<div dir="ltr">Crispin, Philip: <br><br>Please recognize that WHO has a gratuitous war against solid fuels simply because a house of cards has been built on no data on fuel/stove types, paltry emission, concentration, and exposure measurements, and patently ludicrous assumptions. <br><br>All of these have passed certain standards of practice that have been accepted by the public health community (or nobody bothers). The most recent GBD 2015 paper in Lancet (link posted by Crispin; I have some notes on it) has a couple of nice tables and figures about how these standards of evidence and methods have been met. It may help to go through these in a dispassionate way and try to construct a biomedical basis of association between fuel use and disease incidence to realize just how illogical the whole enterprise is. <br><br>Therefore, it does not matter if you speak of kerosene or ethanol. Deaths from fuel use are concocted BY ASSUMPTION. Solid fuels are ASSUMED to be uniformly DIRTY FUELs. This is "fact-free" science. <br><br>Let's look at this claim - "“the leading cause of death for younger adolescent girls aged 10–14 years is lower respiratory infections, such as pneumonia – often a result of household air pollution from cooking with solid fuels.”<br><br>A. How many females? WHO press release <a href="http://www.who.int/mediacentre/news/releases/2017/yearly-adolescent-deaths/en/" target="_blank">More than 1.2 million adolescents die every year, nearly all preventable</a> says, <br><div><br></div><div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px"><div><br></div><div><span style="color:rgb(51,51,51);font-family:Helvetica,Arial,sans-serif;font-size:13px">Data in the report, </span><i style="color:rgb(51,51,51);font-family:Helvetica,Arial,sans-serif;font-size:13px">Global accelerated action for the health of adolescents (AA-HA!): Guidance to support country implementation</i><span style="color:rgb(51,51,51);font-family:Helvetica,Arial,sans-serif;font-size:13px">, reveal stark differences in causes of death when separating the adolescent group by age (younger adolescents aged 10–14 years and older ones aged 15–19 years) and by sex.</span></div><div><span style="color:rgb(51,51,51);font-family:Helvetica,Arial,sans-serif;font-size:13px"><br></span></div><div><span style="color:rgb(51,51,51);font-family:Helvetica,Arial,sans-serif;font-size:13px">...........</span></div><div><span style="color:rgb(51,51,51);font-family:Helvetica,Arial,sans-serif;font-size:13px">The picture for girls differs greatly. The leading cause of death for younger adolescent <u>girls aged 10–14 years are lower respiratory infections, such as pneumonia</u> – <u>often</u> a result of indoor air pollution from cooking with <u>dirty fuels</u>. </span></div></blockquote><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px"><br></blockquote><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px"><div><font color="#333333" face="Helvetica, Arial, sans-serif"><br></font></div></blockquote><span style="color:rgb(51,51,51);font-family:Helvetica,Arial,sans-serif">Female adolescent deaths in the age group <b>10-19</b> from LRI numbered 36, 337 in 2015. The corresponding number for males 10-19 was 36,018, negligibly lower than that for females.</span><br></div><div><font color="#333333" face="Helvetica, Arial, sans-serif"><br></font></div><div><font color="#333333" face="Helvetica, Arial, sans-serif">To put the number in perspective, the main report's summary - </font><a href="http://apps.who.int/iris/bitstream/10665/255415/1/9789241512343-eng.pdf?ua=1" target="_blank">Global Accelerated Action for the Health of Adolescents (AA-HA!)Guidance to Support Country Implementation – Summary</a> - shows females age group 10-14 deaths due to LRI as <b>7.3 per 100,000</b> population, not surprising. Nowhere can I find the absolute number for females 10-14 deaths from LRIs, but it seems to be less than 15,000. <br><br>So the accurate statement could be "An estimated 15,000 girls aged 10 to 14 died of lower respiratory infections, including pneumonia, in 2015. Exposure to pollution from household cooking has been established as a risk factor for such illnesses. "<br><br>I have a problem even with this, because there is no factual basis for such assertions. Death data for youth in the developing world are just as poor as those for the elderly if not more so. (Varies by cause -- accidents and murders are one thing, suicides and LRI another.) </div><div><br></div><div><b>B. How are they dying? </b></div><div><font color="#333333" face="Helvetica, Arial, sans-serif"><br></font></div><div><font color="#333333" face="Helvetica, Arial, sans-serif">The main report - </font><a href="http://apps.who.int/iris/bitstream/10665/255415/5/9789241512343-annexes-eng.pdf?ua=1" target="_blank">Global Accelerated Action for the Health of Adolescents (AA-HA!)Guidance to Support Country Implementation Annexes 1–6 and Appendices I–IV</a> only says, "<span style="color:rgb(51,51,51);font-family:Helvetica,Arial,sans-serif">Risk factors associated with chronic respiratory diseases, including asthma include tobacco use, second-hand tobacco smoke; other indoor pollutants; outdoor air pollutants; allergens; and occupational agents."