<div dir="ltr">Xavier: <br><br>I see my name was mentioned. <br><br>I will try to make the briefest possible responses to your questions. I might comment in greater detail to Crispin's posts; he causes me heartburns sometimes. <br><br>"<span style="color:rgb(31,73,125);font-family:Calibri,sans-serif;font-size:11pt">So you say IAP wouldn’t change much if stoves were electrical.</span><p class="MsoNormal" style="margin:0px;color:rgb(34,34,34);font-family:arial,sans-serif;font-size:small;font-style:normal;font-variant-ligatures:normal;font-variant-caps:normal;font-weight:400;letter-spacing:normal;text-align:start;text-indent:0px;text-transform:none;white-space:normal;word-spacing:0px;background-color:rgb(255,255,255);text-decoration-style:initial;text-decoration-color:initial"><span style="font-size:11pt;font-family:Calibri,sans-serif;color:rgb(31,73,125)">What about Outdoor Air Pollution (OAP)? Isn’t most of it in Ulan Bator from stoves and cars?"</span></p>
<br>1. I don't think Crispin has any basis to claim IAP wouldn't change much if stoves were electrical. Perhaps with the lowest-emission coal stoves, but not compared to traditional stoves, fuels, operating practices, and ger design (or for HOBs in UB and Aimac centers). <br><br>2. It is meaningless to distinguish OAP and IAP. What matters is exposures, according to age/sex/medical condition/duration according to concentration and composition. I hold that the PM2.5 concentration is a weak proxy for exposures, and the assumptions of equitoxicity, no threshold are simply untenable. Then you add the rigmarole of Integrated Exposure Response to compute Relative Risk, using data for one type of PM2.5 for one type of cohort and then apply it to anybody everywhere. This is not just nonsense, it is becoming an intellectual nuisance. <br><br>3. Using chimneys, or burning coal in a central power plant equipped with PM and SO2 controls to deliver electricity to home use, changes the composition and location, residence times of pollutants. "Outdoors" - which is a contextual term - some pollutants react in presence of sunlight to produce a different composition of pollutants. One may do source apportionment studies of varying quality, assumptions, and data sources. For UB, the contribution of stoves, cars, power plants, industry, building boilers, dust storms, etc. would vary by time of day and season. <br><br>A lot of public health dogma rides on faith. But we need dogma to focus people's attention. <br><br>If God gives us dogma, the Devil is in the details. <br><br>You imagine "<span style="color:rgb(31,73,125);font-family:Calibri,sans-serif;font-size:14.6667px;font-style:normal;font-variant-ligatures:normal;font-variant-caps:normal;font-weight:400;letter-spacing:normal;text-align:start;text-indent:0px;text-transform:none;white-space:normal;word-spacing:0px;background-color:rgb(255,255,255);text-decoration-style:initial;text-decoration-color:initial;float:none;display:inline">solutions are relatively straight-forward". </span>Not so. Localized air-quality management plans take an enormous amount of systematic work. Changing or banning fuels or devices - or for that matter, people (what would it take to dislocate all the poor and throw them miles away?) - is an easy answer for people who don't bother with economics, politics, totality of population health over long periods. <br><br>Nikhil<br><div class="gmail_extra"><br clear="all"><div><div class="gmail_signature" data-smartmail="gmail_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><div dir="ltr"><div><font face="georgia, serif">------------------------------------------------------------------------<br>Nikhil Desai</font></div><div><span style="font-family:georgia,serif;font-size:small">(US +1) 202 568 5831</span><font face="georgia, serif"><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></div></div>
<br><div class="gmail_quote">On Tue, May 8, 2018 at 3:37 PM, Xavier Brandao <span dir="ltr"><<a href="mailto:xvr.brandao@gmail.com" target="_blank">xvr.brandao@gmail.com</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
<div lang="FR" link="blue" vlink="purple">
<div class="m_-7717877233457146506Section1">
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Hello Crispin,<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">So you say IAP wouldn’t change much if stoves were electrical.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">What about Outdoor Air Pollution (OAP)? Isn’t most of it
in Ulan Bator from stoves and cars?<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">I googled about the issue. I have to admit I was skeptical at
first about the absence of farm animals being correlated to the frequency of
asthma cases, or the importance of smoking indoor.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">But actually, I couldn’t find a lot of studies pointing
