U.S. Environmental Protection Agency Cookstove Research Meeting, Feb 2015 – Presentations

Presenter Presentation Title
Costa, Dan EPA Cookstoves Research (PDF) (9 pp, 1.38 MB)
Moss, Jacob The U.S. Commitment to Clean Cookstoves (PDF) (6 pp, 620 K)
Bailis, Robert Experimental Interventions to Facilitate Clean Cookstove Adoption, Promote Clean Indoor Air, and Mitigate Climate Change (PDF) (28 pp, 3.21 MB)
Baumgartner, Jill Improving Air Quality, Health and the Environment Through Household Energy Interventions in the Tibetan Plateau (PDF) (34 pp, 3.31 MB)
Bond, Tami C. A Global Map of Feasible Residential Solutions, Emphasizing Stoves with Space Heating Uses (PDF) (27 pp, 2.71 MB)
Edwards, Rufus Characterization of Emissions from Small, Variable Solid Fuel Combustion Sources for Determining Global Emissions and Climate Impact (PDF) (22 pp, 3.17 MB)
Hannigan, Mike REACCTING: Research on Emissions Air Quality, Climate, and Cooking Technology in Northern Ghana (PDF) (49 pp, 5.03 MB)
Pierce, Jeff
Kodros, Jack
CSU Global Modeling and Climate Effects (PDF) (40 pp, 3.87 MB)
Smith, Kirk SOMAARTH -I Demographic Development and Environment Surveillance Site (DDESS) (PDF) (20 pp, 4.2 MB)
Smith, Kirk Household/Outdoor Pollution in India: EPA STAR Grant (PDF) (45 pp, 3.91 MB)
Volckens, John
Pierce, Jeff
Quantifying the Climate, Air Quality, and Health Benefits of Improved Cookstoves: An Integrated Laboratory, Field and Modeling Study (PDF) (17 pp, 1.33 MB)
Birnbaum, Linda Assessing Exposures and Health Effects Related to Indoor Biomass Fuel Burning (PDF) (13 pp, 1.2 MB)
Mehta Sumi Phase 2 Research and Evaluation Roadmap Public Health, Environment, and Climate (PDF) (18 pp, 5.23 MB)
Sage, Mike
Yip, Fuyuen
Evaluation of Acceptability and Performance of Stove Options for Reducing Household Air Pollution in Rural West Kenya (PDF) (26 pp, 3.18 MB)


Sustainable diffusion of sustainable technologies? An entrepreneur-led initiative to promote improved cookstoves in rural western Kenya. Sustainability: Science, Practice, & Policy, Spring 2015.

Authors: Barry Ness & Ann Åkerman, Lund University Centre for Sustainability Studies, PO Box 170, Lund, 22100 Sweden (email: barry.ness@lucsus.lu.se; ann.akerman@lucsus.lu.se)

This article presents the accomplishments and challenges of a rural sustainable development initiative in Nyanza Province, Kenya. Our focus is on the sale and financing of a simple technology—an improved cookstove—by a local entrepreneur. The theoretical basis of the research is innovation systems and (social) entrepreneurship. We first define the major challenges of the diffusion process encountered throughout the initiative’s early years, with special concentration on maintaining the working capital to sell and finance additional innovations.

We next present the measures to address the challenge, including detailed written contracts, a modest fee for late payments, a contractsigning witness, and money-transfer options by mobile telephone. We subsequently present repayment rates for up to one year after implementing the changes, which show a general pattern of improvement. Finally, we discuss the sustainability of the technology, repayment rates, innovation systems, and entrepreneurship in sub-Saharan Africa. The main message of the research is that the major challenge is not creating more sustainable technologies, but overcoming difficulties in diffusion processes.

Household air pollution and cancers other than lung: a meta-analysis. Environmental Health, Mar 2015.

Authors: Sowmya Josyula (sowmya.josyula@einstein.yu.edu)Juan Lin (juan.lin@einstein.yu.edu), et al.

