Biomass-fuelled improved cookstove intervention to prevent household air pollution in Northwest Ethiopia: a cluster randomized controlled trial

Abstract

Background Household air pollution from biomass fuels burning in traditional cookstoves currently appeared as one of the most serious threats to public health with a recent burden estimate of 2.6 million premature deaths every year worldwide, ranking highest among environmental risk factors and one of the major risk factors of any type globally. Improved cookstove interventions have been widely practiced as potential solutions. However, studies on the effect of improved cookstove interventions are limited and heterogeneous which suggested the need for further research. Methods A cluster randomized controlled trial study was conducted to assess the effect of biomass-fuelled improved cookstove intervention on the concentration of household air pollution compared with the continuation of an open burning traditional cookstove. A total of 36 clusters were randomly allocated to both arms at a 1:1 ratio, and improved cookstove intervention was delivered to all households allocated into the treatment arm. All households in the included clusters were biomass fuel users and relatively homogenous in terms of basic socio-demographic and cooking-related characteristics. Household air pollution was determined by measuring the concentration of indoor fine particulate, and the effect of the intervention was estimated using the Generalized Estimating Equation. Results A total of 2031 household was enrolled in the study across 36 randomly selected clusters in both arms, among which data were obtained from a total of 1977 households for at least one follow-up visit which establishes the intention-to-treat population dataset for analysis. The improved cookstove intervention significantly reduces the concentration of household air pollution by about 343 μg/m3 (Ḃ = − 343, 95% CI − 350, − 336) compared to the traditional cookstove method. The overall reduction was found to be about 46% from the baseline value of 859 (95% CI 837–881) to 465 (95% CI 458–472) in the intervention arm compared to only about 5% reduction from 850 (95% CI 828–872) to 805 (95% CI 794–817) in the control arm. Conclusions The biomass-fuelled improved cookstove intervention significantly reduces the concentration of household air pollution compared to the traditional method. This suggests that the implementation of these cookstove technologies may be necessary to achieve household air pollution exposure reductions. Trial registration The trial project was retrospectively registered on August 2, 2018, at the clinical trials.gov registry database (https://clinicaltrials.gov/) with the NCT03612362 registration identifier number.

Association between Lifestyle Changes and at-Home Hours during and after the State of Emergency Due to the COVID-19 Pandemic in Japan

“…While walking and standing decreased across all age groups, heavy physical work or strenuous exercise decreased or increased among some younger adults. An increase in media exposure after the COVID-19 pandemic was reported [ 9 ], and exercise and fitness promotions were introduced on multiple media [ 18 ]. Furthermore, fitness videos and social interactions motivate followers that are already physically active [ 19 ].…”

“…Evidence indicates that the state of emergency between April and May 2020 caused a decrease in PA among workers [ 8 ] and a deterioration in general health status due to significant changes in lifestyle and body weight among urban residents [ 9 ]. However, these changes were observed in groups that were susceptible to the stay-at-home request.…”

High Levels of Fine Particulate Matter (PM2.5) Concentrations from Burning Solid Fuels in Rural Households of Butajira, Ethiopia

“…This was also supported by the participants of our previous qualitative research from the same community who witnessed that cooking using improved cookstoves reduced the problem of wood smoke [ 41 ]. Some locally available improved cookstoves have been tested and found to reduce emission of particulate matter by 46% during traditional cooking in the dwelling [ 48 ]. However, other studies did not find statistically significant differences in the concentration of the particulate matter by the type of stove used in field studies with the exception of modest improvements in emission levels [ 49 , 50 ].…”

Fuel and Emission Efficiency test for locally produced charcoal stoves using charcoal sourced from selected tree species in Adola Woyu District, Ethiopia

“…These significant differences might be associated with the types of charcoal fuel and variation in the design of charcoal produced at the different localities of the country. The highest greenhouse gas mitigation of charcoal stoves under investigation has a great contribution to reducing the working load on children and women [36], [47], reduce household air pollution, and respiratory diseases [12].…”