very clearly at the relationship between OAP and respiratory infections.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Well, you probably know all the studies about Mongolia already.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></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 of less air pollution. » says Social Health institute.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="http://www.unoosa.org/documents/pdf/psa/activities/2006/graz/presentations/01-02.pdf" target="_blank">http://www.unoosa.org/<wbr>documents/pdf/psa/activities/<wbr>2006/graz/presentations/01-02.<wbr>pdf</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">p 12.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">So, is it because of the OAP of the city, or the fact they live
in the city and far from farm animals, and so built weaker immune systems? Or
because of the cold (colder in Ulan Bator ?!), or dust (dustier ?).<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Litterature seemed indeed to point that children build asthma defenses
when they live close to farm animals (in rural regions). While when living in
cities, there are more admissions in hospitals due to asthma.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://www.ncbi.nlm.nih.gov/pubmed/17298344" target="_blank">https://www.ncbi.nlm.nih.gov/<wbr>pubmed/17298344</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">This one attributes a bit quickly:<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">« Importantly the lung function of the children on the
steppe was significantly better than those living in Ulaanbaatar. 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. »<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4043223/" target="_blank">https://www.ncbi.nlm.nih.gov/<wbr>pmc/articles/PMC4043223/</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">It also says:<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">« Similar patterns of adverse health risk such as asthma,
obesity and autism in proximity to freeways and major roads have previously
been well documented by us and our colleagues in Los Angeles, CA. »<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">The study seems to show that depending on the world region,
different factors are involved in allergies:<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://pdfs.semanticscholar.org/7dca/35da8463d9c600f3651e1bb77ab3af259fc7.pdf" target="_blank">https://pdfs.semanticscholar.<wbr>org/7dca/<wbr>35da8463d9c600f3651e1bb77ab3af<wbr>259fc7.pdf</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><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:<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4835771/" target="_blank">https://www.ncbi.nlm.nih.gov/<wbr>pmc/articles/PMC4835771/</a>
-> but it is in a rural area. It doesn’t explain why there are more
cases in Ulan Bator. Seems unlikely that people smoke more in urban areas?<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">It does not exclude the influence of IAP from stoves, and refers
to a study saying that stoves contributes a lot to IAP.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">This one, in Ulan Bator, points to both indoor smoking and air
pollution:<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://www.sciencedirect.com/science/article/pii/S1323893015001586" target="_blank">https://www.sciencedirect.com/<wbr>science/article/pii/<wbr>S1323893015001586</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">This one puts again indoor parental smoking and IAP from stoves
as probable causes, and maybe outdoor air pollution: <u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://journals.lww.com/epidem/fulltext/2011/01001/Indoor_Air_Pollution_in_Different_Mongolian.96.aspx" target="_blank">https://journals.lww.com/<wbr>epidem/fulltext/2011/01001/<wbr>Indoor_Air_Pollution_in_<wbr>Different_Mongolian.96.aspx</a><u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><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. »<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://www.unicef.org/mongolia/Mongolia_air_pollution_crisis_ENG.pdf" target="_blank">https://www.unicef.org/<wbr>mongolia/Mongolia_air_<wbr>pollution_crisis_ENG.pdf</a><u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">There seem to be a long list of medical studies (page 86) saying
that air pollution has an effect on children’s health, and even that OAP
does:<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://www.unicef.org/publications/files/UNICEF_Clear_the_Air_for_Children_30_Oct_2016.pdf" target="_blank">https://www.unicef.org/<wbr>publications/files/UNICEF_<wbr>Clear_the_Air_for_Children_30_<wbr>Oct_2016.pdf</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">There are studies correlating OAP and respiratory diseases in
other parts of the world:<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://www.ncbi.nlm.nih.gov/pubmed/22871325" target="_blank">https://www.ncbi.nlm.nih.gov/<wbr>pubmed/22871325</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://www.jacionline.org/article/S0091-6749(17)32516-2/fulltext" target="_blank">https://www.jacionline.org/<wbr>article/S0091-6749(17)32516-2/<wbr>fulltext</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><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.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Regarding dust: there are more diseases in Ulan Bator than in
rural areas, yet the latter are more dusty (are they?). And Ulan Bator is far
