Primary Cooking Research Articles

Determinants of Household Cooking Energy Choice in Public Housing Estates in Maiduguri, Borno State, North-East Nigeria

The growing utilization of traditional energy sources particularly in developing countries has in recent times been drawing disturbing attention from researchers and policy makers in view of the environmental and health consequences associated with such fuels. Hence the need to empirically examine the economic and socio-demographic factors that drive household cooking energy choice in public housing estates in Maiduguri, Borno State, North-East Nigeria. A survey questionnaire was used to elicit data from a sample of 355 household-heads from the target population of 3,192 households using systematic sampling technique. Multinomial Logistic Regression was used to analyze the probability of households’ choice of different energy types used for cooking purposes. The results revealed that higher income, higher educational level, occupation of the household head; location of residence, kitchen type and ownership of dwelling had positive effects on the probability of choosing cleaner sources of energy for cooking. Meanwhile, lower income and larger household size had positive correlation with the likelihood of choosing traditional energy sources such as fuelwood and charcoal as the primary cooking energy source among households. It is recommended that policy makers and stakeholders in the energy sector should take adequate and proactive steps that will promote access to cleaner, efficient, affordable and modern sources of energy for household cooking activities in Borno State, North-east Nigeria.

Self-Reported Primary Cooking Fuels Use and Risk of Chronic Digestive Diseases: A Prospective Cohort Study of 0.5 Million Chinese Adults.

Household air pollution (HAP) from inefficient combustion of solid fuels is a major health concern worldwide. However, prospective evidence on the health impacts of solid cooking fuels and risks of chronic digestive diseases remains scarce. We explored the effects of self-reported primary cooking fuels on the incidence of chronic digestive diseases. The China Kadoorie Biobank recruited 512,726 participants 30-79 years of age from 10 regions across China. Information on primary cooking fuels at the current and previous two residences was collected via self-reporting at baseline. Incidence of chronic digestive diseases was identified through electronic linkage and active follow-up. Cox proportional hazards regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of self-reported long-term cooking fuel patterns and weighted duration of self-reported solid cooking fuel use with chronic digestive diseases incidence. Linear trend was tested by assigning the medians of weighted duration in each group and then taking those as continuous variables in the models. Subgroup analyses were undertaken across the baseline characteristics of participants. During y of follow-up, 16,810 new cases of chronic digestive diseases were documented, among which 6,460 were diagnosed as cancers. Compared with long-term cleaner fuel use, self-reported long-term use of solid cooking fuels (i.e., coal, wood) was associated with elevated risks of chronic digestive diseases (; 95% CI: 1.02, 1.13), including nonalcoholic fatty liver disease (NAFLD) (; 95% CI: 1.10, 1.87), hepatic fibrosis/cirrhosis (; 95% CI: 1.05, 1.73), cholecystitis (; 95% CI: 1.07, 1.32), and peptic ulcers (; 95% CI: 1.00, 1.33). The longer the weighted duration of self-reported solid cooking fuel use, the higher the risks of chronic digestive diseases, hepatic fibrosis/cirrhosis, peptic ulcers, and esophageal cancer (). The aforementioned associations were modified by sex and body mass index (BMI). Positive associations of always solid cooking fuel use with chronic digestive disease, hepatic fibrosis/cirrhosis, NAFLD, and cholecystitis were observed among women but not men. The longer the weighted duration of self-reported solid cooking fuel use, the higher the risk of NAFLD among those with a BMI . Long-term self-reported solid cooking fuels use was associated with higher risks of chronic digestive diseases. The positive association of HAP from solid cooking fuels with chronic digestive diseases indicates for an imminent promotion of cleaner fuels as public health interventions. https://doi.org/10.1289/EHP10486.

Widespread Clean Cooking Fuel Scale-Up and under-5 Lower Respiratory Infection Mortality: An Ecological Analysis in Ecuador, 1990-2019.

