Pilot Projects
Project Title: Exposures, Biomarkers, and Health Status in Households Cooking with Biomass in Sauri, Kenya
Principal Investigator: Jeanine D'Armiento, M.D., Ph.D.
Collaborators: Patrick Kinney, Sc.D. (CEHNM), Richard Deckelbaum, M.D. (Institute of Nutrition), Vijay Modi, Ph.D. (Dept. of Mechanical Engineering), Eleanne van Vliet (Ph.D. candidate, Dept. of Environmental Health Sciences)
Year: 2006
Award Amount: $25,000
Summary. Along with unsafe water and sanitation, indoor air pollution ranks among the most important environmental contributors to morbidity worldwide. The largest source of indoor air pollution is the combustion of biomass fuels, which include wood, charcoal, crop residues and dried animal dung. Nearly half of the world's population uses biomass combustion for cooking and household energy and it is associated with many diseases, including acute respiratory infections, chronic obstructive pulmonary diseases, low birth weight babies and various cancers. Women and children who are most exposed to the indoor air pollution from the burning of these fuels are particularly vulnerable. It is estimated that indoor air pollution causes 2.2-2.8 million deaths per year, including the deaths of 1 million children due to acute lower respiratory infections.
There are several factors that contribute to the high level of pollution generated by biomass combustion. Often, the stoves women use have poor combustion capacity and can utilize only about 5-15% of available fuel energy. Because of incomplete combustion, these stoves produce heavy smoke and release a number of harmful pollutants. This, combined with poor ventilation in cooking areas, significantly increases the amount of hazardous particles in the kitchens where women and children spend much of their daily lives.
Researchers at Columbia and elsewhere have begun developing possible solutions to this important problem including the improvement of ventilation in cooking areas, the introduction of fuel efficient, less smoky stoves and the education of villagers about the environment and the issues surrounding biomass. Still, a sufficient understanding of the true impact of biomass combustion on human health, and the potential improvements that can be made by the implementation of these possible solutions are lacking.
An indoor biomass combustion working group has taken shape over the past year (described in detail in Section I, Strategic Vision and Impact on Environmental Health). Dr. D'Armiento, a member of the aforementioned group, leads this proposal whose overall objective is to develop and field test methods for assessing exposures, nutritional status and respiratory health associated with indoor cooking with biomass fuels in Sauri, Kenya, thereby proving the feasibility of obtaining reliable data on exposures and health in this setting and also providing data upon which power calculations can be based for the larger study. The goal of this Pilot Project is to recruit 30 non-smoking households that use wood fuel for un-vented indoor cooking and that have at least one child under the age of five, collect a one-week integrated particulate matter (PM2.5 and black carbon) sample in the kitchen and/or main activity room using a battery-operated, pump-driven monitoring device, measure lung function by spirometry for each household member capable of performing the maneuver, collect respiratory health histories, collect daily respiratory symptom diaries for each household member, collect a 10 mL blood sample from one family member in each household (usually the mother) who is responsible for most cooking and analyze the acquired samples for total antioxidants, TBARS, vitamin C and fat-soluble vitamins (e.g., vitamins A and E). The data and experience gained in this Pilot Project will be used to design and seek funding for a large-scale study which tests the effectiveness of interventions to reduce indoor smoke exposures from biomass combustion in the Millennium Villages (MV). The MV Project represents a large-scale, long-term effort to improve health and economic wellbeing among the very poor in Africa (http://www.earthinstitute.columbia.edu/mvp/), addressing issues such water, food production and health care.
Results & Outcomes. The field research component of the Pilot Project was carried out in the rural village of Sauri located in Western Kenya from July 15 through August 30, 2006. The field researchers collected PM2.5 samples from 30 households (a total of 150 filters) as well as spirometry data on 51 adults (including 15 men) living in the 30 study households in the study sample. Preliminary survey results demonstrate that participant women had been cooking an average of 36 years and cooked an average of 3.5 hours per day. Analyses of filters obtained from household air sampling, as well as lung function data collected via spirometry are currently underway. Specifically, the filters have been weighed for fine particulate matter (PM2.5) and will be further analyzed for black carbon (through reflectance technology) as well as other chemicals (PAHs, other metals). Preliminary results, based on filter analysis from 19 of the 30 households, show average levels of PM2.5 ranging from 151 to 2463 µg/m3 indoors compared to an average of 81 µg/m3 outdoors. Our laboratory has well established in vitro and in vivo systems for studying cigarette smoke-induced lung injury and disease. Utilizing these established methodologies, we will perform experiments to understand the molecular effects of exposure to biomass smoke. We will isolate the particles from filters collected in the huts by dissolving the particulate matter in dimethylsulfoxide and then treat normal human small airway epithelial cells with concentrations ranging from 0.0001µg/ml to 500µg/ml. Changes in expression of specific inflammatory cytokines and chemokines such as IL-1beta, IL-8, GM-CSF, TNF-alpha, and sICAM-1 after exposure to PM2.5 will be assessed. In addition, the effect of PM2.5 treatment on cell viability and apoptosis will be examined. Data analysis on spriometry measurements is expected to be complete over the next two months.