Household light makes global heat: high black carbon emissions from kerosene wick lamps

Factors Determining Black Carbon Exposures among Pregnant Women Enrolled in the HAPIN Trial

Residential biomass burning is an important source of black carbon (BC) exposure among rural communities in low- and middle-income countries. We collected 7165 personal BC samples and individual/household level information from 3103 pregnant women enrolled in the Household Air Pollution Intervention Network trial. Women in the intervention arm received free liquefied petroleum gas stoves and fuel throughout pregnancy; women in the control arm continued the use of biomass stoves. Median (IQR) postintervention BC exposures were 9.6 μg/m3 (5.2-14.0) for controls and 2.8 μg/m3 (1.6-4.8) for the intervention group. Using mixed models, we characterized predictors of BC exposure and assessed how exposure contrasts differed between arms by select predictors. Primary stove type was the strongest predictor (R2 = 0.42); the models including kerosene use, kitchen location, education, occupation, or stove use hours also provided additional explanatory power from the base model adjusted only for the study site. Our full, trial-wide, model explained 48% of the variation in BC exposures. We found evidence that the BC exposure contrast between arms differed by study site, adherence to the assigned study stove, and whether the participant cooked. Our findings highlight factors that may be addressed before and during studies to implement more impactful cookstove intervention trials.

Aerosols heat up the Himalayan climate

The impact of aerosols, especially the absorbing aerosols, in the Himalayan region is important for climate. We closely examine ground-based high-quality observations of aerosol characteristics including radiative forcing from several locations in the Indo-Gangetic Plain (IGP), the Himalayan foothills and the Tibetan Plateau, relatively poorly studied regions with several sensitive ecosystems of global importance, as well as highly vulnerable large populations. This paper presents a state-of-the-art treatment of the warming that arises from these particles, using a combination of new measurements and modeling techniques. This is a first-time analysis of its kind, including ground-based observations, satellite data, and model simulations, which reveals that the aerosol radiative forcing efficiency (ARFE) in the atmosphere is clearly high over the IGP and the Himalayan foothills (80-135 Wm-2 per unit aerosol optical depth (AOD)), with values being greater at higher elevations. AOD is >0.30 and single scattering albedo (SSA) is ∼0.90 throughout the year over this region. The mean ARFE is 2-4 times higher here than over other polluted sites in South and East Asia, owing to higher AOD and aerosol absorption (i.e., lower SSA). Further, the observed annual mean aerosol-induced atmospheric heating rates (0.5-0.8 Kelvin/day), which are significantly higher than previously reported values for the region, imply that the aerosols alone could account for >50 % of the total warming (aerosols + greenhouse gases) of the lower atmosphere and surface over this region. We demonstrate that the current state-of-the-art models used in climate assessments significantly underestimate aerosol-induced heating, efficiency and warming over the Hindu Kush - Himalaya - Tibetan Plateau (HKHTP) region, indicating a need for a more realistic representation of aerosol properties, especially of black carbon and other aerosols. The significant, regionally coherent aerosol-induced warming that we observe in the high altitudes of the region, is a significant factor contributing to increasing air temperature, observed accelerated retreat of the glaciers, and changes in the hydrological cycle and precipitation patterns over this region. Thus, aerosols are heating up the Himalayan climate, and will remain a key factor driving climate change over the region.

Attributed radiative forcing of air pollutants from biomass and fossil burning emissions

Energy is vital to human society but significantly contributes to the deterioration of environmental quality and the global issue of climate change. Biomass and fossil fuels are important energy sources but have distinct pollutant emission characteristics during the burning process. This study aimed at attributing radiative forcing of climate forcers, including greenhouse gases but also short-lived climate pollutants, from the burning of fossil and biomass fuels, and the spatiotemporal characteristics. We found that air pollutant emissions from the burning process of biofuel and fossil fuels induced RFs of 68.2 ± 36.8 mW m^-2 and 840 ± 225 mW m^-2, respectively. The relatively contribution of biomass burning emissions was 7.6% of that from both fossil and biofuel combustion processes, while its contribution in energy supply was 11%. These relative contributions varied obviously across different regions. The per unit energy consumption of biomass fuel in the developed regions, such as North America (0.57 ± 0.33 mW m^-2/10⁷TJ) and Western Europe (0.98 ± 0.79 mW m^-2/10⁷TJ), had higher impacts of combustion emission related RFs compared to that of developing regions, like China (0.40 ± 0.26 mW m^-2/10⁷TJ), and South and South-East Asia (0.31 ± 0.71 mW m^-2/10⁷TJ) where low efficiency biomass burning in residential sector produced significant amounts of organic matter that had a cooling effect. Note that the study only evaluated fuel combustion emission related RFs, and those associated with the production of fuels and land use change should be studied later in promoting a comprehensive understanding on the climate impacts of biomass utilization.

Measuring and predicting personal and household Black Carbon levels from 88 communities in eight countries

Black Carbon (BC) is an important component of household air pollution (HAP) in low- and middle- income countries (LMICs), but levels and drivers of exposure are poorly understood. As part of the Prospective Urban and Rural Epidemiological (PURE) study, we analyzed 48-hour BC measurements for 1187 individual and 2242 household samples from 88 communities in 8 LMICs (Bangladesh, Chile, China, Colombia, India, Pakistan, Tanzania, and Zimbabwe). Light absorbance (10^-5 m^-1) of collected PM_2.5 filters, a proxy for BC concentrations, was calculated via an image-based reflectance method. Surveys of household/personal characteristics and behaviors were collected after monitoring. The geometric mean (GM) of personal and household BC measures was 2.4 (3.3) and 3.5 (3.9)·10^-5 m^-1, respectively. The correlation between BC and PM_2.5 was r = 0.76 for personal and r = 0.82 for household measures. A gradient of increasing BC concentrations was observed for cooking fuels: BC increased 53% (95%CI: 30, 79) for coal, 142% (95%CI: 117, 169) for wood, and 190% (95%CI: 149, 238) for other biomass, compared to gas. Each hour of cooking was associated with an increase in household (5%, 95%CI: 3, 7) and personal (5%, 95%CI: 2, 8) BC; having a window in the kitchen was associated with a decrease in household (-38%, 95%CI: -45, -30) and personal (-31%, 95%CI: -44, -15) BC; and cooking on a mud stove, compared to a clean stove, was associated with an increase in household (125%, 95%CI: 96, 160) and personal (117%, 95%CI: 71, 117) BC. Male participants only had slightly lower personal BC (-0.6%, 95%CI: -1, 0.0) compared to females. In multivariate models, we were able to explain 46-60% of household BC variation and 33-54% of personal BC variation. These data and models provide new information on exposure to BC in LMICs, which can be incorporated into future exposure assessments, health research, and policy surrounding HAP and BC.

