Environmental Factor, June 2011, National Institute of Environmental Health Sciences
International workshop deliberates on indoor air pollution, cook stoves
By Ed Kang
Balbus leads NIEHS efforts on climate change(https://www.niehs.nih.gov/about/od/programs/climatechange/index.cfm) and human health. In this capacity he serves as HHS principal to the U.S. Global Change Research Program, for which he also co-chairs the Interagency Working Group on Climate Change and Health. (Photo courtesy of Michael Spencer)
Led by the United Nations Foundation, the Global Alliance for Clean Cookstoves is a public-private partnership with the ultimate goal of making cleaner, healthier cook stoves universally accessible. In videotaped remarks, U.S. Secretary of State Hillary Rodham Clinton proudly spoke of the U.S. government's commitment of more than $50 million - nearly half from NIH - to help promote this technology throughout the developing world.
Smith, standing left, and Birnbaum took the opportunity to pursue dialogue with other global health leaders during one of the question and answer sessions. (Photo courtesy of Michael Spencer)
An international workshop convened May 9-11 in Arlington, Va., to discuss current evidence on adverse health effects of indoor air pollution and to exchange views on improving human health. Spearheaded by NIEHS, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and the Fogarty International Center (FIC), the meeting of more than 150 scientists and policy makers from multiple countries focused on research gaps, exposure assessment, and the burgeoning global initiative that aims to deliver clean, affordable cook stoves to the developing world.
Global leaders in public health took the opportunity to emphasize their commitment to support further efforts. Among the speakers were NIEHS/NTP Director Linda Birnbaum, Ph.D.; Francis Collins, M.D., Ph.D., director of the National Institutes of Health; Kris Balderston, representative for global partnerships in the Office of the U.S. Secretary of State; Gina McCarthy, assistant administrator for the U.S. Environmental Protection Agency Office of Air and Radiation; and Pilar Nores de Garcia, president of the Peruvian Instituto Trabajo y Familia (Institute for Labor and Family), who spoke about the successes of the Peruvian National Stove Program.
Also playing major roles in the workshop were officials from partner NIH institutes and centers, including FIC Director Roger Glass, M.D., Ph.D.; NICHD Director Alan Guttmacher, M.D.; and NICHD Associate Director for Prevention Research and Health Promotion William Martin, M.D.
According to conference organizer, NIEHS Senior Advisor for Public Health John Balbus, M.D.(https://www.niehs.nih.gov/about/od/advisor/balbus/), the workshop presented a first-ever opportunity to hear the state-of-the-science on the health impacts of indoor air pollution and to identify critical research needs. The need for such a meeting is considerable since the poorer half of the world's population uses biomass - wood, crop residue, or dung - or coal as fuel to cook and heat, contributing to a variety of health conditions including pneumonia, lung cancer, cardiovascular disease, low birth weight, and cognitive impairment. The World Health Organization states that indoor air pollution in developing countries is the fourth leading cause of morbidity and mortality, and the second leading environmental contributor to ill health affecting primarily women and children.
Exposure assessment critical to progress
In his opening remarks to the assembly, Balbus spotlighted the need to improve exposure assessment to quantify the relationship between specific levels of emissions reduction and improvements in population health status. Not all scenarios in developing countries are identical - differences in behavior, fuel characteristics, and stove construction are confounded with weather factors, overall health condition, nutrition, and other pollution sources contributing to the complexity of assessing human exposure.
Kirk Smith, Ph.D.(http://coeh.berkeley.edu/people/faculty/smithkirk.htm) , a longtime NIEHS grantee from the University of California, Berkeley, further set the tone for the meeting by defining the scope of the global problem. In a presentation titled, “Household air pollution in lower and middle income countries,” he described his decades of exposure studies in places such as Guatemala, India, Nepal, and China.
Smith and Balbus described the importance of biomarkers and the development of inexpensive, portable electronic monitors as a means to gather exposure assessment data. “Unless researchers can determine with precision how dirty is unhealthy, it will not be possible to inform cook stove designers and program managers of the essential answer to the question how clean is clean,” said Balbus.
Organizers intend to issue a full report of the workshop proceedings by mid-summer, identifying areas of research gaps and opportunities to reduce global health disparities.
(Ed Kang is a public affairs specialist in the Office of Communications and Public Liaison and a regular contributor to the Environmental Factor.)