Addressing the Impact of Household Energy and Indoor Air Pollution on the Health of the Poor: Implications for Policy Action and Intervention Measures pot

... Air Pollution on the Health of the Poor Implications for Policy Action and Intervention Measures |17 Addressing the Impact of Household Energy and Indoor Air Pollution on the Health of the Poor: ... stove, and whether the child is carried on the Addressing the Impact of Household Energy and Indoor Air Pollution on the Health of the Poor Implications for Policy Action and Intervention Measures |9mother's ... for information and action is greatest. Addressing the Impact of Household Energy and Indoor Air Pollution on the Health of the Poor Implications for Policy Action and Intervention Measures |15...

... 1991 consider environment and pollution. The indoor air quality and the health and comfort in the workplace environment depends upon a number of factors in the life cycle of the building. For ... reflects on the health, comfort and productivity of individuals in buildings. The main reason for the lack of awareness of the problems is due to the fact that the effects of indoor air pollution ... population (Gravesen et al., 1990). The indoor air quality and healthy and comfortable internal environ- ment is the product of the interaction of design, con- struction, use and maintenance of...

... pollution reduction, the sustainability of interventions in resource-poor contexts has been questioned. Nonetheless, efforts should continue to promote indoor air pollution reduction in populations ... is the most cost-effective intervention for sub-Saharan Africa.44 In a randomised controlled trial on the effects of indoor smoke on the risk of pneumonia in children, the introduction of ... International Classification of Diseases. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Based on the Recommendations of the Ninth Revision Conference...