Effect of a solar lighting intervention on fuel-based lighting use and exposure to household air pollution in rural Uganda: A randomized controlled trial

Solar lighting is an alternative to polluting kerosene and other fuel-based lighting devices relied upon by millions of families in resource-limited settings. Whether solar lighting provides sustained displacement of fuel-based lighting sources and reductions in personal exposure to fine particulate matter (PM₂ .₅ ) and black carbon (BC) has not been examined in randomized controlled trials. Eighty adult women living in rural Uganda who utilized fuel-based (candles and kerosene lamps) and/or clean (solar, grid, and battery-powered devices) lighting were randomized in a 1:1 ratio to receive a home solar lighting system at no cost to study participants (ClinicalTrials.gov NCT03351504). Among intervention group participants, kerosene lamps were completely displaced in 92% of households using them. The intervention led to an average exposure reduction of 36.1 μg/m³ (95% CI -70.3 to -2.0) in PM₂ .₅ and 10.8 μg/m³ (95% CI -17.6 to -4.1) in BC, corresponding to a reduction from baseline of 37% and 91%, respectively. Reductions were greatest among participants using kerosene lamps. Displacement of kerosene lamps and personal exposure reductions were sustained over 12 months of follow-up. Solar lighting presents an immediate opportunity for achieving sustained reductions in personal exposure to PM_2.5 and BC and should be considered in household air pollution intervention packages.

Pregnant Women's Exposure to Household Air Pollution in Rural Bangladesh: A Feasibility Study for Poriborton: The CHANge Trial

The use of liquefied petroleum gas (LPG) for cooking is a strategy to reduce household air pollution (HAP) exposure and improve health. We conducted this feasibility study to evaluate personal exposure measurement methods to representatively assess reductions in HAP exposure. We enrolled 30 pregnant women to wear a MicroPEM for 24 h to assess their HAP exposure when cooking with a traditional stove (baseline) and with an LPG stove (intervention). The women wore the MicroPEM an average of 77% and 69% of the time during the baseline and intervention phases, respectively. Mean gravimetric PM_2.5 mass and black carbon concentrations were comparable during baseline and intervention. Temporal analysis of the MicroPEM nephelometer data identified high PM_2.5 concentrations in the afternoon, late evening, and overnight during the intervention phase. Likely seasonal sources present during the intervention phase were emissions from brick kiln and rice parboiling facilities, and evening kerosene lamp and mosquito coil use. Mean background adjusted PM_2.5 concentrations during cooking were lower during intervention at 71 μg/m³, versus 105 μg/m³ during baseline. Representative real-time personal PM_2.5 concentration measurements supplemented with ambient PM_2.5 measures and surveys will be a valuable tool to disentangle external sources of PM_2.5, other indoor HAP sources, and fuel-sparing behaviors when assessing the HAP reduction due to intervention with LPG stoves.

Will open waste burning become India's largest air pollution source?

India struggles with frequent exceedances of the ambient air quality standard for particulate matter and benzene. In the past two decades, India has made considerable progress in tackling indoor air pollution, by phasing out kerosene lamps, and pushing biofuel using households towards Liquefied Petroleum Gas (LPG) usage. In this study, we use updated emission inventories and trends in residential fuel consumption, to explore changes in the contribution of different sectors towards India's largest air pollution problem. We find that residential fuel usage is still the largest air pollution source, and that the <10% households using cow dung as cooking fuel contribute ∼50% of the residential PM_2.5 emissions. However, if current trends persist, residential biofuel usage in India is likely to be phased out by 2035. India's renewable energy policies are likely to reduce emissions in the heat and electricity sector, and manufacturing industries, in the mid-term. PM_2.5 emissions from open waste burning, on the other hand, hardly changed in the decade from 2010 to 2020. We conclude that without strong policies to promote recycling and upcycling of non-biodegradable waste, and the conversion of biodegradable waste to biogas, open waste burning is likely to become India's largest source of air pollution by 2035. While our study is limited to India, our findings are of relevance for other countries in the global South suffering from similar waste management challenges.

Air quality during COVID-19 lockdown and its implication toward sustainable development goals

Air pollution is directly as well as indirectly linked with several of the United Nations Sustainable Development Goals (SDGs). Hence, focused efforts and strategies toward improving the air quality can lead to direct reduction in the adverse impacts on human health and our cities and setting climate mitigation targets. The worldwide outbreak of the novel coronavirus (COVID-19) has forced various governments around the world to suspend nonessential activities due to the unavailability of the vaccine. This unprecedented lockdown led to significant decline in major criteria air pollutants—PM_2.5, PM₁₀, CO, and NO₂—with more than 50% decline in several cities across the world. However, SO₂ did not change much over some regions, while O₃ has shown some increase. The majority of these changes are well supported by the reduced pollutant emissions, primarily from vehicular sources in urban areas. A slight decline has also been observed in global greenhouse gas (GHG) emissions during the lockdowns. The lockdown illustrates the need for a potential shift of anthropogenic activities toward a more sustainable lifestyle for ameliorating air quality and thus paving the pathway to achieve SDGs. The COVID-19-induced lockdown scenario should be exploited to understand future measures to improve air quality and mitigate the adverse health and climate effects. This chapter explores the impact of the national lockdowns on urban air quality across the globe. Learnings from this natural intervention and future policy implications toward improving air quality are further discussed.

Use, cost-effectiveness, and end user perspectives of a home solar lighting intervention in rural Uganda: a mixed methods, randomized controlled trial

Energy poverty is prevalent in resource-limited settings, leading households to use inefficient fuels and appliances that contribute to household air pollution. Randomized controlled trials of household energy interventions in low and middle income countries have largely focused on cooking services. Less is known about the adoption and impact of clean lighting interventions. We conducted an explanatory sequential mixed methods study as part of a randomized controlled trial of home solar lighting systems in rural Uganda in order to identify contextual factors determining the use and impact of the solar lighting intervention. We used sensors to track usage, longitudinally assessed household lighting expenditures and health-related quality of life, and performed cost-effectiveness analyses. Qualitative interviews were conducted with all 80 trial participants and coded using reflexive thematic analysis. Uptake of the intervention solar lighting system was high with daily use averaging 8.23 ± 5.30 hours per day. The intervention solar lighting system increased the EQ5D index by 0.025 [95% CI 0.002 - 0.048] and led to an average monthly reduction in household lighting costs by -1.28 [-2.52, -0.85] US dollars, with higher savings in users of fuel-based lighting. The incremental cost-effectiveness ratio for the solar lighting intervention was $2025.72 US dollars per quality adjusted life year (QALY) gained making the intervention cost-effective when benchmarked against the gross domestic product (GDP) per capita in Uganda. Thematic analysis of qualitative data from individual interviews showed that solar lighting was transformative and associated with numerous benefits that fit within a Social Determinants of Health (SDOH) framework. The benefits included improved household finances, improved educational performance of children, increased household safety, improved family and community cohesion, and improved perceived household health. Our findings suggest that household solar lighting interventions may be a cost-effective approach to improve health-related quality of life by addressing SDOH.

