<html><head><meta http-equiv="Content-Type" content="text/html charset=utf-8"></head><body style="word-wrap: break-word; -webkit-nbsp-mode: space; -webkit-line-break: after-white-space;" class=""><div class="">List:</div><div class=""><br class=""></div><div class=""><span class="Apple-tab-span" style="white-space:pre"> </span>There is a great deal more useful information in the full document at </div><div class=""><a href="https://www.healtheffects.org/system/files/Comm18-HAP-NCD.pdf" class="">https://www.healtheffects.org/system/files/Comm18-HAP-NCD.pdf</a></div><div class=""><br class=""></div><div class=""><span class="Apple-tab-span" style="white-space:pre"> </span>A bit on Tiers in and near Figure 16 (p44).</div><div class=""><br class=""></div><div class=""><span class="Apple-tab-span" style="white-space:pre"> </span>So far, I've only skimmed.</div><div class=""><br class=""></div><div class="">Ron</div><br class=""><div><blockquote type="cite" class=""><div class="">On Jul 31, 2018, at 10:39 PM, Ronal W. Larson <<a href="mailto:rongretlarson@comcast.net" class="">rongretlarson@comcast.net</a>> wrote:</div><br class="Apple-interchange-newline"><div class=""><meta http-equiv="Content-Type" content="text/html charset=utf-8" class=""><div style="word-wrap: break-word; -webkit-nbsp-mode: space; -webkit-line-break: after-white-space;" class=""><div class="">List</div><div class=""><br class=""></div><div class=""><span class="Apple-tab-span" style="white-space:pre"> </span>1. I'll be reading this (a relatively short paper attached below) tonight. Looks well done so far. If Professor Smith recommends it - I want to read it and hope most of you will also. There is more at: <a href="https://www.healtheffects.org/publication/household-air-pollution-and-noncommunicable-disease" class="">https://www.healtheffects.org/publication/household-air-pollution-and-noncommunicable-disease</a></div><div class=""><br class=""></div><div class=""><span class="Apple-tab-span" style="white-space:pre"> </span>2. I presume Nikhil is still preparing a response to the question posed to him by Professor Gadgil a few days ago - for citations. I'd be satisfied if Nikhil simply told us what he sees wrong with this paper. </div><div class=""><br class=""></div><div class=""><span class="Apple-tab-span" style="white-space:pre"> </span>3. On Nikhil's behalf, Crispin gave a lengthy response to Professor Gadgil, but again - contained none of the cites that Professor Gadgil requested. So I hope Crispin also will refute this one (which I believe supports Prof. Gadget's belief in WHO and similar data like in this new report).</div><div class=""><br class=""></div><div class=""><span class="Apple-tab-span" style="white-space:pre"> </span>4. I have finished the short book by Professor Doug Brugge - and now can recommend it. The chapter on stove health impacts is the shortest - and mostly (and appropriately) credits Kirk Smith. But I learned a lot much more on PM2.5 and epidemiology in later chapters. Maybe more later on this.</div><div class=""><br class=""></div><div class=""><span class="Apple-tab-span" style="white-space:pre"> </span>5. We are working in an area (biomass stoves) where way too little health-related science has been performed - compared say to cigarette smoking. While Crispin and Nihil are preparing a rebuttal to this new report above, I also hope they will include data on the relative validity of health statistics for cigarette smoke (a much less serious problem than the one this list is addressing - but one that seems to have been settled scientifically).</div><div class=""><br class=""></div>Ron<br class=""><div class=""><br class=""><blockquote type="cite" class=""><div class="">Begin forwarded message:</div><br class="Apple-interchange-newline"><div style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px;" class=""><span style="font-family: -webkit-system-font, 'Helvetica Neue', Helvetica, sans-serif;" class=""><b class="">From: </b></span><span style="font-family: -webkit-system-font, Helvetica Neue, Helvetica, sans-serif;" class="">"Kirk R. SMITH" <<a href="mailto:krksmith@berkeley.edu" class="">krksmith@berkeley.edu</a>><br class=""></span></div><div style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px;" class=""><span style="font-family: -webkit-system-font, 'Helvetica Neue', Helvetica, sans-serif;" class=""><b class="">Subject: </b></span><span style="font-family: -webkit-system-font, Helvetica Neue, Helvetica, sans-serif;" class=""><b class="">[stove and climate] The newest review of HAP health impacts</b><br class=""></span></div><div style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px;" class=""><span style="font-family: -webkit-system-font, 'Helvetica Neue', Helvetica, sans-serif;" class=""><b class="">Date: </b></span><span style="font-family: -webkit-system-font, Helvetica Neue, Helvetica, sans-serif;" class="">July 31, 2018 at 9:49:55 PM MDT<br class=""></span></div><div style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px;" class=""><span style="font-family: -webkit-system-font, 'Helvetica Neue', Helvetica, sans-serif;" class=""><b class="">To: </b></span><span style="font-family: -webkit-system-font, Helvetica Neue, Helvetica, sans-serif;" class="">"Kirk R. SMITH" <<a href="mailto:krksmith@berkeley.edu" class="">krksmith@berkeley.edu</a>><br class=""></span></div><br class=""><div class=""><div class="WordSection1" style="page: WordSection1; font-family: Helvetica; font-size: 18px; font-style: normal; font-variant-caps: normal; font-weight: normal; letter-spacing: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px;"><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">New study out of the Health Effects Institute in Boston – press release below. Great job by excellent authors and highly competent reviewers and published by a reputable source. (I might add that it is about time in that for 20 years at least some of us have been trying to push HEI to take on this issue. Better late than never, I suppose. Or perhaps, better said as smart people can change their mind once they see the facts.)