Nationwide household transitions to the use of clean-burning cooking fuels are a promising pathway to reducing under-5 lower respiratory infection (LRI) mortality, the leading cause of child mortality globally, but such transitions are rare and evidence supporting an association between increased clean fuel use and improved health is limited. This study aimed to investigate the association between increased primary clean cooking fuel use and under-5 LRI mortality in Ecuador between 1990 and 2019. We documented cooking fuel use and cause-coded child mortalities at the canton (county) level in Ecuador from 1990 to 2019 (in four periods, 1988-1992, 1999-2003, 2008-2012, and 2015-2019). We characterized the association between clean fuel use and the rate of under-5 LRI mortalities at the canton level using quasi-Poisson generalized linear and generalized additive models, accounting for potential confounding variables that characterize wealth, urbanization, and child health care and vaccination rates, as well as canton and period fixed effects. We estimated averted under-5 LRI mortalities accrued over 30 y by predicting a counterfactual count of canton-period under-5 LRI mortalities were clean fuel use to not have increased and comparing with predicted canton-period under-5 LRI mortalities from our model and observed data. From 1990 to 2019, the proportion of households primarily using a clean cooking fuel increased from 59% to 95%, and under-5 LRI mortality fell from 28 to 7 per 100,000 under-5 population. Canton-level clean fuel use was negatively associated with under-5 LRI mortalities in linear and nonlinear models. The nonlinear association suggested a threshold at approximately 60% clean fuel use, above which there was a negative association. Increases in clean fuel use between 1990 and 2019 were associated with an estimated 7,300 averted under-5 LRI mortalities (95% confidence interval: 2,600, 12,100), accounting for nearly 20% of the declines in under-5 LRI mortality observed in Ecuador over the study period. Our findings suggest that the widespread household transition from using biomass to clean-burning fuels for cooking reduced under-5 LRI mortalities in Ecuador over the last 30 y. https://doi.org/10.1289/EHP11016.

Did COVID-19 Change the Availability and Use of Clean Energy for Cooking? Evidence From Ghana.

A major part of Ghana's current household energy policy is focused on using a branded cylinder recirculation model (BCRM) to promote the safe use of Liquefied Petroleum Gas (LPG) for primary cooking. The implementation of the BCRM is expected to increase LPG adoption by households to the announced policy goal of 50% of the population by 2030. We investigated the impact of the COVID-19 pandemic on the implementation of the BCRM, availability, and household use of cleaner fuels. This was assessed using existing data on clean fuel use prior to the COVID-19 pandemic. Additional data was collected using questionnaire-based household surveys and qualitative interviews. It was found that the expansion of BCRM was significantly impacted by the COVID-19 pandemic. Planning activities such as baseline data collection and stakeholder engagement were delayed due to the COVID-19 restrictions. Changes in household incomes during the pandemic had the biggest percentage effect on household choice of cooking fuel, causing a regression in some cases, to polluting fuel use. This study provides insights that could be valuable in future understanding of the interactions between pandemic control measures and economic disruptions that may affect household energy choices for cooking.

Impact of solid fuel usage on respiratory symptoms among reproductive aged women: a cross-sectional study in Sri Lanka

BackgroundWorldwide, around 3 billion people rely on solid fuel for their daily energy needs. Household air pollution secondary to solid fuel burning is a major risk factor for respiratory mobility among vulnerable populations. This study aimed to investigate the respiratory symptoms associated with solid fuel usage, the level of kitchen fuel smoke exposure and its association with respiratory symptoms among reproductive-aged women in Sri Lanka, where most households exclusively use firewood as the primary cooking fuel.MethodsA descriptive cross-sectional study was conducted among 403 reproductive-aged women (15 to 49 years) in the Central Province, Sri Lanka. A structured interviewer-administered questionnaire was used to collect data, and an exposure assessment was done using a breath carbon monoxide monitor.ResultsAfter adjusting for potential confounding factors by the logistic regression models, the odds ratios (OR) of the liquid petroleum gas-only users for at least one respiratory symptom relevant to cough (OR: 0.39; 95% confidence interval [CI]: 0.20–0.78), wheezing (OR: 0.47; 95% [CI]: 0.26–0.87), and dyspnea (OR: 0.44; 95% CI: 0.24–0.84) were significantly lower compared to firewood-only users. The mean of expired air carbon monoxide and estimated carboxyhemoglobin levels of liquid petroleum gas-only users (2.84 ± 2.85 ppm; 1.08 ± 0.46%) were significantly lower than those of firewood-only users (5.27 ± 4.64 ppm; 1.47 ± 0.74%).ConclusionsThe use of firewood increased the risk of respiratory symptoms among reproductive-aged women in Sri Lanka. Health education focused on positive behavioral changes and effective and efficient clean energy policies are recommended to mitigate the risk associated with solid fuel smoke exposure.

