A new study led by University of California, Berkeley, researchers spotlight the human health effects of exposure to smoke from open fires and dirty cookstoves, the primary source of cooking and heating for 43 percent, or some 3 billion members, of the world's population. Women and young children in poverty are particularly vulnerable. In the first study, the researchers found a dramatic one-third reduction in severe pneumonia diagnoses among children in homes with smoke-reducing chimneys on their cookstoves. The second study uncovered a surprising link between prenatal maternal exposure to woodsmoke and poorer performance in markers for IQ among school-aged children.
The findings on pneumonia, the chief cause of death for children five and under, will be published in the journal The Lancet on Nov. 10, two days before World Pneumonia Day. While previous research has linked exposure to household cooking smoke to respiratory infections, the latest results come from the first-ever randomized controlled trial -- the gold standard of scientific experiments -- on air pollution.
"This study is critically important because it provides compelling evidence that reducing household woodsmoke exposure is a public health intervention that is likely on a par with vaccinations and nutrition supplements for reducing severe pneumonia, and is worth investing in," said Kirk Smith, professor of global environmental health at UC Berkeley's School of Public Health and principal investigator of the RESPIRE (Randomized Exposure Study of Pollution Indoors and Respiratory Effects) study. "There is a huge burden of disease and death due to child pneumonia, and there aren't a lot of good interventions out there," added Dr. Arthur Reingold, a UC Berkeley professor of epidemiology and an internationally recognized expert on infectious diseases, who was not part of the RESPIRE trial. "Randomized controlled trials are frequently demanded by funding agencies and decision makers before they are willing to make substantial investments in new technologies or strategies, and this study provides the needed evidence of an intervention that works."
In the RESPIRE study -- which includes partners from Guatemala's Universidad Del Valle, the U.S. Centers for Disease Control and Prevention, University of Liverpool, Norway's University of Bergen and the World Health Organization -- researchers worked with rural communities in the Western Highlands of Guatemala. Households with a pregnant woman or young infant were randomly assigned to either receive a woodstove with a chimney or to continue cooking with traditional open woodfires.
The researchers found that using chimneys to vent cooking smoke outside homes led to a more striking decrease in cases of severe pneumonia compared with total pneumonia cases, possibly because the reduction in smoke with the chimney stoves was insufficient to significantly reduce all risk.
"The amount of smoke exposure babies were getting from the open woodfire stoves is comparable to having them smoke three to five cigarettes a day," said Smith, whose research in this field began 30 years ago. "The chimney stoves reduced that smoke exposure by half, on average."
In all there were 265 children in the chimney-stove homes and 253 children in the control homes. During the study, the researchers reported 149 children in the chimney-stove homes and 180 in the open-fire homes with physician-diagnosed pneumonia. For severe pneumonia, characterized by low blood oxygenation, there were 72 cases in the chimney-stove group and 101 in the control group.
The findings on pneumonia, the chief cause of death for children five and under, will be published in the journal The Lancet on Nov. 10, two days before World Pneumonia Day. While previous research has linked exposure to household cooking smoke to respiratory infections, the latest results come from the first-ever randomized controlled trial -- the gold standard of scientific experiments -- on air pollution.
"This study is critically important because it provides compelling evidence that reducing household woodsmoke exposure is a public health intervention that is likely on a par with vaccinations and nutrition supplements for reducing severe pneumonia, and is worth investing in," said Kirk Smith, professor of global environmental health at UC Berkeley's School of Public Health and principal investigator of the RESPIRE (Randomized Exposure Study of Pollution Indoors and Respiratory Effects) study. "There is a huge burden of disease and death due to child pneumonia, and there aren't a lot of good interventions out there," added Dr. Arthur Reingold, a UC Berkeley professor of epidemiology and an internationally recognized expert on infectious diseases, who was not part of the RESPIRE trial. "Randomized controlled trials are frequently demanded by funding agencies and decision makers before they are willing to make substantial investments in new technologies or strategies, and this study provides the needed evidence of an intervention that works."
In the RESPIRE study -- which includes partners from Guatemala's Universidad Del Valle, the U.S. Centers for Disease Control and Prevention, University of Liverpool, Norway's University of Bergen and the World Health Organization -- researchers worked with rural communities in the Western Highlands of Guatemala. Households with a pregnant woman or young infant were randomly assigned to either receive a woodstove with a chimney or to continue cooking with traditional open woodfires.
The researchers found that using chimneys to vent cooking smoke outside homes led to a more striking decrease in cases of severe pneumonia compared with total pneumonia cases, possibly because the reduction in smoke with the chimney stoves was insufficient to significantly reduce all risk.
"The amount of smoke exposure babies were getting from the open woodfire stoves is comparable to having them smoke three to five cigarettes a day," said Smith, whose research in this field began 30 years ago. "The chimney stoves reduced that smoke exposure by half, on average."
In all there were 265 children in the chimney-stove homes and 253 children in the control homes. During the study, the researchers reported 149 children in the chimney-stove homes and 180 in the open-fire homes with physician-diagnosed pneumonia. For severe pneumonia, characterized by low blood oxygenation, there were 72 cases in the chimney-stove group and 101 in the control group.
**Source: University of California - Berkeley
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