In-use emissions from biomass and LPG stoves measured during a large, multi-year cookstove intervention study in rural India

Biomass smoke exposure and somatic growth among children: The RESPIRE and CRECER prospective cohort studies in rural Guatemala

BACKGROUND

Cooking-related biomass smoke is a major source of household air pollution (HAP) and an important health hazard. Prior studies identified associations between HAP exposure and childhood stunting; less is known for underweight and wasting. Few studies had personal HAP measurements.

METHODS

557 households in rural Guatemala were enrolled in the CRECER study, the follow-up study of the RESPIRE randomized intervention trial. They were assigned to three groups that received chimney stoves at different ages of the study children. Multiple personal carbon monoxide (CO) exposure measurements were used as proxies for HAP exposures. Children's heights and weights were measured from 24 to 60 months of age. Height-for-age z-score (HAZ), weight-for-age z-score (WAZ), and weight-for-height z-score (WHZ) were calculated based on the World Health Organization's Multicentre Growth Reference Study. HAZ, WAZ, and WHZ below -2 were classified as stunting, underweight, and wasting, respectively. Generalized linear models and mixed effects models were applied.

RESULTS

541 children had valid anthropometric data, among whom 488 (90.2 %) were stunted, 192 (35.5 %) were underweight, and 2 (0.3 %) were wasted. A 1 ppm higher average CO exposure was associated with a 0.21 lower HAZ (95 % CI: 0.17-0.25), a 0.13 lower WAZ (95 % CI: 0.10-0.17) and a 0.06 lower WHZ (95 % CI: 0.02-0.10).The associations for HAZ were stronger among boys (coefficient = -0.29, 95 % CI: -0.35 - -0.22) than among girls (coefficient = -0.15, 95 % CI: -0.20 - -0.10). A 1 ppm-year higher cumulative CO exposure was associated with a higher risk of moderate stunting among boys (OR = 1.27, 95 % CI: 1.05-1.59), but not among girls.

DISCUSSION

In this rural Guatemalan population, higher HAP exposure was associated with lower HAZ and WAZ. The associations between HAP and HAZ/stunting were stronger among boys. Reducing HAP might benefit childhood somatic growth in rural populations of low-income countries.

Energy inequality and air pollution nexus in India

Energy usage, inequality, and their impacts are deeply intertwined, especially in India. Every year, cooking using biomass-based solid fuel usage causes death to tens of thousands of Indians, specifically, economically unprivileged people. Solid fuel burning has been known as one of the prominent sources of ambient PM_2.5 (particulate matter with an aerodynamic diameter of <2.5 μm) concentration in the atmosphere. Thus, limiting the PM_2.5 emission from biomass-based cooking fuel through the transition to LPG has gained priority. The government report in India indicates that nearly 8 million households became beneficiaries of the LPG connection through the PMUY scheme till 2019. The transition to clean cooking fuel may have an influence on the ambient PM_2.5 concentration. In this study, to explore the nexus between energy inequality and air pollution, we investigated the present status of clean fuel usage in India and its drivers, including the impact of such a massive transition to cleaner fuel on ambient air quality, with a specific focus on PM_2.5. The results show an improvement of 15 % in LPG usage from 2015 to 2019 in India., Yet the majority of poorer (>60 %) and poorest communities (>90 %) still use solid biomass as the cooking fuel. No significant correlation (r = 0.036; p-value ≫ 0.05) was obtained between LPG usage and ambient PM_2.5 concentration suggesting the influence of other confounding factors which might subdue the anticipated effect of the usage of clean fuel. The analysis suggests, despite the successful launching of the PMUY, the low LPG usage pattern among the poor, because of the lack of an effective subsidy policy, might jeopardize the effort to fix the standard of ambient air as per WHO.

Community kitchen tandoors (CKT)-a potential candidate for air pollution mitigation strategies?

