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<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext;mso-fareast-language:EN-US">Dear Xavier<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext;mso-fareast-language:EN-US"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext;mso-fareast-language:EN-US">Spot on.<o:p></o:p></span></p>
<p><span style="color:windowtext">></span>It seems indeed that we are able to understand and measure quite well exposure, but to measure impact on health is the huge next step.<span style="color:windowtext"><o:p></o:p></span></p>
<p><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext">Well, as Nikhil would have it, a ‘huge leap’. He is more aware of what the guys who created these things say about them.<o:p></o:p></span></p>
<p><span style="color:windowtext">></span>So my take would be that you would not venture into designing a study on health impact, but would for now focus on exposure?
<span style="color:windowtext"><o:p></o:p></span></p>
<p><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext">I can’t even say. ‘for now’. I do not know what they plan to do with the results.
<o:p></o:p></span></p>
<p><span style="color:windowtext">></span>Understanding exposure and its sources might help us understand health impact?<span style="color:windowtext"><o:p></o:p></span></p>
<p><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext">Well, no. To do that requires a health impact study and exposure measurement at the same time, as was really well done in the Malawi study.
<o:p></o:p></span></p>
<p><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext">For Kyrgyzstan we will be able to say that stove x creates an exposure of y for the householders. Replacing it with stove m changes the exposure, the time of day, the peaks
and the seasonal total, for example. Whatever modeling is performed based on these exposures has to stand on its own logical base. At least we will be able to say whether or not indoor air quality is improved, and by how much.
<o:p></o:p></span></p>
<p><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext">In Tajikistan (where I know of no such study) they are dreadfully afraid of CO poisoning. Each case is widely reported. In many homes they do not run stove through the night
because of this persistent fear. As a result the house is very cold in the morning. This
<i>has</i> to have health consequences for the elderly and infants. There is a lot of information available on ambient temperature and disease/death.<o:p></o:p></span></p>
<p><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext">So a stove that can safely operate through the night, burn locally available fuels, be CO-safe and affordable is a big plus for this population. We have put stoves into 40 locations
for the winter to see if some of these attributes are present, according to the users. The Kyrgyz report on safe over-night burning was noted already. At least 4 Model 4’s will be tried in Tajikistan. Not much, but a good start.<o:p></o:p></span></p>
<p><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext">Regards<o:p></o:p></span></p>
<p><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext">Crispin<o:p></o:p></span></p>
<p><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext"><o:p> </o:p></span></p>
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