn INDIA a stove without chimney must be FORBIDDEN .
NAFTALENE and ANTRACEN , the BENZENE cyclic components are the RISKY DANGERS .

You dont need a dose rate …..1 ug can start CANCER .      I got it …..from own gal .

Regards
Frans

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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.
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.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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