Community kitchen tandoor (CKT) is a clay-based hollow cylindrical device commonly used in South Asian and Middle Eastern countries for baking flatbreads and cooking meat. These CKTs, generally fuelled by charcoal or wood, contribute significantly to the pollution loads in ambient air along with occupational exposure hazards. CKTs, being a part of the informal sector, lack emissions and safety guidelines. This study surveys 139 restaurants in CKT hotspots of New Delhi, India, to understand tandoor design and operational parameters and to assess PM_2.5 and CO exposure concentrations at representative field restaurants. PM_2.5 and CO exposure concentrations from traditional CKT was found to be several-folds higher than safe indoor air quality levels. Further, the traditional CKT was evaluated for different improved fuels (like briquettes and pellets) in the laboratory for PM_2.5 and CO microenvironment concentrations. It was found that the fuel improvements in traditional CKT could not improve microenvironment concentrations to the desired levels; hence, an automated pellet-fed forced-draft improved tandoor with an improved combustion chamber design is demonstrated. The results of the laboratory trial of improved tandoor were compared with traditional tandoor (using pellets) and have shown 84% and 94% reductions in PM_2.5 and CO concentrations, respectively, indicating significant benefits to the environment and health. We recommend implementing such improved CKT, on a large scale, combined with other identified control options, as a potential candidate under air pollution mitigation strategies in cities' action plans under National Clean Air Programme (NCAP).

Widespread Clean Cooking Fuel Scale-Up and under-5 Lower Respiratory Infection Mortality: An Ecological Analysis in Ecuador, 1990-2019

BACKGROUND

Nationwide household transitions to the use of clean-burning cooking fuels are a promising pathway to reducing under-5 lower respiratory infection (LRI) mortality, the leading cause of child mortality globally, but such transitions are rare and evidence supporting an association between increased clean fuel use and improved health is limited.

OBJECTIVES

This study aimed to investigate the association between increased primary clean cooking fuel use and under-5 LRI mortality in Ecuador between 1990 and 2019.

METHODS

We documented cooking fuel use and cause-coded child mortalities at the canton (county) level in Ecuador from 1990 to 2019 (in four periods, 1988-1992, 1999-2003, 2008-2012, and 2015-2019). We characterized the association between clean fuel use and the rate of under-5 LRI mortalities at the canton level using quasi-Poisson generalized linear and generalized additive models, accounting for potential confounding variables that characterize wealth, urbanization, and child health care and vaccination rates, as well as canton and period fixed effects. We estimated averted under-5 LRI mortalities accrued over 30 y by predicting a counterfactual count of canton-period under-5 LRI mortalities were clean fuel use to not have increased and comparing with predicted canton-period under-5 LRI mortalities from our model and observed data.

RESULTS

From 1990 to 2019, the proportion of households primarily using a clean cooking fuel increased from 59% to 95%, and under-5 LRI mortality fell from 28 to 7 per 100,000 under-5 population. Canton-level clean fuel use was negatively associated with under-5 LRI mortalities in linear and nonlinear models. The nonlinear association suggested a threshold at approximately 60% clean fuel use, above which there was a negative association. Increases in clean fuel use between 1990 and 2019 were associated with an estimated 7,300 averted under-5 LRI mortalities (95% confidence interval: 2,600, 12,100), accounting for nearly 20% of the declines in under-5 LRI mortality observed in Ecuador over the study period.

DISCUSSION

Our findings suggest that the widespread household transition from using biomass to clean-burning fuels for cooking reduced under-5 LRI mortalities in Ecuador over the last 30 y. https://doi.org/10.1289/EHP11016.

Association of household air pollution with glucose homeostasis markers in Chinese rural women: Effect modification of socioeconomic status

BACKGROUND

Socioeconomic status (SES) was a crucial influencing factor of household air pollution (HAP). However, few studies have explored the potential effect modification of SES on the associations of HAP with type 2 diabetes mellitus (T2DM) and glucose homeostasis.