A Systematic Review and Appraisal of Epidemiological Studies on Household Fuel Use and Its Health Effects Using Demographic and Health Surveys

The domestic combustion of polluting fuels is associated with an estimated 3 million premature deaths each year and contributes to climate change. In many low- and middle-income countries (LMICs), valid and representative estimates of people exposed to household air pollution (HAP) are scarce. The Demographic and Health Survey (DHS) is an important and consistent source of data on household fuel use for cooking and has facilitated studies of health effects. However, the body of research based on DHS data has not been systematically identified, nor its strengths and limitations critically assessed as a whole. We aimed to systematically review epidemiological studies using DHS data that considered cooking fuel type as the main exposure, including the assessment of the extent and key drivers of bias. Following PRISMA guidelines, we searched PubMed, Web of Science, Scopus and the DHS publication portal. We assessed the quality and risk of bias (RoB) of studies using a novel tool. Of 2748 records remaining after removing duplicates, 63 were read in full. A total of 45 out of 63 studies were included in our review, spanning 11 different health outcomes and representing 50 unique analyses. In total, 41 of 45 (91%) studies analysed health outcomes in children <5 years of age, including respiratory infections (n = 17), death (all-cause) (n = 14), low birthweight (n = 5), stunting and anaemia (n = 5). Inconsistencies were observed between studies in how cooking fuels were classified into relatively high- and low-polluting. Overall, 36/50 (80%) studies reported statistically significant adverse associations between polluting fuels and health outcomes. In total, 18/50 (36%) of the analyses were scored as having moderate RoB, while 16/50 (32%) analyses were scored as having serious or critical RoB. Although HAP exposure assessment is not the main focus of the DHS, it is the main, often only, source of information in many LMICs. An appreciable proportion of studies using it to analyse the association between cooking fuel use and health have potential for high RoB, mostly related to confounder control, exposure assessment and misclassification, and outcome ascertainment. Based on our findings, we provide some suggestions for ways in which revising the information collected by the DHS could make it even more amenable to studies of household fuel use and health, and reduce the RoB, without being onerous to collect and analyse.

Logistic regression analysis of environmental and other variables and incidences of tuberculosis in respiratory patients

The objective of this study was to examine the association of 14 variables with TB in respiratory patients. The variables included: urban/rural, persons in 1200 sqft area, TB in family, crowding, smoking (family member), gender, age, education, smoking, workplace, kitchen location, cooking fuel, ventilation, and kerosene uses. Eight hundred respiratory patients were tested for sputum positive pulmonary TB; 500 had TB and 300 did not. An analysis of the unadjusted odds ratio (UOR) and adjusted OR (AOR) was undertaken using logistic regression to link the probability of TB incidences with the variables. There was an inconsistency in the significance of variables using UOR and AOR. A subset model of 4 variables (kerosene uses, ventilation, workplace, and gender) based on significant AOR was adjudged acceptable for estimating the probability of TB incidences. Uses of kerosene (AOR 2.62 (1.95, 3.54)) consistently related to incidences of TB. It was estimated that 50% reduction in kerosene uses could reduce the probability of TB by 13.29% in respiratory patients. The major recommendation was to replace kerosene uses from households with a supply of clean fuel like liquid petroleum or natural gas and rural electrification.

Estimating the Energy Demand and Growth in Off-Grid Villages: Case Studies from Myanmar, Indonesia, and Laos

Under the Sustainable Development Goals (SDGs), the world has pledged to “leaving no one behind”. Responding to goal No. 7 on the agenda, efforts to provide modern energy to all the world population must be pushed forward. This is important because electrification in the rural area can indirectly support opportunities for social and economic development resulting in an acceleration of the eradication of poverty. The research goal of this study is to contribute insights about the scale of energy demand in unelectrified villages in the Southeast Asian countries and to discuss some factors that might influence the energy demand growth. This is done by making projections based on surveys and interviews, including a time-use survey, in three off-grid villages located in Myanmar, Indonesia, and Laos. Our analysis presented the living condition, highlight the types of energy sources, how, and in what rhythms people use energy on a daily basis in those villages. The demands in each case study villages were then projected based on several constructed scenarios. It was found that the factors of household size, proximity to the city, climate, and topography may influence the present and future growth of energy demands in the villages. The estimated energy demand may be useful for project managers to design a pilot off-grid energy system project in a similar environment and pointed out important factors to consider when formulating off-grid energy policies in the region.

Adverse health impacts of cooking with kerosene: A multi-country analysis within the Prospective Urban and Rural Epidemiology Study

BACKGROUND

Kerosene, which was until recently considered a relatively clean household fuel, is still widely used in low- and middle-income countries for cooking and lighting. However, there is little data on its health effects. We examined cardiorespiratory effects and mortality in households using kerosene as their primary cooking fuel within the Prospective Urban Rural Epidemiology (PURE) study.

METHODS

We analyzed baseline and follow-up data on 31,490 individuals from 154 communities in China, India, South Africa, and Tanzania where there was at least 10% kerosene use for cooking at baseline. Baseline comorbidities and health outcomes during follow-up (median 9.4 years) were compared between households with kerosene versus clean (gas or electricity) or solid fuel (biomass and coal) use for cooking. Multi-level marginal regression models adjusted for individual, household, and community level covariates.

RESULTS

Higher rates of prevalent respiratory symptoms (e.g. 34% [95% CI:15-57%] more dyspnea with usual activity, 44% [95% CI: 21-72%] more chronic cough or sputum) and lower lung function (differences in FEV1: -46.3 ml (95% CI: -80.5; -12.1) and FVC: -54.7 ml (95% CI: -93.6; -15.8)) were observed at baseline for kerosene compared to clean fuel users. The odds of hypertension was slightly elevated but no associations were observed for blood pressure. Prospectively, kerosene was associated with elevated risks of all-cause (HR: 1.32 (95% CI: 1.14-1.53)) and cardiovascular (HR: 1.34 (95% CI: 1.00-1.80)) mortality, as well as major fatal and incident non-fatal cardiovascular (HR: 1.34 (95% CI: 1.08-1.66)) and respiratory (HR: 1.55 (95% CI: 0.98-2.43)) diseases, compared to clean fuel use. Further, compared to solid fuel users, those using kerosene had 20-47% higher risks for the above outcomes.

