childhood stunting associated with use of solid cook fuel: the role of cooking practices
TRANSCRIPT
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Childhood Stunting Associated With Solid fuel: The Role of Cooking Practices
Nisha Malhotra, Vancouver School of Economics and International Relations, Faculty of Arts, University of British Columbia.
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What Is the Problem?
70% of the Indian population relies on solid fuels
Solid fuels produce toxic pollutants
Serious health consequences
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NFHS III (2005-2006) – Use of Solid Fuels
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NFHS III (2005-2006) – Regional Differences
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Solid Fuel Smoke: The Pollutants
Biofuel smoke contain a large number of harmful pollutants.
Particular matter (PM)/SPM carbon monoxide Nitrogen dioxide Polycyclicaromatic hydrocarbons (PAHs) Benzo (alpha) pyrene extracted from SPM 1,3-butadiene, Benzene, selenium, formaldehyde,
Styrene, etc. (Kandpal et al. 1994)
Coal in addition also releases some toxic elements. Sulfur dioxide (SO2), Fluorine (F), Mercury (Hg), Arsenic
(As), Lead (Pb)
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Health Consequences
Anaemia ARIs & Respiratory Illnesses (Tuberculosis) Cancer: Lung/Bladder/Kidney/Pancreatic Immunodeficiency disorders Cognitive decline
Ref: Martorell et al. (1996) ; Haas et al. (1995); Erikson et al (2001); Pelletier (1994)
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What Is the Problem?
70% of the Indian population relies on solid fuels.
Solid fuels produce pollutants with serious health consequences.
Our Question Do they also lead to Childhood
Stunting?
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Stunting Consequences
Higher likelihood of contracting illnesses, lower recovery rates lower likelihood of survival
▪ Future intellect▪ Future health status
Percentage of women with short stature varies strikingly according to the degree of stunting at 3 years of age
Martorell et al. (1992)▪ Reproductive performance▪ Predicts child’s birth size and survival
Martorell et al. (1996) ; Haas et al. (1995); Erikson et al (2001); Pelletier (1994)
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Pathway
Stunting: Bone age retardation and bone maturation in children
(Schlipkoter et al. 1986) Impair early childhood skeletal growth (coal – Czech) (Ghosh et. al.
2011)
Intrauterine Growth RetardationBirth weight and length, head circumference, cognitive skills at age 5-Poland - PAHs (Jedrychowski et. all. 2004)) ; PM and PAHs (Dejmek et. all. 2000)
▪ endocrine disruptors: Benzo[a]pyrene and phenanthrene
▪ Inhibit insulinlike growth factors (embryonic development) and epidermal growth factors in placenta ▪ Hayakawa et. all. (2009; Guyda et. all. (1991)
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Existing Evidence-Stunting Indoor Coal Use (Czech Republic) - Smith et. all
2005 Coal combustion Heating – Height for Age Z
score
Biofuel smoke in 7 developing countries (Cambodia, Nepal Dominican Republic, Haiti, Jordan,
Moldova, Namibia) - Kyu et. al. 2009
Biofuel Smoke-Height for age Z score; Stunting
Biofuel smoke in India-Mishra & Retherford 2007
Biofuel Smoke - Anaemia and Stunting
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Safe and Unsafe Fuel
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The Energy Ladder-Wealth Index
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The Energy Ladder- can be replicated with NFHS3
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Answer the Question
DATA NFHS III (2005-2006) Children – Less than 3 years of age (~ 21,000)Outcome Stunting - Height-for-age Height: Height by Age Z score (HAZ )Exposure Solid Fuel: Coal/Charcoal (2.25%); Wood (50%);
Crop Waste & shrubs (6.84%) ; Animal Dung (9.8%)
Natural Gas/LPG (26.85%); Kerosene (3.45%)
Childhood Stunting associated with Solid Fuel?
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Answer the Question
Control Variables: Wealth Index (D.V); Religion Dummies Diet: Breastfeeding; Other than BM; 4 Food
Groups; Iodine Salt City Density: Mega City, Large City D.V. Maternal Characteristic: Education; Work
status; Age; Autonomy (Decision to access health care), Mother Smokes; Media Exposure; Maternal Height
Child Demography: Male; Birth Order; Twin Birth; Age
Sanitation: Open Defecation; Water Treatment Cooking Environment: Inside, Separate
Kitchen, Window
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Results
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Fuel Security?
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Wealth Index
1 2 3 4 5
Why ?
Solid fuel is used even among the wealthiest quintile
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Source: www.tribuneindia.com
LPG Scarcity Consumers turn to traditional fuels Mahesh Sharma, Mandi Ahmedgarh, January 2011
A woman burns cow dung cakes and wood
Schools turn to wood as LPG costs dear Arun SharmaBindrakh village (Punjab), November 2012
Cooking Staff preparing midday meals in a School
New reports might shed some light on some of the reasons -
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Affordability and Access
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What Is the Problem?
70% of the Indian population relies on solid fuels.
Solid fuels produce pollutants with serious health consequences.
Our Question Do they also lead to Childhood Stunting?-
SuggestiveCan this association be mitigated -
cooking practices?
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Cooking Environment
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A one room house – Let’s add windows and set a separate kitchen.
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Combined K-S: (D= 0.0628) & (P value =0.000)
Two-sample Kolmogorov-Smirnov test
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Results
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Results
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• Stunting is shown to be associated with the use of Solid Fuels• This association can be mitigated by following safer cooking practices
• Outside • Separate location for a kitchen• Ventilation – Window
Learn
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Public health perspective
Efficient Cooking Stoves Replacing solid fuel with cleaner fuels
Substitution across solid fuels?
Ensuring proper ventilation We need a greater discussion on cooking
practices that can reduce “Pollution concentrations”- cumulative exposure.