from the Gobi desert, correct?<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://www.ncbi.nlm.nih.gov/pubmed/21488467" target="_blank">https://www.ncbi.nlm.nih.gov/<wbr>pubmed/21488467</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">This study looks at all the sources of air pollution, among
which dust and ash ponds. It still concludes:<u></u><u></u></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. »<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="http://www.urbanemissions.info/wp-content/uploads/docs/2013-09-AQAH-Ulaanbaatar-PM-Pollution.pdf" target="_blank">http://www.urbanemissions.<wbr>info/wp-content/uploads/docs/<wbr>2013-09-AQAH-Ulaanbaatar-PM-<wbr>Pollution.pdf</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">You’re quoted a bit below Crispin BTW.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Are there meta-analysis of medical studies on the correlation
between OAP and respiratory diseases? It seems to me we don’t know for
sure to what extent each factor contributes to diseases and mortality. But we
have good hints that the main factors may be:<u></u><u></u></span></p>
<p class="m_-7717877233457146506MsoListParagraph"><u></u><span style="font-size:11.0pt;font-family:Symbol;color:#1f497d"><span>·<span style="font:7.0pt "Times New Roman"">
</span></span></span><u></u><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">OAP and IAP from stoves<u></u><u></u></span></p>
<p class="m_-7717877233457146506MsoListParagraph"><u></u><span style="font-size:11.0pt;font-family:Symbol;color:#1f497d"><span>·<span style="font:7.0pt "Times New Roman"">
</span></span></span><u></u><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">indoor smoking<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">To me there seems to be only a handful of factors. That means
that solutions are relatively straight-forward.<u></u><u></u></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.<u></u><u></u></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?<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">News are always alarmist. We see « 7 million deaths because
of air pollution!!! » because we work in stoves, but in the news, there
are also:<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">« 6 million deaths because of smoking!!! »<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://www.popsci.com/smoking-is-still-bad-for-you" target="_blank">https://www.popsci.com/<wbr>smoking-is-still-bad-for-you</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">« Poor diet is a factor in one in five
deaths !!! »<u></u><u></u></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/2017/sep/14/poor-diet-is-a-factor-in-one-in-five-deaths-global-disease-study-reveals" target="_blank">https://www.theguardian.com/<wbr>society/2017/sep/14/poor-diet-<wbr>is-a-factor-in-one-in-five-<wbr>deaths-global-disease-study-<wbr>reveals</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">That’s true, news tend to make us think that the main
cause of mortality in Mongolia is air pollution. But if we go through a few
articles, we see they actaully also talk about other causes:<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://www.mcc.gov/our-impact/story/story-preventing-mongolias-leading-killers" target="_blank">https://www.mcc.gov/our-<wbr>impact/story/story-preventing-<wbr>mongolias-leading-killers</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://www.theguardian.com/global-development/2017/nov/07/mongolia-liver-cancer-crisis-no-other-country-has-a-problem-like-this" target="_blank">https://www.theguardian.com/<wbr>global-development/2017/nov/<wbr>07/mongolia-liver-cancer-<wbr>crisis-no-other-country-has-a-<wbr>problem-like-this</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="https://www.theguardian.com/world/2013/oct/20/ulan-bator-killer-winter-stoves" target="_blank">https://www.theguardian.com/<wbr>world/2013/oct/20/ulan-bator-<wbr>killer-winter-stoves</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">News also talk more about respiratory diseases, because many
children suffer from it.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><a href="http://time.com/longform/ulan-bator-mongolia-most-polluted-capital/" target="_blank">http://time.com/longform/ulan-<wbr>bator-mongolia-most-polluted-<wbr>capital/</a>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">It is understandable that even if these diseases are not the
major killer at the population level, they are still given a higher priority by
public deciders, than, say, heart diseases which strike mostly adults.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">So human lives are shortened by a number of diseases. There is a
number of causes for these diseases. And we are working on one of these causes:
stoves.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">So I agree, there is no need to be alarmist, and to exagerate or
misrepresent a truth which is, actually, already quite alarming. But the fact
that the situation is a bit more complex than the one presented the WHO reports
or the newspapers doesn’t mean air pollution isn’t a serious issue.
