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Matte T, Lane K, Tipaldo JF, Barnes J, Knowlton K, Torem E, Anand G, Yoon L, Marcotullio P, Balk D, Constible J, Elszasz H, Ito K, Jessel S, Limaye V, Parks R, Rutigliano M, Sorenson C, Yuan A. NPCC4: Climate change and New York City's health risk. Ann N Y Acad Sci 2024. [PMID: 38922909 DOI: 10.1111/nyas.15115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 06/28/2024]
Abstract
This chapter of the New York City Panel on Climate Change 4 (NPCC4) report considers climate health risks, vulnerabilities, and resilience strategies in New York City's unique urban context. It updates evidence since the last health assessment in 2015 as part of NPCC2 and addresses climate health risks and vulnerabilities that have emerged as especially salient to NYC since 2015. Climate health risks from heat and flooding are emphasized. In addition, other climate-sensitive exposures harmful to human health are considered, including outdoor and indoor air pollution, including aeroallergens; insect vectors of human illness; waterborne infectious and chemical contaminants; and compounding of climate health risks with other public health emergencies, such as the COVID-19 pandemic. Evidence-informed strategies for reducing future climate risks to health are considered.
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Affiliation(s)
- Thomas Matte
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Kathryn Lane
- New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Jenna F Tipaldo
- CUNY Graduate School of Public Health and Health Policy and CUNY Institute for Demographic Research, New York, New York, USA
| | - Janice Barnes
- Climate Adaptation Partners, New York, New York, USA
| | - Kim Knowlton
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Emily Torem
- New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Gowri Anand
- City of New York, Department of Transportation, New York, New York, USA
| | - Liv Yoon
- School of Kinesiology, The University of British Columbia, Vancouver, Canada
| | - Peter Marcotullio
- Department of Geography and Environmental Science, Hunter College, CUNY, New York, New York, USA
| | - Deborah Balk
- Marxe School of Public and International Affairs, Baruch College and also CUNY Institute for Demographic Research, New York, New York, USA
| | | | - Hayley Elszasz
- City of New York, Mayors Office of Climate and Environmental Justice, New York, New York, USA
| | - Kazuhiko Ito
- New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Sonal Jessel
- WE ACT for Environmental Justice, New York, New York, USA
| | - Vijay Limaye
- Natural Resources Defense Council, New York, New York, USA
| | - Robbie Parks
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Mallory Rutigliano
- New York City Mayor's Office of Management and Budget, New York, New York, USA
| | - Cecilia Sorenson
- Mailman School of Public Health, Columbia University, New York, New York, USA
- Global Consortium on Climate and Health Education, Columbia University, New York, New York, USA
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Ariel Yuan
- New York City Department of Health and Mental Hygiene, New York, New York, USA
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Li W, Goodman JE, Long C. Population attributable fraction of gas cooking and childhood asthma: What was missed? GLOBAL EPIDEMIOLOGY 2024; 7:100141. [PMID: 38510536 PMCID: PMC10951895 DOI: 10.1016/j.gloepi.2024.100141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/27/2024] [Accepted: 03/07/2024] [Indexed: 03/22/2024] Open
Affiliation(s)
- Wenchao Li
- Gradient, One Beacon St., 17th Floor, Boston, MA 02108, USA
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3
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Cox LA. An AI assistant to help review and improve causal reasoning in epidemiological documents. GLOBAL EPIDEMIOLOGY 2024; 7:100130. [PMID: 38188038 PMCID: PMC10767365 DOI: 10.1016/j.gloepi.2023.100130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/08/2023] [Accepted: 11/24/2023] [Indexed: 01/09/2024] Open
Abstract
Drawing sound causal inferences from observational data is often challenging for both authors and reviewers. This paper discusses the design and application of an Artificial Intelligence Causal Research Assistant (AIA) that seeks to help authors improve causal inferences and conclusions drawn from epidemiological data in health risk assessments. The AIA-assisted review process provides structured reviews and recommendations for improving the causal reasoning, analyses and interpretations made in scientific papers based on epidemiological data. Causal analysis methodologies range from earlier Bradford-Hill considerations to current causal directed acyclic graph (DAG) and related models. AIA seeks to make these methods more accessible and useful to researchers. AIA uses an external script (a "Causal AI Booster" (CAB) program based on classical AI concepts of slot-filling in frames organized into task hierarchies to complete goals) to guide Large Language Models (LLMs), such as OpenAI's ChatGPT or Google's LaMDA (Bard), to systematically review manuscripts and create both (a) recommendations for what to do to improve analyses and reporting; and (b) explanations and support for the recommendations. Review tables and summaries are completed systematically by the LLM in order. For example, recommendations for how to state and caveat causal conclusions in the Abstract and Discussion sections reflect previous analyses of the Study Design and Data Analysis sections. This work illustrates how current AI can contribute to reviewing and providing constructive feedback on research documents. We believe that such AI-assisted review shows promise for enhancing the quality of causal reasoning and exposition in epidemiological studies. It suggests the potential for effective human-AI collaboration in scientific authoring and review processes.
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Affiliation(s)
- Louis Anthony Cox
- Cox Associates, Entanglement, and University of Colorado, United States of America
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Kashtan Y, Nicholson M, Finnegan CJ, Ouyang Z, Garg A, Lebel ED, Rowland ST, Michanowicz DR, Herrera J, Nadeau KC, Jackson RB. Nitrogen dioxide exposure, health outcomes, and associated demographic disparities due to gas and propane combustion by U.S. stoves. SCIENCE ADVANCES 2024; 10:eadm8680. [PMID: 38701214 PMCID: PMC11068006 DOI: 10.1126/sciadv.adm8680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/02/2024] [Indexed: 05/05/2024]
Abstract
Gas and propane stoves emit nitrogen dioxide (NO2) pollution indoors, but the exposures of different U.S. demographic groups are unknown. We estimate NO2 exposure and health consequences using emissions and concentration measurements from >100 homes, a room-specific indoor air quality model, epidemiological risk parameters, and statistical sampling of housing characteristics and occupant behavior. Gas and propane stoves increase long-term NO2 exposure 4.0 parts per billion volume on average across the United States, 75% of the World Health Organization's exposure guideline. This increased exposure likely causes ~50,000 cases of current pediatric asthma from long-term NO2 exposure alone. Short-term NO2 exposure from typical gas stove use frequently exceeds both World Health Organization and U.S. Environmental Protection Agency benchmarks. People living in residences <800 ft2 in size incur four times more long-term NO2 exposure than people in residences >3000 ft2 in size; American Indian/Alaska Native and Black and Hispanic/Latino households incur 60 and 20% more NO2 exposure, respectively, than the national average.
