<html xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns:m="http://schemas.microsoft.com/office/2004/12/omml" xmlns="http://www.w3.org/TR/REC-html40">
<head>
<meta http-equiv=Content-Type content="text/html; charset=iso-8859-1">
<meta name=Generator content="Microsoft Word 12 (filtered medium)">
<style>
<!--
/* Font Definitions */
@font-face
{font-family:"Cambria Math";
panose-1:2 4 5 3 5 4 6 3 2 4;}
@font-face
{font-family:Cambria;
panose-1:2 4 5 3 5 4 6 3 2 4;}
@font-face
{font-family:Calibri;
panose-1:2 15 5 2 2 2 4 3 2 4;}
@font-face
{font-family:Tahoma;
panose-1:2 11 6 4 3 5 4 4 2 4;}
@font-face
{font-family:Consolas;
panose-1:2 11 6 9 2 2 4 3 2 4;}
@font-face
{font-family:"Calibri Light";
panose-1:2 15 3 2 2 2 4 3 2 4;}
@font-face
{font-family:"Segoe UI";
panose-1:2 11 5 2 4 2 4 2 2 3;}
/* Style Definitions */
p.MsoNormal, li.MsoNormal, div.MsoNormal
{margin:0cm;
margin-bottom:.0001pt;
font-size:12.0pt;
font-family:"Times New Roman","serif";}
h1
{mso-style-priority:9;
mso-style-link:"Titre 1 Car";
margin:0cm;
margin-bottom:.0001pt;
font-size:12.0pt;
font-family:"Times New Roman","serif";
font-weight:normal;}
h2
{mso-style-priority:9;
mso-style-link:"Titre 2 Car";
margin:0cm;
margin-bottom:.0001pt;
font-size:12.0pt;
font-family:"Times New Roman","serif";
font-weight:normal;}
a:link, span.MsoHyperlink
{mso-style-priority:99;
color:blue;
text-decoration:underline;}
a:visited, span.MsoHyperlinkFollowed
{mso-style-priority:99;
color:purple;
text-decoration:underline;}
pre
{mso-style-priority:99;
mso-style-link:"Préformaté HTML Car";
margin:0cm;
margin-bottom:.0001pt;
font-size:12.0pt;
font-family:"Times New Roman","serif";}
p.MsoAcetate, li.MsoAcetate, div.MsoAcetate
{mso-style-priority:99;
mso-style-link:"Texte de bulles Car";
margin:0cm;
margin-bottom:.0001pt;
font-size:12.0pt;
font-family:"Times New Roman","serif";}
p.MsoListParagraph, li.MsoListParagraph, div.MsoListParagraph
{mso-style-priority:34;
margin-top:0cm;
margin-right:0cm;
margin-bottom:0cm;
margin-left:36.0pt;
margin-bottom:.0001pt;
font-size:12.0pt;
font-family:"Times New Roman","serif";}
span.Titre1Car
{mso-style-name:"Titre 1 Car";
mso-style-priority:9;
mso-style-link:"Titre 1";
font-family:"Cambria","serif";
color:#365F91;
font-weight:bold;}
span.Titre2Car
{mso-style-name:"Titre 2 Car";
mso-style-priority:9;
mso-style-link:"Titre 2";
font-family:"Cambria","serif";
color:#4F81BD;
font-weight:bold;}
span.PrformatHTMLCar
{mso-style-name:"Préformaté HTML Car";
mso-style-priority:99;
mso-style-link:"Préformaté HTML";
font-family:Consolas;}
span.TextedebullesCar
{mso-style-name:"Texte de bulles Car";
mso-style-priority:99;
mso-style-link:"Texte de bulles";
font-family:"Tahoma","sans-serif";}
p.msonormal0, li.msonormal0, div.msonormal0
{mso-style-name:msonormal;
mso-style-priority:99;
mso-margin-top-alt:auto;
margin-right:0cm;
mso-margin-bottom-alt:auto;
margin-left:0cm;
font-size:12.0pt;
font-family:"Times New Roman","serif";}
p.m1427370255489925728m-6954213936357860605m-3450496578589204744intro-text-p, li.m1427370255489925728m-6954213936357860605m-3450496578589204744intro-text-p, div.m1427370255489925728m-6954213936357860605m-3450496578589204744intro-text-p
{mso-style-name:m_1427370255489925728m_-6954213936357860605m_-3450496578589204744intro-text-p;
mso-style-priority:99;
mso-margin-top-alt:auto;
margin-right:0cm;
mso-margin-bottom-alt:auto;
margin-left:0cm;
font-size:12.0pt;
font-family:"Times New Roman","serif";}
p.Heading1, li.Heading1, div.Heading1
{mso-style-name:"Heading 1";
mso-style-link:"Heading 1 Char";
margin:0cm;
margin-bottom:.0001pt;
font-size:12.0pt;
font-family:"Times New Roman","serif";}
span.Heading1Char
{mso-style-name:"Heading 1 Char";
mso-style-priority:9;
mso-style-link:"Heading 1";
font-family:"Calibri Light","sans-serif";
color:#2F5496;}
p.Heading2, li.Heading2, div.Heading2
{mso-style-name:"Heading 2";
mso-style-link:"Heading 2 Char";
margin:0cm;
margin-bottom:.0001pt;
font-size:12.0pt;
font-family:"Times New Roman","serif";}
span.Heading2Char