Estimating the spill-over impacts of a clean cooking fuel program: Evidence from Ghana

• We investigate the spill-over impacts of Ghana's Rural LPG Promotion Program (RLPGPP) • No significant increase in LPG use nor reduction in dirty fuel use is observed among beneficiary districts • After matching beneficiary and non-beneficiary districts, significant reduction in poverty is observed. • The increase in refill station construction and operation during the period of the RLPGPP implementation might play a role in reducing poverty in beneficiary districts. Transition to cleaner cooking fuels is a key challenge for sustainable development. This study evaluates the spill-over impact of a program that distributes liquefied petroleum gas (LPG) cylinders and accessories for free on cooking fuel choice and poverty alleviation in Ghana. We construct a district-level dataset based on the Ghana Living Standards Surveys 6 and 7, collected before and after the program implementation, respectively. Using difference-in-differences combined with matching techniques, we find that the program had no significant spill-over impacts on primary household cooking fuel; LPG use did not increase and firewood use did not decrease among rural households in treated districts. However, there is a possible association between the program and poverty reduction in treated districts, and the likely channel is investments in refill stations. The results suggest that the program should refine its implementation strategy to yield substantial effects on cooking fuel choice. In addition, implementing the program with the right infrastructure in place could increase the benefits associated with it.

Associations between biomass fuel use and child health: a community-based study in Bhaktapur, Nepal

Abstract Background Biomass fuel use for cooking is widespread in low- and middle-income countries. Previous studies have mainly focused on adverse health outcomes in adults or specific diseases. In a cohort among young children living in Bhaktapur, Nepal, we aimed to describe the association between the use of biomass cooking fuels in families with child health using measures of linear growth, cognition and chronic illness. Methods Caregivers of 600 marginally stunted children aged 6-11 months were interviewed about their primary source of cooking fuel at enrolment into a randomized controlled trial. Children's body length (n = 572) was measured at age 18-23 months. At the same time, blood samples (n = 497) were taken, and we measured leukocyte telomere length (LTL) as a marker of chronic disease risk. We chose LTL expressed as z-scores as a measure of chronic disease. Cognitive abilities were measured by the Wechsler Preschool and Primary Scale of Intelligence, 4th edition (WPPSI-IV) and NEPSY-II subtests when the children were 4 years old (n = 531). Associations were estimated in multiple regression models. Results About 18% of all families used biomass as primary cooking fuel. Children from families using biomass fuel were on average slightly shorter (mean difference 0.14 Z-scores, 95% CI: 0.28, 0.00), had lower IQ scores (mean difference 2.2 (95% CI: 0.5, 3.9), and shorter LTL (mean difference: 0.09 (95% CI: 0.05 to 0.13) compared to those not using biomass fuel. The observed associations were unaltered after adjusting for relevant confounders. Conclusions In children from households in poor, urban neighborhoods in Nepal, biomass fuel use for cooking was associated with health indicators for child growth and cognition as well as longevity and chronic illnesses reflected in shortening of telomeres. As this was an observational study, residual confounding cannot be excluded. Our findings support the ongoing effort to reduce exposure to biomass fuel in low-resource settings. Key messages

