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Open Access Publications from the University of California

Scholarly Works (21 results)

  • Thesis
  • Peer Reviewed
UC Berkeley Electronic Theses and Dissertations (2016)

Exposure to fine particles (PM2.5) resulting from solid fuel use for household energy needs – including cooking, heating, and lighting – is one of the leading causes of ill-health globally and is responsible for approximately 4 million premature deaths and 84 million lost disability-adjusted life years globally. The well-established links between cooking and ill-health are modulated by complex social, behavioral, technological, and environmental issues that pose unique challenges to efforts that seek to reduce this large health burden. Despite growing interest in the field – and numerous technical solutions that, in the laboratory at least, reduce emissions of harmful air pollutants from solid fuel combustion – there exists a need for refined tools, models, and techniques (1) for measuring environmental pollution in households using solid fuel, (2) for tracking adoption of interventions, and (3) for estimating the potential health benefits attributable to an intervention.

Part of the need for higher spatial and temporal resolution data on particular concentrations and dynamics is being met by low-cost sensing platforms that provide large amounts of time-resolved data on critical parameters of interest, including PM2.5 concentrations and time-of-use metrics for heat-generating appliances, like stoves. Use of these sensors can result in non-trivial challenges, including those related to data management and analysis, and field logistics, but also enables novel lines of inquiry and insight. Chapter 2 presents a long-term deployment of real-time PM2.5 sensors in rural, solid-fuel-using kitchens, specifically seeking to evaluate how well commonly measured 24 or 48-hour samples represent long-term means. While short-term measures were poor predictors of long-term means, the dataset enabled evaluation of numerous sampling strategies – including sampling once per week, month, or season – that had much lower errors and higher probabilities of estimating the true mean.

Chapters 3 and 4 describe the selection and deployment of 200 advanced cookstoves to pregnant women in rural Palwal District, Haryana, India. Chapter 3 focuses on selection and evaluation of an intervention stove in the community, including preliminary measurement of exposure to PM2.5 and CO. These data suggest one method of piloting interventions and exposure assessment methods prior to larger rollouts to ensure community acceptability and feasibility. Chapter 4 specifically addresses adoption and use of the intervention stove over a period of approximately one year through the deployment of data-logging thermometers on 200 traditional and intervention stoves. Intervention stove use declined steadily over time and stabilized after approximately 200 days, while use of the traditional stove remained constant, emphasizing the need for monitoring both traditional and intervention stoves and for monitoring for periods of time beyond just the initial deployment to truly understand use. Chapter 4 additionally investigated intervention stove failures and how well short measures of stove use predict long- term trends (similar to the analysis performed in Chapter 2).

Chapter 5 focuses on utilizing the best available knowledge of exposure-response relationships to estimate the potential health impacts of an intervention at the national level in a software package called HAPIT, the Household Air Pollution Intervention Tool. HAPIT combines background disease data from the 2010 Global Burden of Disease with demographic and socioeconomic data and relative risk estimates from the integrated exposure-response curves to estimate disability-adjusted life years (DALYs) and deaths that could be averted by an exposure- reducing household air pollution intervention. Chapter 5 outlines the methodologies powering HAPIT and contains two example scenarios – one in which open fires are replaced by well- operating chimney stoves, and a second where they are replaced by LPG -- informed by data from the RESPIRE trial and ongoing work in Guatemala.

Chapter 6 synthesizes work from the proceeding chapters and offers suggestions for future lines of inquiry.