Household air pollution (HAP) from solid fuel combustion contributes to 2.6% of the global burden of disease. HAP emissions are an established lung carcinogen; however, associations with other cancer sites have not been fully explored. We conducted a meta-analysis of 18 case–control studies. Using fixed-effects models, utilizing the adjusted odds ratios (OR) and 95% confidence intervals (95% CI) from each study, we evaluated the association between HAP and cervical neoplasia (663 cases and 1747 controls) and upper aero-digestive tract cancers (6022 cases and 15 325 controls).

We found that HAP was associated with cervical neoplasia (OR = 6.45; 95%CI = 3.12-13.35; 4 studies); oral (OR = 2.54; 95% CI = 1.92-3.34; 4 studies; 1000 cases /3450 controls); nasopharyngeal (OR = 1.80; 95%CI = 1.26-2.28; 6 studies; 2231 cases/2160 controls); pharyngeal (OR = 3.56; 95%CI = 2.22-5.70; 4 studies; 1036 cases/3746 controls); and laryngeal (OR = 2.34; 95% CI = 1.71- 3.20; 5 studies; 1416 cases/4514 controls) cancers. The elevated risk for esophageal cancer (OR = 1.92; 95%CI = 0.82-4.48; 2 studies; 339 cases/1455 controls) was non-significant.

HAP was associated with cervical neoplasia among studies that accounted for HPV infection (OR = 9.60; 95%CI = 3.79-24.32) and smoking (OR = 4.72; 95%CI = 1.84-12.07). Similarly, our observed associations between HAP and upper aero-digestive tract cancers remained significantly elevated when analyses were restricted to studies that controlled for smoking. No significant publication bias was detected. Our results suggest that the carcinogenic effect of HAP observed for lung cancer may extend to other cancers, including those of the cervix and the upper aero-digestive tract. Further research is needed to confirm these associations in prospective studies.


Prevalence of chronic obstructive pulmonary disease and variation in risk factors across four geographically diverse resource-limited settings in Peru. Respiratory Research, Feb 2015,

Authors, Devan Jaganath (djagana1@jhmi.edu)J Jaime Miranda (jaime.miranda@upch.pe), et al.

Background – It is unclear how geographic and social diversity affects the prevalence of chronic obstructive pulmonary disease (COPD). We sought to characterize the prevalence of COPD and identify risk factors across four settings in Peru with varying degrees of urbanization, altitude, and biomass fuel use.

Methods – We collected sociodemographics, clinical history, and post-bronchodilator spirometry in a randomly selected, age-, sex- and site-stratified, population-based sample of 2,957 adults aged ≥35 years (median age was 54.8 years and 49.3% were men) from four resource-poor settings: Lima, Tumbes, urban and rural Puno. We defined COPD as a post-bronchodilator FEV1/FVC < 70%.

Results – Overall prevalence of COPD was 6.0% (95% CI 5.1%–6.8%) but with marked variation across sites: 3.6% in semi-urban Tumbes, 6.1% in urban Puno, 6.2% in Lima, and 9.9% in rural Puno (p < 0.001). Population attributable risks (PARs) of COPD due to smoking ≥10 pack-years were less than 10% for all sites, consistent with a low prevalence of daily smoking(3.3%). Rather, we found that PARs of COPD varied by setting. In Lima, for example, thehighest PARs were attributed to post-treatment tuberculosis (16% and 22% for men andwomen, respectively). In rural Puno, daily biomass fuel for cooking among women wasassociated with COPD (prevalence ratio 2.22, 95% CI 1.02–4.81) and the PAR of COPD dueto daily exposure to biomass fuel smoke was 55%.

Conclusions – The burden of COPD in Peru was not uniform and, unlike other settings, was not predominantly explained by tobacco smoking. This study emphasizes the role of biomass fuel use, and highlights pulmonary tuberculosis as an often neglected risk factor in endemic areas

Does household use of biomass fuel cause lung cancer? A systematic review and evaluation of the evidence for the GBD 2010 study. Thorax, March 2015.