And that we shouldn’t be working on that issue with the highest possible
energy.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Best,<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Xavier<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></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:<a href="mailto:stoves-bounces@lists.bioenergylists.org" target="_blank">stoves-bounces@lists.<wbr>bioenergylists.org</a>] <b>De la part de</b> Crispin
Pemberton-Pigott<br>
<b>Envoyé :</b> lundi 7 mai 2018 03:05<span class=""><br>
<b>À :</b> Discussion of biomass cooking stoves<br>
<b>Objet :</b> Re: [Stoves] Air pollution kills<u></u><u></u></span></span></p>
</div>
</div>
<p class="MsoNormal"><u></u> <u></u></p>
<p class="MsoNormal"><span lang="EN-CA" style="font-size:11.0pt;font-family:"Calibri","sans-serif"">Dear
Xavier<u></u><u></u></span></p><span class="">
<p class="MsoNormal"><span lang="EN-CA" style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Let’s take Ulan Bator. There are 1.5 million inhabitants.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">If all of them were using electrical heating and cooking, and
driving bicycles instead of cars:<u></u><u></u></span></p>
<ul style="margin-top:0cm" type="disc">
<li class="MsoNormal" style="color:#1f497d"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">would we
likely see less indoor and outdoor air pollution?<u></u><u></u></span></li>
<li class="MsoNormal" style="color:#1f497d"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">would we
likely see less cases of respiratory infections like bronchitis,
pneumonias, etc.?<u></u><u></u></span></li>
<li class="MsoNormal" style="color:#1f497d"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">would the
respiratory infections cases likely be less acute?<u></u><u></u></span></li>
<li class="MsoNormal" style="color:#1f497d"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">would there
likely be less cases of deaths due to a respiratory infection?<u></u><u></u></span></li>
<li class="MsoNormal" style="color:#1f497d"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">would the life
expectancy of the population likely be higher?<u></u><u></u></span></li>
</ul>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u> <u></u></span></p>
<ul style="margin-top:0cm" type="disc">
<ol style="margin-top:0cm" start="1" type="1">
<li class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">There isn’t much air
pollution now indoors so it would probably not be reduced. In a home
where no one smokes and they have a typical Stove Programme stove, the majority
of IAP is caused by smoking and cooking. In the case of IAP in gers
(yurts) the indoor air is generally better than the ambient air outside.<u></u><u></u></span></li>
<li class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">Respiratory infections are
greatly influenced by the temperature in the home and seasonal flu.
Assuming people would not be heating their homes any higher than they are
now (which means ‘chronically cold all the time’) the rate
would probably not change much. This was demonstrated in Kyrgyzstan when
it was shown that increasing the average temperature 5 degrees and
heating for more than 16 hrs per day instead of 2-6 there was a huge
medical health benefit – nothing to do with smoke. Being
chronically cold in a stove-smoke-free environment would help reduce eye
irritation and asthma attacks, I think. <u></u><u></u></span></li>
<li class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">I can’t see the
acuteness of the infections being much affected with an annual average
PM2.5 of 160 microgrammes, if nothing is done to address the chronic
underheating issue. Mostly children get sick, and they get sick because
they are cold so much of the time, or are subjected to large changes in
temperature all day from traditional stoves going from zero to 40 kW then
back to zero. Electric heating would moderate that, presumable, but you
described changing the energy source, not the temperature profile. <u></u><u></u></span></li>
<li class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">About the deaths, this is the
same as Q3 about acute problems. Remember that changing the energy
sources for a few things doesn’t change all the other sources of
air pollution : ash ponds, the Gobi Desert, and vehicles. Using
electric vehicles would remove about 50% of the PM2.5 downtown, but not
the considerable fugitive dust created by those vehicles on dirt roads.