CONCLUSIONS

Kerosene use for cooking was associated with higher rates of baseline respiratory morbidity and increased risk of mortality and cardiorespiratory outcomes during follow-up when compared to either clean or solid fuels. Replacing kerosene with cleaner-burning fuels for cooking is recommended.

Developing a Low-Cost Passive Method for Long-Term Average Levels of Light-Absorbing Carbon Air Pollution in Polluted Indoor Environments

We propose a low-cost passive method for monitoring long-term average levels of light-absorbing carbon air pollution in polluted indoor environments. Building on prior work, the method here estimates the change in reflectance of a passively exposed surface through analysis of digital images. To determine reproducibility and limits of detection, we tested low-cost passive samplers with exposure to kerosene smoke in the laboratory and to environmental pollution in 20 indoor locations. Preliminary results suggest robust reproducibility (r = 0.99) and limits of detection appropriate for longer-term (~1-3 months) monitoring in households that use solid fuels. The results here suggest high precision; further testing involving "gold standard" measurements is needed to investigate accuracy.

The Perspective of Total Lighting as a Key Factor to Increase the Sustainability of Strategic Activities

In the last decades, lighting has evolved from a branch of engineering ensuring safety and performance in indoor and outdoor installations, to a key discipline interacting with a wide spectrum of fields and having a deep impact on our daily lives. Although this evolution also applies to other areas of knowledge, the special features of lighting make its potential and also its limitations different. It is not the typical field where a well-established mathematical framework allows a departure from well-defined input and identifying clear effects and conclusions. The reason is that lighting is a field dealing with the interaction between a physical phenomenon and a physiological and psychological system, the human being. In addition to the complexity of its basis, the relationship between lighting and sustainability has become stronger in recent years. This relationship is bi-directional in some cases: on one hand, advanced societies require more and more complex lighting installations, which means high energy consumption, use of raw materials, financial costs, manufacturing and maintenance processes, waste and emissions to the atmosphere. On the other hand, good lighting has an impact on issues like productivity, well-being, happiness, disease avoidance, safety, and many other qualitative aspects whose direct or indirect impact on sustainability is remarkable. This work will analyze how lighting can give answers to questions related to sustainability, not only from the classic topics of energy consumption and waste management, but from a wider and global perspective. The results of these works are analyzed, and the basis of the new framework of total lighting, discussed.

Predictors of personal exposure to black carbon among women in southern semi-rural Mozambique

Sub-Saharan Africa (SSA) has the highest proportion of people using unclean fuels for household energy, which can result in products of incomplete combustion that are damaging for health. Black carbon (BC) is a useful marker of inefficient combustion-related particles; however, ambient air quality data and temporal patterns of personal exposure to BC in SSA are scarce. We measured ambient elemental carbon (EC), comparable to BC, and personal exposure to BC in women of childbearing age from a semi-rural area of southern Mozambique. We measured ambient EC over one year (2014-2015) using a high-volume sampler and an off-line thermo-optical-transmission method. We simultaneously measured 5-min resolved 24-h personal BC using a portable MicroAeth (AE51) in 202 women. We used backwards stepwise linear regression to identify predictors of log-transformed 24-h mean and peak (90th percentile) personal BC exposure. We analyzed data from 187 non-smoking women aged 16-46 years. While daily mean ambient EC reached moderate levels (0.9 μg/m³, Standard Deviation, SD: 0.6 μg/m³), daily mean personal BC reached high levels (15 μg/m³, SD: 19 μg/m³). Daily patterns of personal exposure revealed a peak between 6 and 7 pm (>35 μg/m³), attributable to kerosene-based lighting. Key determinants of mean and peak personal exposure to BC were lighting source, kitchen type, ambient EC levels, and temperature. This study highlights the important contribution of lighting sources to personal exposure to combustion particles in populations that lack access to clean household energy.

Updated Emission Factors from Diffuse Combustion Sources in Sub-Saharan Africa and Their Effect on Regional Emission Estimates

Diffuse emission sources outside of kitchen areas are poorly understood, and measurements of their emission factors (EFs) are sparse for regions of sub-Saharan Africa. Thirty-one in-field emission measurements were taken in northern Ghana from combustion sources common to rural regions worldwide. Sources sampled included commercial cooking, trash burning, kerosene lanterns, and diesel generators. EFs were calculated for carbon monoxide (CO), carbon dioxide (CO₂), as well as carbonaceous particulate matter, specifically elemental carbon (EC) and organic carbon (OC). EC and OC emissions were measured from kerosene lighting events (EF_EC = 25.1 g/kg-fuel SD = 25.7, EF_OC = 9.5 g/kg-fuel SD = 10.0). OC emissions from trash burning events were large and highly variable (EF_OC = 38.9 g/kg-fuel SD = 30.5). Combining our results with other recent in-field emission factors for rural Ghana, we explored updated emission estimates for Ghana using a region specific emissions inventory. Large differences are calculated for all updated source emissions, showing a 96% increase in OC and 78% decrease in EC compared to prior estimates for Ghana's emissions. Differences for carbon monoxide were small when averaged across all updated source types (-1%), though the household wood use and trash burning categories individually show large differences.

Current respiratory symptoms and risk factors in pregnant women cooking with biomass fuels in rural Ghana

BACKGROUND

More than 75% of the population in Ghana relies on biomass fuels for cooking and heating. Household air pollution (HAP) emitted from the incomplete combustion of these fuels has been associated with adverse health effects including respiratory effects in women that can lead to chronic obstructive pulmonary disease (COPD), a major contributor to global HAP-related mortality. HAP is a modifiable risk factor in the global burden of disease, exposure to which can be reduced.

OBJECTIVE

This study assessed the prevalence of respiratory symptoms, as well as associations between respiratory symptoms and HAP exposure, as measured using continuous personal carbon monoxide (CO), in nonsmoking pregnant women in rural Ghana.

METHODS

We analyzed current respiratory health symptoms and CO exposures upon enrollment in a subset (n = 840) of the population of pregnant women cooking with biomass fuels and enrolled in the GRAPHS randomized clinical control trial. Personal CO was measured using Lascar continuous monitors. Associations between CO concentrations as well as other sources of pollution exposures and respiratory health symptoms were estimated using logistic regression models.