{mso-style-name:"Heading 2 Char";
mso-style-priority:9;
mso-style-link:"Heading 2";
font-family:"Calibri Light","sans-serif";
color:#2F5496;}
p.HTMLPreformatted, li.HTMLPreformatted, div.HTMLPreformatted
{mso-style-name:"HTML Preformatted";
mso-style-link:"HTML Preformatted Char";
margin:0cm;
margin-bottom:.0001pt;
font-size:12.0pt;
font-family:"Times New Roman","serif";}
span.HTMLPreformattedChar
{mso-style-name:"HTML Preformatted Char";
mso-style-priority:99;
mso-style-link:"HTML Preformatted";
font-family:Consolas;}
p.BalloonText, li.BalloonText, div.BalloonText
{mso-style-name:"Balloon Text";
mso-style-link:"Balloon Text Char";
margin:0cm;
margin-bottom:.0001pt;
font-size:12.0pt;
font-family:"Times New Roman","serif";}
span.BalloonTextChar
{mso-style-name:"Balloon Text Char";
mso-style-priority:99;
mso-style-link:"Balloon Text";
font-family:"Segoe UI","sans-serif";}
span.m1427370255489925728m-6954213936357860605m-3450496578589204744header-text
{mso-style-name:m_1427370255489925728m_-6954213936357860605m_-3450496578589204744header-text;}
span.m1427370255489925728m-6954213936357860605m-3450496578589204744content-reference
{mso-style-name:m_1427370255489925728m_-6954213936357860605m_-3450496578589204744content-reference;}
span.m1427370255489925728m-6954213936357860605hoenzb
{mso-style-name:m_1427370255489925728m_-6954213936357860605hoenzb;}
span.EmailStyle37
{mso-style-type:personal;
font-family:"Calibri","sans-serif";
color:#1F497D;}
span.EmailStyle38
{mso-style-type:personal;
font-family:"Calibri","sans-serif";
color:windowtext;}
span.EmailStyle39
{mso-style-type:personal;
font-family:"Calibri","sans-serif";
color:#1F497D;}
span.EmailStyle40
{mso-style-type:personal;
font-family:"Calibri","sans-serif";
color:windowtext;}
span.EmailStyle41
{mso-style-type:personal;
font-family:"Calibri","sans-serif";
color:#1F497D;}
span.EmailStyle42
{mso-style-type:personal;
font-family:"Calibri","sans-serif";
color:windowtext;}
span.EmailStyle43
{mso-style-type:personal-reply;
font-family:"Calibri","sans-serif";
color:#1F497D;}
.MsoChpDefault
{mso-style-type:export-only;
font-size:10.0pt;}
@page Section1
{size:612.0pt 792.0pt;
margin:70.85pt 70.85pt 70.85pt 70.85pt;}
div.Section1
{page:Section1;}
/* List Definitions */
@list l0
{mso-list-id:48191344;
mso-list-template-ids:1778919814;}
@list l0:level1
{mso-level-number-format:bullet;
mso-level-text:\F0B7;
mso-level-tab-stop:36.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;
mso-ansi-font-size:10.0pt;
font-family:Symbol;}
@list l1
{mso-list-id:691078671;
mso-list-type:hybrid;
mso-list-template-ids:625759768 67895297 67895299 67895301 67895297 67895299 67895301 67895297 67895299 67895301;}
@list l1:level1
{mso-level-number-format:bullet;
mso-level-text:\F0B7;
mso-level-tab-stop:none;
mso-level-number-position:left;
text-indent:-18.0pt;
font-family:Symbol;}
@list l1:level2
{mso-level-tab-stop:72.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l1:level3
{mso-level-tab-stop:108.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l1:level4
{mso-level-tab-stop:144.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l1:level5
{mso-level-tab-stop:180.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l1:level6
{mso-level-tab-stop:216.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l1:level7
{mso-level-tab-stop:252.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l1:level8
{mso-level-tab-stop:288.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l1:level9
{mso-level-tab-stop:324.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l2
{mso-list-id:814569001;
mso-list-type:hybrid;
mso-list-template-ids:1903335142 67895297 269025295 67895301 67895297 67895299 67895301 67895297 67895299 67895301;}
@list l2:level1
{mso-level-number-format:bullet;
mso-level-text:\F0B7;
mso-level-tab-stop:none;
mso-level-number-position:left;
text-indent:-18.0pt;
font-family:Symbol;}
@list l2:level2
{mso-level-tab-stop:72.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l2:level3