</div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">Interesting that it is framed under a “noncommunicable disease” framework. This is due to the growing interest in NCDs to be sure, but also because the impacts on pneumonia in children, the major accepted non-NCD impact, is dropping rapidly worldwide. This came about not to great improvements in pollution levels, but to great improvements in child health due to better nutrition, primary health care and vaccines. Thus, kids may still be getting respiratory infections from smoke, but they die from such infections much less frequently than the past. On the other hand, there are range of other impacts on children that are not included yet in the official categories of diseases (from the global burden of disease projects) associated with household pollution, including a range of adverse pregnancy outcomes and associated child morbidity/mortality, plus probably stunting and cognitive impacts. Thus, children are not off the hook from being beneficiaries of clean household environments.</div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">Unfortunately, the summary press release below fails to note the importance of household fuels in creating ambient air pollution exposures in many countries. Indeed, in both India and China, studies have shown that households are probably the first (India) or second (China) most important source of ambient pollution, measured as PM2.5, the best indicator for health impacts. To be clear, this point is made in the policy summary, attached, and in the main report (see link). As we are seeing in China, however, it probably ought to have been one of the main points being made since cleaning up households is making big progress as a means to control ambient levels, rather than for the benefit of the households themselves. Perhaps backwards, but nevertheless this realization has triggered healthful policy changes that otherwise likely might not have happened soon. </div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">The point now, at least from my perspective, is perhaps not so much improving impact estimates, worthy scientific exercises as they are although always changing and subject to uncertainty, but finding ways to motivate policy. The ambient air pollution link is clearly one of them</div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">Undoubtedly, however, the contents of the press release were not under direct control of the authors themselves/k</div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">Policy summary attached and on my website below. Main report available at</div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class=""><a href="https://www.healtheffects.org/publication/household-air-pollution-and-noncommunicable-disease" style="color: rgb(149, 79, 114); text-decoration: underline;" class="">https://www.healtheffects.org/publication/household-air-pollution-and-noncommunicable-disease</a></div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">NEW REPORT: One in Three Households Worldwide Exposed to Household Air Pollution;</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">Growing Evidence Links Their Exposure to 2.6 Million Deaths from Heart, Lung,</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">and Other Diseases --<span class="Apple-converted-space"> </span></div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">(BOSTON July 26, 2018) A total of 2.5 billion people — a third of the global population —</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">were exposed to household air pollution (HAP) in 2016 from the use of solid fuels for cooking</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">and heating, according to a new report, Household Air Pollution and Noncommunicable Disease,</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">issued today by the Health Effects Institute1 (HEI) at<span class="Apple-converted-space"> </span><a href="http://www.healtheffects.org/" style="color: rgb(149, 79, 114); text-decoration: underline;" class="">www.healtheffects.org</a>.</div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">That enormous population, exposed to high levels of particulate matter from HAP, faces a</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">significant health risk. HEI’s synthesis of the latest scientific evidence found a growing number</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">of epidemiological studies and systematic science reviews with evidence that HAP exposures</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">increase the risk of many noncommunicable diseases, including lung and heart disease, cataracts,</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">and lung cancer.</div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">All told, this translates into HAP exposure contributing substantially to the global burden of</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">disease, an estimated 2.6 million deaths in 2016. The economic consequences of the HAP-attributable</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">health burden are also large: the best available estimate from the World Bank</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">suggests an annual global welfare loss in 2013 of about $1.5 trillion in 2011 U.S. dollars from</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">HAP exposures alone.