Authors: Nigel Bruce1, Mukesh Dherani1, Rui Liu2, H Dean Hosgood III3,4, Amir Sapkota5, Kirk R Smith2, Kurt Straif6, Qing Lan3, Daniel Pope1

+ Author Affiliations

1Department of Public Health and Policy, University of Liverpool, Liverpool, UK
2Environmental Health Sciences, School of Public Health, University of California Berkeley, California, USA
3Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
4Division of Epidemiology, Albert Einstein College of Medicine, Bronx, New York, USA
5Maryland Institute for Applied Environmental Health, University of Maryland, School of Public Health, College Park, Maryland, USA
6International Agency for Research on Cancer, Lyon, France
Correspondence to: Dr Nigel G Bruce, Department of Public Health and Policy, University of Liverpool, Whelan Building, Quadrangle, Liverpool L69 3GB, UK; ngb@liv.ac.uk

Background – Around 2.4 billion people use traditional biomass fuels for household cooking or heating. In 2006, the International Agency for Research on Cancer (IARC) concluded emissions from household coal combustion are a Group 1 carcinogen, while those from biomass were categorised as 2A due to epidemiologic limitations. This review updates the epidemiologic evidence and provides risk estimates for the 2010 Global Burden of Disease study.

Methods – Searches were conducted of 10 databases to July 2012 for studies of clinically diagnosed or pathologically confirmed lung cancer associated with household biomass use for cooking and/or heating.

Findings – Fourteen eligible studies of biomass cooking or heating were identified: 13 had independent estimates (12 cooking only), all were case-control designs and provided 8221 cases and 11 342 controls. The ORs for lung cancer risk with biomass for cooking and/or heating were OR 1.17 (95% CI 1.01 to 1.37) overall, and 1.15 (95% CI 0.97 to 1.37) for cooking only. Publication bias was not detected, but more than half the studies did not explicitly describe a clean reference category. Sensitivity analyses restricted to studies with adequate adjustment and a clean reference category found ORs of 1.21 (95% CI 1.05 to 1.39) for men (two reports, compiling five studies) and 1.95 (95% CI 1.16 to 3.27) for women (five reports, compiling eight studies). Exposure–response evidence was seen for men, and higher risk for women in developing compared with developed countries, consistent with higher exposures in the former.

Conclusions – There is now stronger evidence for biomass fuel use causing lung cancer, but future studies need better exposure assessment to strengthen exposure–response evidence.


Characterization of biomass burning emissions from cooking fires, peat, crop residue, and other fuels with high-resolution proton-transfer-reaction time-of-flight mass spectrometry. Atmos. Chem. Phys., 15, 845–865, 2015.

Authors: C. E. Stockwell1, P. R. Veres2,3, J. Williams4, and R. J. Yokelson1
1University of Montana, Department of Chemistry, Missoula, MT, USA
2Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
3Chemical Sciences Division, Earth System Research Laboratory, National Oceanic and
Atmospheric Administration, Boulder, CO, USA
4Max Planck Institute for Chemistry, Atmospheric Chemistry Department, 55128 Mainz, Germany
Correspondence to: R. J. Yokelson (bob.yokelson@umontana.edu)

We deployed a high-resolution proton-transfer reaction time-of-flight mass spectrometer (PTR-TOF-MS) to measure biomass-burning emissions from peat, crop residue,cooking fires, and many other fire types during the fourth FireLab at Missoula Experiment (FLAME-4) laboratory campaign.A combination of gas standard calibrations and composition sensitive, mass-dependent calibration curves was applied to quantify gas-phase non-methane organic compounds(NMOCs) observed in the complex mixture of fire emissions. We used several approaches to assign the best identities to most major “exact masses”, including many high molecular mass species. Using these methods, approximately 80–96 % of the total NMOC mass detected by the PTR-TOFMSand Fourier transform infrared (FTIR) spectroscopy was positively or tentatively identified for major fuel types.