{mso-level-tab-stop:108.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l2:level4
{mso-level-tab-stop:144.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l2:level5
{mso-level-tab-stop:180.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l2:level6
{mso-level-tab-stop:216.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l2:level7
{mso-level-tab-stop:252.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l2:level8
{mso-level-tab-stop:288.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l2:level9
{mso-level-tab-stop:324.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l3
{mso-list-id:1748728856;
mso-list-template-ids:-277025550;}
@list l3:level1
{mso-level-number-format:bullet;
mso-level-text:\F0B7;
mso-level-tab-stop:36.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;
mso-ansi-font-size:10.0pt;
font-family:Symbol;}
@list l3:level2
{mso-level-tab-stop:72.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;}
@list l4
{mso-list-id:1970091193;
mso-list-template-ids:-946674264;}
@list l4:level1
{mso-level-number-format:bullet;
mso-level-text:\F0B7;
mso-level-tab-stop:36.0pt;
mso-level-number-position:left;
text-indent:-18.0pt;
mso-ansi-font-size:10.0pt;
font-family:Symbol;}
ol
{margin-bottom:0cm;}
ul
{margin-bottom:0cm;}
-->
</style>
<!--[if gte mso 9]><xml>
<o:shapedefaults v:ext="edit" spidmax="1026" />
</xml><![endif]--><!--[if gte mso 9]><xml>
<o:shapelayout v:ext="edit">
<o:idmap v:ext="edit" data="1" />
</o:shapelayout></xml><![endif]-->
</head>
<body lang=FR link=blue vlink=purple>
<div class=Section1>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Dear Crispin,<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>OK, but maybe not all studies are like the Korean one.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Then, for Ulan-Bator, for Mongolia, and as well for the world,
there is a need of a serious meta-analysis, which also reviews and criticizes
the methodology of the epidemiological studies on air pollution.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Then only, we might have a better view on the current landscape
of research, of the state-of-the-art on air pollution and health.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>« </span><span lang=EN-US style='font-size:11.0pt;
font-family:"Calibri","sans-serif"'>There is correlation between OAP and IAP
and infections, but they are associations, not causal relationships.”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Sure, I understand the difference. But from what I understand
there are fields of research where this is the best you can get. That doesn’t
mean it doesn’t have grounds.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>I wouldn’t throw epidemiology with the bath water. It
seems to me that it is epidemiology which found the link between smoking and
lung cancer:<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><a
href="https://www.theguardian.com/society/2005/apr/24/smoking.medicineandhealth">https://www.theguardian.com/society/2005/apr/24/smoking.medicineandhealth</a>
<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>“The
claim that 4.3m people ‘die from air pollution’ per annum is
clearly false”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Indeed, but they might say instead: “Based on our data and
statistics and methodology, we have attributed the death of around 4.3 million
people to air pollution. It might be less, or more. We might be wrong, but this
is the best we have, sorry. The fact is that we highly suspect air pollution to
be dangerous for human health, so beware.”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>That would be more correct. Would that change the outcome, which
is to take public policy measures to try to mitigate air pollution?<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>« </span><span lang=EN-US style='font-size:11.0pt;
font-family:"Calibri","sans-serif"'>Who simple is this statement? Did anyone
measure IAP in the rural areas where they burn dung for heating and cooking?