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Affiliation(s)
- Yannai Kashtan
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, CA 94305, USA
| | - Metta Nicholson
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, CA 94305, USA
| | - Colin J. Finnegan
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, CA 94305, USA
| | - Zutao Ouyang
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, CA 94305, USA
| | - Anchal Garg
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, CA 94305, USA
| | - Eric D. Lebel
- PSE Healthy Energy, 1140 Broadway, Suite 750, Oakland, CA 94612, USA
| | | | | | - Janet Herrera
- Central California Asthma Collaborative, Suite J, 1400 Chester Ave., Bakersfield, CA 93301, USA
| | - Kari C. Nadeau
- T.H. Chan School of Public Health, Harvard University, 677 Huntington Ave., Boston, MA 02115, USA
| | - Robert B. Jackson
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, CA 94305, USA
- Woods Institute for the Environment and Precourt Institute for Energy, Stanford, CA 94305, USA
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5
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Hartinger SM, Palmeiro-Silva YK, Llerena-Cayo C, Blanco-Villafuerte L, Escobar LE, Diaz A, Sarmiento JH, Lescano AG, Melo O, Rojas-Rueda D, Takahashi B, Callaghan M, Chesini F, Dasgupta S, Posse CG, Gouveia N, Martins de Carvalho A, Miranda-Chacón Z, Mohajeri N, Pantoja C, Robinson EJ, Salas MF, Santiago R, Sauma E, Santos-Vega M, Scamman D, Sergeeva M, Souza de Camargo T, Sorensen C, Umaña JD, Yglesias-González M, Walawender M, Buss D, Romanello M. The 2023 Latin America report of the Lancet Countdown on health and climate change: the imperative for health-centred climate-resilient development. LANCET REGIONAL HEALTH. AMERICAS 2024; 33:100746. [PMID: 38800647 PMCID: PMC11117061 DOI: 10.1016/j.lana.2024.100746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/27/2024] [Accepted: 04/06/2024] [Indexed: 05/29/2024]
Abstract
In 2023, a series of climatological and political events unfolded, partly driving forward the global climate and health agenda while simultaneously exposing important disparities and vulnerabilities to climate-related events. On the policy front, a significant step forward was marked by the inaugural Health Day at COP28, acknowledging the profound impacts of climate change on health. However, the first-ever Global Stocktake showed an important gap between the current progress and the targets outlined in the Paris Agreement, underscoring the urgent need for further and decisive action. From a Latin American perspective, some questions arise: How do we achieve the change that is needed? How to address the vulnerabilities to climate change in a region with long-standing social inequities? How do we promote intersectoral collaboration to face a complex problem such as climate change? The debate is still ongoing, and in many instances, it is just starting. The renamed regional centre Lancet Countdown Latin America (previously named Lancet Countdown South America) expanded its geographical scope adding Mexico and five Central American countries: Costa Rica, El Salvador, Guatemala, Honduras, and Panama, as a response to the need for stronger collaboration in a region with significant social disparities, including research capacities and funding. The centre is an independent and multidisciplinary collaboration that tracks the links between health and climate change in Latin America, following the global Lancet Countdown's methodologies and five domains. The Lancet Countdown Latin America work hinges on the commitment of 23 regional academic institutions, United Nations agencies, and 34 researchers who generously contribute their time and expertise. Building from the first report, the 2023 report of the Lancet Countdown Latin America, presents 34 indicators that track the relationship between health and climate change up to 2022, aiming at providing evidence to public decision-making with the purpose of improving the health and wellbeing of Latin American populations and reducing social inequities through climate actions focusing on health. This report shows that Latin American populations continue to observe a growing exposure to changing climatic conditions. A warming trend has been observed across all countries in Latin America, with severe direct impacts. In 2022, people were exposed to ambient temperatures, on average, 0.38 °C higher than in 1986-2005, with Paraguay experiencing the highest anomaly (+1.9 °C), followed by Argentina (+1.2 °C) and Uruguay (+0.9 °C) (indicator 1.1.1). In 2013-2022, infants were exposed to 248% more heatwave days and people over 65 years old were exposed to 271% more heatwave days than in 1986-2005 (indicator 1.1.2). Also, compared to 1991-2000, in 2013-2022, there were 256 and 189 additional annual hours per person, during which ambient heat posed at least moderate and high risk of heat stress during light outdoor physical activity in Latin America, respectively (indicator 1.1.3). Finally, the region had a 140% increase in heat-related mortality from 2000-2009 to 2013-2022 (indicator 1.1.4). Changes in ecosystems have led to an increased risk of wildfires, exposing individuals to very or extremely high fire danger for more extended periods (indicator 1.2.1). Additionally, the transmission potential for dengue by Aedes aegypti mosquitoes has risen by 54% from 1951-1960 to 2013-2022 (indicator 1.3), which aligns with the recent outbreaks and increasing dengue cases observed across Latin America in recent months. Based on the 2023 report of the Lancet Countdown Latin America, there are three key messages that Latin America needs to further explore and advance for a health-centred climate-resilient development. Latin American countries require intersectoral public policies that simultaneously increase climate resilience, reduce social inequities, improve population health, and reduce greenhouse gas (GHG) emissions. The findings show that adaptation policies in Latin America remain weak, with a pressing need for robust vulnerability and adaptation (V&A) assessments to address climate risks effectively. Unfortunately, such assessments are scarce. Up to 2021, Brazil is the only country that has completed and officially reported a V&A to the 2021 Global Survey conducted by the World Health Organization (WHO). Argentina, Guatemala, and Panama have also conducted them, but they have not been reported (indicator 2.1.1). Similarly, efforts in developing and implementing Health National Adaptation Plans (HNAPs) are varied and limited in scope. Brazil, Chile, and Uruguay are the only countries that have an HNAP (indicator 2.1.2). Moreover, self-reported city-level climate change risk assessments are very limited in the region (indicator 2.1.3). The collaboration between meteorological and health sectors remains insufficient, with only Argentina, Brazil, Colombia, and Guatemala self-reporting some level of integration (indicator 2.2.1), hindering comprehensive responses to climate-related health risks in the region. Additionally, despite the urgent need for action, there has been minimal progress in increasing urban greenspaces across the region since 2015, with only Colombia, Nicaragua, and Venezuela showing slight improvements (indicator 2.2.2). Compounding these challenges is the decrease in funding for climate change adaptation projects in Latin America, as evidenced by the 16% drop in funds allocated by the Green Climate Fund (GCF) in 2022 compared to 2021. Alarmingly, none of the funds approved in 2022 were directed toward climate change and health projects, highlighting a critical gap in addressing health-related climate risks (indicator 2.2.3). From a vulnerability perspective, the Mosquito Risk Index (MoRI) indicates an overall decrease in severe mosquito-borne disease risk in the region due to improvements in water, sanitation, and hygiene (WASH) (indicator 2.3.1). Brazil and Paraguay were the only countries that showed an increase in this indicator. It is worth noting that significant temporal variation within and between countries still persists, suggesting inadequate preparedness for climate-related changes. Overall, population health is not solely determined by the health sector, nor are climate policies a sole responsibility of the environmental sector. More and stronger intersectoral collaboration is needed to pave development