We report data for many rarely measured or previously unmeasured emissions in several compound classes including aromatic hydrocarbons, phenolic compounds, and furans; many of these are suspected secondary organic aerosol precursors.A large set of new emission factors (EFs) for a range of globally significant biomass fuels is presented. Measurements show that oxygenated NMOCs accounted for the largest fraction of emissions of all compound classes. In a brief studyof various traditional and advanced cooking methods, the EFs for these emissions groups were greatest for open three stone cooking in comparison to their more advanced counterparts. Several little-studied nitrogen-containing organic compounds were detected from many fuel types, that together accounted for 0.1–8.7 % of the fuel nitrogen, and some may play a role in new particle formation.

Innovating Energy Access for Remote Areas: Discovering Untapped Resources: Proceedings, 2014.

Martina Schäfer | Daniel Kammen | Noara Kebir | Daniel Philipp (editors)

Some of the papers in the proceedings are:

  • The influence of the end user’s context on the dissemination of domestic biogas systems in developing countries
  • Scale vs. Substance? Lessons from a Context-responsive Approach to Market-based Stove Development in Western Kenya
  • Feasibility study assessing the impact of biogas digesters on indoor air pollution in households in Uganda
  • How to Scale Up Green Microfinance? A Comparative Study of Energy Lending in Peru
  • Microfinancing decentralized solar energy systems in India: Innovative products through group approach
  • Innovative Energy Access for Remote Areas – “The LUAV-Light Up a Village” project

Relationship Between Daily Exposure to Biomass Fuel Smoke and Blood Pressure in High-Altitude Peru. Hypertension, Mar 2015.

Authors: Melissa Burroughs Peña, Karina M. Romero, Eric J. Velazquez, Victor G. Davila-Roman, Robert H. Gilman, Robert A. Wise, J. Jaime Miranda, William Checkley

Correspondence to William Checkley, Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1800 Orleans St, Suite 9121, Baltimore, MD 21205.
E-mail wcheckl1@jhmi.edu

Household air pollution from biomass fuel use affects 3 billion people worldwide; however, few studies have examined the relationship between biomass fuel use and blood pressure. We sought to determine if daily biomass fuel use was associated with elevated blood pressure in high altitude Peru and if this relationship was affected by lung function. We analyzed baseline information from a population-based cohort study of adults aged ≥35 years in Puno, Peru. Daily biomass fuel use was self-reported. We used multivariable regression models to examine the relationship between daily exposure to biomass fuel smoke and blood pressure outcomes. Interactions with sex and quartiles of forced vital capacity were conducted to evaluate for effect modification. Data from 1004 individuals (mean age, 55.3 years; 51.7% women) were included.

We found an association between biomass fuel use with both prehypertension (adjusted relative risk ratio, 5.0; 95% confidence interval, 2.6–9.9) and hypertension (adjusted relative risk ratio, 3.5; 95% confidence interval, 1.7–7.0). Biomass fuel users had a higher systolic blood pressure (7.0 mm Hg; 95% confidence interval, 4.4–9.6) and a higher diastolic blood pressure (5.9 mm Hg; 95% confidence interval, 4.2–7.6) when compared with nonusers. We did not find interaction effects between daily biomass fuel use and sex or percent predicted forced vital capacity for either systolic blood pressure or diastolic blood pressure. Biomass fuel use was associated with a higher likelihood of having hypertension and higher blood pressure in Peru. Reducing exposure to household air pollution from biomass fuel use represents an opportunity for cardiovascular prevention.

Effectiveness of interventions to reduce indoor air pollution and/or improve health in homes using solid fuel in lower and middle income countries: protocol for a systematic review. Systematic Reviews, March 2015, 4:22 doi:10.1186/s13643-015-0012-8

Authors: Reginald Quansah, Caroline A Ochieng, Sean Semple, Sanjar Juvekar, Jacques Emina, Frederick Ato Armah and Isaac Luginaah

Background – Indoor air pollution (IAP) interventions are widely promoted as a means of reducing indoor air pollution/health from solid fuel use; and research addressing impact of these interventions has increased substantially in the past two decades. It is timely and important to understand more about effectiveness of these interventions. We describe the protocol of a systematic review to (i) evaluate effectiveness of IAP interventions to improve indoor air quality and/or health in homes using solid fuel for cooking and/or heating in lower- and middle-income countries, (ii) identify the most effective intervention to improve indoor air quality and/or health, and (iii) identify future research needs.

