Indoor air pollution exposure from use of indoor stoves and fireplaces in association with breast cancer: a case-control study. Environmental Health, Dec 2014, 13:108 doi:10.1186/1476-069X-13-108.

Authors: Alexandra J White (, Susan L Teitelbaum (, et al.

Background – Previous studies suggest that polycyclic aromatic hydrocarbons (PAHs) may adversely affect breast cancer risk. Indoor air pollution from use of indoor stoves and/or fireplaces is animportant source of ambient PAH exposure. However, the association between indoor stove/fireplace use and breast cancer risk is unknown. We hypothesized that indoor stove/fireplace use in a Long Island, New York study population would be positively associated with breast cancer and differ by material burned, and the duration and timing of exposure. We also hypothesized that the association would vary by breast cancer subtype defined by p53 mutation status, and interact with glutathione S-transferases GSTM1, T1, A1and P1 polymorphisms.

Methods – Population-based, case-control resources (1,508 cases/1,556 controls) were used to conduct unconditional logistic regression to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI).ResultsBreast cancer risk was increased among women reporting ever burning synthetic logs (whichmay also contain wood) in their homes (OR = 1.42, 95%CI 1.11, 1.84), but not for everburning wood alone (OR = 0.93, 95%CI 0.77, 1.12). For synthetic log use, longer duration >7years, older age at exposure (>20 years; OR = 1.65, 95%CI 1.02, 2.67) and 2 or more variantsin GSTM1, T1, A1 or P1 (OR = 1.71, 95%CI 1.09, 2.69) were associated with increased risk.

Conclusions – Burning wood or synthetic logs are both indoor PAH exposure sources; however, positive associations were only observed for burning synthetic logs, which was stronger for longer exposures, adult exposures, and those with multiple GST variant genotypes. Therefore, our results should be interpreted with care and require replication.

Facts on U.S. Support for Clean Cooking Sector, Clean Cookstoves - 21 November 2014

U.S. Department of State
Office of the Spokesperson
Washington, D.C.
November 21, 2014

Fact Sheet

The United States’ Expanded Support to the Clean Cooking Sector and the Global Alliance for Clean Cookstoves

Secretary of State John Kerry, U.S. Agency for International Development (USAID) Administrator Rajiv Shah, and Environmental Protection Agency (EPA) Administrator Gina McCarthy announced on Nov. 21, 2014 renewed and enhanced support by the United States for the clean cooking sector and the Global Alliance for Clean Cookstoves (Alliance).

These actions will help improve health, reduce environmental degradation, mitigate climate change, and generate economic empowerment and opportunity for women and girls.

The Alliance is a public-private partnership led by the United Nations Foundation that aims to create a thriving global market for clean and efficient household cooking stoves and fuels.

  • In January 2015, the Alliance will launch Phase 2 of its ten-year Strategic Business Plan.

Nearly 3 billion people have little choice but to cook over open fires or traditional stoves. The World Health Organization estimates more than 4 million people die prematurely every year because of exposure to smoke from these stoves; these exposures rank as the world’s fourth worst health risk – and the second worst for women and girls.

Cookstoves also account for more than 20 percent of global emissions of black carbon – an important short-lived pollutant that impacts near-term climate change and the health of local communities.

The United States anticipates contributing up to $200 million through 2020 towards an enhanced range of work in the clean cooking sector, including: attracting up to $25 million in financing by reducing the risk banks face in providing loans to cookstove businesses; investing $59 million in new research to build the evidence base for clean cooking interventions; and contributing $16 million towards field implementation activities.

The United States is also working to develop a guarantee financing package to mobilize an additional $100 million in private financing for the clean cooking sector.

These new contributions will help the Alliance achieve its goal of enabling 100 million homes to adopt clean and efficient cooking solutions by 2020.

These contributions build on the United States’ initial five-year commitment from 2011-2015 and bring the cumulative ten-year U.S. contribution to the clean cooking sector and the Alliance up to a possible $325 million.

All projected support is subject to the availability of funds.

Department of State – up to $2.5 million

• The Department of State will continue to utilize its diplomatic outreach to support Alliance efforts both globally and in the Alliance’s focus countries in Africa, Asia, and Latin America. The Department is also investing up to $2.5 million to: 1) scale adoption of household energy products by increasing the number of women entrepreneurs who are able to effectively and efficiently distribute these products, and 2) identify innovative financing options to support the deployment of cooking stoves with climate benefits, in the context of the Climate and Clean Air Coalition.