    Cover page: Inspecting what you expect: Applying modern tools and techniques to evaluate the effectiveness of household energy interventions
    • Article
    • Peer Reviewed
    UC Berkeley Previously Published Works (2019)
    Indoor exposure to fine particulate matter (PM2.5) is a prominent health concern. However, few studies have examined the effectiveness of long-term use of indoor air filters for reduction of PM2.5 exposure and associated decrease in adverse health impacts in urban India. We conducted 20 simulations of yearlong personal exposure to PM2.5 in urban Delhi using the National Institute of Standards and Technology's CONTAM program (NIST, Gaithersburg, MD, USA). Simulation scenarios were developed to examine different air filter efficiencies, use schedules, and the influence of a smoker at home. We quantified associated mortality reductions with Household Air Pollution Intervention Tool (HAPIT, University of California, Berkeley, CA, USA). Without an air filter, we estimated an annual mean PM2.5 personal exposure of 103 µg/m3 (95% Confidence Interval (CI): 93, 112) and 137 µg/m3 (95% CI: 125, 149) for households without and with a smoker, respectively. All day use of a high-efficiency particle air (HEPA) filter would reduce personal PM2.5 exposure to 29 µg/m3 and 30 µg/m3, respectively. The reduced personal PM2.5 exposure from air filter use is associated with 8-37% reduction in mortality attributable to PM2.5 pollution in Delhi. The findings of this study indicate that air filter may provide significant improvements in indoor air quality and result in health benefits.
      Cover page: Modeling the Impact of an Indoor Air Filter on Air Pollution Exposure Reduction and Associated Mortality in Urban Delhi Household
      • Article
      • Peer Reviewed
      UC Berkeley Previously Published Works (2023)
      Low-cost air quality (LCAQ) sensors are increasingly being used for community air quality monitoring. However, data collected by low-cost sensors contain significant noise, and proper calibration of these sensors remains a widely discussed, but not yet fully addressed, area of concern. In this study, several LCAQ sensors measuring nitrogen dioxide (NO2) and ozone (O3) were deployed in six cities in the United States (Atlanta, GA; New York City, NY; Sacramento, CA; Riverside, CA; Portland, OR; Phoenix, AZ) to evaluate the impacts of different climatic and geographical conditions on their performance and calibration. Three calibration methods were applied, including regression via linear and polynomial models and random forest methods. When signals from carbon monoxide (CO) sensors were included in the calibration models for NO2 and O3 sensors, model performance generally increased, with pronounced improvements in selected cities such as Riverside and New York City. Such improvements may be due to (1) temporal co-variation between concentrations of CO and NO2 and/or between CO and O3; (2) different performance levels of low-cost CO, NO2, and O3 sensors; and (3) different impacts of environmental conditions on sensor performance. The results showed an innovative approach for improving the calibration of NO2 and O3 sensors by including CO sensor signals into the calibration models. Community users of LCAQ sensors may be able to apply these findings further to enhance the data quality of their deployed NO2 and O3 monitors.
        Cover page: Unexpected Performance Improvements of Nitrogen Dioxide and Ozone Sensors by Including Carbon Monoxide Sensor SignalCreative Commons 'BY' version 4.0 license
        • Article
        • Peer Reviewed
        UC Berkeley Previously Published Works (2021)
        The World Health Organization and the United States Centers for Disease Control have recommended universal face masking by the general public to slow the spread of COVID-19. A number of recent studies have evaluated the filtration efficiency and pressure differential (an indicator of breathability) of various, widely available materials that the general public can use to make face masks at home. In this review, we summarize those studies to provide guidance for both the public to select the best materials for face masks and for future researchers to rigorously evaluate and report on mask material testing. Of the tested fabric materials and material combinations with adequate breathability, most single and multilayer combinations had a filtration efficiency of <30%. Most studies evaluating commonly available mask materials did not follow standard methods that would facilitate comparison across studies, and materials were often described with too few details to allow consumers to purchase equivalent materials to make their own masks. To improve the usability of future study results, researchers should use standard methods and report material characteristics in detail.
          Cover page: Review of the Breathability and Filtration Efficiency of Common Household Materials for Face Masks
          • Article
          • Peer Reviewed
          UC Berkeley Previously Published Works (2019)

          Background

          Whether cooking with solid fuels, as occurs widely in developing countries, including Nepal, is a risk factor for pulmonary tuberculosis (PTB) is uncertain. Epidemiologic studies have produced variable results. This case-control study sought to resolve this issue with a large sample size and a population-based control group.

          Methods

          PTB cases (N = 581), aged 18-70 were recruited from diagnostic centers in Kaski and neighboring districts of Nepal. Population-based controls (N = 1226) were recruited. Persons who had previously been diagnosed with TB were excluded. Questionnaires were administered at participants' homes.