METHODS

A total of 20900 participants were obtained from the Henan Rural Cohort. HAP reflected by cooking fuel type and cooking duration was assessed via questionnaire. SES was evaluated by two dimensions: educational level and average monthly income. Associations of cooking fuel type, cooking duration with T2DM and glucose homeostasis indices (insulin, fasting plasma glucose (FPG), and HOMA-β) were assessed by the generalized linear model. Analyses were also conducted in different SES groups to explore the potential effect modification.

RESULTS

Significant negative association of cooking fuel type and cooking duration with T2DM, FPG, and HOMA-β was not observed. However, cooking with solid fuel and long-duration cooking were associated with decreased insulin level in women, and the adjusted coefficients were - 0.35 (95% confidence interval (95% CI): - 0.53, - 0.17) and - 0.36 (95% CI: -0.50, -0.21), respectively. Results from stratified analyses showed that these associations were more prominent in women with low average monthly income, with corresponding coefficient of - 0.57 (95% CI: -0.77, -0.37) for cooking with solid fuel and - 0.34 (95% CI: -0.52, -0.16) for long-duration cooking. Among women with low average monthly income, the largest decreased insulin level was observed in those who cooked with solid fuel, long-duration and poor kitchen ventilation, while the negative association of cooking fuel type and cooking duration with insulin level was slightly alleviated in the good kitchen ventilation group.

CONCLUSIONS

Low average monthly income aggravated the negative association of HAP and insulin level among rural women, while improving kitchen ventilation may be a practical intervention.

TRAIL REGISTRATION

The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375.

The Effect of Kitchen Ventilation Modification on Independent and Combined Associations of Cooking Fuel Type and Cooking Duration with Suicidal Ideation: A Cross-Sectional Study

Although household air pollution (HAP) is associated with an increased risk of mental disorders, evidence remains scarce for the relationship between HAP and suicidal ideation. A total of 21,381 qualified participants were enrolled on the Henan Rural Cohort Study. HAP information including cooking fuel type, cooking duration and kitchen ventilation was collected by questionnaires. Suicidal ideation was evaluated by item nine of the Patient Health Questionnaire-9 (PHQ-9). Independent and combined associations of cooking fuel type and cooking duration with suicidal ideation were explored by logistic regression models. Analyses were conducted in different kitchen ventilation groups to detect the potential effect modification. The adjusted odds ratio (OR) and 95% confidence interval (95% CI) of solid fuel users versus clean fuel users for suicidal ideation was 1.37 (1.16, 1.62), and the risk of suicidal ideation increased by 15% (95% CI: 5%, 26%) for each additional hour of the cooking duration. Participants cooking with solid fuel for long durations were related to the highest risk of suicidal ideation (OR (95% CI): 1.51 (1.22, 1.87)). However, all these associations were not observed in those cooking with mechanical ventilation. Mechanical ventilation ameliorated relationships between solid fuel use and long-duration cooking with suicidal ideation.

Physical, chemical and optical properties of PM2.5 and gaseous emissions from cooking with biomass fuel in the Indo-Gangetic Plain

The current study was designed to capture real-world cooking process-wise emissions generated by the combustion of mixed biomass fuel in traditional mud cookstoves in rural kitchens of the north Indian state of Uttar-Pradesh during regular meal preparations. Combustion characteristics, including modified combustion efficiency, thermal efficiency and burn rate, were examined to understand their relationship with emissions. Variations were observed in emission factors (EFs) of PM_2.5, trace gases, namely CO, CO₂, NO_x and SO_2, for different cooking processes. While the highest emission of PM_2.5, CO and SO₂ were observed for boiling (7.0 ± 2.7, 68 ± 29.3, 1.0 ± 1.7 gkg^-1, respectively), CO₂ and NO_x recorded the highest EFs for frying (1537 ± 278.2 & 1.6 ± 0.9 gkg^-1 respectively). Although the study reported similar carbon content emissions for different processes, high EC emissions were observed for baking (1.1 ± 0.3 gkg^-1). A high concentration of K⁺ (indicating biomass burning) and toxic trace metals including Al, Cu, Sr, Ti, Mo & Cd has been reported in the present study. EFs of black carbon and brown carbon from mixed fuel burning during uncontrolled cooking have been discussed for different cooking processes which are critical inputs to emission inventories and radiative forcing calculation. The processes of frying and sautéing were found to be more consistent in emissions of pollutants than boiling and baking (variability- 13 %-167 %). Overall, this study emphasizes that a measurement of combustion characteristics and cooking method type should also be contemplated along with fuel and stove types during field emission studies.