U.S. Agency for International Development (USAID) – up to $135 million

• USAID – through two of its Development Credit Authority loan guarantee vehicles, and in partnership with the Swedish International Development Agency (SIDA) – will mobilize up to $125 million in new private financing for manufacturers and distributors of clean cookstoves and cooking fuel. More specifically, USAID and SIDA are:

– Launching a $100 million credit facility, in partnership with three international financial institutions, to support the proliferation of household technology products. This facility may attract $25 million in new private lending that will enable clean stove and fuel enterprises to expand their product lines, increase production, and reach new markets.

– Working on developing, in partnership with anchor financial partners and institutional investors, a guarantee financing package dedicated to mobilizing an additional $100 million in private financing for manufacturers and distributors of clean stoves and fuels.

• USAID will contribute $10 million to support market development and engage private-sector participation to help scale adoption of stoves and fuels that meet household energy needs and release fewer pollutants. The goal of these efforts is to improve health, reduce environmental degradation, mitigate climate change, foster economic growth, and empower women.

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The Global Alliance for Clean Cookstoves seeks to create a thriving global market for clean cookstoves and fuels, with the goal to enable 100 million households to adopt clean and efficient cooking technologies by 2020. The Spark Fund provides investment-like growth capital and capacity development support to help enterprises reach commercial viability, scale, and ultimately unlock additional investments for future growth.

The Spark Fund targets the specific capital and capacity development needs of social enterprises that have passed proof-of-concept, are at the venture or growth stage, and are focused on the commercial up-scaling of their operations. As such, enterprises supported by Spark will be:

1) Market-based, commercially viable enterprises

2) Venture or growth stage ventures that are generating income and are not yet mature enough to access growth capital from traditional investment sources

3) Scalable enterprises with the potential to make a significant contribution to the Alliance’s goal of enabling 100 million households to adopt clean and efficient cooking technologies and fuels by 2020

The Spark Fund III will be accepting applications between from November 17th 2014 to January 30th 2015, 6:00pm EST. Finalists will be notified by March 1st 2015 and after completion of in-depth due diligence and panel judging, up to 6 qualifying enterprises will be selected to receive funding by June 1st 2015.

NANO-AETHALOMETER: Understanding Biomass Cooking Behaviors, 2014.

Julien Caubel, Daniel Wilson. Center for Effective Global Action.

Research Purpose – Measure geographic distribution of BC to monitor where and how biomass is burned, and understand the resulting impacts on human health and environment.

  • Current technologies are too expensive, cumbersome or unreliable at measuring BC
  • Need for a low-cost, compact instrument that can be deployed both on the ground and in the air to accurately and directly measure BC distributions on large scale

Project Summary - Lightweight, compact BC sensor built and tested.Measurement performance is comparable to costlycommercial instruments.

  • Balloon launched successfully in India with satellitebasedglobal telemetry and communications system
  • The Nano-Aethalometer will be deployed both on theground and in the air around rural communities inIndia to monitor biomass cookstove user trends andbehaviors
  • Ultimately, this data and information will enable moreeffective reductions of the health and environmentalimpacts associated with biomass cookstoves in thedeveloping world

Selling Sustainability: Delivering Cookstoves Is Easier than Convincing People to Use Them. California Magazine, Fall 2014.

An excerpt – David I. Levine is an unusual kind of salesman. The UC Berkeley Haas School of Business professor’s products are good: cost-effective, ecofriendly water filters and cookstoves. But Levine found that where his products were most needed—in Uganda, Bangladesh, and Kenya—people weren’t buying.

“The biggest mystery is cookstoves,” says Levine. Traditional biomass cookstoves kill more than 4 million people a year due to various illnesses associated with indoor air pollution, including 1 million children under the age of 5 due to pneumonia, according to the World Health Organization. Such stoves also contribute to deforestation and global climate change. Improved cookstoves, which cost around $10, use half the fuel, stay hot longer, and emit less smoke. For many, this switch would be an easy sell; but for impoverished households, that was not the case.

“All these health benefits are very uncertain,” Levine says. “They’re in the distant future.” It’s hard for people to accept that their stoves are causing deaths. What’s more, Levine says, long-term environmental effects are marginal problems for families who don’t have savings, bank accounts, or even locks on their doors.

After several iterations, Levine devised a successful payment plan for these cookstoves. Households were given a free trial followed by a rent-to-own plan in which they would pay for the cookstove mostly out of fuel savings. Throw in a return policy, and Levine saw a significant increase in sales.