pathways that consider solid adaptation to climate change, greater reductions of GHG emissions, and that increase social equity and population health. These policies involve sectors such as finance, transport, energy, housing, health, and agriculture, requiring institutional structures and policy instruments that allow long-term intersectoral collaboration. Latin American countries need to accelerate an energy transition that prioritises people's health and wellbeing, reduces energy poverty and air pollution, and maximises health and economic gains. In Latin America, there is a notable disparity in energy transition, with electricity generation from coal increasing by an average of 2.6% from 1991-2000 to 2011-2020, posing a challenge to efforts aimed at phasing out coal (indicator 3.1.1). However, this percentage increase is conservative as it may not include all the fossil fuels for thermoelectric electricity generation, especially during climate-related events and when hydropower is affected (Panel 4). Yet, renewable energy sources have been growing, increasing by an average of 5.7% during the same period. Access to clean fuels for cooking remains a concern, with 46.3% of the rural population in Central America and 23.3% in South America lacking access to clean fuels in 2022 (indicator 3.1.2). It is crucial to highlight the concerning overreliance on fossil fuels, particularly liquefied petroleum gas (LPG), as a primary cooking fuel. A significant majority of Latin American populations, approximately 74.6%, rely on LPG for cooking. Transitioning to cleaner heating and cooking alternatives could also have a health benefit by reducing household air pollution-related mortality. Fossil fuels continue to dominate road transport energy in Latin America, accounting for 96%, although some South American countries are increasing the use of biofuels (indicator 3.1.3). Premature mortality attributable to fossil-fuel-derived PM2.5 has shown varied trends across countries, increasing by 3.9% from 2005 to 2020 across Latin America, which corresponds to 123.5 premature deaths per million people (indicator 3.2.1). The Latin American countries with the highest premature mortality rate attributable to PM2.5 in 2020 were Chile, Peru, Brazil, Colombia, Mexico, and Paraguay. Of the total premature deaths attributable to PM2.5 in 2020, 19.1% was from transport, 12.3% from households, 11.6% from industry, and 11% from agriculture. From emission and capture of GHG perspective, commodity-driven deforestation and expansion of agricultural land remain major contributors to tree cover loss in the region, accounting for around 80% of the total loss (indicator 3.3). Additionally, animal-based food production in Latin America contributes 85% to agricultural CO2 equivalent emissions, with Argentina, Brazil, Panama, Paraguay, and Uruguay ranking highest in per capita emissions (indicator 3.4.1). From a health perspective, in 2020, approximately 870,000 deaths were associated with imbalanced diets, of which 155,000 (18%) were linked to high intake of red and processed meat and dairy products (indicator 3.4.2). Energy transition in Latin America is still in its infancy, and as a result, millions of people are currently exposed to dangerous levels of air pollution and energy poverty (i.e., lack of access to essential energy sources or services). As shown in this report, the levels of air pollution, outdoors and indoors, are a significant problem in the whole region, with marked disparities between urban and rural areas. In 2022, Peru, Chile, Mexico, Guatemala, Colombia, El Salvador, Brazil, Uruguay, Honduras, Panama, and Nicaragua were in the top 100 most polluted countries globally. Transitioning to cleaner sources of energy, phasing out fossil fuels, and promoting better energy efficiency in the industrial and housing sectors are not only climate mitigation measures but also huge health and economic opportunities for more prosperous and healthy societies. Latin American countries need to increase climate finance through permanent fiscal commitments and multilateral development banks to pave climate-resilient development pathways. Climate change poses significant economic costs, with investments in mitigation and adaptation measures progressing slowly. In 2022, economic losses due to weather-related extreme events in Latin America were US$15.6 billion -an amount mainly driven by floods and landslides in Brazil-representing 0.28% of Latin America's Gross Domestic Product (GDP) (indicator 4.1.1). In contrast to high-income countries, most of these losses lack insurance coverage, imposing a substantial financial strain on affected families and governments. Heat-related mortality among individuals aged 65 and older in Latin America reached alarming levels, with losses exceeding the equivalent of the average income of 451,000 people annually (indicator 4.1.2). Moreover, the total potential income loss due to heat-related labour capacity reduction amounted to 1.34% of regional GDP, disproportionately affecting the agriculture and construction sectors (indicator 4.1.3). Additionally, the economic toll of premature mortality from air pollution was substantial, equivalent to a significant portion of regional GDP (0.61%) (indicator 4.1.4). On a positive note, clean energy investments in the region increased in 2022, surpassing fossil fuel investments. However, in 2020, all countries reviewed continued to offer net-negative carbon prices, revealing fossil fuel subsidies totalling US$23 billion. Venezuela had the highest net subsidies relative to current health expenditure (123%), followed by Argentina (10.5%), Bolivia (10.3%), Ecuador (8.3%), and Chile (5.6%) (indicator 4.2.1). Fossil fuel-based energy is today more expensive than renewable energy. Fossil fuel burning drives climate change and damages the environment on which people depend, and air pollution derived from the burning of fossil fuels causes seven million premature deaths each year worldwide, along with a substantial burden of disease. Transitioning to sustainable, zero-emission energy sources, fostering healthier food systems, and expediting adaptation efforts promise not only environmental benefits but also significant economic gains. However, to implement mitigation and adaptation policies that also improve social wellbeing and prosperity, stronger and solid financial systems are needed. Climate finance in Latin American countries is scarce and strongly depends on political cycles, which threatens adequate responses to the current and future challenges. Progress on the climate agenda is lagging behind the urgent pace required. While engagement with the intersection of health and climate change is increasing, government involvement remains inadequate. Newspaper coverage of health and climate change has been on the rise, peaking in 2022, yet the proportion of climate change articles discussing health has declined over time (indicator 5.1). Although there has been significant growth in the number of scientific papers focusing on Latin America, it still represents less than 4% of global publications on the subject (indicator 5.3). And, while health was mentioned by most Latin American countries at the UN General Debate in 2022, only a few addressed the intersection of health and climate change, indicating a lack of awareness at the governmental level (indicator 5.4). The 2023 Lancet Countdown Latin America report underscores the cascading and compounding health impacts of anthropogenic climate change, marked by increased exposure to heatwaves, wildfires, and vector-borne diseases. Specifically, for Latin America, the report emphasises three critical messages: the urgent action to implement intersectoral public policies that enhance climate resilience across the region; the pressing need to prioritise an energy transition that focuses on health co-benefits and wellbeing, and lastly, that need for increasing climate finance by committing to sustained fiscal efforts and engaging with multilateral development banks. By understanding the problems, addressing the gaps, and taking decisive action, Latin America can navigate the challenges of climate change, fostering a more sustainable and resilient future for its population. Spanish and Portuguese translated versions of this Summary can be found in Appendix B and C, respectively. The full translated report in Spanish is available in Appendix D.
