BMJ Editorial: Air pollution, stroke, and anxiety

March 30, 2015 · 1 comment

BMJ Editorial: Air pollution, stroke, and anxiety. British Medical Journal, March 24, 2015.

Author: Michael Brauer, professor

Particulate air pollution is an emerging risk factor for an increasing number of common conditions

The effects of air pollution on the lungs and heart are now widely appreciated, with expanding evidence for an important role in cardiac disease.1 The Global Burden of Disease Study identified fine particulate matter (PM2.5) in outdoor air and household air pollution from use of solid fuels as the ninth and fourth leading risk factors, respectively, for disease worldwide,2 and the World Health Organization attributes one in every eight deaths to air pollution.3 The effects of air pollution are not limited to cardiopulmonary diseases. Recent evidence suggests a role in diverse outcomes, including diabetes,4 low birth weight, and preterm birth.5 This research stems from improved understanding of the role of air pollution in initiating systemic inflammation, a response that may affect multiple organ systems. Two linked studies (doi:10.1136/bmj.h1295, doi:10.1136/bmj.h1111) add to growing evidence that air pollution is an important risk factor for an increasing number of common diseases.6 7

In the first of the two papers, Shah and colleagues6 systematically reviewed and meta-analysed 103 studies conducted in 28 countries and including 6.2 million events to assess the role of short term fluctuations in air pollution as a trigger for stroke. Although evidence from several cohort studies of long term exposure to particulate matter indicates associations with stroke mortality, such findings are not universal.8

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How Cookstoves Research is Changing the World

March 30, 2015 · 0 comments

How Cookstoves Research is Changing the World | Source: American Thoracic Society News, March 2015.

Three billion people in the world, a number unchanged in nearly 30 years, cook their food with an open fire, causing respiratory problems such as pneumonia in children and COPD and lung cancer in adults, as well as cardiovascular diseases. Estimates in 2012 from the Global Burden of Disease project, indicate that smoke from these traditional cooking methods causes a staggering four million premature deaths each year.

Until the last decade, this major health issue had gone largely unnoticed by most medical scientists and public health experts. ATS members, in collaboration with organizations, government officials, and institutions across the world, have played important roles in describing the health impacts of cook smoke, conducting clinical trials with cleaner-burning biomass stoves, and highlighting gaps in knowledge of the problem. In recent months, their efforts have gained momentum.

Their findings have contributed to the publication of the World Health Organization’s Indoor Air Quality Guidelines, a report on childhood pneumonia from the Institute of Health Metrics and Evaluation, and a Lancet Respiratory Household Air Pollution (HAP) Commission.

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

March 23, 2015 · 0 comments

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

March 23, 2015 · 0 comments

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

March 23, 2015 · 0 comments

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

March 23, 2015 · 0 comments

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

March 12, 2015 · 0 comments

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

March 12, 2015 · 0 comments

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

March 12, 2015 · 2 comments

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

March 12, 2015 · 0 comments

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.

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