The strategy worked because “you don’t have to worry about whether people believe the doctors, or how people think about the hazards to a child’s health,” he says. “It comes down to money.”

But Levine’s approach turned up a new obstacle: Many customers do not trust vendors, regardless of free trials. Furthermore, vendors are hesitant to give credit to customers—despite the fact that in his pilot program, Levine received more than 97 percent of scheduled payments in Uganda. He is now testing mobile payments and layaway options to overcome this challenge.



Turn Down Heat, Confronting the New Climate Normal: Executive Summary, 2014. World Bank.

The benefits of strong, early action on climate change, action that follows clean, low carbon pathways and avoids locking in unsustainable growth strategies, far outweigh the costs. Many of the worst projected climate impacts could still be avoided by holding warming to below 2°C. But, the time to act is now. The data show that dramatic climate changes, heat and weather extremes are already impacting people, damaging crops and coastlines and putting food, water, and energy security at risk. Across the three regions studied in this report, record-breaking temperatures are occurring more frequently, rainfall has increased in intensity in some places, while drought-prone regions are getting dryer. In an overview of social vulnerability, the poor and underprivileged, as well as the elderly and children, are found to be often hit the hardest. There is growing evidence, that even with very ambitious mitigation action, warming close to 1.5°C above pre-industrial levels by mid-century is already locked-in to the Earth’s atmospheric system and climate change impacts such as extreme heat events may now be unavoidable.1 If the planet continues warming to 4°C, climatic conditions, heat and other weather extremes considered highly unusual or unprecedented today would become the new climate normal—a world of increased risks and instability. T

Female Labor Force Participation and Household Dependence on Biomass Energy: Evidence from National Longitudinal Data. World Development
Volume 67, March 2015, Pages 424–437

Authors: Paul J. Burke, Guy Dundas


  • We examine drivers of household biomass energy use using national longitudinal data.
  • Our dataset covers up to 175 countries during the period 1990–2010.
  • Female labor force involvement is associated with less household biomass energy use.
  • The opportunity cost of women’s time appears to influence household energy choices.
  • Our results on the role of income are consistent with the fuel stacking model.

Summary – Air pollution from household biomass combustion is an important cause of poor health in developing countries. This study employs national-level longitudinal data for up to 175 countries during 1990–2010 and finds that female labor force participation is associated with reductions in household biomass energy use. Consistent with the “fuel stacking” model, higher incomes are linked to use of other types of energy by households, but not significantly associated with reductions in use of biomass energy. The results highlight the multifaceted nature of household energy transitions and suggest an avenue by which female empowerment can lead to improved health outcomes.

Voice of America – Making Cooking Stoves Safer Worldwide, December 11, 2014

Smoky cook fires are a leading cause of indoor airpollution - poor air quality inside buildings. Indoor airpollution kills more than four million people each year. The problem is bigger than malaria, tuberculosis orHIV, the virus that causes the disease AIDS.

Recently, people concerned about the issue met fortwo days of discussions in New York City. Their hopewas to persuade private industry to build and sell betterstoves.

Traditional open-fire cooking affects the health of bothhuman beings and the world’s environment. Collectingwood for cooking fires is one of the main causes ofdeforestation. And the gases and soot that comefrom the fires pollute the air. They also are partlyresponsible for rising temperatures.

At the meeting, former Secretary of State Hillary Clintonnoted that almost three billion people use traditional stoves for heating andcooking. Because of their widespread use, she said, indoor air pollution is aninternational problem.

“But it also, if approached correctly, could be an economic opportunity. And that is the idea behind the alliance.”

The Global Alliance for Clean Cookstoves supports companies that make andsell affordable, efficient and less-polluting cookers. The alliance alsosupports research into developing better stoves.

Ms. Clinton helped launch the group in 2010. At the meeting, the United Statespromised $200 million in financial support and research money. Butorganizers wanted to raise $500 million.

Radha Muthiah is the executive director of the alliance. She says four yearsafter the group was launched, 20 million more households are using cleancookstoves.

“We’ve proven that this market-based approach works. Twenty millionstoves later, we know that this is a recipe that can be scaled up.”

Jim Jetter works as a researcher for the United States EnvironmentalProtection Agency. He says it is not easy to build a low-cost device thatpeople will use.