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Affiliation(s)
- Stella M. Hartinger
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Yasna K. Palmeiro-Silva
- Institute for Global Health, University College London, London, UK
- Centro de Políticas Públicas UC, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Camila Llerena-Cayo
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luciana Blanco-Villafuerte
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luis E. Escobar
- Department of Fish and Wildlife Conservation, Virginia Tech, Blacksburg, VA, USA
| | - Avriel Diaz
- Columbia University, International Research Institute for Climate and Society New York, USA
| | | | - Andres G. Lescano
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Oscar Melo
- Centro Interdisciplinario de Cambio Global, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - David Rojas-Rueda
- Environmental and Radiological Health Sciences, Colorado State University, CO, USA
- Colorado School of Public Health, Colorado State University, CO, USA
| | - Bruno Takahashi
- Departament of Communication, Michigan State University, MI, USA
| | - Max Callaghan
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Francisco Chesini
- Departamento de Salud Pública, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Shouro Dasgupta
- Centro Euro-Mediterraneo sui Cambiamenti Climatici (CMCC), Venice, Italy
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Science (LSE), London, UK
| | - Carolina Gil Posse
- Facultad de Ciencias Sociales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Nelson Gouveia
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Nahid Mohajeri
- Institute of Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, London, UK
| | - Chrissie Pantoja
- Nicholas School of the Environment and Sanford School of Policy Policy, Duke University, Durham, NC, USA
- Departamento Académico de Economía, Universidad del Pacífico, Lima, Peru
| | - Elizabeth J.Z. Robinson
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Science (LSE), London, UK
| | | | - Raquel Santiago
- Faculdade de Nutrição, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Enzo Sauma
- Engineering Faculty, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Santos-Vega
- Grupo de Biología y Matemática Computacional (BIOMAC), Universidad de los Andes, Bogotá, Colombia
- Departamento Ciencias Biológicas, Universidad de Los Andes, Bogotá, Colombia
| | - Daniel Scamman
- Institute for Sustainable Resources, University College London, London, UK
| | | | | | - Cecilia Sorensen
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, Department of Emergency Medicine, Columbia Irving Medical Center, NY, USA
| | - Juan D. Umaña
- Grupo de Biología y Matemática Computacional (BIOMAC), Universidad de los Andes, Bogotá, Colombia
| | - Marisol Yglesias-González
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria Walawender
- Institute for Global Health, University College London, London, UK
| | - Daniel Buss
- Pan American Health Organization, Washington, DC, USA
| | - Marina Romanello
- Institute for Global Health, University College London, London, UK
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Canaday FT, Georas SN, Croft DP. Examining the impact of air pollution, climate change, and social determinants of health on asthma and environmental justice. Curr Opin Pulm Med 2024; 30:276-280. [PMID: 38411188 PMCID: PMC10959677 DOI: 10.1097/mcp.0000000000001065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
PURPOSE OF REVIEW In this review, we discuss the current literature examining the impact air pollution and climate change has on asthma onset, control, and exacerbation. This review also addresses the risk of exposure to specific disproportionately affected communities, highlighting health disparities in exposure and asthma outcomes. RECENT FINDINGS Recent studies have shifted from highlighting the associations between asthma exacerbations and indoor and outdoor air pollution. Studies are now focused on confirming the association of asthma incidence from these same exposures. Many studies have linked particulate matter to adverse asthma outcomes, however, the pollutant exposures that pose the greatest risk and the effect of natural disasters fueled by climate change are under current study. Some studies have observed that the true burden that pollutant exposures have on asthma outcomes occurs at the intersection of exposure and vulnerability. Future studies in this area will address social determinants of health, societal factors such as redlining and other systemic racism practices. SUMMARY Although decades of research support the causal link between gaseous and particulate air pollution and the exacerbation of preexisting asthma, recent studies suggest air pollution can cause incident (new onset) asthma. Studies have started to focus on the underlying drivers of poor outcomes in asthma. Many of the structural impediments to high quality asthma care at the society level (e.g. poverty, redlining, systemic racism) also are risk factors for worsened climate events and air pollution exposure. The individuals in these disproportionately affected groups are doubly affected by worsened exposure and worsened access to care for the resultant asthma exacerbations or incident asthma. More research is needed to understand the specific climate and air pollution mitigation efforts where disproportionately affected communities would derive the most benefit.