</div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">Most of those affected live in low- and middle-income countries in Asia and Africa. These</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">populations — and especially the women and children inside the homes — face a double burden:</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">from the air they breathe indoors as well as from outdoor air pollution from the full range of</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">industrial, transport, and other sources. (Detailed estimates of these double burdens in each</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">country in the world are available at<span class="Apple-converted-space"> </span><a href="http://www.stateofglobalair.org/" style="color: rgb(149, 79, 114); text-decoration: underline;" class="">www.stateofglobalair.org</a>.)</div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">Clean energy solutions are necessary to reduce disease burden substantially. The report</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">found the traditional interventions to reduce exposure — introducing improved solid fuel</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">cookstoves — have had mixed effects, with some reductions in exposure but relatively few</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">health benefits. Cost of the alternatives, cultural attachment to the older stoves, and challenges</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">in operating the new stoves all likely contribute to lower than expected improvements in</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">exposure and health. These findings suggest that more extensive clean energy solutions, such as</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">bringing natural gas and electricity to rural homes, are needed to significantly reduce health</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">burden.</div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">Introducing those new solutions has the potential for substantial public health benefits.</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">HEI’s Global Burden of Disease from Major Air Pollution Sources (GBD MAPS) project</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">estimates that, in China and India alone, policies that shift to reliance on clean fuels could</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">decrease the future burden of disease from ambient air pollution attributable to residential</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">burning of solid fuels by at least 30% and possibly by more than 95%, depending on the policy.</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">In India, for example, a policy that would virtually eliminate use of biomass cookstoves by 2050</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">could avoid 500,000 early deaths from outdoor air pollution annually relative to a business-as-usual</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">scenario; eliminating these stoves would have substantial benefits indoors as well.</div><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;"> </p><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">This new HEI Report, Household Air Pollution and Noncommunicable Disease, which was</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">intensively peer reviewed prior to HEI publication by leading global experts on disease and</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">household air pollution, is available at<span class="Apple-converted-space"> </span><a href="http://www.healtheffects.org/" style="color: rgb(149, 79, 114); text-decoration: underline;" class="">www.healtheffects.org</a><span class="Apple-converted-space"> </span>as HEI Communication 18, and in</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">a special Summary for Policy Makers. For further information on the report, please contact:</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">Katy Walker, Principal Scientist, HEI (<a href="mailto:kwalker@healtheffects.org" style="color: rgb(149, 79, 114); text-decoration: underline;" class="">kwalker@healtheffects.org</a>; +1 617 488 2310</div><div style="border-style: none none solid; border-bottom-color: windowtext; border-bottom-width: 1pt; padding: 0in 0in 1pt;" class=""><p class="MsoNormal" style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif; border: none; padding: 0in;"> </p></div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">Kirk R. Smith, MPH, PhD <<a href="mailto:krksmith@berkeley.edu" style="color: rgb(149, 79, 114); text-decoration: underline;" class="">krksmith@berkeley.edu</a>></div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">Professor of Global Environmental Health</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">University of California Berkeley, 94720-7360 USA</div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">Director, Collaborative Clean Air Policy Centre, Delhi;<span class="Apple-converted-space"> </span><span style="color: rgb(31, 73, 125);" class=""> </span><a href="https://ccapc.org.in/" style="color: rgb(149, 79, 114); text-decoration: underline;" class=""><span style="font-size: 10.5pt; font-family: Arial, sans-serif; color: blue;" class="">https://ccapc.org.in/</span></a></div><div style="margin: 0in 0in 0.0001pt; font-size: 11pt; font-family: Calibri, sans-serif;" class="">Darbari Seth Block, India Habitat Centre, Lodhi Road, New Delhi, 110003</div><div style="margin: 0in 0in 0.0001pt; 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