Background: Nearly 3 billion people worldwide rely on solid fuel combustion to meet basic household energy needs. The resulting exposure to air pollution causes an estimated 4.5% of the global burden of disease. Large variability and a lack of resources for research and development have resulted in highly uncertain exposure estimates.Objective: We sought to identify research priorities for exposure assessment that will more accurately and precisely define exposure–response relationships of household air pollution necessary to inform future cleaner-burning cookstove dissemination programs.Data Sources: As part of an international workshop in May 2011, an expert group characterized the state of the science and developed recommendations for exposure assessment of household air pollution.Synthesis: The following priority research areas were identified to explain variability and reduce uncertainty of household air pollution exposure measurements: improved characterization of spatial and temporal variability for studies examining both short- and long-term health effects; development and validation of measurement technology and approaches to conduct complex exposure assessments in resource-limited settings with a large range of pollutant concentrations; and development and validation of biomarkers for estimating dose. Addressing these priority research areas, which will inherently require an increased allocation of resources for cookstove research, will lead to better characterization of exposure–response relationships.Conclusions: Although the type and extent of exposure assessment will necessarily depend on the goal and design of the cookstove study, without improved understanding of exposure–response relationships, the level of air pollution reduction necessary to meet the health targets of cookstove interventions will remain uncertain.Citation: Clark ML, Peel JL, Balakrishnan K, Breysse PN, Chillrud SN, Naeher LP, Rodes CE, Vette AF, Balbus JM. 2013. Health and household air pollution from solid fuel use: the need for improved exposure assessment. Environ Health Perspect 121:1120–1128; http://dx.doi.org/10.1289/ehp.1206429

Exposure to higher personal-level PM₂.₅ during routine daily activity measured with low-bias and minimally-confounded personal monitors was associated with modest increases in systolic blood pressure and trends towards arterial vasoconstriction. Comparable elevations in community PM₂.₅ levels were not related to these outcomes, suggesting that specific components within personal and background ambient PM₂.₅ may elicit differing cardiovascular responses.

The US Environmental Protection Agency recently conducted the Detroit Exposure and Aerosol Research Study (DEARS). The study began in 2004 and involved community, residential, and personal-based measurements of air pollutants targeting 120 participants and their residences. The primary goal of the study was to evaluate and describe the relationship between air toxics, particulate matter (PM), PM constituents, and PM from specific sources measured at a central site monitor with those from the residential and personal locations. The impact of regional, local (point and mobile), and personal sources on pollutant concentrations and the role of physical and human factors that might influence these concentrations were investigated. A combination of active and passive sampling methodologies were employed in the collection of PM mass, criteria gases, semivolatile organics, and volatile organic compound air pollutants among others. Monitoring was conducted in six selected neighborhoods along with one community site using a repeated measure design. Households from each of the selected communities were monitored for 5 consecutive days in the winter and again in the summer. Household, participant and a variety of other surveys were utilized to better understand human and household factors that might affect the impact of ambient-based pollution sources upon personal and residential locations. A randomized recruitment strategy was successful in enrolling nearly 140 participants over the course of the study. Over 36,000 daily-based environmental data points or records were ultimately collected. This paper fully describes the design of the DEARS and the approach used to implement this field monitoring study and reports select preliminary findings.

Particle size distributions were measured indoors and outdoors of a single, detached residence during the Fresno particulate matter exposure studies in winter (February 1-28, 1999) and spring (April 18-May 16, 1999). Data was collected for particle sizes ranging from about 0.01 to 2.5 ¹m. These data were used to investigate the temporal relationships between indoor and outdoor aerosol concentrations and to determine particle deposition rates and penetration factors for discrete particle sizes. Indoor/outdoor aerosol concentration ratios for particle sizes >1 ¹m were diurnally variable with highest ratios occurring during daytime (6:00-18:00) due to resuspension from indoor activities. Daytime and nighttime (19:00-7:00) aerosol concentration ratios were very similar for particle sizes <1 ¹m. Particle deposition rates were determined by measuring the decay in indoor aerosol concentrations after indoor levels were elevated by in ltration of native ambient aerosols. Deposition rates varied depending on particle size and were consistent with model results up to about 0.4 ¹m. The experimentally determined deposition rates were considerably higher than model results at larger particle sizes, suggesting the possibility of an additional indoor loss mechanism. Penetration factors were determined to be less than unity for all particle sizes and ranged from 0.5 to 0.9.

This work investigated the resuspension and subsequent translocation of particulate matter (PM) from carpeted flooring surfaces due to walking. In addition, the effect of HVAC systems and ceiling fans on mixing and/or translocation of resuspended PM was studied. Testing took place both in a residence with a wellworn, soiled carpet and in an environmental test chamber. Prescribed walking occurred with PM measurements taken at multiple sampling heights. Scanning electron microscopy (SEM) of carpet fibers was used to determine the fraction of dust available for resuspension. These data, in conjunction with resuspended mass concentrations from this study, were used to generate emission factors by particle size for walking on both new and worn carpet.Carpet loading does not affect the emission factor, indicating that the amount of resuspended PM is directly proportional to the available PM in the carpet. While relative humidity (RH) plays an important role in resuspension from new carpets, with high RH enhancing resuspension, it has the opposite affect with old carpets, with increased RH decreasing resuspension. With the HVAC system on, translocated particles 1.2 m horizontally from the source had number concentrations of approximately 20-40% of those at the source. With a ceiling fan on, extensive mixing was noted with little difference seen in particle resuspension by height. With the ceiling fan off, there was very little mixing present and particle size varied substantially by height.