Complex dynamics in sustaining clean cooking and food access through a pandemic: A COVID-19 impact study in peri-urban Cameroon

Access to clean energy for cooking is central to achieving Sustainable Development Goal 7. Latest predictions suggest that this goal will not be met by 2030, with further setbacks due to the COVID-19 pandemic. We investigated the impacts of COVID-19 restrictions on household cooking fuel, practices and dietary behaviours in a peri-urban community in Central Cameroon. Using surveys (n = 333) and qualitative semi-structured interviews (n = 12), we found negative financial impacts and high levels of food insecurity, with 83 % and 56 % of households reporting reduced income and insufficient food, respectively. Households reduced food intake and cooking frequency and relied more heavily on local sources (e.g., farmland) to feed their families. Changes in primary cooking fuel were less pronounced and fuel choice was inherently linked to cooking behaviours, with some households utilising LPG more often for simple tasks, such as reheating food. Local systems were key in sustaining food and fuel access and households demonstrated resilience by employing numerous mechanisms to overcome challenges. Our findings underline the vulnerability of households in maintaining sufficient food intake and sustaining clean cooking, highlighting how policy needs to take a nuanced approach considering food-energy dynamics and strengthening local systems to ensure access to clean energy is resistant to system shocks.

The association between household biomass fuel use and leukocyte telomere length among toddlers in Bhaktapur, Nepal

BackgroundBiomass fuels are still in use for cooking by many households in resource poor countries such as Nepal and is a major source of household air pollution (HAP). Chronic exposure to HAP has been shown to be associated with shorter telomere length in adults.ObjectivesTo measure the association between exposure related to household biomass fuel in infancy and leukocyte telomere length (LTL) at 18–23 months of age among 497 children from Bhaktapur, Nepal.MethodsIn a prospective cohort study design, we have collected information on household cooking fuel use and several clinical, anthropometric, demographic, and socioeconomic variables. We estimated the association between biomass fuel use and the relative LTL in multiple linear regression models.ResultsMost of the families (78%) reported liquified petroleum gas (LPG) as the primary cooking fuel, and 18.7% used biomass. The mean relative (SD) LTL was 1.03 (0.19). Children living in households using biomass fuel had on average 0.09 (95% CI: 0.05 to 0.13) units shorter LTL than children in households with no biomass fuel use. The observed association was unaltered after adjusting for relevant confounders. The association between LTL and biomass use was strongest among children from households with ≤2 rooms and without separate kitchen.SignificanceExposure to biomass fuel use in early life might have consequences for longevity, and risk of chronic illnesses reflected in shortening of the telomeres. Our findings support the ongoing effort to reduce exposure to biomass fuel in low-resource settings.Impact statementsBiomass for cooking is a leading source of household air pollution in low and middle-income countries, contributing to many chronic diseases and premature deaths. Chronic exposure to biomass fuel through oxidative stress and inflammation has been associated with a shortening of the telomeres, a “biological marker” of longevity. This prospective cohort study describes the association between household biomass fuel use and leukocyte telomere length among 497 toddlers. Leukocyte telomere length was significantly shorter among children living in households with biomass fuel than in children from homes where mainly LPG was used for cooking.Clinical Trial registrationClinicaltrials.gov: NCT02272842, registered October 21, 2014, Universal Trial Number: U1111-1161-5187 (September 8, 2014)

Socioeconomic Determinants of Household Stove Use-Choice and Stove Stacking Patterns in Ghana Using Multinomial Logit Models