<br><br>This is standard IHME language and I have no objection to it. But note that "other indoor pollutants" and "outdoor air pollutants" are mentioned, without any specific reference to "dirty fuels". <br><br>Writers of WHO press releases just threw in gratuitous language to please UN Foundation (a major donor to WHO and contracted to run GACC). </span></div><div><font color="#333333" face="Helvetica, Arial, sans-serif"><br></font></div><div><font color="#333333" face="Helvetica, Arial, sans-serif">Horror, horror. The reality of science in Washington and Geneva. Money sitting in Seattle. </font></div><div><font color="#333333" face="Helvetica, Arial, sans-serif"><br></font></div><div><font color="#333333" face="Helvetica, Arial, sans-serif"><br></font></div><div><font color="#333333" face="Helvetica, Arial, sans-serif"><b>C. Why bother? <br><br><br></b></font><div><a href="http://www.who.int/life-course/partners/global-strategy/ewec-globalstrategyreport-200915.pdf?ua=1" target="_blank">THE GLOBALSTRATEGYFOR WOMEN’S,CHILDREN’S ANDADOLESCENTS’HEALTH(2016-203<wbr>0)</a><font color="#333333" face="Helvetica, Arial, sans-serif"><br></font></div><div><font color="#333333" face="Helvetica, Arial, sans-serif"><br></font></div><div><font color="#333333" face="Helvetica, Arial, sans-serif"><br></font></div><div><font color="#333333" face="Helvetica, Arial, sans-serif">Cites a 2006 WHO Report to claim, "</font>Globally, more than 3 billion people cook with wood, dung, coal and other solid fuels on open fires or traditional stoves. If 50 per cent of people who use solid fuels indoors <u>gained access to cleaner fuels, health-system cost savings would amount to US$165 million annually. Gains in health-related productivity would range from 17 to 62 per cent in urban areas and 6 to 15 per cent in rural areas.</u>"<br><br>That is something I can connect to, instead of aDALY blather. <br><br>But then I see meaningless platitudes in "Energy and Environment", something WHO should develop better skills in: <br><br></div><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px"><div>"• Reduce <u>household and ambient air pollution through the increased use of clean energy fuels and technologies in the home</u> (for cooking, heating, lighting)</div><div>• Take steps to <u>mitigate and adapt to climate changes that affect the health of women, children and adolescents</u></div><div>• Eliminate non-essential uses of lead (e.g. in paint) and mercury (e.g. in health care and artisanal mining) and ensure the safe recycling of lead- or mercury-containing waste</div><div>• <u>Reduce air pollution and climate emissions and improve green spaces by using lowemissions technology and renewable energy"</u></div><div><u><br></u></div></blockquote>Who appointed WHO as the world's central planner? <br><br>Or the world's mommy? </div><div><br></div><div><span style="color:rgb(51,51,51);font-family:Helvetica,Arial,sans-serif">Just recite "clean energy", "low emissions", "renewable", "mitigate and adapt to climate changes". Why bother thinking who is going to do this how? <br><br><b>D/. Where are adolescent dying of what? </b></span><br><br></div><div><font color="#333333" face="Helvetica, Arial, sans-serif">By far the largest burden of LRI is in Sub-Saharan Africa (p. 19), and slightly lower than what is euphemistically called "interpersonal violence" in the Americas. <br><br>Go figure. WHO is not going to utter a word about the high murder rate of American (north, central and south) youth, but has to put in its platitudes about "dirty fuels". Once hysteria sets in... <br><br>This is environmental imperialism plain and simple. WHO has been hijacked by ideologues of "clean fuels" in the name of preventable premature deaths. How ludicrous. They don't have a leg to stand on. <br></font></div><div><font color="#333333" face="Helvetica, Arial, sans-serif"><br></font></div>I think Dr Chan is leaving her successor a mind-boggling agenda creep. <br><br>What next - "clean cookstoves" to be added to the <a href="https://www.unfpa.org/sites/default/files/pub-pdf/Final%20UN%20Commission%20Report_14sept2012.pdf" target="_blank">LIFE-SAVING