CONCLUSION

There was a positive association between CO exposure per 1 ppm increase and a composite respiratory symptom score of current cough (lasting >5 days), wheeze and/or dyspnea (OR: 1.2, p = 0.03). CO was also positively associated with wheeze (OR: 1.3, p = 0.05), phlegm (OR: 1.2, p = 0.08) and reported clinic visit for respiratory infection in past 4 weeks (OR: 1.2, p = 0.09). Multivariate models showed significant associations between second-hand tobacco smoke and a composite outcome (OR: 2.1, p < 0.01) as well as individual outcomes of cough >5 days (OR: 3.1, p = 0.01), wheeze (OR: 2.7, p < 0.01) and dyspnea (OR: 2.2, p = 0.01). Other covariates found to be significantly associated with respiratory outcomes include involvement in charcoal production business and dyspnea, and involvement in burning grass/field and wheeze. Results suggest that exposure to HAP increases the risk of adverse respiratory symptoms among pregnant women using biomass fuels for cooking in rural Ghana.

Chemical Composition and Emissions Factors for Cookstove Startup (Ignition) Materials

Air pollution from cookstoves creates a substantial human and environmental health burden. A disproportionate fraction of emissions can occur during stove ignition (startup) compared to main cooking, yet startup material emissions are poorly quantified. Laboratory tests were conducted to measure emissions from startups using kerosene, plastic bags, newspaper, fabric, food packaging, rubber tire tubes, kindling, footwear, and wood shims. Measured pollutants included: fine particulate matter mass (PM_2.5), PM_2.5 elemental and organic carbon, methane, carbon monoxide, carbon dioxide, benzene, and formaldehyde. Results demonstrate substantial variability in the measured emissions across materials on a per-startup basis. For example, kerosene emitted 496 mg PM_2.5 and 999 mg CO per startup, whereas plastic bags emitted 2 mg PM_2.5 and 30 mg CO. When considering emissions on a per-mass basis, the ordering of materials from highest-to-lowest emissions changes, emphasizing the importance of establishing how much material is needed to start a stove. The proportional contribution of startups to overall emissions varies depending on startup material type, stove type, and cooking event length; however, results demonstrate that startup materials can contribute substantially to a cookstove's emissions. Startup material choice is especially important for cleaner stove-fuel combinations where the marginal benefits of reduced emissions are potentially greater.

Exposure reductions associated with introduction of solar lamps to kerosene lamp-using households in Busia County, Kenya

Solar lamps are a clean and potentially cost-effective alternative to polluting kerosene lamps used by millions of families in developing countries. By how much solar lamps actually reduce exposure to pollutants, however, has not been examined. Twenty households using mainly kerosene for lighting were enrolled through a secondary school in Busia County, Kenya. Personal PM_2.5 and CO concentrations were measured on a school pupil and an adult in each household, before and after provision of 3 solar lamps. PM_2.5 concentrations were measured in main living areas, pupils' bedrooms, and kitchens. Usage sensors measured use of kerosene and solar lighting devices. Ninety percent of baseline kerosene lamp use was displaced at 1-month follow-up, corresponding to average PM_2.5 reductions of 61% and 79% in main living areas and pupils' bedrooms, respectively. Average 48-h exposure to PM_2.5 fell from 210 to 104 μg/m³ (-50%) among adults, and from 132 to 35 μg/m³ (-73%) among pupils. Solar lamps displaced most kerosene lamp use in at least the short term. If sustained, this could mitigate health impacts of household air pollution in some contexts. Achieving safe levels of exposure for all family members would likely require also addressing use of solid-fuel stoves.

Burns and fires in South Africa's informal settlements: Have approved kerosene stoves improved safety?

This study is a follow-on to an intervention project that implemented South African Bureau of Standards approved kerosene stoves and safety education in 150 households of a Johannesburg informal settlement. An investigation conducted 12 months later established that 43 stoves had operational defects, yet 23 households continued using the faulty appliances. This study focuses on (1) the psychological and behavioural factors associated with continued use of faulty stoves by the 23 households, and (2), the specific technical failures of these stoves. The study involved one-on-one recall interviews with the households using defective stoves (N=21) and laboratory-based stove tests for seven of the affected appliances. The results indicate that the stoves had defects in critical safety features such as flame control and the self-extinguishing mechanism. Four stove malfunctions of minor burn affect were reported in the study. Continued use of the damaged stoves was significantly associated with the time from receipt of the stove to detection of first failure: stoves that failed later on were more significantly likely to remain in use as compared to those that failed sooner. The findings point to the need for strengthening enforcement of appliance standards, public education on kerosene stove use, and structural change for the energy-poor.

Kitchen PM2.5 concentrations and child acute lower respiratory infection in Bhaktapur, Nepal: The importance of fuel type

BACKGROUND

Globally, solid fuels are used by about 3 billion people for cooking and a smaller number use kerosene. These fuels have been associated with acute lower respiratory infection (ALRI) in children. Previous work in Bhaktapur, Nepal, showed comparable relationships of biomass and kerosene cooking fuels with ALRI in young children, compared to those using electricity for cooking. We examine the relationship of kitchen PM_2.5 concentrations to ALRI in those households.

METHODS

ALRI cases and age-matched controls were enrolled from a cohort of children 2-35 months old. 24-h PM_2.5 was measured once in each participant's kitchen. The main analysis was carried out with conditional logistic regression, with PM_2.5 measures specified both continuously and as quartiles.

RESULTS

In the kitchens of 393 cases and 431 controls, quartiles of increasing PM_2.5 concentration were associated with a monotonic increase in odds ratios (OR): 1.51 (95% CI: 1.00, 2.27), 2.22 (1.47, 3.34), 2.48 (1.63, 3.77), for the 3 highest exposure quartiles. The general kitchen concentration-response shape across all stoves was supralinear. There was evidence for increased risk with biomass stoves, but the slope for kerosene stoves was steeper, the highest quartile OR being 5.36 (1.35, 21.3). Evidence for increased risk was also found for gas stoves.

CONCLUSION

Results support previous reports that biomass and kerosene cooking fuels are both ALRI risk factors, but suggests that PM_2.5 from kerosene is more potent on a unit mass basis. Further studies with larger sample sizes and preferably using electricity as the baseline fuel are needed.

