kirstie jagoe and gaia association presents on wb madagascar study at 13th world congress on public...

8/2/2019 Kirstie Jagoe and Gaia Association Presents on WB Madagascar Study at 13th World Congress on Public Health

1/34

Ethanol as a Household Fuel in

Madagascar

Kirstie Jagoe

13th World Congress on Public Health

Addis Ababa


2/34

Overview

The challenge

Aim of study

Study sites and design

Methods of data collection

ResultsStove use and perceptions

Impacts on household air pollution

Impacts on personal exposure levelsHealth related impacts

Conclusions

Next steps


3/34

The Challenge

80% natural forested areas

have been lost.

If rate of forest reductions

remains at current rate all

forests will be lost in 40 years.95% of households rely on

woody biomass- primarily fuel

wood and charcoal for their

household energy.

Huge public health impact-

particularly for women and

children


4/34

Aim of the study

To evaluate the health and socio-economic impacts

of ethanol as a household cooking fuel and

alternative interventions in the context Madagascar.


5/34

Study sites

Ambositra

Vatomandry


6/34

Overview of study design

11 months 12 months 16 months

Control

Awareness only

Charcoal

Ethanol

Wood

INT

Round 2monitoring

Wet

Round 3monitoring

Dry

Baselinemonitoring

Wet

Approximately 30 HH in each intervention group

Each group received the awareness raising

information except the control group


7/34

Intervention stoves and fuels

Charcoal stove

Ethanol (Cleancook)Fantana pipa wood stove

Ethanol fuel


8/34

Methods of data collection

Questionnaire collected information on

Demographic characteristics

Aspects related to stove and fuel use

Health symptoms and perceptions


9/34

Indoor Air Pollution Monitoring

Household kitchenconcentrations of fineparticulate matter

(PM2.5) and carbonmonoxide (CO)measured in kitchenarea.

Monitoring periodslasted 24 hours


10/34

Personal Exposure Monitoring

24hr measurements of CO in main cook and on onechild


11/34

Personal Exposure Monitoring

PM2.5 best measure of combustion-related healthdamaging pollutants but expensive and difficult tomonitor.

Relationship between PM2.5 and CO variesbetween different fuel/stove combinations

Used kitchen PM2.5 and CO to derive fuel specific

regression equations. Used these equations to predict PM2.5 exposure

from individuals CO monitor.


12/34

Results


13/34

Ventilation and location in kitchens

0

1020

30

40

50

60

70

8090

100

Enclosed Semi-open

Percentage

Ambositra

Vatomandry

Kitchen Ambositra (%) Vatomandry (%)In building separate from house 6.3 54.4

Separate kitchen attached to house 44.8 18.9

Kitchen in living area of house 49.0 26.7


14/34

Stove use patterns: Primary Stove

Stove Intervention Groups

Ethanol Charcoal Wood

Ambositra Round 2 80% (n=26) 90% (n=28) -

Round 3 97% (n=30) 100% (n=31) -

Vatomandry Round 2 91% (n=29) 91% (n=29) 100% (n=33)

Round 3 77% (n=24) 100% (n=30) 94% (n=31)


15/34

Stove use patterns: Secondary Stove

Stove Intervention Groups

Ethanol Charcoal Wood

Ambositra Round 2 84% (n=27) 52% (n=16) -

Round 3

81% (n=25) 42% (n=13) -Vatomandry Round 2 75% (n=24) 47% (n=15) 42% (n=14)

Round 3 84% (n=26) 27% (n=8) 36% (n=12)

Higher proportion of secondary stove use in the ethanolgroup- No real difference between sites.

After 5 months no-one had abandoned their ethanolstove


16/34

Impacts on Air Pollution


17/34

Impacts on Air Pollution: Vatomandry

24-hr average kitchen CO (ppm)

0

10

20

30

40

50

60

70

80

90

100

Ethanol (All) Imp. Wood Imp. Charcoal Awar. Raising Only (All) Control (All)

1 2 3 1 2 3 1 2 3 1 2 3 1 2 3


18/34

HAP reductions in ethanol group

Baseline Fuel Ambositra

CO (ppm) PM2.5(ug/m3)

Base Round 3 % change Base Round 3 % change

Charcoal42 (30) 8(9) -79% 389(489) 142(83) -57%

Baseline Fuel Vatomandry

CO (ppm) PM2.5(ug/m3)

Base Round 3 %change

Base Round 3 %change

Wood 14(21) 1(1) -93% 665(500) 98(55) -85%

Charcoal 15(26) 0.7(1) -93% 251(226) 89 (56) -72%


19/34

Impact on Personal Exposure

Lack of precision and smallrange of CO made results insome groups unreliable

Regression equations used topredict mothers/childs

exposure to PM2.5 for

All groups in Ambositra

Wood stove interventiongroup only in Vatomandry


20/34

Baseline personal exposure

For adults the overall levels of personal exposure to CO

were much higher in Ambostira (8.45ppm (4.64-14.7))

compared to Vatomandry ( 0.82ppm (0.42-1.65)

Consistent with kitchen levels and household design.

VatomandryAmbositra


21/34


22/34

Impacts on personal exposure: Vatomandry

AdultsVatomandry had much

lower levels of exposure

than Ambositra

Reductions in CO 45%-wood stove and 54%

ethanol.

Reductions in predicted

PM2.5 relative to controls

60% in wood stove group.

ChildrenRelative to the control

group; 30% reduction in

wood group. 14% (non-

sig) reduction in ethanol.Small reduction could

be due to the fact that

the CO levels were very

low at start of study inthis community.


23/34

Perceptions of stoves


24/34


25/34

Perceptions of ethanol stove

Round 2It is clean (56.2%

Ambositra and 40.6% in

Vatomandry)

It saves time (40.6%Ambositra, 34.3%

Vatomandry)

It is easy to use (50.0%(n=16) Ambositra).

Makes life easier 53.1%

in Vatomandry

Round 3 Good impacts on their

daily lives (100%)

Key percieved

advantages of ethanolstove;

Ease of use

Time saved incooking

Clean kitchen


26/34


27/34

Health Impacts

Photo: Courtesy Don ONeil HELPS

International


28/34

Baseline health status

For the women, the level of chronic respiratorysymptoms (chronic cough and phlegm),

reported by 20% of wood users.

Headache and eye irritation common.

Burns and scalds to cooks common.

One-quarter of parents reported child 10cm.


29/34

Health Impacts: Ambositra

In the ethanol group, compared to the control group

likelihood of reporting headaches reduced by 93%

(p


30/34

Health Impacts: Vatomandry

All three intervention stoves reduced the prevalence

of headache and eye irritation, with the overall

strongest effects for the ethanol group.

In the ethanol group, the likelihood of reporting

headaches was reduced by 87% (p


31/34

Summary and conclusions

Cleancook ethanol stove performed well, was used

consistently and substantially reduced household air

pollution and personal exposure levels.

Ethanol stove reduced symptoms and burns in

adults but reduction in burns not detectable inchildren.

Locally produced Fantana Pipa wood stove is very

promising as interim household energy

improvement- but needs further design adaptationsand rigorous laboratory testing


32/34


33/34


34/34

kirstie jagoe and gaia association presents on wb madagascar study at 13th world congress on public...

Documents