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</o:shapelayout></xml><![endif]--></head><body lang=EN-CA link="#0563C1" vlink="#954F72"><div class=WordSection1><p class=MsoPlainText>Dear Jay<o:p></o:p></p><p class=MsoPlainText><o:p> </o:p></p><p class=MsoPlainText>I appreciate the discussion. I have been working with Prof Lodoysamba in Mongolia for going on 6 years with a view to burning (rather than emitting) the vast majority of particulates produce by the evaporation of lignite in domestic stoves. The (nuclear methods) analysis of the component particles by Lodoysamba and a university in New Zealand has been particularly instructive in that the chemical composition of the particles allows for a source apportionment to be constructed and the influence of a stove replacement programme (ongoing) to be evaluated.<o:p></o:p></p><p class=MsoPlainText><o:p> </o:p></p><p class=MsoPlainText>With this in mind, the composition of the smoke from cigarettes and coal and wood is probably worth thinking about because I believe they are not all that similar. While obviously there are overlapping compounds such as formaldehyde, CO and so one, the health risk is not from particle <i>per se</i> but from what they contain, factored for their size (in the sense of being able to deliver their ‘payload’). This raises the question of how to compare PM concentrations of PM2.5 that have very different source materials.<o:p></o:p></p><p class=MsoPlainText><o:p> </o:p></p><p class=MsoPlainText>The comparison made using ‘x number of cigarettes per day’ is valid if we speak only of particles, but are there not large differences between the typical condensed tars from cigarettes and the hydrocarbons from lignite and the BC or condensed volatiles from wood fires? It is unlikely they have identical health impacts.<o:p></o:p></p><p class=MsoPlainText><o:p> </o:p></p><p class=MsoPlainText>The reason I ask is that in order to assess the value of avoiding PM2.5 emissions, we have to create an impact assessment method. In Ulaanbaatar the $ value of the health impact was made by Jostein Nygaard (WB) and we have a target reduction – now to be >80% – whereas before it was not even considered possible to achieve that. The difference is the application of modern combustion principles to the stoves which has allowed us to achieve reductions in excess of 98% relative to the (rather terrible) baseline.<o:p></o:p></p><p class=MsoPlainText><o:p> </o:p></p><p class=MsoPlainText>When seeking funds we have to justify the expense and show value for money. If I pull a ‘equal to xx cigarettes’ argument out of my back pocket, I have to defend the direct comparison of PM mass concentrations between wood smoke and tobacco smoke. I am not aware of that having been asserted and defended. Because woods and coals vary considerably in content (i.e. Ulaanbaatar coal, for example, being particularly low in Sulphur and tars) it would seem necessary to do the sort of investigation that Lodoysamba has been performing (best ref is the AMHIB Report, part of the UB-CAP chain of WB activities).<o:p></o:p></p><p class=MsoPlainText><o:p> </o:p></p><p class=MsoPlainText>What is your view?<o:p></o:p></p><p class=MsoPlainText><o:p> </o:p></p><p class=MsoPlainText>Many thanks<br>Crispin<o:p></o:p></p><p class=MsoPlainText><o:p> </o:p></p><p class=MsoPlainText><o:p> </o:p></p><p class=MsoPlainText><span style='font-size:8.0pt'>C Pemberton-Pigott<o:p></o:p></span></p><p class=MsoPlainText><span style='font-size:8.0pt'>Senior Technical Advisor,<o:p></o:p></span></p><p class=MsoPlainText><span style='font-size:8.0pt'>Stove Emissions and Efficiency Testing Laboratory, (SEET)<o:p></o:p></span></p><p class=MsoPlainText><span style='font-size:8.0pt'>City of Ulaanbaatar<o:p></o:p></span></p><p class=MsoPlainText><span style='font-size:8.0pt'>Mongolia<o:p></o:p></span></p><p class=MsoPlainText><span style='font-size:8.0pt'><a href="mailto:crispin@newdawn.sz">crispin@newdawn.sz</a> <o:p></o:p></span></p><p class=MsoPlainText>++++++++++<o:p></o:p></p><p class=MsoPlainText><o:p> </o:p></p><p class=MsoPlainText>I'm traveling and don't have access to all my files as a result so I can't give you details from when I was actively working on this a few years ago. There is only 1 study that I could find then that modeled the passive particulates in a house from a certain number of cigarettes being smoked and a typical amount of air exchange. The levels were actually around the lower part of the range in the group in Guatemala that had the rocket stoves installed. For cigarette smoke, we know that this amount of smoking in a household is associated with increased childhood pneumonia. In the long-run, personal exposure is what counts and this is hard to measure for particulates which is why Kirk Smith's group used personal CO monitors on children instead. I think it would be useful for someone to mount a large study that paid women to carry a particulate sampling system inside a life-size baby doll to get accurate ranges for what a typical infant is exposed to. Ideally this would be done in multiple locations where etiologic research on pneumonia in children is being done. Unfortunately the clinicians doing those large studies did not opt to look at smoke exposure levels; that probably goes along with the mindset that has been encountered in the past from the Gates Foundation that seems to dismiss attempts to lower exposure to combustion products as not as worthy of attention as their efforts to diagnose and treat these pneumonias more quickly and adequately in order to lower the death rate.<o:p></o:p></p><p class=MsoPlainText><o:p> </o:p></p><p class=MsoPlainText>Jay Smith, MD, MPH<o:p></o:p></p></div></body></html>