Association of ambient and household air pollution with lung function in young adults in an peri-urban area of South-India: A cross-sectional study

OBJECTIVE

Although there is evidence for the association between air pollution and decreased lung function in children, evidence for adolescents and young adults is scarce. For a peri-urban area in India, we evaluated the association of ambient PM_2.5 and household air pollution with lung function for young adults who had recently attained their expected maximum lung function.

METHODS

We measured, using a standardized protocol, forced expiratory volume in the first second (FEV₁) and forced vital capacity (FVC) in participants aged 20-26 years from the third follow-up of the population-based APCAPCS cohort (2010-2012) in 28 Indian villages. We estimated annual average PM_2.5outdoors at residence using land-use regression. Biomass cooking fuel (a proxy for levels of household air pollution) was self-reported. We fitted a within-between linear-mixed model with random intercepts by village, adjusting for potential confounders.

RESULTS

We evaluated 1,044 participants with mean age of 22.8 (SD = 1) years (range 20-26 years); 327 participants (31%) were female. Only males reported use of tobacco smoking (9% of all participants, 13% of males). The mean ambient PM_2.5 exposure was 32.9 (SD = 2.8) µg/m³; 76% reported use of biomass as cooking fuel. The adjusted association between 1 µg/m³ increase in PM_2.5 was -27 ml (95% CI, -89 to 34) for FEV₁ and -5 ml (95% CI, -93 to 76) for FVC. The adjusted association between use of biomass was -112 ml (95% CI, -211 to -13) for FEV₁ and -142 ml (95% CI, -285 to 0) for FVC. The adjusted association was of greater magnitude for those with unvented stove (-158 ml, 95% CI, -279 to -36 for FEV₁ and -211 ml, 95% CI, -386 to -36 for FVC).

CONCLUSIONS

We observed negative associations between ambient PM_2.5 and household air pollution and lung function in young adults who had recently attained their maximum lung function.

Assessing the Effects of Stove Use Patterns and Kitchen Chimneys on Indoor Air Quality during a Multiyear Cookstove Randomized Control Trial in Rural India

We conducted indoor air quality (IAQ) measurements during a multiyear cookstove randomized control trial in two rural areas in northern and southern India. A total of 1205 days of kitchen PM_2.5 were measured in control and intervention households during six ∼3 month long measurement periods across two study locations. Stoves used included traditional solid fuel (TSF), improved biomass, and liquefied petroleum gas (LPG) models. Intent-to-treat analysis indicates that the intervention reduced average 24 h PM_2.5 and black carbon in only one of the two follow-up measurement periods in both areas, suggesting mixed effectiveness. Average PM_2.5 levels were ∼50% lower in households with LPG (for exclusive LPG use: >75% lower) than in those without LPG. PM_2.5 was 66% lower in households making exclusive use of an improved chimney stove versus a traditional chimney stove and TSF-exclusive kitchens with a built-in chimney had ∼60% lower PM_2.5 than those without a chimney, indicating that kitchen ventilation can be as important as the stove technology in improving IAQ. Diurnal trends in real-time PM_2.5 indicate that kitchen chimneys were especially effective at reducing peak concentrations, which leads to decreases in daily PM_2.5 in these households. Our data demonstrate a clear hierarchy of IAQ improvement in real world, "stove-stacking" households, driven by different stove technologies and kitchen characteristics.

