Impact of improved stoves, house construction and child location on levels of indoor air pollution exposure in young Guatemalan children

Abstract

The goal of this study was to assess the impact of improved stoves, house ventilation, and child location on levels of indoor air pollution and child exposure in a rural Guatemalan population reliant on wood fuel. The study was a random sample of 204 households with children less than 18 months in a rural village in the western highlands of Guatemala. Socio-economic and household information was obtained by interview and observation. Twentyfour hour carbon monoxide (CO) was used as the primary measure of kitchen pollution and child exposure in all homes, using Gastec diffusion tubes. Twenty-four hour kitchen PM 3.5 was measured in a random sub-sample (n ¼ 29) of kitchens with co-located CO tubes. Almost 50% of the homes still used open fires, around 30% used chimney stoves (planchas) mostly from a large donor-funded programme, and the remainder of homes used various combinations including bottled gas and open fires. The 24-h kitchen CO was lowest for homes with self-purchased planchas: mean (95% CI) CO of 3.09 ppm (1.87-4.30) vs. 12.4 ppm (10.2-14.5) for open fires. The same ranking was found for child CO exposure, but with proportionately smaller differentials (Po0.0001). The 24-h kitchen PM 3.5 in the sub-sample showed similar differences (n ¼ 24, Po0.05). The predicted child PM for all 203 children (based on a regression model from the sub-sample) was 375 mg/m 3 (270-480) for self-purchased planchas and 536 mg/m 3 (488-584) for open fires. Multivariate analysis showed that stove/fuel type was the most important determinant of kitchen CO, with some effect of kitchen volume and eaves. Stove/fuel type was also the key determinant of child CO, with some effect of child position during cooking. The improved stoves in this community have been effective in reducing indoor air pollution and child exposure, although both measures were still high by international standards. Large donor-funded stove programmes need to aim for wider acceptance and uptake by the local families. Better stove maintenance is also required.

The impact of improved wood-burning stoves on fine particulate matter concentrations in rural Mexican homes

“…The installation of the Patsari stoves resulted in a median 71% reduction in 48-h PM 2.5 concentrations near the stove and 58% reduction in the kitchen; however, indoor concentrations remained nearly four times higher than outdoor standards. Several studies that have been conducted in Guatemala to evaluate the impacts of the plancha stove on indoor air pollution (Naeher et al, 2000;Albalak et al, 2001;Bruce et al, 2004) found comparable results. These studies, however, were longitudinal in design, and therefore the changes in concentrations found could be influenced by household factors (such as household size, income, design, etc.)…”

“…Adaptation to improved Patsari stoves can mean a significant behavioral change for many women, as it often includes shifting from cooking on the floor in a kneeling position to the standing position, chopping wood into smaller pieces, longer cooking times, and technology that requires frequent maintenance for adequate performance. The impact of the stoves on indoor air quality may improve with time, as participants use their stoves more, or deteriorate as participants abandon the new technology or fail to provide proper maintenance or use, as has been observed with other stove dissemination efforts (Bruce et al, 2004). It is important, therefore, that longer term impacts of improved stove programs are also evaluated.…”

“…Few systematic evaluations have been made on the effectiveness of improved stove programs in reducing indoor air pollution (McCracken and Smith, 1998;Ezzati et al, 2000a;Naeher et al, 2000;Albalak et al, 2001;Bruce et al, 2004). A recent interdisciplinary effort has begun in Mexico to disseminate 1500 improved Patsari wood-burning stoves in the state of Michoaca´n and to comprehensively evaluate their social, health, and environmental impacts (Masera et al, 2005).…”

The exposure of infants and children to carbon monoxide from biomass fuels in The Gambia: a measurement and modeling study

“…Data on personal exposure to pollutants in biomass smoke are necessary for analysis of association with disease outcomes, but has been measured or estimated in few studies (Ezzati et al, 2000;Naeher et al, 2001;Balakrishnan et al, 2002;Bruce et al, 2004;Dasgupta et al, 2006;Mestl et al, 2007;Dionisio et al, 2008;McCracken et al, 2009). In particular, a metric of usual exposure is desired because exposure may vary from day to day and health effects may depend on cumulative exposure.…”

Neglected diseases of neglected populations: Thinking to reshape the determinants of health in Latin America and the Caribbean

“…Urban drainage improvements and improved household water storage systems can reduce urban malaria [69]. Improved wood stoves (biofuel stoves), substitution of biofuels with gas or other improved rural fuel/energy sources, and improved kitchen ventilation all reduce exposure of women and young children to harmful indoor air pollutants arising from exposure to smoke from traditional woodstoves and open fires [70]. Solar stoves, solar water disinfection and solar energy panels are possible alternatives to traditional wood stoves, boiling water with biofuels and burning kerosene lamps in the home, though their higher costs must be addressed [71].…”