Kerosene lighting contributes to household air pollution in rural Uganda

The literature on the contribution of kerosene lighting to indoor air particulate concentrations is sparse. In rural Uganda, kitchens are almost universally located outside the main home, and kerosene is often used for lighting. In this study, we obtained longitudinal measures of particulate matter 2.5 microns or smaller in size (PM_2.5 ) from living rooms and kitchens of 88 households in rural Uganda. Linear mixed-effects models with a random intercept for household were used to test the hypotheses that primary reported lighting source and kitchen location (indoor vs outdoor) are associated with PM_2.5 levels. During initial testing, households reported using the following sources of lighting: open-wick kerosene (19.3%), hurricane kerosene (45.5%), battery-powered (33.0%), and solar (1.1%) lamps. During follow-up testing, these proportions changed to 29.5%, 35.2%, 18.2%, and 9.1%, respectively. Average ambient, living room, and kitchen PM_2.5 levels were 20.2, 35.2, and 270.0 μg/m³ . Living rooms using open-wick kerosene lamps had the highest PM_2.5 levels (55.3 μg/m³ ) compared to those using solar lighting (19.4 μg/m³ ; open wick vs solar, P=.01); 27.6% of homes using open-wick kerosene lamps met World Health Organization indoor air quality standards compared to 75.0% in homes using solar lighting.

Household air pollution following replacement of traditional open fire with an improved rocket type cookstove

Cooking with biomass fuel is an important source of household air pollution (HAP) in developing countries, and a leading risk factor for ill-health. Although various designs of "improved cookstoves" (ICS) have been promoted as HAP interventions in these settings, few of them have undergone in-field evaluation, partly due to the challenge of conducting field measurements in remote settings. In this study we assessed the change in carbon monoxide (CO) exposure following the replacement of the traditional three-stone stove with a popular ICS in 49 homes in Western Kenya. We also assessed the suitability of using kitchen CO as a proxy for kitchen PM_2.5. Reduction in 48h mean kitchen CO was 3.1ppm (95% CI: -8.1, 1.8) and in personal CO was 0.9ppm (95% CI: -4.3, 2.6) following stove replacements. Overall, 48-h kitchen and personal CO exposures were lower after stove replacement (28% and 12%, respectively) but with wide confidence intervals that also suggested possible increases in exposure. There were statistically significant reductions in peak kitchen and personal CO concentrations represented by the 8-h 95th percentile: reductions of 26.1ppm (95% CI: -44.6, -7.6) and 8.0ppm (95% CI: -12.2, -3.8), respectively. This is equivalent to 53% reduction in kitchen CO and 39% reduction in personal CO. We found good correlation between kitchen CO and PM_2.5 concentrations overall (r=0.73, n=33 over averaging periods approximating 1day), which varied by time of day and exposure setting. These variations limit the applicability of CO as a proxy measure for PM_2.5 concentrations. A combination of interventions, including better designed stoves, improved ventilation and cleaner fuels, may be needed to reduce HAP to levels that are likely to improve health.

Air Quality Impact of Diffuse and Inefficient Combustion Emissions in Africa (DICE-Africa)

Anthropogenic pollution in Africa is dominated by diffuse and inefficient combustion sources, as electricity access is low and motorcycles and outdated cars proliferate. These sources are missing, out-of-date, or misrepresented in state-of-the-science emission inventories. We address these deficiencies with a detailed inventory of Diffuse and Inefficient Combustion Emissions in Africa (DICE-Africa) for 2006 and 2013. Fuelwood for energy is the largest emission source in DICE-Africa, but grows from 2006 to 2013 at a slower rate than charcoal production and use, and gasoline and diesel for motorcycles, cars, and generators. Only kerosene use and gas flaring decline. Increase in emissions from 2006 to 2013 in this work is consistent with trends in satellite observations of formaldehyde and NO₂, but much slower than the explosive growth projected with a fuel consumption model. Seasonal biomass burning is considered a large pollution source in Africa, but we estimate comparable emissions of black carbon and higher emissions of nonmethane volatile organic compounds from DICE-Africa. Nitrogen oxide (NO_x ≡ NO + NO₂) emissions are much lower than from biomass burning. We use GEOS-Chem to estimate that the largest contribution of DICE-Africa to annual mean surface fine particulate matter (PM_2.5) is >5 μg m^-3 in populous Nigeria.

Household Air Pollution: Sources and Exposure Levels to Fine Particulate Matter in Nairobi Slums

With 2.8 billion biomass users globally, household air pollution remains a public health threat in many low- and middle-income countries. However, little evidence on pollution levels and health effects exists in low-income settings, especially slums. This study assesses the levels and sources of household air pollution in the urban slums of Nairobi. This cross-sectional study was embedded in a prospective cohort of pregnant women living in two slum areas—Korogocho and Viwandani—in Nairobi. Data on fuel and stove types and ventilation use come from 1058 households, while air quality data based on the particulate matters (PM_2.5) level were collected in a sub-sample of 72 households using the DustTrak™ II Model 8532 monitor. We measured PM_2.5 levels mainly during daytime and using sources of indoor air pollutions. The majority of the households used kerosene (69.7%) as a cooking fuel. In households where air quality was monitored, the mean PM_2.5 levels were high and varied widely, especially during the evenings (124.6 µg/m³ SD: 372.7 in Korogocho and 82.2 µg/m³ SD: 249.9 in Viwandani), and in households using charcoal (126.5 µg/m³ SD: 434.7 in Korogocho and 75.7 µg/m³ SD: 323.0 in Viwandani). Overall, the mean PM_2.5 levels measured within homes at both sites (Korogocho = 108.9 µg/m³ SD: 371.2; Viwandani = 59.3 µg/m³ SD: 234.1) were high. Residents of the two slums are exposed to high levels of PM_2.5 in their homes. We recommend interventions, especially those focusing on clean cookstoves and lighting fuels to mitigate indoor levels of fine particles.

