[Stoves] Yet another review paper (2014): Perspectives in Household Air Pollution Research: Who Will Benefit from Interventions

[Nikhil Desai]

Ron:

Your references led to more references; here  Clark, M.L. & Peel, J.L.
Perspectives
in Household Air Pollution Research: Who Will Benefit from Interventions?
<https://link.springer.com/article/10.1007/s40572-014-0021-0#citeas>  Curr
Envir Health Rpt (2014) 1: 250. https://doi.org/10.1007/s40572-014-0021-0

"Several investigators have hypothesized that those individuals who are
more susceptible to the adverse effects of air pollution exposure may also
be the groups that benefit most from efforts to reduce air pollution levels
(e.g., traffic reduction plans, industrial facility closings, indoor air
filter interventions) [47
<https://link.springer.com/article/10.1007/s40572-014-0021-0#CR47>, 48
<https://link.springer.com/article/10.1007/s40572-014-0021-0#CR48>], *yet
this question has largely been ignored in the cookstove field*. Valid
assessments of the true exposure-response relationships among various
subpopulations are necessary to inform a more accurate estimate of the
global burden of disease attributed to cookstove smoke, an identified
research gap needed to convince governments and policy makers to enact
interventions [49
<https://link.springer.com/article/10.1007/s40572-014-0021-0#CR49>].
Evidence regarding who benefits from improved air quality is limited and
inconsistent.* It is not known whether larger predicted benefits among
certain subpopulations are due to differences in greater relative
improvements associated with air pollution reductions (i.e., different
exposure-response functions experienced by the subgroups) or differences in
absolute improvements because of poorer baseline health status, which may
be independent of air pollution* [47
<https://link.springer.com/article/10.1007/s40572-014-0021-0#CR47>]. "
`(Emphasis added).

Let me put this in simple but contentious terms: as of 2014 at least,
NOBODY KNEW. Kirk Smith's robust physicist approach to setting the
boundaries of HAP as solid fuel origin emissions meant that, in practical
terms, solid fuels were demonized and LPG/gas/electricity promised as "life
saving" (aDALY terms, at least).

Mind you, one of the co-authors here (J. Peel) also co-wrote with Kirk
Smith the paper "Mind the gap" (2010), in my view opening up a radical (but
mistaken) path to concocting the Integrated Exposure Response, whereby Kirk
Smith ignored all the chemical diversity, took PM2. equitoxicity as an
article of faith, and his colleagues manufactured extremely limited
concentration estimates from some 600 Indian households during winters (as
I remember it; I forget the village locations and months).

What happened in 2014 is well-known: a set of hasty "literature reviews"
for the WHO, and Burnett et al.
<https://www.ncbi.nlm.nih.gov/pubmed/24518036> cooking up the IER, IHME the
HAP DALYs. Then EPA contractors essentially dictating to WHO the terms of
HCFC Guidelines
<https://www.who.int/airpollution/guidelines/household-fuel-combustion/IAQ_HHFC_guidelines.pdf>
and
thereby the ISO TC-285 methods and tier levels.

What Clark and Peel observed in 2014 is still valid, more so since GACC has
morphed into CCA, paid marketers of LPG, and Kirk Smith is still looking to
market aDALY consultancies if Goldman Sachs and Gold Standard have their
way.

For biomass stovers, though, the question remains: how much really needs to
be known to make a meaningful change? Thee authors say "The ability to know
what to expect from cookstove interventions (i.e., to accurately describe
the presence of the subgroup response, as simplified in Figure 1, as being
a meaningful shift in health improvement) is crucial to reducing scientific
uncertainty and to encourage policy makers to enact change. "

What has happened is that "scientific uncertainty" and ignorance are
suppressed and a new religion of LPG has taken shape in CCA.

My view is, quantification of "health effects" is academic sideshow. The
real challenge is to develop biomass stove designs for commercial and
household markets that can make demonstrable contributions to reduction in
air pollution exposures. I submit household wood cookstoves can do  that,
charcoal stoves do that, and commercial charcoal stoves could do that
faster. But then, that's just a hunch. CCA has got the money to spread the
gas.

N

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


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