Many people in the rural areas are reasonably well fed and clothed. A lot of
people in Ulaanbaatar were driven there by absolute poverty and live in
desperate conditions, some depending on coal vouchers to obtain fuel. How did
the temperature of the home affect the incidence, and what is the socioeconomic
conditions of the families with high occurrence? Are there bronchitis epidemics
in town that do not occur in rural areas because the possibility of
transmission is so much lower? Yes the OAP is much lower in rural areas, but is
their exposure to smoke, for example, lower or higher?”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Sure, it raises a lot of questions. But let’s say we
believe the data the doctors have. I’d say this is a fact:<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>”Children in Ulaanbaatar, are taken bronchitis in 1.4-2.7
times and bronchitis asthma in 5.5-7.9 times more than children who are living
in rural areas”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Mentioning this “less air pollution.” is already
attributing a cause. <o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>“Prof
Lodoysamba confirmed the ‘colder’ hypothesis this winter using a
pretty sophisticated monitoring station at his home in Nalaikh with
thermometers at different heights above the ground.”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Maybe the cold is responsible of the bronchitis in Nalaikh, but
not in Ulan Bator. Maybe the cold is responsible everywhere and that is not
well measured or known.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Then, that “colder hypothesis” would infirm what was
found in this study, that air pollution from stoves was the main cause. Prof.
Lodoysamba was one of the co-writers of this study:<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><a
href="http://www.urbanemissions.info/wp-content/uploads/docs/2013-09-AQAH-Ulaanbaatar-PM-Pollution.pdf">http://www.urbanemissions.info/wp-content/uploads/docs/2013-09-AQAH-Ulaanbaatar-PM-Pollution.pdf</a>
<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>“</span><span
lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>Attributing
something as a cause does not mean that removing the attributed cause avoids
the problem. Suppose the attribution was in error by 80%?”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Sure, it could well be that: “oh, every household has an
electric stove now, but still the number of bronchitis cases are high.”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Science is never definitive, always evolving.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif"'> <span
lang=EN-CA><o:p></o:p></span></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>“Regarding
proximity to highways: who lives next to noisy and polluted highways in
California: the well fed and exercised with good medical treatment? Or poor
people with poor health coverage, bad diets and no access to recreational
facilities? Correlation is not causation. “<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>We’d need to look at the study methodology to know if they
took this factor into account. Maybe they did. Maybe they compared poor people
next to highways, to poor people remote from highways.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>“There
must be children for whom it is the worst environmental risk, and others for
whom it is now.”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Sure, but if there are 10 000 children in the first group
and 2000 in the second group, then air pollution is the biggest environmental
risk for children in UB.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>“The
major impediment to achieving this is the parade of baseless claims that coal
cannot be burned cleanly”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Sure, if coal stoves can burn cleanly like or almost like
electric stoves, that’s fine by me.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>“That
is unbelievable. The “main source”? The cause? That is a clear
claim that second hand smoke causes bronchitis.”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Well, cause, by association. Actually, it doesn’t necessarily
makes a hierarchy between causes, it also says: “Second, other potential
risk factors of LRTI-related hospital admissions might have been overlooked in
our investigation, such as the type of fuel used in household stoves,
nutrition, antenatal cigarette smoke exposure, and nursery attendance, where
children might contract an infection from others.Therefore, caution should be
taken in interpreting these study findings.“<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>”Think
about that. The record low for Ulaanbaatar is -54 C (2002). The annual average
is -2C. Is it possible that people earning $2500 per year live in a chronically
