Are cleaner cooking solutions clean enough? A systematic review and meta-analysis of particulate and carbon monoxide concentrations and exposures



Pope, Daniel ORCID: 0000-0003-2694-5478, Johnson, Michael, Fleeman, Nigel ORCID: 0000-0002-4637-9779, Jagoe, Kirstie, Duarte, Rui, Maden, Michelle ORCID: 0000-0003-4419-6343, Ludolph, Ramona, Bruce, Nigel, Shupler, Matthew ORCID: 0000-0003-0259-9101, Adair-Rohani, Heather
et al (show 1 more authors) (2021) Are cleaner cooking solutions clean enough? A systematic review and meta-analysis of particulate and carbon monoxide concentrations and exposures. ENVIRONMENTAL RESEARCH LETTERS, 16 (8). 083002-083002.

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Abstract

<jats:title>Abstract</jats:title> <jats:p>Globally, approximately 3 billion primarily cook using inefficient and poorly vented combustion devices, leading to unsafe levels of household air pollution (HAP) in and around the home. Such exposures contribute to nearly 4 million deaths annually (WHO 2018a, 2018b ). Characterizing the effectiveness of interventions for reducing HAP concentration and exposure is critical for informing policy and programmatic decision-making on which cooking solutions yield the greatest health benefits. This review synthesizes evidence of in-field measurements from four cleaner cooking technologies and three clean fuels, using field studies aimed at reducing HAP concentration and personal exposure to health damaging pollutants (particulate matter (PM<jats:sub>2.5</jats:sub>) and carbon monoxide (CO)). Fifty studies from Africa, Asia, South and Latin America, provided 168 estimates synthesized through meta-analysis. For PM<jats:sub>2.5</jats:sub> kitchen concentrations, burning biomass more cleanly through improved combustion stoves (ICS) with (<jats:italic>n</jats:italic> = 29; 63% reduction) or without (<jats:italic>n</jats:italic> = 12; 52%) venting (through flue or chimney) and through forced-draft combustion (<jats:italic>n</jats:italic> = 9; 50%) was less effective than cooking with clean fuels including ethanol (<jats:italic>n</jats:italic> = 4; 83%), liquefied petroleum gas (LPG) (<jats:italic>n</jats:italic> = 11; 83%) and electricity (<jats:italic>n</jats:italic> = 6; 86%). Only studies of clean fuels consistently achieved post-intervention kitchen PM<jats:sub>2.5</jats:sub> levels at or below the health-based WHO interim target level 1 (WHO-IT1) of 35 <jats:italic>μ</jats:italic>g m<jats:sup>−3</jats:sup>. None of the advanced combustion stoves (gasifiers) achieved WHO-IT1, although no evidence was available for pellet fuelled stoves. For personal exposure to PM<jats:sub>2.5,</jats:sub> none of the ICS (<jats:italic>n</jats:italic> = 11) were close to WHO-IT1 whereas 75% (<jats:italic>n</jats:italic> = 6 of 8) of LPG interventions were at or below WHO-IT1. Similar patterns were observed for CO, although most post-intervention levels achieved the WHO 24 h guideline level. While clean cooking fuel interventions (LPG, electric) significantly reduce kitchen concentrations and personal exposure to PM<jats:sub>2.5</jats:sub> in household settings, stove stacking and background levels of ambient air pollution, have likely prevented most clean fuel interventions from approaching WHO-IT1. In order to maximize health gains, a wholistic approach jointly targeting ambient and HAP should be followed in lower-and-middle income countries.</jats:p>

Item Type: Article
Uncontrolled Keywords: improved cookstove, clean fuel, concentration, exposure, household air pollution
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 23 Aug 2021 08:30
Last Modified: 18 Jan 2023 21:33
DOI: 10.1088/1748-9326/ac13ec
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3134144