Background and Aim: Air pollution is the fourth-highest risk factor for premature deaths globally and the second-highest risk factor for premature deaths in Ghana. Understanding the socioeconomic correlates of cooking stove/fuel choices and stove stacking patterns is a precursor to designing effective household air pollution interventions. Methods: The study used a quantitative cross-sectional design to collect data from sampled districts in all 16 regions of Ghana, covering about 7,400 household-level respondents in 370 enumeration areas (EAs); across 177 urban EAs and 193 rural EAs. Face-to-face interviews were conducted at home. The questionnaire was designed to elicit information on primary, secondary, and tertiary cooking stoves and fuels. Results: Use of LPG correlates positively with education (Primary education-RRR:2.377, p<0.01, CI: 95), (Middle/JHS education-RRR:3.019, p<0.0, CI:95), (Technical/SHS education-RRR:6.491, p<0.01, CI: 95), (Post-secondary/University education-RRR:14.41, p<0.01, CI:95). Similarly, use of an LPG-charcoal stove mix compared to Charcoal stove-open fire mix correlates positively with education. All else equal, households with more than one cookstove (RRR:1.185, p<0.05, CI:95), and urban households (RRR:6.488, p<0.01, CI:95) reported using LPG stoves as their primary cookstove more frequently than did households using a single stove or living in rural areas. The age of the primary cook (RRR:1.44, p<0.1, CI:95), household income (RRR: 1.052, p<0.1, CI:95), and urbanicity (RRR:4.134, p<0.01, CI:95) were statistically significant in predicting use of an LPG-Charcoal mix compared to Charcoal stove-open fire mix. LPG, charcoal and 3-stone (open fire) stoves refer to cooking devices that are fueled by combustible gas, charcoal and wood respectively. Conclusion: Most households in Ghana use multiple cookstoves and fuels. Biomass fuel use is concentrated in poorer, less educated, and rural households. Equitable household energy transitions will require particular attention to encouraging sustained exclusive use of clean fuels in these communities to improve health. Keywords: socioeconomic factors, cookstove, choice, stove stacking,

Household air pollution, polycyclic aromatic hydrocarbons and esophageal cancer risk in Kenya: ESCCAPE case-control study

Background and Aim Esophageal squamous cell carcinoma (ESCC) is highly prevalent in Western Kenya. Established risk factors (e.g. smoking and alcohol consumption) are not common in female patients. Exposure to household air pollution (HAP) from solid fuels used for cooking and heating might be relevant in ESCC aetiology. As such, this study aims to examine the relationship between self-reported indicators of exposure to HAP with risk of ESCC in Western Kenya. Methods Six-hundred and four (604) ESCC cases and six-hundred and thirty-one (631) controls were recruited during three phases of the ESCCAPE Kenya case-control study. Surveys on risk factors were conducted with all participants. Surveys included questions on demographic and socio-economic factors, and fuels used in the home currently and during childhood, and their proximity to heating and cooking sources. Results When accounting for confounding demographic factors, odds ratios (OR) derived from binomial regression illustrates a significantly increased risk of esophageal cancer among those who use firewood as their primary cooking fuel (OR: 2.187; CI: 1.368-3.557). Women were almost three times as likely to have esophageal cancer when using firewood as the primary cooking fuel (OR: 2.821; CI: 1.255-6.917). Risk of esophageal cancer was significantly greater among participants who cooked in their living room (OR: 1.954; CI: 1.234-3.107). Findings demonstrate greater wood burning exposure is associated with significantly heightened risk of esophageal cancer. Conclusions Findings from the ESCCAPE case-control study indicate the potential role of exposure to smoke from firewood used in cooking and heating, in the complex aetiology of ESCC. Given the increased lifetime exposure to woodsmoke for women due to traditional domestic roles, and their lower exposure to other known risk factors, reliance on solid fuels for domestic energy could be an important potentially preventable risk factor for women in areas when the occurrence of ESCC is high.

Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000–18: a geospatial modelling study

More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000-257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Bill & Melinda Gates Foundation.