... 22appropriateplace for HWTSneedstobefound,within the widerframework of water and sanitationinterventions.Regionalfactors(e.g.water and culture),sourcewaterquality,localburden of disease(i.e.whetherdrinkingwateris the majorcause of diarrhoeainaparticularlocation)areexamples of variablestobestudied.Furtherworkisalsoneededtosupportsustained and correctuse of treatmenttechnologies,includingresearch on implementationmodels and technologyperformanceevaluation.1.5.2Effectiveness of improvedsolidfuelstoves The assessment of stoveeffectivenessrequiresconsiderationnotonlywhether the improveddelivers on HAPreduction and otherpotentialbenefitssuchasfuelsavings,butalsowhetheritisacceptabletousers,ismaintained and remainsineverydayuse.Itisusefultodistinguishefficacy(whatan intervention deliversinidealcircumstances)fromeffectiveness(whatitdoesinrealisticsituations) and efficiency(whetheritdoessocost‐effectively).Thesefactorsareconsideredin the overallreport,but the focusinthissectionis on howeffective the interventionsareinpracticeinreducinglevels of HAPin the home, and for personalexposures. Impact of interventions on household pollution and personalexposure On waytoreduceemissions and henceHAPlevels and personalexposureistoimprove the completeness of combustion.InEastAfricacheapimprovedstoveswithoutflues,burningeitherwood(e.g. the Upesi)orcharcoal,arepopular and arereportedtoreducekitchen pollution byimprovingcombustion,althoughfew(ifany)measurementsareavailabletosupportthis. The currentKenyanstudydoesincludemeasurement of PM2.5(Section3).Flue‐lesswoodstoves of the Rockettype,whichusean'elbow'combustionchambertoimprovecombustion,arebeingintroducedinanumber of Africancountries.Theseareclaimedtodeliverlargeremissionreductions,butformalevaluationisawaited and theyaremoreexpensivethan the Upesi. The mostencouragingnewdevelopmentinbiomasscombustiontechnologyis the gasifierstove,whichusessecondarycombustion,withorwithout the aid of forcedventilationusingasmallfan.Varioustype of thesestoves,whicharerapidlygainingpopularityinChina and India,canburneither(finelychopped)'raw'biomass,orprocessed(pelletized)biomass, and deliveremissionlevels of PM2.5closetothose of LPGstoves(KirkRSmith,personalcommunication).Theyarehoweverquiteexpensive(US$40‐75), and thereistodateverylimitedexperiencewithuseinverypoor,ruralcommunities. The secondapproachtoreducingemissionsinto the homeistoattachaflue,orarrangeahoodwithachimney.ImprovedstoveswithflueshavebeenpromotedextensivelyinseveralAsiancountries,althoughmanyhavebeenfoundtobeinpoorconditionafterafewyears.SomestudiesfromIndiahaveshownvariable and sometimesmodestorminimalreductionsin pollution. For example,LaxmichimneystovesinhomeslocatedinMaharasthra,Indiaresultedina24%reduction of PM2.5 and a39%reduction of CO,whileasukhadchimneystovein the Bundelkhandregion of Indiareducedkitchenconcentrations of PM2.5 and COby44% and 70%respectively(Chengappaetal.,2007).SimilarexperiencewithfluedstoveshasbeenreportedfromLatinAmerica.PlanchastovesinGuatemala(made of cementblocks,withametalplate and flue)canreducePMby60to70%, and byasmuchas90%whenwellmaintained.Typical24‐hourPMlevels(PM10,PM3.5, and PM2.5havebeenreported)withopenfires of 1,000–2,000g/m3havebeenreducedto300–500g/m3, and insomecaseslessthan100g/m3.(Alabalaketal.,2001). ... 14project,however,thesestovesappeartobewell‐liked and well‐used, and arereportedtosavewood,reducesmoke and the consequentirritation,cough,headaches,etc.,aswellas the level of sootin the kitchen.Womenhavere‐organisedtheirkitchensinresponsetothis,bringingpots and otherutensilsmuchcloserto the stove. The reasons for thisinconsistencybetweenfieldexperience(reportedreductionsinsmoke and irritation) and testfindings (for PM2.5)arenotclear,asreductionsinambientkitchenPM2.5 of somewherearound40‐50%(atleast)mightbeexpectedgiven the reportedimprovementsin the kitchenenvironment. The projectteamusedanestablishedprotocol and equipment for making the measurements.Information on the numbers of stovesadoptedineachcommunity, and hencelevel(%) of uptake,wasnotreportedacross the studyareaoravailabletous(althoughthesedatashouldbeavailableto the project).Itisthereforenotpossibletocomment on whetheradoptionhasmet the targetsetin the projectobjectives.Whileeffectiveness of the stovesremainsopentoquestion and willbefurtherassessedonce the newmeasurementresultsareavailable, the model of promotion and sale of acook‐stoveproductthatiswell‐liked and usedisanimportantachievement and of value for the future of the project.Synergies The approach of combining the promotion and delivery of HWTS and HHEproductsmetwithacross the boardpositiveresponses.Itappearsmorecost‐effectivethanif the sameproductswerepromotedthroughseparateprogrammes.Combineddeliverymayalsoachievehighercompliance,butthisdoesneedfurtheranalysis.Therewerenosubstantiveconcernswithany of the criteriaidentifiedfrom the backgroundreviewpaper. Impact on health outcomesAnalysis of the results of the impacts of the interventions on diarrhoea and pneumoniaincidenceisawaited.Itcanbeexpectedthat the reportedlevel of compliancewithwatertreatmentwouldhavesome impact on diarrhoea,particularlywhere the higherlevelshavebeenreached. On the otherhand, the verymodestreductioninPM2.5levelsrecorded for the Upesistovewouldnot(ifconfirmed)beexpectedtoleadtosubstantialreductionsinrisk of pneumonia.Sustainability and scalingupWithrespectto the twolinkedissues of sustainability and scaling‐up the outcome of the evaluationalsoispositive,althoughbothdependtosomedegreeatleast on the existence and modusoperandi of SWAP. The vendorsspokentosaidthattheywerecommittedtocontinuingtheirwork,evenifSWAPceasedoperations,butonlyiftheycouldstillobtain the products.From the perspective of the SWAPmanagement, the vendorsarestilldependent on SWAP’ssupportwithtraining,followupvisits,supply of products,motivatingthemwithincentives and so on. SWAPitselfisalsostilldonordependent, and hasrecentlydevelopedabusinessplantoraiseitsownincome.However,given the factthatSWAPoperatesasimilarmethodologyacrossitswholearea of operations for delivering the watertreatment,ITNs and other(original)set of products,itdoesseemreasonabletoassumethatdelivery of theseplus the stoveswouldalsobepossibleacrossthismuchlargerarea.Todate,scalingup of the improvedstovesacrossthiswiderareahasbeenveryslow,dueto the needtoscaleupproduction, and also for training of installers.Considerationalsoneeds ... %)(i)Efficacy The efficacy of WGhasbeenestablishedinscientificliterature, and willnotbefurtherdiscussedhere(Latagne,2007).However, the fieldefficacyissuediscussedinSection2.2isimportant. The breakableWGbottle‐topshastened the expiry of the productleadingto the onlyimporters of WGhaltingtheirservicestoACMS.(InFebruary2010,WHOwasinformedthatACMSwaslooking for newpartnerstoobtainfreshsupplies). The subsequentreturn of bottlesaffected the databyreducing the availabletimetotest the effect of the jointinterventions, and alsoinfluencing the intervention population’sview of the product and health impacts.(ii)EffectivenessEffectivenessdepends on how the productsareusedinpractice, for which'usercompliance'iscritical.Belowisasummary of keycomplianceinformation,obtainedfrom the GTZfinalreport and internalevaluation.Awareness and adoptionAsdemonstratedinFigure2.3 on the followingpage,awareness of WGgrewfromapproximately3%to35% of intervention households, and actualusageincreasedfromapproximately1%to34% of householdsover the course of the project.Furthermore,accordingtoGTZapproximately90% of productawarenesswascreatedthrough the project,suggesting the awarenesscampaignhadaconsiderableeffect.Figure2.3Awareness and adoptionfigures for WaterGuard,firelesscooker and MMS(ExtractedfromGTZ,2009)LegendTranslationHorizontalaxis:(Yellowbox‐Sensitisation):Awareness of WG;Awareness of MMS and firelesscooker;(Graybox‐Adoption):Reportedusage of WG;Reportedusage of MMS;Reportedusage of firelesscooker;Goodpractices of woodstorage;Goodpractices of household waterstorage.Verticalaxis:proportion of respondents(%).Legend:1st,2nd, and 3rdphasesofassessment(asexplainedat the beginningofSection2.4)...