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Affiliation(s)
- Felicia T Canaday
- Department of Medicine, Division of Pulmonary and Critical Care, University of Rochester Medical Center, Rochester, New York, USA
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7
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Puzzolo E, Fleeman N, Lorenzetti F, Rubinstein F, Li Y, Xing R, Shen G, Nix E, Maden M, Bresnahan R, Duarte R, Abebe L, Lewis J, Williams KN, Adahir-Rohani H, Pope D. Estimated health effects from domestic use of gaseous fuels for cooking and heating in high-income, middle-income, and low-income countries: a systematic review and meta-analyses. THE LANCET. RESPIRATORY MEDICINE 2024; 12:281-293. [PMID: 38310914 DOI: 10.1016/s2213-2600(23)00427-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/03/2023] [Accepted: 11/07/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND Exposure to household air pollution from polluting domestic fuel (solid fuel and kerosene) represents a substantial global public health burden and there is an urgent need for rapid transition to clean domestic fuels. Gas for cooking and heating might possibly affect child asthma, wheezing, and respiratory health. The aim of this review was to synthesise the evidence on the health effects of gaseous fuels to inform policies for scalable clean household energy. METHODS In this systematic review and meta-analysis, we summarised the health effects from cooking or heating with gas compared with polluting fuels (eg, wood or charcoal) and clean energy (eg, electricity and solar energy). We searched PubMed, Scopus, Web of Science, MEDLINE, Cochrane Library (CENTRAL), Environment Complete, GreenFile, Google Scholar, Wanfang DATA, and CNKI for articles published between Dec 16, 2020, and Feb 6, 2021. Studies eligible for inclusion had to compare gas for cooking or heating with polluting fuels (eg, wood or charcoal) or clean energy (eg, electricity or solar energy) and present data for health outcomes in general populations. Studies that reported health outcomes that were exacerbations of existing underlying conditions were excluded. Several of our reviewers were involved in screening studies, data extraction, and quality assessment (including risk of bias) of included studies; 20% of studies were independently screened, extracted and quality assessed by another reviewer. Disagreements were reconciled through discussion with the wider review team. Included studies were appraised for quality using the Liverpool Quality Assessment Tools. Key health outcomes were grouped for meta-analysis and analysed using Cochrane's RevMan software. Primary outcomes were health effects (eg, acute lower respiratory infections) and secondary outcomes were health symptoms (eg, respiratory symptoms such as wheeze, cough, or breathlessness). This study is registered with PROSPERO, CRD42021227092. FINDINGS 116 studies were included in the meta-analysis (two [2%] randomised controlled trials, 13 [11%] case-control studies, 23 [20%] cohort studies, and 78 [67%] cross-sectional studies), contributing 215 effect estimates for five grouped health outcomes. Compared with polluting fuels, use of gas significantly lowered the risk of pneumonia (OR 0·54, 95% CI 0·38-0·77; p=0·00080), wheeze (OR 0·42, 0·30-0·59; p<0·0001), cough (OR 0·44, 0·32-0·62; p<0·0001), breathlessness (OR 0·40, 0·21-0·76; p=0·0052), chronic obstructive pulmonary disease (OR 0·37, 0·23-0·60; p<0·0001), bronchitis (OR 0·60, 0·43-0·82; p=0·0015), pulmonary function deficit (OR 0·27, 0·17-0·44; p<0·0001), severe respiratory illness or death (OR 0·27, 0·11-0·63; p=0·0024), preterm birth (OR 0·66, 0·45-0·97; p=0·033), and low birth weight (OR 0·70, 0·53-0·93; p=0·015). Non-statistically significant effects were observed for asthma in children (OR 1·04, 0·70-1·55; p=0·84), asthma in adults (OR 0·65, 0·43-1·00; p=0·052), and small for gestational age (OR 1·04, 0·89-1·21; p=0·62). Compared with electricity, use of gas significantly increased risk of pneumonia (OR 1·26, 1·03-1·53; p=0·025) and chronic obstructive pulmonary disease (OR 1·15, 1·06-1·25; p=0·0011), although smaller non-significant effects were observed for higher-quality studies. In addition, a small increased risk of asthma in children was not significant (OR 1·09, 0·99-1·19; p=0·071) and no significant associations were found for adult asthma, wheeze, cough, and breathlessness (p>0·05). A significant decreased risk of bronchitis was observed (OR 0·87, 0·81-0·93; p<0·0001). INTERPRETATION Switching from polluting fuels to gaseous household fuels could lower health risk and associated morbidity and mortality in resource-poor countries where reliance on polluting fuels is greatest. Although gas fuel use was associated with a slightly higher risk for some health outcomes compared with electricity, gas is an important transitional option for health in countries where access to reliable electricity supply for cooking or heating is not feasible in the near term. FUNDING WHO.
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Affiliation(s)
- Elisa Puzzolo
- Department of Public Health, Policy, and Systems, University of Liverpool, Liverpool, UK.
| | - Nigel Fleeman
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Federico Lorenzetti
- Department of Public Health, Policy, and Systems, University of Liverpool, Liverpool, UK
| | - Fernando Rubinstein
- Department of Public Health, Policy, and Systems, University of Liverpool, Liverpool, UK
| | - Yaojie Li
- College of Urban and Environmental Sciences, Peking University, Beijing, China
| | - Ran Xing
- College of Urban and Environmental Sciences, Peking University, Beijing, China
| | - Guofeng Shen
- College of Urban and Environmental Sciences, Peking University, Beijing, China
| | - Emily Nix
- Department of Public Health, Policy, and Systems, University of Liverpool, Liverpool, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Rebecca Bresnahan
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Rui Duarte
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Lydia Abebe
- Public Health, Environmental and Social Determinants of Health, WHO, Geneva, Switzerland
| | - Jessica Lewis
- Public Health, Environmental and Social Determinants of Health, WHO, Geneva, Switzerland
| | - Kendra N Williams
- Public Health, Environmental and Social Determinants of Health, WHO, Geneva, Switzerland
| | - Heather Adahir-Rohani
- Public Health, Environmental and Social Determinants of Health, WHO, Geneva, Switzerland
| | - Daniel Pope
- Department of Public Health, Policy, and Systems, University of Liverpool, Liverpool, UK
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8
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Seltenrich N. Clearing the Air: Gas Stove Emissions and Direct Health Effects. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:22001. [PMID: 38416539 PMCID: PMC10901287 DOI: 10.1289/ehp14180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 04/05/2024] [Accepted: 01/08/2024] [Indexed: 02/29/2024]
Abstract
Gas range use has direct health effects-beyond those from climate change related to fossil fuels. If kitchens are not well ventilated, benzene, nitrogen dioxide, and other VOCs may reach levels known to harm health.