Methods – This review will be conducted according to the National Institute for Health and Care Excellence (NICE) guidelines and will be reported following the PRISMA statement. Ovid MEDLINE, Ovid Embase, SCOPUS, and PubMed searches were conducted in September 2013 and updated in November 2014 (and include any further search updates in February 2015). Additional references will be located through searching the references cited by identified studies and through the World Health Organization Global database of household air pollution measurements. We will also search our own archives. Data extraction and risk of bias assessment of all included papers will be conducted independently by five reviewers.

Discussion – The study will provide insights into what interventions are most effective in reducing indoor air pollution and/or adverse health outcomes in homes using solid fuel for cooking or heating in lower- or middle-income countries. The findings from this review will be used to inform future IAP interventions and policy on poverty reduction and health improvement in poor communities who rely on biomass and solid fuels for cooking and heating.

WHO indoor air quality guidelines on household fuel combustion: Strategy implications of new evidence on interventions and exposure–risk functions. Atmospheric Environment,  April 2015.

Authors: Nigel Bruce, Dan Pope, Eva Rehfuess, Kalpana Balakrishnan, Heather Adair-Rohani, Carlos Dora


  • New WHO air quality guidelines will address household air pollution (HAP).
  • Action on HAP could lower risk of multiple child and adult diseases by 20–50%.
  • New evidence shows levels at or below 35 μg/m3 PM2.5 (WHO IT-1) are needed.
  • Most improved solid fuel stoves result in PM2.5 levels well above IT-1.
  • Intervention strategy must shift towards accelerating access to clean fuels.

Background: 2.8 billion people use solid fuels as their primary cooking fuel; the resulting high levels of household air pollution (HAP) were estimated to cause more than 4 million premature deaths in 2012. The people most affected are among the world’s poorest, and past experience has shown that securing adoption and sustained use of effective, low-emission stove technologies and fuels in such populations is not easy. Among the questions raised by these challenges are (i) to what levels does HAP exposure need to be reduced in order to ensure that substantial health benefits are achieved, and (ii) what intervention technologies and fuels can achieve the required levels of HAP in practice? New WHO air quality guidelines are being developed to address these issues.

Aims: To address the above questions drawing on evidence from new evidence reviews conducted for the WHO guidelines.

Methods: Discussion of key findings from reviews covering (i) systematic reviews of health risks from HAP exposure, (ii) newly developed exposure–response functions which combine combustion pollution risk evidence from ambient air pollution, second-hand smoke, HAP and active smoking, and (iii) a systematic review of the impacts of solid fuel and clean fuel interventions on kitchen levels of, and personal exposure to, PM2.5 and carbon monoxide (CO).

Findings: Evidence on health risks from HAP suggest that controlling this exposure could reduce the risk of multiple child and adult health outcomes by 20–50%. The new integrated exposure–response functions (IERs) indicate that in order to secure these benefits, HAP levels require to be reduced to the WHO IT-1 annual average level (35 μg/m3 PM2.5), or below. The second review found that, in practice, solid fuel ‘improved stoves’ led to large percentage and absolute reductions, but post-intervention kitchen levels were still very high, at several hundreds of μg/m3 of PM2.5, although most solid fuel stove types met the WHO 24-hr average guideline for CO of 7 mg/m3. Clean fuel user studies were few, but also did not meet IT-1 for PM2.5, likely due to a combination of continuing multiple stove and fuel use, other sources in the home (e.g. kerosene lamps), and pollution from neighbours and other outdoor sources.

Conclusions: Together, this evidence implies there needs to be a strategic shift towards more rapid and widespread promotion of clean fuels, along with efforts to encourage more exclusive use and control other sources in and around the home. For households continuing to rely on solid fuels, the best possible low-emission solid fuel stoves should be promoted, backed up by testing and in-field evaluation.