underheated home? Ya think??”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>If millions of dollars should go to preventing under-heating
rather than clean stoves, then that is worth a medical study, to attribute
deaths to cold. If there is no such study, it is understandable public deciders
well, decide, to focus on air pollution.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>It seems to me that the good news is that solving the issue of
cold in homes and IAP go hand-in-hand.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>”Some
say 45% depending on where you measure it. It was improved <i>uuugely</i>. Yet
people popped up to say nothing was achieved by the programme. Short memories.”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>For sure, celebrating successes and giving credit where credit is
due is really important. Otherwise we tend to think we live in a bleak world
where nothing happens.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>”I
am sure asthma attacks decreased because air pollution aggravates asthma. I do
not have stats, however. It just seems likely.”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>It seems to me also. And until you have a cohort of doctors,
statisticians, scientists to make more studies with a large number of
variables, and check, this is the best a public decider can get.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>”Now
we need to address the low pressure boilers which are more and more common and
burn 4 times as much fuel as the ger stoves, at least. They were not included
in the ger stove programme. We are working on the at the moment.”<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>That seems exciting! Good luck with that.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><br>
Best,<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><br>
Xavier<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<div>
<div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0cm 0cm 0cm'>
<p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>De :</span></b><span
style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> Stoves
[mailto:stoves-bounces@lists.bioenergylists.org] <b>De la part de</b> Crispin
Pemberton-Pigott<br>
<b>Envoyé :</b> mercredi 9 mai 2018 00:20<br>
<b>À :</b> Discussion of biomass cooking stoves<br>
<b>Objet :</b> Re: [Stoves] Air pollution kills<o:p></o:p></span></p>
</div>
</div>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>Dear
Xavier<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>Thank
you for being skeptical. Science works on challenges, <i>nullis in verba</i>.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>On
the IAP matter in UB, there are generalisations one can make and specific
circumstances worth noting. There is a study of the effect on indoor air
pollution from the improved stoves (Korean study, available in English). The
concluded that the improved stoves which reduce PM2.5 output by 90-98% <i>increased
</i>indoor air pollution, which was so unbelievable that I bothered to
investigate the study quite carefully.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>What
I found was that they did indeed measure an increase, on average, in IAP but:
the difference was well inside their margin of error (a small fraction of the
variations measured, rendering the conclusion meaningless. Further, on
those days when they were measuring, the ambient (outdoor) air pollution
closely matched the claimed indoor air quality, save that in every case the IAP
was lower than the OAP. In short, all the Koreans measured was the effect
on IAP from outside air.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>The
worst aspect of the paper was that they claimed a statistically significant
difference: the new stoves provided worse IAP than the old stoves – which
the numbers did not support at all. There <i>was</i> a difference in the
averages, and the new stove measurements were higher, but the difference was a
small fraction of the Sigma 1 of their numbers, which is to say, the difference
was <i>not</i> statistically significant. <o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>Decent
chimney stoves with a correctly fitted chimney have very little effect on IAP.
We have ample recent evidence of this in Kyrgyzstan if there was any doubt.
Improper operation can lead to fugitive emissions from the stove – for
example leaving the ash drawer open a bit ‘to give more power’
breaks the draft from the chimney and the top surfaces can leak smoke into the
room as they are no longer under negative pressure.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>There
is correlation between OAP and IAP and infections, but they are associations,
not causal relationships. We can ask Nikhil about which words to use exactly.