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9
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Patra SS, Jiang J, Ding X, Huang C, Reidy EK, Kumar V, Price P, Keech C, Steiner G, Stevens P, Jung N, Boor BE. Dynamics of nanocluster aerosol in the indoor atmosphere during gas cooking. PNAS NEXUS 2024; 3:pgae044. [PMID: 39015346 PMCID: PMC11250196 DOI: 10.1093/pnasnexus/pgae044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/16/2024] [Indexed: 07/18/2024]
Abstract
Nanocluster aerosol (NCA: particles in the size range of 1-3 nm) are a critically important, yet understudied, class of atmospheric aerosol particles. NCA efficiently deposit in the human respiratory system and can translocate to vital organs. Due to their high surface area-to-mass ratios, NCA are associated with a heightened propensity for bioactivity and toxicity. Despite the human health relevance of NCA, little is known regarding the prevalence of NCA in indoor environments where people spend the majority of their time. In this study, we quantify the formation and transformation of indoor atmospheric NCA down to 1 nm via high-resolution online nanoparticle measurements during propane gas cooking in a residential building. We observed a substantial pool of sub-1.5 nm NCA in the indoor atmosphere during cooking periods, with aerosol number concentrations often dominated by the newly formed NCA. Indoor atmospheric NCA emission factors can reach up to ∼1016 NCA/kg-fuel during propane gas cooking and can exceed those for vehicles with gasoline and diesel engines. Such high emissions of combustion-derived indoor NCA can result in substantial NCA respiratory exposures and dose rates for children and adults, significantly exceeding that for outdoor traffic-associated NCA. Combustion-derived indoor NCA undergo unique size-dependent physical transformations, strongly influenced by particle coagulation and condensation of low-volatility cooking vapors. We show that indoor atmospheric NCA need to be measured directly and cannot be predicted using conventional indoor air pollution markers such as PM2.5 mass concentrations and NO x (NO + NO2) mixing ratios.
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Affiliation(s)
- Satya S Patra
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN 47907, USA
- Ray W. Herrick Laboratories, Center for High Performance Buildings, Purdue University, West Lafayette, IN 47907, USA
| | - Jinglin Jiang
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN 47907, USA
- Ray W. Herrick Laboratories, Center for High Performance Buildings, Purdue University, West Lafayette, IN 47907, USA
| | - Xiaosu Ding
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Chunxu Huang
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN 47907, USA
- Ray W. Herrick Laboratories, Center for High Performance Buildings, Purdue University, West Lafayette, IN 47907, USA
| | - Emily K Reidy
- Department of Chemistry, Indiana University, Bloomington, IN 47405, USA
| | - Vinay Kumar
- O’Neill School of Public and Environmental Affairs, Indiana University, Bloomington, IN 47405, USA
| | - Paige Price
- O’Neill School of Public and Environmental Affairs, Indiana University, Bloomington, IN 47405, USA
| | | | - Gerhard Steiner
- GRIMM Aerosol Technik Ainring GmbH & Co. KG, Ainring 83404, Germany
| | - Philip Stevens
- Department of Chemistry, Indiana University, Bloomington, IN 47405, USA
- O’Neill School of Public and Environmental Affairs, Indiana University, Bloomington, IN 47405, USA
| | - Nusrat Jung
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Brandon E Boor
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN 47907, USA
- Ray W. Herrick Laboratories, Center for High Performance Buildings, Purdue University, West Lafayette, IN 47907, USA
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10
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Rom WN. Annals of Education: Teaching Climate Change and Global Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:41. [PMID: 38248506 PMCID: PMC10815579 DOI: 10.3390/ijerph21010041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/22/2023] [Accepted: 12/24/2023] [Indexed: 01/23/2024]
Abstract
The climate crisis is a health emergency: breaking temperature records every successive month, increasing mortality from hurricanes/cyclones resulting in >USD150 billion/year in damages, and mounting global loss of life from floods, droughts, and food insecurity. An entire course on climate change and global public health was envisioned, designed for students in public health, and delivered to Masters level students. The course content included the physical science behind global heating, heat waves, extreme weather disasters, arthropod-related diseases, allergies, air pollution epidemiology, melting ice and sea level rise, climate denialism, renewable energy and economics, social cost of carbon, and public policy. The methods included student engagement in presenting two air pollution epidemiological or experimental papers on fossil fuel air pollution. Second, they authored a mid-term paper on a specific topic in the climate crisis facing their locale, e.g., New York City. Third, they focused on a State, evaluating their climate change laws and their plans to harness renewable wind, solar, storage, nuclear, and geothermal energy. Students elsewhere covered regional entities' approach to renewable energy. Fourth, the global impact was presented by student teams presenting a country's nationally determined contribution to the Paris Climate Agreement. Over 200 Master's students completed the course; the participation and feedback demonstrated markedly improved knowledge and evaluation of the course over time.