Fuel stacking implications for willingness to pay for cooking fuels in peri-urban Kathmandu Valley, Nepal

Overcoming cooking fuel “stacking” is a major challenge impeding transitions to clean cooking in low- and middle-income countries. Though clean fuels are increasingly available in these countries' urban centers, continued use of polluting technology reinforces energy poverty, due to time costs associated with fuel collection, the household air pollution generated, and the contribution of the latter to dangerous levels of ambient air pollution. While there is much evidence of the association between income and clean fuel use, the impacts of policy instruments that alter fuel prices have been underexplored. We conducted a double-bounded contingent valuation experiment with 360 households who use firewood and liquefied petroleum gas (LPG) in peri-urban areas of Kathmandu Valley, to elicit respondents' strength of preference regarding their primary cooking fuels. We examine the determinants of cooking fuel stacking, the relationship between fuel stacking behavior and preferences for cooking fuel, and calculate willingness to pay (WTP) for households' primary fuels. We find that stacking is associated with household demographic variables and the time burden of firewood collection; meanwhile, wealthier households, those having more empowered women, and those affected by the 2015 trade blockade in Nepal use more LPG. Fuel stacking among primary LPG users is negatively related to demand for LPG. Among primary LPG users, WTP for a 14.2 kg LPG cylinder ranges between 1267 and 1496 NPR (11–15 USD, or between 3.5 and 4.9 NPR/MJ of useful energy), but WTP for 1 MJ of useful cooking energy is considerably higher due to the highly price inelastic demand for firewood (42–145 NPR/MJ, 0.36–1.25 USD/MJ). Our findings have implications for the pricing of clean fuels in urban Nepal, as they indicate an asymmetric response around price changes for LPG and firewood.

Widening inequities in clean cooking fuel use and food security: compounding effects of COVID-19 restrictions and VAT on LPG in a Kenyan informal urban settlement

Universal access to cleaner cooking fuels (including liquefied petroleum gas (LPG)) is a key target of Sustainable Development Goal 7. Currently, approximately 40 million Kenyans rely on polluting cooking fuels (e.g. charcoal, wood). While the Kenyan government aims to rapidly scale up use of LPG for cooking by 2030, COVID-19 restrictions and a 16% value added tax (VAT) re-introduced on LPG in 2021 have likely hampered progress in LPG uptake. We aimed to quantify the effect of these economic shocks on food and energy security in Langas informal urban settlement in western Kenya. We further evaluated whether households most adversely affected by COVID-19 restrictions were more likely to be socioeconomically impacted by the VAT re-imposition. A cross-sectional survey (n = 1542) assessed changes in cooking fuel patterns, food security and livelihoods of primary cooks due to these two economic shocks. While under COVID-19 restrictions, 75% (n = 1147) of participants reported income declines and 18% (n = 164) of participants using LPG (n = 922) switched their primary cooking fuel to charcoal, wood or kerosene. Households reporting lower income while under COVID-19 restrictions had 5.3 times (95% CI:[3.8,7.4]) the odds of experiencing food insecurity as those with no change in income. Unemployment and food insecurity under COVID-19 restrictions were substantially higher among informal sector workers (70% and 60%, respectively) compared with business/government employees (45% and 37%, respectively). Following the VAT re-introduction, 44% (n = 356) of households using LPG consumed less, and 34% (n = 276) cooked more frequently with polluting fuels. Individuals switching away from LPG under COVID-19 restrictions had 3.0 times (95% CI:[2.1,4.3]) the odds of reducing their LPG consumption due to the VAT re-introduction as those maintaining use of LPG. COVID-19 restrictions and the VAT re-introduction disproportionately negatively affected informal sector workers’ livelihoods. A zero-rating of VAT on LPG can help alleviate deepened inequities in LPG access in Kenya.

The forgotten coal: Charcoal demand in sub-Saharan Africa

Charcoal is an important cooking fuel in urban Africa. In this paper, we estimate the current number of charcoal users and project trends for the coming decades. Charcoal production is often not effectively regulated, and it hence contributes to forest degradation. Moreover, charcoal has adverse health effects for its users. At the same time, charcoal constitutes an important income source in deprived rural areas, while the current alternative, gas, is a mostly imported fossil fuel. We find that 195 million people in sub-Saharan Africa rely on charcoal as their primary cooking fuel and gauge that another 200 million use charcoal as secondary fuel. Our scenarios suggest that clean cooking initiatives are outweighed by strong urban population growth and hence charcoal usage is expected to remain high over the coming decades. Policies should therefore target end-users, forest management, and regulation of charcoal production to enable sustainable production and use of charcoal.