The claim that 4.3m people ‘die from air pollution’ per annum is
clearly false and a misrepresentation of the published evidence used to support
the claims that air pollution shortens lives – by attribution (not
medical evidence).<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>« Children
in Ulaanbaatar, are taken bronchitis in 1.4-2.7 times and bronchitis asthma in
5.5-7.9 times more than children who are living in rural areas of less air
pollution. » says Social Health institute. </span><span lang=EN-US
style='font-family:"Calibri","sans-serif"'><a
href="http://www.unoosa.org/documents/pdf/psa/activities/2006/graz/presentations/0102.pdf">http://www.unoosa.org/documents/pdf/psa/activities/2006/graz/presentations/0102.pdf</a></span><span
lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'> p 12.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>Who
simple is this statement? Did anyone measure IAP in the rural areas where they
burn dung for heating and cooking? Many people in the rural areas are
reasonably well fed and clothed. A lot of people in Ulaanbaatar were driven
there by absolute poverty and live in desperate conditions, some depending on
coal vouchers to obtain fuel. How did the temperature of the home affect the
incidence, and what is the socioeconomic conditions of the families with high
occurrence? Are there bronchitis epidemics in town that do not occur in rural
areas because the possibility of transmission is so much lower? Yes the OAP is
much lower in rural areas, but is their exposure to smoke, for example, lower
or higher?<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal style='margin-top:12.0pt'><span lang=EN-US style='font-size:
11.0pt;font-family:"Calibri","sans-serif"'>When the Kyrgyz villagers were
keeping their homes free of IAP (with chimneys and non-leaking stoves) <i>and 5
degrees warmer</i> the incidence of bronchitis dropped to zero (51 homes,
2016-17 season). I interviewed parents in February in the Naryn region and they
all said before they got the new stove the children were “sick all
winter” before and “much sicker than this winter” and so on.
Chronic cold spreads disease among children. Bronchitis is a bacterial
infection. PM2.5 is sterilized. So you are looking for pre-dispositions caused
by PM2.5, not ‘causes’. <o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>It
is dusty pretty much everywhere. The city is definitely smokier, and it can be
quite bad if the wind drops, because below -30 the city is colder than the
mountains around, or communities at higher elevation such as nearby Nalaikh
where the coal comes from. Prof Lodoysamba confirmed the
‘colder’ hypothesis this winter using a pretty sophisticated
monitoring station at his home in Nalaikh with thermometers at different
heights above the ground. The city, below -30, is colder, smokier, has a poorer
diet and more fugitive dust than rural areas. But a traditional stove burning
dung can be pretty smoky, and we have zero measurement of IAP in rural homes.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>«So we concluded that the level of urban air pollution in the
capital city is clearly having an adverse impact on the pulmonary health of
urban Mongolian children.»</span><span lang=EN-US style='font-size:11.0pt;
font-family:"Calibri","sans-serif"'><o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>They
can conclude that but that is no proof. That is an association. It is why
Nikhil keeps pointing out that you cannot make claims for causes and avoidances
without knowing a heck of a lot about the sub-population you are examining.
Attributing something as a cause does not mean that removing the
attributed cause avoids the problem. Suppose the attribution was in error by
80%?<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>Regarding
proximity to highways: who lives next to noisy and polluted highways in
California: the well fed and exercised with good medical treatment? Or poor
people with poor health coverage, bad diets and no access to recreational
facilities? Correlation is not causation. <o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>“</span><span
style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>UNICEF
says: « Outdoor air pollution is the most significant environmental risk
faced by children in Ulaanbaatar.</span><span lang=EN-CA style='font-size:11.0pt;
font-family:"Calibri","sans-serif"'>”</span><span style='font-size:11.0pt;
font-family:"Calibri","sans-serif";color:#1F497D'><o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>Hmm…
Is alcohol an environmental risk? What about smoking? The air pollution
is awful on some days, and visible, and variable from place to place. There must
be children for whom it is the worst environmental risk, and others for whom it
is now. The point is that we can remove virtually all of it with improved
combustion of the very same fuels they now use. The major impediment to
achieving this is the parade of baseless claims that coal cannot be burned
cleanly, and therefore they must ban it – the only fuel available at a
price they can afford. The sheer stupidity of blaming the fuel for the
performance of the stove cannot have a greater effect on the people. Those
advocates of fuel bans based on the misbelief that the fuel is the problem, are
partnering with the advocates of ‘alternatives’ costing multiple
times as much and which provide no additional benefit save in some cases,
convenience. Free electricity is lovely – if the nation can afford it. No
nation I know of can, so how can Mongolia? Other countries are now
depending on the great progress made in coal stove designs from Mongolia. How
is it possible that the Mongolians are deprived of the benefits of this work?