Air quality and climate connections

Multiple linkages connect air quality and climate change. Many air pollutant sources also emit carbon dioxide (CO2), the dominant anthropogenic greenhouse gas (GHG). The two main contributors to non-attainment of U.S. ambient air quality standards, ozone (O3) and particulate matter (PM), interact with radiation, forcing climate change. PM warms by absorbing sunlight (e.g., black carbon) or cools by scattering sunlight (e.g., sulfates) and interacts with clouds; these radiative and microphysical interactions can induce changes in precipitation and regional circulation patterns. Climate change is expected to degrade air quality in many polluted regions by changing air pollution meteorology (ventilation and dilution), precipitation and other removal processes, and by triggering some amplifying responses in atmospheric chemistry and in anthropogenic and natural sources. Together, these processes shape distributions and extreme episodes of O3 and PM. Global modeling indicates that as air pollution programs reduce SO2 to meet health and other air quality goals, near-term warming accelerates due to "unmasking" of warming induced by rising CO2. Air pollutant controls on CH4, a potent GHG and precursor to global O3 levels, and on sources with high black carbon (BC) to organic carbon (OC) ratios could offset near-term warming induced by SO2 emission reductions, while reducing global background O3 and regionally high levels of PM. Lowering peak warming requires decreasing atmospheric CO2, which for some source categories would also reduce co-emitted air pollutants or their precursors. Model projections for alternative climate and air quality scenarios indicate a wide range for U.S. surface O3 and fine PM, although regional projections may be confounded by interannual to decadal natural climate variability. Continued implementation of U.S. NOx emission controls guards against rising pollution levels triggered either by climate change or by global emission growth. Improved accuracy and trends in emission inventories are critical for accountability analyses of historical and projected air pollution and climate mitigation policies.

IMPLICATIONS

The expansion of U.S. air pollution policy to protect climate provides an opportunity for joint mitigation, with CH4 a prime target. BC reductions in developing nations would lower the global health burden, and for BC-rich sources (e.g., diesel) may lessen warming. Controls on these emissions could offset near-term warming induced by health-motivated reductions of sulfate (cooling). Wildfires, dust, and other natural PM and O3 sources may increase with climate warming, posing challenges to implementing and attaining air quality standards. Accountability analyses for recent and projected air pollution and climate control strategies should underpin estimated benefits and trade-offs of future policies.

Reductions in indoor black carbon concentrations from improved biomass stoves in rural India

Deployment of improved biomass burning cookstoves is recognized as a black carbon (BC) mitigation measure that has the potential to achieve health benefits and climate cobenefits. Yet, few field based studies document BC concentration reductions (and resulting human exposure) resulting from improved stove usage. In this paper, data are presented from 277 real-world cooking sessions collected during two field studies to document the impacts on indoor BC concentrations inside village kitchens as a result of switching from traditional stoves to improved forced draft (FD) stoves. Data collection utilized new low-cost cellphone methods to monitor BC, cooking duration, and fuel consumption. A cross sectional study recorded a reduction of 36% in BC during cooking sessions. An independent paired sample study demonstrated a statistically significant reduction of 40% in 24 h BC concentrations when traditional stoves were replaced with FD stoves. Reductions observed in these field studies differ from emission factor reductions (up to 99%) observed under controlled conditions in laboratory studies. Other nonstove sources (e.g., kerosene lamps, ambient concentrations) likely offset the reductions. Health exposure studies should utilize reductions determined by field measurements inside village kitchens, in conjunction with laboratory data, to assess the health impacts of new cooking technologies.

Indicators linking health and sustainability in the post-2015 development agenda

The UN-led discussion about the post-2015 sustainable development agenda provides an opportunity to develop indicators and targets that show the importance of health as a precondition for and an outcome of policies to promote sustainable development. Health as a precondition for development has received considerable attention in terms of achievement of health-related Millennium Development Goals (MDGs), addressing growing challenges of non-communicable diseases, and ensuring universal health coverage. Much less attention has been devoted to health as an outcome of sustainable development and to indicators that show both changes in exposure to health-related risks and progress towards environmental sustainability. We present a rationale and methods for the selection of health-related indicators to measure progress of post-2015 development goals in non-health sectors. The proposed indicators show the ancillary benefits to health and health equity (co-benefits) of sustainable development policies, particularly those to reduce greenhouse gas emissions and increase resilience to environmental change. We use illustrative examples from four thematic areas: cities, food and agriculture, energy, and water and sanitation. Embedding of a range of health-related indicators in the post-2015 goals can help to raise awareness of the probable health gains from sustainable development policies, thus making them more attractive to decision makers and more likely to be implemented than before.

Household cooking with solid fuels contributes to ambient PM2.5 air pollution and the burden of disease

BACKGROUND

Approximately 2.8 billion people cook with solid fuels. Research has focused on the health impacts of indoor exposure to fine particulate pollution. Here, for the 2010 Global Burden of Disease project (GBD 2010), we evaluated the impact of household cooking with solid fuels on regional population-weighted ambient PM2.5 (particulate matter ≤ 2.5 μm) pollution (APM2.5).

OBJECTIVES

We estimated the proportion and concentrations of APM2.5 attributable to household cooking with solid fuels (PM2.5-cook) for the years 1990, 2005, and 2010 in 170 countries, and associated ill health.

METHODS

We used an energy supply-driven emissions model (GAINS; Greenhouse Gas and Air Pollution Interactions and Synergies) and source-receptor model (TM5-FASST) to estimate the proportion of APM2.5 produced by households and the proportion of household PM2.5 emissions from cooking with solid fuels. We estimated health effects using GBD 2010 data on ill health from APM2.5 exposure.

RESULTS

In 2010, household cooking with solid fuels accounted for 12% of APM2.5 globally, varying from 0% of APM2.5 in five higher-income regions to 37% (2.8 μg/m3 of 6.9 μg/m3 total) in southern sub-Saharan Africa. PM2.5-cook constituted > 10% of APM2.5 in seven regions housing 4.4 billion people. South Asia showed the highest regional concentration of APM2.5 from household cooking (8.6 μg/m3). On the basis of GBD 2010, we estimate that exposure to APM2.5 from cooking with solid fuels caused the loss of 370,000 lives and 9.9 million disability-adjusted life years globally in 2010.

CONCLUSIONS

PM2.5 emissions from household cooking constitute an important portion of APM2.5 concentrations in many places, including India and China. Efforts to improve ambient air quality will be hindered if household cooking conditions are not addressed.

Profiles of chronic obstructive lung disease: characteristics of stable chronic obstructive lung disease in different parts of Asia

PURPOSE OF REVIEW

This review discusses the recent Asian chronic obstructive lung disease (COPD) studies that characterize stable COPD, to understand its peculiarities.

RECENT FINDINGS

Asian research has improved our understanding of COPD. Household air pollution (HAP) is as important as smoking. Smoking in Asia is varied, and noncigarette smoking exposure remains under-investigated. Prevalence studies are often questionnaire based. Spirometry-based prevalence needs study. Burden of obstructive lung disease studies are getting published. Female COPD in Asia is predominantly HAP induced. The patients are underweight, milder 'Global Initiative for Obstructive Lung Disease- class' and have compromised health-related quality of life often with depression and anxiety, but other comorbidities do occur and are getting defined.Nonsmokers' COPD is often associated with small airway thickening, less emphysema, but considerable morbidity. Asian COPD may have an eosinophilic component, but its significance is unknown. There is genetic predisposition among some Asians to COPD, and among some patients to lung cancer. The emerging pandemic of lifestyle diseases demands that metabolic and cardiovascular comorbidities in COPD need investigation.