... J. Vizcarra. Environmental Air Pollution 16 Indoor Air Pollution Indoor Air Pollution INDOOR AIR POLLUTION ALSO AFFECTS OUTDOOR AIR INDOOR AIR POLLUTION ALSO AFFECTS OUTDOOR AIR QUALITYQUALITYNigel ... be for a much longer period each day. Ref: Addressing the links between indoor air pollution, household energy and human health. Based on the WHO-USAID Consultation on the Health Impact of Household ... 2004.19 Indoor Air Pollution Indoor Air Pollution HOUSEHOLD ENERGY, IAP AND HEALTH HOUSEHOLD ENERGY, IAP AND HEALTH  3 billion people rely on solid fuels  Solid fuels comprise 10 15% of the total...

... agreementsunder the UNECE Convention on Long-range Transboundary Air Pollution (LRTAP). Since itsratification in 1979, this Convention has contributed to lower transboundary air pollution through policy measures ... agreementsunder the UNECE Convention on Long-range Transboundary Air Pollution (LRTAP). Since itsratification in 1979, this Convention has contributed to lower transboundary air pollution through policy measures ... of exceedance of the nitrogen critical loadprovides an indication of the level of risk of adverseeffects of nitrogen on ecosystems Air pollution will remain a problem in the future• Air pollution...

... Winter air pollution concentrations on respiratory health of Dutch children. Environmental Researh, 64, 136-150.von der Hardt, H. (1985) Air pollution and bronchopulmonary disease in children MonatsschrKinderheilkd, ... (1997) Air Pollution and Child Health: Priorities for Action. Activity ReportNo. 38: Report of a Meeting of and EHP Technical Advisory Group on Air Pollution, July 17-18, 1996Arlington, Virginia.Bono, ... 66-74.Norpoth, K. (1997) Latest information on the interaction between environment and airwaydiseases exercising an influence on the legal assessment of occupational obstructive airwaydiseases...

... time, environmental impacts,etc.) of these potential interventions on health. Available information relates mainly to the impact on fuel consumption, emission levels, and in fewer cases on the resultant ... for a wider range of interventions and settings.• For better information on key parameters used in the analyses and on the full range of household adjustments to interventions. Addressing the ... Energy and Human Health Based on the WHO-USAID Global Consultation on the Health Impact of Indoor Air Pollution and Household Energy in Developing Countries (Meeting report)Washington, DC3-4...

... affect the health of residents. The regulation of chemical emission from furniture and the education of residents are required.COMMUNICATION BETWEENMEDICAL INSTITUTIONS AND REGIONAL HEALTH ... N.(2009) Study of Indoor Air Pollution. Indoor Env-iron., 12, 71–86 (in Japanese).13) Irie, T. (2007) Historical review on the indoor envi-ronment and health. Indoor Environ., 10, 129–135(in ... under normal conditions. VOCs arenumerous and varied, and also harmful or toxic.Regarding indoor air pollution, the air concentra-tion of some organic compounds is regulated. The WHO has proposed...

... arelikely to contribute the most to the concentration and exposure profiles, and the results of this studyare likely to be useful as representing the indoor air pollution profile for the rural households ... simple and reliable environmental health indicator for indoor air quality. Sinceimproved stoves seem to offer one of the best near-term options for reducing the human health impacts of household ... venti-lation is not achieved at the expense of air quality in the rest of the household. Since households withseparate kitchens are at lower risk of high livingconcentrations, the direction of the...