Advocates, that’s how. Advocators of heat pumps, subsidised electricity,
dimethyl ether, natural gas, LPG, wood pellets, processed coal – every
and anything that costs a lot, but not ultra-clean-burning coal stoves
developed right up the road <i>in a university-owned, government-supported
stove development centre</i>!<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>“</span><span
style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>For
bronchitis, this study points to indoor smoking from parents as the main source
of children’s bronchitis cases:</span><span lang=EN-CA style='font-size:
11.0pt;font-family:"Calibri","sans-serif"'>”</span><span
style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>That
is unbelievable. The “main source”? The cause? That is a clear
claim that second hand smoke causes bronchitis.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>“</span><span
style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>I
didn’t see anywhere that respiratory diseases were due to the cold in
Mongolia.</span><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>”</span><span
style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>Think
about that. The record low for Ulaanbaatar is -54 C (2002). The annual average
is -2C. Is it possible that people earning $2500 per year live in a chronically
underheated home? Ya think??<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>« With 50 % of the ambient PM pollution (and more in the
winter months) originating from household stoves for cooking and heating, this
sector tops the list of the most opportunistic of the interventions for better
air quality. »<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>That
is 2013. Times have changed. The stove programme was in full swing in 2013. The
% dropped from 88% (2010) in one district to an average of 45% in 2015 (in
winter). In summer the air is very clean (12 µg/m<sup>3</sup>, for
example).<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>So, if « 7 million deaths » from WHO may be far
fetched, it seems reasonable to me to call for cleaner stoves.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>And, in the case of Ulan Bator, to sensitize people against
indoor smoking: is it actually being done?<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>Preaching
against smoking is everywhere. The number f people smoking in developing
countries is increasing rapidly because they are targeted by vendors. The
advertising has been driven out of developed country media. It is <i>very</i>
reasonable to call for clean stoves. Very clean. Why not? The benefits are
huge, but it is not the entire problem. Without doubt the strangest country I
have worked in is Mongolia because the clean burning solutions were developed
there, tested there, supported financially yet are maligned for political
purposes. Everyone wants to blame others for “not solving the air
pollution problem”. After the stove replacement programme stopped at the
end of 2015, air pollution was down 65%. Some say 45% depending on where you
measure it. It was improved <i>uuugely</i>. Yet people popped up to say nothing
was achieved by the programme. Short memories. <o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>I
am sure asthma attacks decreased because air pollution aggravates asthma. I do
not have stats, however. It just seems likely. Now we need to address the low
pressure boilers which are more and more common and burn 4 times as much fuel
as the ger stoves, at least. They were not included in the ger stove programme.
We are working on the at the moment. Products were tested last week
– efficiency was too high. I will reduce it.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>In
the meantime, Kyrgyzstan starts rolling out improved stoves (locally made) to
14,000 homes, slowly at first. The coal combustors are all based on the
Mongolian developments. South Africa localised the design and we have a model
ready for testing since last Monday. It is a beauty, and will incorporate
lessons learned from the use of the plastic refractory materials in Ulaanbaatar
last year. It is a game-changer.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>Keep
pushing! Rocks don’t move by themselves.<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'>Crispin<o:p></o:p></span></p>
<p class=MsoNormal><span lang=EN-CA style='font-size:11.0pt;font-family:"Calibri","sans-serif"'><o:p> </o:p></span></p>
</div>
<div id="DAB4FAD8-2DD7-40BB-A1B8-4E2AA1F9FDF2"><br /> <table style="border-top: 1px solid #D3D4DE;">
<tr>
<td style="width: 55px; padding-top: 18px;"><a href="https://www.avast.com/sig-email?utm_medium=email&utm_source=link&utm_campaign=sig-email&utm_content=emailclient" target="_blank"><img src="https://ipmcdn.avast.com/images/icons/icon-envelope-tick-round-orange-animated-no-repeat-v1.gif" alt="" width="46" height="29" style="width: 46px; height: 29px;" /></a></td>
<td style="width: 470px; padding-top: 17px; color: #41424e; font-size: 13px; font-family: Arial, Helvetica, sans-serif; line-height: 18px;">Garanti sans virus. <a href="https://www.avast.com/sig-email?utm_medium=email&utm_source=link&utm_campaign=sig-email&utm_content=emailclient" target="_blank" style="color: #4453ea;">www.avast.com</a> </td>
</tr>
</table>
<a href="#DAB4FAD8-2DD7-40BB-A1B8-4E2AA1F9FDF2" width="1" height="1"> </a></div></body>
</html>