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Affiliation(s)
- William N Rom
- Department of Global and Environmental Health, School of Global Public Health, New York University, 708 Broadway, New York, NY 10003, USA
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11
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Ferguson L, Taylor J, Symonds P, Davies M, Dimitroulopoulou S. Analysis of inequalities in personal exposure to PM 2.5: A modelling study for the Greater London school-aged population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 905:167056. [PMID: 37717780 DOI: 10.1016/j.scitotenv.2023.167056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/17/2023] [Accepted: 09/11/2023] [Indexed: 09/19/2023]
Abstract
Exposure to air pollution can lead to negative health impacts, with children highly susceptible due to their immature immune and lung systems. Childhood exposure may vary by socio-economic status (SES) due to differences in both outdoor and indoor air pollution levels, the latter of which depends on, for example, building quality, overcrowding and occupant behaviours; however, exposure estimates typically rely on the outdoor component only. Quantifying population exposure across SES requires accounting for variations in time-activity patterns, outdoor air pollution concentrations, and concentrations in indoor microenvironments that account for pollution-generating occupant behaviours and building characteristics. Here, we present a model that estimates personal exposure to PM2.5 for ~1.3 million children aged 4-16 years old in the Greater London region from different income groups. The model combines 1) A national time-activity database, which gives the percentage of each group in different residential and non-residential microenvironments throughout a typical day; 2) Distributions of modelled outdoor PM2.5 concentrations; 3) Detailed estimates of domestic indoor concentrations for different housing and occupant typologies from the building physics model, EnergyPlus, and; 4) Non-domestic concentrations derived from a mass-balance approach. The results show differences in personal exposure across socio-economic groups for children, where the median daily exposure across all scenarios (winter/summer and weekends/weekdays) is 17.2 μg/m3 (95%CIs: 12.1 μg/m3-41.2 μg/m3) for children from households in the lowest income quintile versus 14.5 μg/m3 (95%CIs: 11.5 μg/m3 - 27.9 μg/m3) for those in the highest income quintile. Though those from lower-income homes generally fare worse, approximately 57 % of London's school-aged population across all income groups, equivalent to 761,976 children, have a median daily exposure which exceeds guideline 24-h limits set by the World Health Organisation. The findings suggest residential indoor sources of PM2.5 are a large contributor to personal exposure for school children in London. Interventions to reduce indoor exposure in the home (for example, via the maintenance of kitchen extract ventilation and transition to cleaner cooking fuels) should therefore be prioritised along with the continued mitigation of outdoor sources in Greater London.
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Affiliation(s)
- Lauren Ferguson
- Institute for Environmental Design and Engineering, Bartlett School of Energy, Environment and Resources, University College London, UK; Air Quality and Public Health Group, UK Health Security Agency, Harwell Science and Innovation Campus, Chilton, UK.
| | - Jonathon Taylor
- Department of Civil Engineering, Tampere University, Finland
| | - Phil Symonds
- Institute for Environmental Design and Engineering, Bartlett School of Energy, Environment and Resources, University College London, UK
| | - Michael Davies
- Institute for Environmental Design and Engineering, Bartlett School of Energy, Environment and Resources, University College London, UK
| | - Sani Dimitroulopoulou
- Institute for Environmental Design and Engineering, Bartlett School of Energy, Environment and Resources, University College London, UK; Air Quality and Public Health Group, UK Health Security Agency, Harwell Science and Innovation Campus, Chilton, UK
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12
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Li W, Long C, Fan T, Anneser E, Chien J, Goodman JE. Gas cooking and respiratory outcomes in children: A systematic review. GLOBAL EPIDEMIOLOGY 2023; 5:100107. [PMID: 37638371 PMCID: PMC10446006 DOI: 10.1016/j.gloepi.2023.100107] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 08/29/2023] Open
Abstract
The most recent meta-analysis of gas cooking and respiratory outcomes in children was conducted by Lin et al. [93] in 2013. Since then, a number of epidemiology studies have been published on this topic. We conducted the first systematic review of this epidemiology literature that includes an in-depth evaluation of study heterogeneity and study quality, neither of which was systematically evaluated in earlier reviews. We reviewed a total of 66 relevant studies, including those in the Lin et al. [93] meta-analysis. Most of the studies are cross-sectional by design, precluding causal inference. Only a few are cohort studies that could establish temporality and they have largely reported null results. There is large variability across studies in terms of study region, age of children, gas cooking exposure definition, and asthma or wheeze outcome definition, precluding clear interpretations of meta-analysis estimates such as those reported in Lin et al. [93]. Further, our systematic study quality evaluation reveals that a large proportion of the studies to date are subject to multiple sources of bias and inaccuracy, primarily due to self-reported gas cooking exposure or respiratory outcomes, insufficient adjustment for key confounders (e.g., environmental tobacco smoke, family history of asthma or allergies, socioeconomic status or home environment), and unestablished temporality. We conclude that the epidemiology literature is limited by high heterogeneity and low study quality and, therefore, it does not provide sufficient evidence regarding causal relationships between gas cooking or indoor NO2 and asthma or wheeze. We caution against over-interpreting the quantitative evidence synthesis estimates from meta-analyses of these studies.
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Affiliation(s)
- Wenchao Li
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
| | - Christopher Long
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
| | - Tongyao Fan
- Penn State College of Medicine, Department of Pharmacology, 500 University Drive, Hershey, PA 17033, United States of America
| | - Elyssa Anneser
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
| | - Jiayang Chien
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
| | - Julie E. Goodman
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
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13
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Paulin LM, Samet JM, Rice MB. Gas Stoves and Respiratory Health: Decades of Data, but Not Enough Progress. Ann Am Thorac Soc 2023; 20:1697-1699. [PMID: 37703392 PMCID: PMC10704234 DOI: 10.1513/annalsats.202306-533vp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/13/2023] [Indexed: 09/15/2023] Open
Affiliation(s)
- Laura M. Paulin
- Section of Pulmonary and Critical Care, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | - Mary B. Rice
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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14
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Cox LA. The gas stove-childhood asthma kerfuffle: A teaching opportunity. GLOBAL EPIDEMIOLOGY 2023; 5:100104. [PMID: 37638367 PMCID: PMC10446003 DOI: 10.1016/j.gloepi.2023.100104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 03/31/2023] Open
Abstract
Several recent news stories have alarmed many politicians and members of the public by reporting that indoor air pollution from gas stoves causes about 13% of childhood asthma in the United States. Research on the reproducibility and trustworthiness of epidemiological risk assessments has identified a number of common questionable research practices (QRPs) that should be avoided to draw sound causal conclusions from epidemiological data. Examples of such QRPs include claiming causation without using study designs or data analyses that allow valid causal inferences; generalizing or transporting risk estimates based on data for specific populations, time periods, and locations to different ones without accounting for differences in the study and target populations; claiming causation without discussing or quantitatively correcting for confounding, external validity bias, or other biases; and not mentioning or resolving contradictory evidence. We examine the recently estimated gas stove-childhood asthma associations from the perspective of these QRPs and conclude that it exemplifies all of them. The quantitative claim that about 13% of childhood asthma in the United States could be prevented by reducing exposure to gas stove pollution is not supported by the data collected or by the measures of association (Population Attributable Fractions) used to analyze the data. The qualitative finding that reducing exposure to gas stove pollution would reduce the burden of childhood asthma in the United States has no demonstrated validity. Systematically checking how and whether QRPs have been addressed before reporting or responding to claims that everyday exposures cause substantial harm to health might reduce social amplification of perceived risks based on QRPs and help to improve the credibility and trustworthiness of published epidemiological risk assessments.