Health and Sustainability Co-Benefits of Eating Behaviors: Towards a Science of Dietary Eco-Wellness

Two of the greatest challenges of our times - climate change and the linked epidemics of obesity, diabetes, and cardiovascular disease - are fueled in part by the over-consumption of carbon-intensive high calorie foodstuffs. Converging evidence from hundreds of studies has confirmed that transitioning from diets high in meat and dairy to largely plant-based diets not only is necessary for climate change mitigation but will also lead to substantive reductions in morbidity and mortality. Nevertheless, there are only the faintest beginnings of a robust science of behavioral eco-wellness, defined here as the study of how individual choices, behaviors, and habits impact both personal health and environmental sustainability. This paper focusses on the sub-field of dietary eco-wellness, which looks at health and sustainability impacts of food production, procurement, preparation, and consumption. To advance this crucial agenda, investigators will need to invent, develop, and assess approaches aimed at helping people transition towards healthier and more sustainable diets. In order to accurately and reliably assess appropriate outcomes, existing assessment methods will need to be refined, new techniques will need to be advanced, and all measurement methods will need to be validated. Local conditions will influence the effectiveness of various approaches, and so it is important that scientists and communities share their stories of success and challenge for others to learn from. This paper reviews emerging evidence from relevant studies in dozens of countries, suggesting next steps, potential pathways, and a framework for interpretation.

A critical review of pollutant emission factors from fuel combustion in home stoves

A large population does not have access to modern household energy and relies on solid fuels such as coal and biomass fuels. Burning of these solid fuels in low-efficiency home stoves produces high amounts of multiple air pollutants, causing severe air pollution and adverse health outcomes. In evaluating impacts on human health and climate, it is critical to understand the formation and emission processes of air pollutants from these combustion sources. Air pollutant emission factors (EFs) from indoor solid fuel combustion usually highly vary among different testing protocols, fuel-stove systems, sampling and analysis instruments, and environmental conditions. In this critical review, we focus on the latest developments in pollutant emission factor studies, with emphases on the difference between lab and field studies, fugitive emission quantification, and factors that contribute to variabilities in EFs. Field studies are expected to provide more realistic EFs for emission inventories since lab studies typically do not simulate real-world burning conditions well. However, the latter has considerable advantages in evaluating formation mechanisms and variational influencing factors in observed pollutant EFs. One main challenge in field emission measurement is the suitable emission sampling system. Reasons for the field and lab differences have yet to be fully elucidated, and operator behavior can have a significant impact on such differences. Fuel properties and stove designs affect emissions, and the variations are complexly affected by several factors. Stove classification is a challenge in the comparison of EF results from different studies. Lab- and field-based methods for quantifying fugitive emissions, as an important contributor to indoor air pollution, have been developed, and priority work is to develop a database covering different fuel-stove combinations. Studies on the dynamics of the combustion process and evolution of air pollutant formation and emissions are scarce, and these factors should be an important aspect of future work.

Spatially Resolved Emission Factors to Reduce Uncertainties in Air Pollutant Emission Estimates from the Residential Sector

The residential sector is a major source of air pollutant emission inventory uncertainties. A nationwide field emission measurement campaign was conducted in rural China to evaluate the variabilities of realistic emission factors (EFs) from indoor solid fuel combustion. For a total of 1313 burning events, the overall average EFs (±standard deviation) of PM_2.5 were 8.93 ± 6.95 and 7.33 ± 9.01 g/kg for biomass and coals, respectively, and 89.3 ± 51.2 and 114 ± 87 g/kg for CO. Higher EFs were found from burning of uncompressed straws, while lower EFs were found from processed biomass pellets, coal briquettes, and relatively clean anthracite coals. Modified combustion efficiency was found to be the most significant factor associated with variations in CO EFs, whereas for PM_2.5, fuel and stove differences determined its variations. Weak correlations between PM_2.5 and CO indicated high uncertainties in using CO as a surrogate for PM_2.5. EFs accurately fit log-normal distributions, and obvious spatial heterogeneity was observed attributed to different fuel-stove combinations across the country. Emission estimation variabilities, which are determined by the interquartile ranges divided by the median values, were notably reduced when spatially resolved EFs were adopted in the inventory.