COMMODITIESFOR WOMEN AND CHILDREN</a> <div><br>Nikhil<br><blockquote style="margin:0px 0px 0px 40px;border:none;padding:0px"><div><u><br></u></div><div><br></div></blockquote></div><div class="gmail_extra"><br clear="all"><div><div class="gmail-m_515637010738153573gmail_signature"><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><font face="georgia, serif">------------------------------<wbr>------------------------------<wbr>------------<br>Nikhil Desai</font></div><div><font face="georgia, serif">(India <a href="tel:+91%2090999%2052080" value="+919099952080" target="_blank">+91) 909 995 2080</a><br><i>Skype: nikhildesai888</i><br></font><br></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div>
<br><div class="gmail_quote">On Thu, Jun 1, 2017 at 4:05 PM, Crispin Pemberton-Pigott <span dir="ltr"><<a href="mailto:crispinpigott@outlook.com" target="_blank">crispinpigott@outlook.com</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left:1px solid rgb(204,204,204);padding-left:1ex">
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Dear Philip</div>
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Is there any evidence for other fuels, and stoves of the base superior kind?</div>
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I fear that ethanol cooking is a similar risk because there are so many crummy ethanol combustors, particular ethanol gel stoves. <span style="font-size:initial;text-align:initial;line-height:initial">Nothing is 'automatically clean'. </span></div>
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<span style="font-size:initial;text-align:initial;line-height:initial">Chemical pneumonia from evaporated paraffin (stoves that overheat the fuel in the tank) is well known and if the current standard SANS1906 is adhered to, controllable. </span></div>
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<span style="font-size:initial;text-align:initial;line-height:initial">For those not familiar with the risk, poor combustion of paraffin can directly cause ill health but the greater risk is overheating the fuel and evaporating it directly into the room. </span></div>
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<span style="font-size:initial;text-align:initial;line-height:initial">Where people use a paraffin wick stove for space heating, the difference between a good and bad stove is very clear. A well designed stove emits very little other than CO2 and water vapour. </span></div>
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<span style="font-size:initial;text-align:initial;line-height:initial">Regards </span></div><span class="gmail-m_515637010738153573HOEnZb"><font color="#888888">
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<span style="font-size:initial;text-align:initial;line-height:initial">Crispin </span>
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<p class="MsoNormal"><span style="color:rgb(31,73,125)">“</span><span style="color:rgb(51,51,51)">the leading cause of death for younger adolescent girls aged 10–14 years is lower respiratory infections, such as pneumonia – often a result of household air pollution
<b>from cooking with solid fuels</b>.” [Emphasis added]</span></p>
<p class="MsoNormal"><span style="color:rgb(51,51,51)"> </span></p>
<p class="MsoNormal"><span style="color:rgb(51,51,51)">We have some fairly solid evidence that respiratory infections were endemic in households cooking and heating on kerosene-fuelled wick stoves; and of minimal similar health effects when clean stoves were fuelled
with solid fuel (wood). </span></p>
<p class="MsoNormal"><span style="color:rgb(51,51,51)"> </span></p>
<p class="MsoNormal"><span style="color:rgb(51,51,51)">I think it is time for the GACC to recognize that it is the fuel/stove combination that leads to indoor air pollution, not just the fuel.</span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125)"> </span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125)">Prof Philip Lloyd</span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125)">Energy Institute, CPUT</span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125)">SARETEC, Sachs Circle</span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125)">Bellville</span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125)">Tel 021 959 4323</span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125)">Cell 083 441 5247</span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125)">PA Nadia 021 959 4330</span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125)"> </span></p>
<p class="MsoNormal"><span style="color:rgb(31,73,125)"> </span></p></div></div></div></div></div></blockquote></div></div></div>