Effects of household environmental exposure and ventilation in association with adverse birth outcomes: A prospective cohort study in rural China

Prenatal exposure to outdoor air pollution have been associated with birth outcomes. However, there is limited evidence on the adverse effects of household indoor air pollution worldwide, much less in rural areas of China. This study aimed to explore the associations of household environmental factors (primary cooking fuel, housing renovation, and home ventilation) with four adverse birth outcomes (preterm birth (PTB), small for gestational age (SGA), low birth weight (LBW), and term low birth weight (T-LBW)). We conducted a cohort study involving 10,324 pregnancies in women who delivered a live-born infant from 2015 to 2018 in Guangxi, China. Risk ratios and 95% confidence intervals (CI) were estimated with control for reproductive history, lifestyle, home environmental confounders, and other potential confounders. A total of 5.4% of the infants were PTB, 10.7% were SGA, 5.5% had LBW, and 3.0% had T-LBW. Household-use induction cookers as the primary cooking fuel during pregnancy was associated with SGA (RR = 1.31, 95% CI: 1.07–1.60), LBW (1.41, 1.09–1.82), and T-LBW(1.62, 1.16–2.26), as compared with household-use gas as the primary cooking fuel. Housing renovation within one year before pregnancy was associated with PTB (1.45, 1.06–1.98) and LBW (1.56, 1.17–2.09), while housing renovation during pregnancy was associated with a higher risk of SGA only in moderate home ventilation conditions (3.74, 1.69–8.28). Our findings suggested that household-use induction cookers as the primary cooking fuel increased the risks of SGA, LBW, and T-LBW. In addition, housing renovation within one year before pregnancy increased the risks of PTB and LBW. Proper home ventilation may reduce the effect on the association between housing renovation during pregnancy and SGA.

Assessing the Demand for Improved Cook Stoves among Low Income Households in Kenya: Case of Baringo and West Pokot Counties

In recent years, clean and improved cooking solutions have significantly evolved globally, generating an attractive market opportunity for enterprises engaging in the provision of innovative cooking appliances, fuels, and financing to speed uptake of the disseminated technologies. Improved Cook stoves (ICS) have been widely touted for their potential to deliver triple wing benefits of improved agricultural productivity, enhanced household health and time savings through reduced scrimmage in sourcing for biomass fuel, and sustainability through reduced local deforestation, further reducing black carbon emissions. Despite decades of promotion, diffusion of ICS has continued to remain slow. This project aimed at investigating the factors that hinder the uptake of ICS in some selected poor villages from Baringo and West Pokot Counties in Kenya, East Africa. Data was collected from 2918 households across 12 villages and analyzed statistically. On average, households spent approximately KES 2149 on fuel per month, covered 2.15 km and spent around 1.5 hours collecting/getting their primary cooking fuel. Majority of the consumers, 94% expressed willingness to pay (WTP) for an ideal cookstove (one that emits less smoke, saves fuel, safe during cooking, easy to light, and that could cook fast). A majority of the consumers (46.5%) preferred to acquire ICSs through equal monthly installments while 40.47% preferred to pay cash and the rest opted for the “pay-to-use” model and whenever cash was available. From the binary Probit model, consumers’ WTP for the ICSs was positively influenced by age and level of education of the head of the family, size of the family, number of children under five years, distance to the source of fuel, and the desire to use and own an ICS. Policies that are aimed at maximizing cook stove effectiveness and uptake among the poor in the target counties and Kenya at large was recommended.

Multinational prediction of household and personal exposure to fine particulate matter (PM2.5) in the PURE cohort study.

