REDUCING RESPIRATORY ILLNESS THROUGH ALLEVIATING KITCHEN SMOKE
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Transcript of REDUCING RESPIRATORY ILLNESS THROUGH ALLEVIATING KITCHEN SMOKE
REDUCING RESPIRATORY ILLNESS THROUGH ALLEVIATING KITCHEN SMOKE
IRISH FORUM FOR GLOBAL HEALTH (IFGH)BIENNIAL CONFERENCE November 29th 2010
Liz Bates
Outline• Health impacts• Limitations - health data• Need for proxy• Monitoring• Interventions – including
examples – discussing benefits and constraints
• Future actions
Worldwide deaths from indoor smoke from solid fuel include...
• 64% occur in low-income countries, especially in South-East Asia and Africa.
• 28% of global deaths caused by indoor smoke from solid fuels occur in China.
21% Lower respiratory infections35% Chronic obstructive pulmonary diseases3% Lung cancers
*GLOBAL HEALTH RISKS: WHO Mortality and burden of disease attributable to selected major risks 2009
Mortality low-income countries* 10 leading risk factor causes of death by income group 2004
* low-income < US$825
10th in the world
DALYs low-income countries* 10 leading risk factor causes of DALYs by income group, 2004
* low-income < US$825
9th in the world
Environmental risk factorsPercentage of deaths / DALYs in low-middle income countries
Indoor smoke
from so
lid fu
els
Unsafe w
ater, s
anita
tion, hyg
iene
Urban outdoor a
ir pollu
tion
Lead
exposu
re
Global cli
mate ch
ange
0.01.02.03.04.05.0
% Deaths% DALYs
Data included in these figuresBased on data for which there is solid evidence• ALRI• COPD• CancerLess evidence• Tuberculosis• LBW & Prematurity – (cause of 29% of all
newborn deaths)• Cardio-vascular diseases
WHO 24hr air quality guidelines for particulate matter
Interim targets
PM2.5 & (PM10)
Rationale
1 75 (150) 15% higher long-term mortality risk relative to the AQG
2 50 (100) Lowers risk from (1) by ~6%
3 37.5 (75) Lowers risk from (2) by (2% - 11%)AQG* 25 (50) Cardiopulmonary and lung cancer
mortality risks not seen to increase (95% confidence level)
*AQG = Air Quality Guidelines (WHO)
Monitoring for PM and CO
PM CO
Typical results for CO woman & room
0 200 400 600 800 1000 1200 1400 16000
10
20
30
40
50
60
CO_rm CO_wm
Approaches to alleviation of IAPBehavioural changes• Cook and child keeping
away from smoke• Cooking in a separate
room • Cutting food small• Cooking outdoors• Transferring ownership
of the problem to the cook and her family
Approaches to alleviation of IAP
Not creating pollution - using clean fuels
• LPG• Ethanol• New fuels such as
plant oils
Approaches to alleviation of IAP
Venting smoke out of the house
• Smoke hoods• Chimney stoves• Eaves spaces
Approaches to alleviation of IAP
Burning fuel efficiently• Using an improved
stove• Using dry fuel• Using a pressure
cooker
Approaches to alleviation of IAP
Burning fuel efficiently• Using an improved
stove• Using dry fuel• Using a pressure
cooker
Reductions achieved in PM, Kenya, Nepal & Sudan – 30households
Kenya 24hr PMMean values
0
100
200
300
400
500
600
700
Rounds
Part
icul
ates
(ug/
m3)
Nepal 24hr PMMean values
0
200
400
600
800
1000
1200
1400
Rounds
Part
icul
ates
(ug/
m3)
Sudan 24hr PMMean values
0
200
400
600
800
1000
1200
1400
Rounds
Part
icul
ates
(ug/
m3)
Issues....if people do not like a stove, or cannot afford it – the efficiency of the intervention to
remove smoke is NIL
Good or bad changes in family life
0 2 4 6 8 10 12
Only use LPG occasionally due to condition of kitchen
Smoke is bad for the eyes - LPG minimises problem
Smoke is bad for you
Need money to f ix kitchen
LPG kisra sag needs f ixing - have to use w ood
Daughter does not use LPG
Health /w ell-being deteriorates w hen LPG runs out
Does not use LPG
Improved family health
No change
No money to ref ill bottle
No smoke / Less smoke
Time saving
Kitchen is good /clean / healthy / relaxing
Quality of life benefits - Kenya
What are the major benefits?
0 20 40 60 80 100
Husband now helps with cookingFood stays clean
Reduces the amount of laundryPersonal cleanliness improved
No excessive heat in roomImproved status / confidence
Saves moneyPots & utensils stay clean
Can get on with other things whilst cookImproved health for self and/or family
Improved cooking conditions / well-beingHouse stays cleaner
Keeps food warmLess / No smoke in house
Uses less fuelSaves time cooking
Number of responses
Quality of life benefits - Nepal
0 20 40 60 80 100 120 140
Improved eyes
Reduced access for vermin
Easier to dry meat
Easier to work
Cleaner clothes
Improved safety
Cleaner roof
Faster cooking
Cleaner home
Improved health
Fuel saving
Reduced smoke
Number of responses
Quality of life benefits - Sudan
What works?• Start project with self-sustaining perspective• Starting with people where the are – not
where we want them to be• Encourage people to ‘own’ the problem• Develop a range of options with community• Develop finance systems that suit them• Treating people as customers
New initiatives: Global Alliance for Clean Cookstoves
• Coordinated through the UN Foundation (UNF) - $250 goal• Founding partner organizations signed up to 100 million
clean cookstoves by 2020• Primary focus on development of robust global stove
industry / market• Unproven hypothesis -biomass stoves exist that are
o clean enough to have major health/climate benefits o affordable by world's poorest half, to sustain sales -
$US10 NO such device is available today Smith KR, What's Cooking? A Brief Update, Energy for Sustainable Development (2010),
doi:10.1016/j.esd.2010.10.002
New initiatives:Global Cookstove Accelerator Facility
• Developing mechanism to make it easier for cookstove programmes to tap funds through CDM, or the voluntary carbon market using Gold Standard
• guaranteeing a price floor on future carbon credits low interest loans
Smith KR, What's Cooking? A Brief Update, Energy for Sustainable Development (2010), doi:10.1016/j.esd.2010.10.002
New initiatives National Biomass Cookstove Initiative (NCI)
• Explicitly aiming to provide every household in India with combustion comparable to LPG in cleanliness and efficiency, whether from modern fuels or biomass
• Competition to increase efforts on R&D• Carbon finance is ‘the icing on the cake’ – they
are after ‘the cake’
Traditional kitchen
Improved kitchen
Thank you...questions?