          Results

          Using liquefied petroleum gas (LPG) as the cookstove reference fuel, for women the odds ratio (OR) for having a primary cookstove that used wood was 0.21 (95% CI: 0.08,0.52); for men the corresponding OR was 0.80 (0.37, 1.74). For biogas, the OR for women was 0.24 (0.06,0.87) and for men, 1.41 (0.61, 3.23).

          Conclusions

          The unexpected finding of a higher risk for women using LPG cookstoves, relative to wood or biogas-burning cookstoves, may be attributable to excluding persons with prior TB. A possible explanation is that emissions, such as ultrafine particles, formed during LPG combustion promote PTB manifestation in infected people who have not previously had PTB. The damage from the initial PTB leaves them susceptible to the PTB-promoting effects of smoke from wood fires. Further studies, excluding participants who have previously had TB are needed to confirm these findings. Use of exhaust hoods to the outdoors for all stoves, well-ventilated kitchens, and gas stoves raised above ground would reduce exposures.
            Cover page: Household fuel use and pulmonary tuberculosis in western Nepal: A case-control study
            • Article
            • Peer Reviewed
            UC Berkeley Previously Published Works (2023)
            Direct exposure to household fine particulate air pollution (HAP) associated with inefficient combustion of fuels (wood, charcoal, coal, crop residues, kerosene, etc.) for cooking, space-heating, and lighting is estimated to result in 2.3 (1.6-3.1) million premature yearly deaths globally. HAP emitted indoors escapes outdoors and is a leading source of outdoor ambient fine particulate air pollution (AAP) in low- and middle-income countries, often being a larger contributor than well-recognized sources including road transport, industry, coal-fired power plants, brick kilns, and construction dust. We review published scientific studies that model the contribution of HAP to AAP at global and major sub-regional scales. We describe strengths and limitations of the current state of knowledge on HAPs contribution to AAP and the related impact on public health and provide recommendations to improve these estimates. We find that HAP is a dominant source of ambient fine particulate matter (PM2.5) globally - regardless of variations in model types, configurations, and emission inventories used - that contributes approximately 20 % of total global PM2.5 exposure. There are large regional variations: in South Asia, HAP contributes ∼ 30 % of ambient PM2.5, while in high-income North America the fraction is ∼ 7 %. The median estimate indicates that the household contribution to ambient air pollution results in a substantial premature mortality burden globally of about 0.77(0.54-1) million excess deaths, in addition to the 2.3 (1.6-3.1) million deaths from direct HAP exposure. Coordinated global action is required to avert this burden.
              Cover page: A global review of the state of the evidence of household air pollutions contribution to ambient fine particulate matter and their related health impacts.
              • Article
              • Peer Reviewed
              UC Berkeley Previously Published Works (2014)
              Household air pollution generated from solid fuel use for cooking is one of the leading risk factors for ill-health globally. Deployment of advanced cookstoves to reduce emissions has been a major focus of intervention efforts. However, household usage of these stoves and resulting changes in usage of traditional polluting stoves is not well characterized. In Palwal District, Haryana, India, we carried out an intervention utilizing the Philips HD4012 fan-assisted stove, one of the cleanest biomass stoves available. We placed small, unobtrusive data-logging iButton thermometers on both the traditional and Philips stoves to collect continuous data on use patterns in 200 homes over 60 weeks. Intervention stove usage declined steadily over time and stabilized after approximately 200 days; use of the traditional stove remained relatively constant. We additionally evaluated how well short-duration usage measures predicted long-term use. Measuring usage over time of both traditional and intervention stoves provides better understanding of cooking behaviors and can lead to more precise quantification of potential exposure reductions and consequent health benefits attributable to interventions.
                Cover page: Patterns of Stove Usage after Introduction of an Advanced Cookstove: The Long-Term Application of Household Sensors
                • Article
                • Peer Reviewed
                UC Berkeley Previously Published Works (2024)
                Exposure to heat is associated with a substantial burden of disease and is an emerging issue in the context of climate change. Heat is of particular concern in India, which is one of the worlds hottest countries and also most populous, where relatively little is known about personal heat exposure, particularly in rural areas. Here, we leverage data collected as part of a randomized controlled trial to describe personal temperature exposures of adult women (40-79 years of age) in rural Tamil Nadu. We also characterize measurement error in heat exposure assessment by comparing personal exposure measurements to the nearest ambient monitoring stations and to commonly used modeled temperature data products. We find that temperatures differ across individuals in the same area on the same day, sometimes by more than 5 °C within the same hour, and that some individuals experience sharp increases in heat exposure in the early morning or evening, potentially a result of cooking with solid fuels. We find somewhat stronger correlations between the personal exposure measurements and the modeled products than with ambient monitors. We did not find evidence of systematic biases, which indicates that adjusting for discrepancies between different exposure measurement methods is not straightforward.
                  Cover page: Heat Exposure among Adult Women in Rural Tamil Nadu, India.
                  • Article
                  • Peer Reviewed
                  UC Berkeley Previously Published Works (2020)