Use of polluting cooking fuels generates household air pollution (HAP) containing health-damaging levels of fine particulate matter (PM2.5). Many global epidemiological studies rely on categorical HAP exposure indicators, which are poor surrogates of measured PM2.5 levels. To quantitatively characterize HAP levels on a large scale, a multinational measurement campaign was leveraged to develop household and personal PM2.5 exposure models. The Prospective Urban and Rural Epidemiology (PURE)-AIR study included 48-hour monitoring of PM2.5 kitchen concentrations (n=2,365) and male and/or female PM2.5 exposure monitoring (n=910) in a subset of households in Bangladesh, Chile, China, Colombia, India, Pakistan, Tanzania and Zimbabwe. PURE-AIR measurements were combined with survey data on cooking environment characteristics in hierarchical Bayesian log-linear regression models. Model performance was evaluated using leave-one-out cross validation. Predictive models were applied to survey data from the larger PURE cohort (22,480 households; 33,554 individuals) to quantitatively estimate PM2.5 exposures. The final models explained half (R2=54%) of the variation in kitchen PM2.5 measurements (root mean square error (RMSE) (log scale):2.22) and personal measurements (R2=48%; RMSE (log scale):2.08). Primary cooking fuel type, heating fuel type, country and season were highly predictive of PM2.5 kitchen concentrations. Average national PM2.5 kitchen concentrations varied nearly 3-fold among households primarily cooking with gas (20μg/m3 (Chile); 55μg/m3 (China)) and 12-fold among households primarily cooking with wood (36μg/m3 (Chile)); 427μg/m3 (Pakistan)). Average PM2.5 kitchen concentration, heating fuel type, season and secondhand smoke exposure were significant predictors of personal exposures. Modeled average PM2.5 female exposures were lower than male exposures in upper-middle/high-income countries (India, China, Colombia, Chile). Using survey data to estimate PM2.5 exposures on a multinational scale can cost-effectively scale up quantitative HAP measurements for disease burden assessments. The modeled PM2.5 exposures can be used in future epidemiological studies and inform policies targeting HAP reduction.

Food Safety Knowledge, Attitudes and Practices of Consumers Regarding Meat Consumption at Home

This study is conducted to determine the meat purchase, storage, handling or preparation, and personal hygiene practices of consumers living in Istanbul and their level of knowledge on food safety practices. A questionnaire was sent to 830 consumers, who were responsible for primary shopping and cooking in their households. Participants achieved a certain score with their responses to the statements in the questionnaire. The difference between the sociodemographic characteristics of the participants and their scores was determined by independent samples t-test and one-way ANOVA. A significant difference was observed in participants' knowledge scores about meat purchasing and carrying, storage and preparation practices and gender (p

Association of using biomass fuel for cooking with depression and anxiety symptoms in older Chinese adults

BackgroundsHousehold air pollution exposure is a crucial public concern and have the potential to seriously affect human health. Using biomass fuels for cooking is the main contributor to household air pollution. However, current evidence linked between cooking with biomass fuels and mental health remains limited. ObjectivesTo explore whether cooking with biomass fuels is associated with depression and anxiety symptoms among older adults in China. MethodsWe obtained data from Chinese Longitudinal Healthy Longevity Survey (CLHLS). Depressive and anxiety symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively. Primary cooking fuel type was self-reported. We used logistic regression and linear regression to evaluate the effects of cooking with biomass fuels on depression and anxiety. ResultsA total of 13,361 participants aged 65 years and older (mean age, 84.2 ± 11.5 years) were included in the presented study. A positive association was found between cooking with biomass fuels and both depression symptoms (adjusted odds ratio 1.23, 95% CI 1.03 to 1.47) and anxiety symptoms (adjusted odds ratio 1.31, 95% CI 1.02 to 1.68). Biomass fuel users had a higher depression scores (0.33, 95% CI 0.03 to 0.61) and a higher anxiety scores (0.20, 95% CI 0.02 to 0.38) compared to clean fuel users. We found no significant interactions between participant characteristics and biomass fuel use on either depression or anxiety symptoms. ConclusionsCooking with biomass fuels was associated with depression and anxiety symptoms in order adults. Further large prospective cohort studies are warranted to confirm this association.