Dust storms are 50 times worse than air pollution from people.
Construction dust is considerable. Stove smoke is only about 45% of
the total. It used to be 88% in some areas.<u></u><u></u></span></li>
<li class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">The life expectancy is
affected negatively by a lot of things other than air pollution :
alcohol is a big problem, the diet consists largely of meat and fat is
appreciated, the average income is very low, there is a great reliance on
traditional medicine. There are a great many car accidents and falls from
horses. Here are the top 25 causes of death in Mongolia (I
don’t have it for UB alone) :<u></u><u></u></span></li>
</ol>
</ul>
</span><p class="m_-7717877233457146506MsoListParagraph" style="margin-left:72.0pt"><img border="0" width="227" height="460" id="m_-7717877233457146506Picture_x0020_1" src="cid:image001.jpg@01D3E65F.551C5C80" alt="cid:image001.jpg@01D3E65F.551C5C80"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u><u></u></span></p><span class="">
<p class="m_-7717877233457146506MsoListParagraph" style="margin-left:72.0pt"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u> <u></u></span></p>
<p class="m_-7717877233457146506MsoListParagraph" style="margin-left:72.0pt"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">Which of those are related to diet
and what is the first on the list that might be contributed to by air
pollution? A lot of people smoke and smoke indoors. Breathing the city air is
on average like smoking a 1/28th of a cigarette per day – the same as
Calcutta.<u></u><u></u></span></p>
<p class="m_-7717877233457146506MsoListParagraph" style="margin-left:72.0pt"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u> <u></u></span></p>
<p class="m_-7717877233457146506MsoListParagraph" style="margin-left:72.0pt"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">So how do Mongolian causes of death
rank in the world?<u></u><u></u></span></p>
<p class="m_-7717877233457146506MsoListParagraph" style="margin-left:72.0pt"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u> <u></u></span></p>
</span><p class="m_-7717877233457146506MsoListParagraph" style="margin-left:72.0pt"><img border="0" width="227" height="371" id="m_-7717877233457146506Picture_x0020_2" src="cid:image002.jpg@01D3E65F.551C5C80" alt="cid:image002.jpg@01D3E65F.551C5C80"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u><u></u></span></p><span class="">
<p class="m_-7717877233457146506MsoListParagraph" style="margin-left:72.0pt"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">Number 1 for liver cancer, stomach
cancer and number three for suicide and stroke. Do you see any diet-related
diseases there cause by consuming a large amount of meat and alcohol?<u></u><u></u></span></p>
<p class="m_-7717877233457146506MsoListParagraph" style="margin-left:72.0pt"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u> <u></u></span></p>
<p class="m_-7717877233457146506MsoListParagraph" style="margin-left:72.0pt"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">They have a very low global ranking
for breast and prostate cancer and diabetes (all >170). <u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">All
things considered, it would be much better if there were no air pollution in
the city, but is it a major killer, or <i>the</i> major killer? Doesn’t
look like it.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">Bright
side :<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">Improving
the domestic combustion devices greatly reduces indoor and outdoor air
pollution, saves money, increase the comfort level, being warm greatly reduces
the incidence of bronchitis, and makes people a lot happier. Those are reasons
enough to support stove programmes. Given the context, it is not going to make
much difference to the premature death rate from ambient air pollution. Moving
people from gers to heated apartments increases their IAQ problems because so
many people smoke and the apartments have a low air change rate. It is
never simple and context is everything.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">Never
assume anything.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">Crispin<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u> <u></u></span></p>
</span></div>
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