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Affiliation(s)
- Louis Anthony Cox
- Cox Associates, MoirAI, Entanglement, University of Colorado, 503 N. Franklin Street, Denver, CO 80218, USA
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15
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Bédard MA, Reyna ME, Moraes TJ, Simons E, Turvey SE, Mandhane P, Brook JR, Subbarao P. Association between gas stove use and childhood asthma in the Canadian CHILD Cohort Study. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:705-708. [PMID: 37296368 PMCID: PMC10351250 DOI: 10.17269/s41997-023-00779-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 04/24/2023] [Indexed: 06/12/2023]
Affiliation(s)
- Marc-Antoine Bédard
- Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children & Research Institute, Toronto, ON, Canada
| | - Myrtha E Reyna
- Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children & Research Institute, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Theo J Moraes
- Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children & Research Institute, Toronto, ON, Canada
| | - Elinor Simons
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Stuart E Turvey
- Department of Pediatrics, BC Children's Hospital, The University of British Columbia, Vancouver, BC, Canada
| | - Piush Mandhane
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Jeffrey R Brook
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Padmaja Subbarao
- Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children & Research Institute, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- Department of Physiology, University of Toronto, Toronto, ON, Canada.
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16
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Kashtan YS, Nicholson M, Finnegan C, Ouyang Z, Lebel ED, Michanowicz DR, Shonkoff SBC, Jackson RB. Gas and Propane Combustion from Stoves Emits Benzene and Increases Indoor Air Pollution. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023. [PMID: 37319002 DOI: 10.1021/acs.est.2c09289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Exposure pathways to the carcinogen benzene are well-established from tobacco smoke, oil and gas development, refining, gasoline pumping, and gasoline and diesel combustion. Combustion has also been linked to the formation of nitrogen dioxide, carbon monoxide, and formaldehyde indoors from gas stoves. To our knowledge, however, no research has quantified the formation of benzene indoors from gas combustion by stoves. Across 87 homes in California and Colorado, natural gas and propane combustion emitted detectable and repeatable levels of benzene that in some homes raised indoor benzene concentrations above well-established health benchmarks. Mean benzene emissions from gas and propane burners on high and ovens set to 350 °F ranged from 2.8 to 6.5 μg min-1, 10 to 25 times higher than emissions from electric coil and radiant alternatives; neither induction stoves nor the food being cooked emitted detectable benzene. Benzene produced by gas and propane stoves also migrated throughout homes, in some cases elevating bedroom benzene concentrations above chronic health benchmarks for hours after the stove was turned off. Combustion of gas and propane from stoves may be a substantial benzene exposure pathway and can reduce indoor air quality.
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Affiliation(s)
- Yannai S Kashtan
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
| | - Metta Nicholson
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
| | - Colin Finnegan
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
| | - Zutao Ouyang
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
| | - Eric D Lebel
- PSE Healthy Energy, 1140 Broadway, Suite 750, Oakland, California 94612, United States
| | - Drew R Michanowicz
- PSE Healthy Energy, 1140 Broadway, Suite 750, Oakland, California 94612, United States
| | - Seth B C Shonkoff
- PSE Healthy Energy, 1140 Broadway, Suite 750, Oakland, California 94612, United States
- Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California 94720, United States
- Energy Technologies Area, Lawrence Berkeley National Lab, Berkeley, California 94720, United States
| | - Robert B Jackson
- Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
- Woods Institute for the Environment and Precourt Institute for Energy, Stanford, California 94305, United States
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17
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Howard C, MacNeill AJ, Hughes F, Alqodmani L, Charlesworth K, de Almeida R, Harris R, Jochum B, Maibach E, Maki L, McGain F, Miller J, Nirmala M, Pencheon D, Robertson S, Sherman JD, Vipond J, Yin H, Montgomery H. Learning to treat the climate emergency together: social tipping interventions by the health community. Lancet Planet Health 2023; 7:e251-e264. [PMID: 36889866 DOI: 10.1016/s2542-5196(23)00022-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 12/06/2022] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Accelerating the decarbonisation of local and national economies is a profound public health imperative. As trusted voices within communities around the world, health professionals and health organisations have enormous potential to influence the social and policy landscape in support of decarbonisation. We assembled a multidisciplinary, gender-balanced group of experts from six continents to develop a framework for maximising the social and policy influence of the health community on decarbonisation at the micro levels, meso levels, and macro levels of society. We identify practical, learning-by-doing approaches and networks to implement this strategic framework. Collectively, the actions of health-care workers can shift practice, finance, and power in ways that can transform the public narrative and influence investment, activate socioeconomic tipping points, and catalyse the rapid decarbonisation needed to protect health and health systems.
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Affiliation(s)
- Courtney Howard
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Dahdaleh Institute for Global Health Research, York University, Toronto, Canada; Blavatnik School of Government, University of Oxford, Oxford, UK.
| | - Andrea J MacNeill
- Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | | | | | - Kate Charlesworth
- Climate Risk and Net Zero Unit, New South Wales Health, Sydney, NSW, Australia
| | - Roberto de Almeida
- Instituto Ideia Ambiental, Foz do Iguaçu, Brazil; Federal University of Latin American Integration, Foz do Iguaçu, Brazil
| | - Roger Harris
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; CODA Change, Sydney, NSW, Australia
| | | | - Edward Maibach
- Center for Climate Change Communication, George Mason University, Fairfax, VA, USA
| | - Lwando Maki
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Forbes McGain
- Western Health, Melbourne, VIC, Australia; Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia
| | - Jeni Miller
- Global Climate and Health Alliance, San Francisco, CA, USA
| | | | - David Pencheon
- Health and Sustainable Development, Medical and Health School, University of Exeter, Exeter, UK
| | | | - Jodi D Sherman
- Yale School of Medicine, Yale University, New Haven, CT, USA; Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Joe Vipond
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Hao Yin
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Yale School of Public Health, Yale University, New Haven, CT, USA; Department of Economics, University of Southern California, Los Angeles, CA, USA
| | - Hugh Montgomery
- CODA Change, Sydney, NSW, Australia; Intensive Care Medicine, University College London, London, UK
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