SUMMARY

COPD in Asia is increasing and burdensome. It is affecting both sexes; is caused by HAP as much as smoking; causes poor quality of life and intense psychological burden; and is associated with unique patho-physiology, which will require research and action.

How shorter black carbon lifetime alters its climate effect

Black carbon (BC), unlike most aerosol types, absorbs solar radiation. However, the quantification of its climate impact is uncertain and presently under debate. Recently, attention has been drawn both to a likely underestimation of global BC emissions in climate models, and an overestimation of BC at high altitudes. Here we show that doubling present day BC emissions in a model simulation, while reducing BC lifetime based on observational evidence, leaves the direct aerosol effect of BC virtually unchanged. Increased emissions, together with increased wet removal that reduces the lifetime, yields modelled BC vertical profiles that are in strongly improved agreement with recent aircraft observations. Furthermore, we explore the consequences of an altered BC profile in a global circulation model, and show that both the vertical profile of BC and rapid climate adjustments need to be taken into account in order to assess the total climate impact of BC.

Validation of MicroAeth® as a Black Carbon Monitor for Fixed-Site Measurement and Optimization for Personal Exposure Characterization

This paper reports on validation experiments with the recently developed microAeth®, a pocket-sized device which is able to obtain real-time and personal measurements of black carbon (BC) aerosol. High reproducibility was observed when comparing the results from six new individual units during fixed-site monitoring out of a window (relative standard deviation [RSD] = 8% ± 5%, N = 1442). The results obtained from the microAeth devices agreed with those obtained from a full size rack mounted Aethalometer, based on both the 1-minute data (R = 0.92, slope = 1.01 ± 0.01, N = 1380) and 24-h average data. The 24-h average of real time data obtained from the microAeths was comparable to the BC concentration obtained from 24-h integrated PM_2.5 filter deposits, as determined by multi-wavelength optical absorption (R = 0.98, slope = 0.92 ± 0.07, N = 12). Rapid environmental changes in relative humidity (RH) and temperature (T) can result in false positive and negative peaks in the real time BC concentrations, though averages > 1-2-hour are only minimally affected. An inlet with a diffusion drier based on Nafion® tubing was developed in order to use BC data with a high time resolution. The data shows that the diffusion drier greatly reduce the impacts from rapid changes in RH and T when the monitoring system is worn in close proximity to the body (e.g., in the vest pocket).

Carbonaceous aerosols emitted from light-duty vehicles operating on gasoline and ethanol fuel blends

This study examines the chemical properties of carbonaceous aerosols emitted from three light-duty gasoline vehicles (LDVs) operating on gasoline (e0) and ethanol-gasoline fuel blends (e10 and e85). Vehicle road load simulations were performed on a chassis dynamometer using the three-phase LA-92 unified driving cycle (UDC). Effects of LDV operating conditions and ambient temperature (-7 and 24 °C) on particle-phase semivolatile organic compounds (SVOCs) and organic and elemental carbon (OC and EC) emissions were investigated. SVOC concentrations and OC and EC fractions were determined with thermal extraction-gas chromatography-mass spectrometry (TE-GC-MS) and thermal-optical analysis (TOA), respectively. LDV aerosol emissions were predominantly carbonaceous, and EC/PM (w/w) decreased linearly with increasing fuel ethanol content. TE-GC-MS analysis accounted for up to 4% of the fine particle (PM2.5) mass, showing the UDC phase-integrated sum of identified SVOC emissions ranging from 0.703 μg km(-1) to 18.8 μg km(-1). Generally, higher SVOC emissions were associated with low temperature (-7 °C) and engine ignition; mixed regression models suggest these emissions rate differences are significant. Use of e85 significantly reduced the emissions of lower molecular weight PAH. However, a reduction in higher molecular weight PAH entities in PM was not observed. Individual SVOC emissions from the Tier 2 LDVs and fuel technologies tested are substantially lower and distributed differently than those values populating the United States emissions inventories currently. Hence, this study is likely to influence future apportionment, climate, and air quality model predictions that rely on source combustion measurements of SVOCs in PM.

Personal exposures to fine particulate matter and black carbon in households cooking with biomass fuels in rural Ghana

OBJECTIVE

To examine cooking practices and 24-h personal and kitchen area exposures to fine particulate matter (PM2.5) and black carbon in cooks using biomass in Ghana.

METHODS

Researchers administered a detailed survey to 421 households. In a sub-sample of 36 households, researchers collected 24-h integrated PM2.5 samples (personal and kitchen area); in addition, the primary cook was monitored for real-time PM2.5. All filters were also analyzed for black carbon using a multi-wavelength reflectance method. Predictors of PM2.5 exposure were analyzed, including cooking behaviors, fuel, stove and kitchen type, weather, demographic factors and other smoke sources.

RESULTS

The majority of households cooked outdoors (55%; 231/417), used biomass (wood or charcoal) as their primary fuel (99%; 412/413), and cooked on traditional fires (77%, 323/421). In the sub-sample of 29 households with complete, valid exposure monitoring data, the 24-h integrated concentrations of PM2.5 were substantially higher in the kitchen sample (mean 446.8 µg/m3) than in the personal air sample (mean 128.5 µg/m3). Black carbon concentrations followed the same pattern such that concentrations were higher in the kitchen sample (14.5 µg/m3) than in the personal air sample (8.8 µg/m3). Spikes in real-time personal concentrations of PM2.5 accounted for the majority of exposure; the most polluted 5%, or 72 min, of the 24-h monitoring period accounted for 75% of all exposure. Two variables that had some predictive power for personal PM2.5 exposures were primary fuel type and ethnicity, while reported kerosene lantern use was associated with increased personal and kitchen area concentrations of black carbon.

CONCLUSION

Personal concentrations of PM2.5 exhibited considerable inter-subject variability across kitchen types (enclosed, semi-enclosed, outdoor), and can be elevated even in outdoor cooking settings. Furthermore, personal concentrations of PM2.5 were not associated with kitchen type and were not predicted by kitchen area samples; rather they were driven by spikes in PM2.5 concentrations during cooking. Personal exposures were more enriched with black carbon when compared to kitchen area samples, underscoring the need to explore other sources of incomplete combustion such as roadway emissions, charcoal production and kerosene use.