                  Introduction

                  Health interventions often target pregnant women and their unborn children. Interventions in rural India targeting pregnant women, however, often do not cover the critical early windows of susceptibility during the first trimester and parts of the second trimester. This pilot seeks to determine if targeting newlyweds could protect entire pregnancies with a clean stove and fuel intervention.

                  Methods

                  We recruited 50 newlywed couples who use biomass as a cooking fuel into a clean cooking intervention that included a liquefied petroleum gas (LPG) stove, two gas cylinders, a table to place the stove on and health education. We first evaluated whether community health workers in this region could identify and recruit couples at marriage. We quantified how many additional days of pregnancy could be covered by an intervention if we recruited at marriage versus recruiting after detection of pregnancy.

                  Results

                  On average, we identified and visited newlywed couples within 40 (SD 21) days of marriage. Of the 50 couples recruited, 25 pregnancies and 18 deliveries were identified during this 1-year study. Due to challenges securing fuel from the LPG supply system, not all couples received their intervention prior to pregnancy. Regardless, couples recruited in the marriage arm had substantially more days with the intervention than couples recruited into a similar arm recruited at pregnancy (211 SD 46 vs 120 SD 45). At scale, a stove intervention targeting new marriages would cover about twice as many weeks of first pregnancies as an intervention recruiting after detection of pregnancy.

                  Conclusions

                  We were able to recruit in early marriage using existing community health workers. Households recruited early in marriage had more days with clean fuel coverage than those recruited at pregnancy. Our findings indicate that recruitment at marriage is feasible and warrants further exploration for stove and other interventions targeting pregnancy-related outcomes.
                    Cover page: Marriage-based pilot clean household fuel intervention in India for improved pregnancy outcomes
                    • Article
                    • Peer Reviewed
                    UC Berkeley Previously Published Works (2019)
                    Household air pollution from the combustion of biomass and coal is estimated to cause approximately 780,000 premature deaths a year in India. The government has responded by promoting uptake of liquefied petroleum gas (LPG) by tens of millions of poor rural families. Many poor households with new LPG stoves, however, continue to partially use traditional smoky chulhas. Our primary objective was to evaluate three strategies to transition pregnant women in rural Maharashtra to exclusive use of LPG for cooking. We also measured reductions in kitchen concentrations of PM2.5 before and after our interventions. Our core intervention was a free stove, 2 free LPG cylinders (one on loan until delivery), and repeated health messaging. We measured stove usage of both the traditional and intervention stoves until delivery. In households that received the core intervention, an average of 66% days had no indoor cooking on a chulha. In an adjacent area, we evaluated a conditional cash transfer (CCT) based on usage of LPG in addition to the core intervention. Results were less successful, due to challenges implementing the CCT. Pregnant women in a third nearby area received the core intervention plus a maximum of one 14.2 kg cylinder per month of free fuel. In their homes, 90% of days had no indoor cooking on a chulha. On average, exclusive LPG use decreased kitchen concentrations of PM2.5 by approximately 85% (from 520 to 72 μg/m3). 85% of participating households agreed to pay the deposit on the 2nd cylinder. This high purchase rate suggests they valued how the second cylinder permitted continuous LPG supply. A program to increase access to second cylinders may, thus, be a straightforward way to encourage use of clean fuels in rural areas.
                      Cover page: Promoting LPG usage during pregnancy: A pilot study in rural Maharashtra, India
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