childhood stunting associated with use of solid cook fuel: the role of cooking practices
TRANSCRIPT
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.
What Is the Problem?
70% of the Indian population relies on solid fuels
Solid fuels produce toxic pollutants
Serious health consequences
NFHS III (2005-2006) – Use of Solid Fuels
NFHS III (2005-2006) – Regional Differences
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)
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)
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?
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)
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)
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
Safe and Unsafe Fuel
The Energy Ladder-Wealth Index
The Energy Ladder- can be replicated with NFHS3
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?
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
Results
Fuel Security?
Wealth Index
1 2 3 4 5
Why ?
Solid fuel is used even among the wealthiest quintile
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 -
Affordability and Access
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?
Cooking Environment
A one room house – Let’s add windows and set a separate kitchen.
Combined K-S: (D= 0.0628) & (P value =0.000)
Two-sample Kolmogorov-Smirnov test
Results
Results
• 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
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.