“It’s a big technical challenge to make a cookstove that has low emissions ofair pollutants, that is fuel efficient, and that is low-cost so that people canafford it — and, most importantly, that it meets the user needs. If it doesn’tmeet the user’s needs, then people do not use the stoves and, and then thereare no benefits.”


Indoor Air Pollution From Burning Yak Dung as a Household Fuel in Tibet. Atmospheric Environment, Nov 2014.

Authors: Qingyang Xiao, Eri Saikawa, , Robert J. Yokelson, Pengfei Chen, Chaoliu Li, Shichang Kang

• Real-time BC and PM2.5 concentrations were measured in households in Nam Co, Tibet.
• 23 households were surveyed on energy use and awareness of indoor air pollution.
• Chimney installation may not by itself ensure adequate indoor air quality.
• We observed a lower BC/PM2.5 ratio for dung combustion than previous estimates.
• About 0.4-1.7 Gg/year of additional BC is emitted by yak dung combustion in Tibet.

Yak dung is widely used for cooking and heating in Tibet. We measured real-time concentrations of black carbon (BC) and fine particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) emitted by yak dung burning in six households with different living conditions and stove types in the Nam Co region, Tibet. We observed a much lower average BC/PM2.5 mass ratio (0.013, range 0.006 to 0.028) from dung combustion in this area than previously reported estimates, ranging between 0.05 and 0.11. Based on our measurements, estimated fuel use, and published emission factors of BC and PM2.5, about 0.4-1.7 Gg/year of BC is emitted by yak dung combustion in Tibet in addition to the previously estimated 0.70 Gg/year of BC for Tibetan residential sources.

Our survey shows that most residents were aware of adverse health impacts of indoor yak dung combustion and approximately 2/3 of residents had already installed chimney stoves to mitigate indoor air pollution. However, our measurements reveal that, without adequate ventilation, installing a chimney may not ensure good indoor air quality. For instance, the 6-h average BC and PM2.5concentrations in a stone house using a chimney stove were 24.5 and 873 μg/m3, respectively. We also observed a change in the BC/PM2.5 ratios before and after a snow event. The impact of dung moisture content on combustion efficiency and pollutant emissions needs further investigation.


Sustained use of biogas fuel and blood pressure among women in rural Nepal. Environmental Research, Volume 136, January 2015, Pages 343–351.

Authors: Maniraj Neupane, Buddha Basnyat, Rainald Fischer, Guenter Froeschl, Marcel Wolbers, Eva A Rehfuess

• We study the impact of sustained use of biogas fuel on blood pressure among females.
• Use of biogas is associated with lower SBP and DBP in cooks >50 years.
• Use of biogas is associated with 68% reduced odds of developing high blood pressure in cooks >50 years.
• Effect of biogas use on blood pressure seems to be age dependent.

Background – More than two fifths of the world’s population cook with solid fuels and are exposed to household air pollution (HAP). As of now, no studies have assessed whether switching to alternative fuels like biogas could impact cardiovascular health among cooks previously exposed to solid fuel use.

Methods – We conducted a propensity score matched cross-sectional study to explore if the sustained use of biogas fuel for at least ten years impacts blood pressure among adult female cooks of rural Nepal. We recruited one primary cook ≥30 years of age from each biogas (219 cooks) and firewood (300 cooks) using household and measured their systolic (SBP) and diastolic blood pressure (DBP). Household characteristics, kitchen ventilation and 24-h kitchen carbon monoxide were assessed. We matched cooks by age, body mass index and socio-economic status score using propensity scores and investigated the effect of biogas use through multivariate regression models in two age groups, 30–50 years and >50 years to account for any post-menopausal changes.

Results – We found substantially reduced 24-h kitchen carbon monoxide levels among biogas-using households. After matching and adjustment for smoking, kitchen characteristics, ventilation status and additional fuel use, the use of biogas was associated with 9.8 mmHg lower SBP [95% confidence interval (CI), −20.4 to 0.8] and 6.5 mmHg lower DBP (95% CI, −12.2 to −0.8) compared to firewood users among women >50 years of age. In this age group, biogas use was also associated with 68% reduced odds [Odds ratio 0.32 (95% CI, 0.14–0.71)] of developing hypertension. These effects, however, were not identified in younger women aged 30–50 years.

Conclusions – Sustained use of biogas for cooking may protect against cardiovascular disease by lowering the risk of high blood pressure, especially DBP, among older female cooks. These findings need to be confirmed in longitudinal or experimental studies.