Prenatal and Postnatal Household Air Pollution Exposures and Pneumonia Risk: Evidence From the Ghana Randomized Air Pollution and Health Study.

BACKGROUND: Nearly 40% of the world's population is exposed daily to household air pollution. The relative impact of prenatal and postnatal household air pollution exposure on early childhood pneumonia, a leading cause of mortality, is unknown. RESEARCH QUESTION: Are prenatal or postnatal household air pollution, or both, associated with pneumonia risk in the first year of life? STUDY DESIGN AND METHODS: The Ghana Randomized Air Pollution and Health Study enrolled 1,414 nonsmoking, pregnant women before 24 weeks' gestation with prospective follow-up to the child's age of 1 year. We measured 72-h personal household air pollution exposures, indexed by carbon monoxide (CO), four times prenatally and three times postnatally. Weekly fieldworker surveillance identified ill-appearing children for physician pneumonia assessment. We used quasi-Poisson models to examine associations between prenatal and postnatal CO and physician-diagnosed pneumonia and severe pneumonia. Sex-specific effects were examined. RESULTS: Of the 1,306 live births, 1,141 infants were followed up with 55,605 child-weeks of fieldworker surveillance. The estimated risk for pneumonia and severe pneumonia in the first year of life increased by 10% (relative risk [RR], 1.10; 95% CI, 1.04-1.16) and 15% (RR, 1.15; 95% CI, 1.03-1.28), respectively, per 1-part per million (ppm) increase in average prenatal CO exposure and by 6% (RR, 1.06; 95% CI, 0.99-1.13) per 1-ppm increase in average postnatal CO exposure. Sex-stratified analyses suggest that in girls, higher prenatal CO exposure was associated with pneumonia risk, while no association was seen in boys. INTERPRETATION: Prenatal household air pollution exposure increased risk of pneumonia and severe pneumonia in the first year of life. Clean-burning interventions may be most effective when begun prenatally. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01335490; URL: www.clinicaltrials.gov.

A method to evaluate factors influencing the microbial reduction in domestic dishwashers.

AIMS: To develop a method that is able to determine the microbial reduction in different dishwasher cleaning cycles and differentiate between different program parameters used. METHODS AND RESULTS: Stainless steel biomonitors were contaminated with Micrococcus luteus or Entereococcus faecium and cleaned in a specially programmed household dishwasher with different cleaning temperatures and durations. No detergent, bleach-free detergent or detergent containing activated oxygen bleach was used. The logarithmic reduction (LR) was determined. The microbial reduction depended on the cleaning temperature, the duration of the cleaning cycles and the detergent type used. LR increased with higher temperatures, longer cleaning cycles and use of detergent. CONCLUSIONS: The factors cleaning cycle temperature, cleaning cycle duration, final rinsing temperature and the use of detergent all contributed to the reduction of test-strains in dishwasher cycles. A combination of longer dishwashing cycles and increased temperatures resulted in LRmax of the microbial load. SIGNIFICANCE AND IMPACT OF THE STUDY: Cycles in domestic appliances are very diverse; therefore a standardized method to determine their ability to reduce the microbial load is of great use. The method described here is able to demonstrate the reductions achieved by dishwashing cycles with different parameters and might help to find the necessary balance between energy saving and an acceptable level of hygiene.

Effects of a large-scale distribution of water filters and natural draft rocket-style cookstoves on diarrhea and acute respiratory infection: A cluster-randomized controlled trial in Western Province, Rwanda.

BACKGROUND: Unsafe drinking water and household air pollution (HAP) are major causes of morbidity and mortality among children under 5 in low and middle-income countries. Household water filters and higher-efficiency biomass-burning cookstoves have been widely promoted to improve water quality and reduce fuel use, but there is limited evidence of their health effects when delivered programmatically at scale. METHODS AND FINDINGS: In a large-scale program in Western Province, Rwanda, water filters and portable biomass-burning natural draft rocket-style cookstoves were distributed between September and December 2014 and promoted to over 101,000 households in the poorest economic quartile in 72 (of 96) randomly selected sectors in Western Province. To assess the effects of the intervention, between August and December, 2014, we enrolled 1,582 households that included a child under 4 years from 174 randomly selected village-sized clusters, half from intervention sectors and half from nonintervention sectors. At baseline, 76% of households relied primarily on an improved source for drinking water (piped, borehole, protected spring/well, or rainwater) and over 99% cooked primarily on traditional biomass-burning stoves. We conducted follow-up at 3 time-points between February 2015 and March 2016 to assess reported diarrhea and acute respiratory infections (ARIs) among children <5 years in the preceding 7 days (primary outcomes) and patterns of intervention use, drinking water quality, and air quality. The intervention reduced the prevalence of reported child diarrhea by 29% (prevalence ratio [PR] 0.71, 95% confidence interval [CI] 0.59-0.87, p = 0.001) and reported child ARI by 25% (PR 0.75, 95% CI 0.60-0.93, p = 0.009). Overall, more than 62% of households were observed to have water in their filters at follow-up, while 65% reported using the intervention stove every day, and 55% reported using it primarily outdoors. Use of both the intervention filter and intervention stove decreased throughout follow-up, while reported traditional stove use increased. The intervention reduced the prevalence of households with detectable fecal contamination in drinking water samples by 38% (PR 0.62, 95% CI 0.57-0.68, p < 0.0001) but had no significant impact on 48-hour personal exposure to log-transformed fine particulate matter (PM2.5) concentrations among cooks (ß = -0.089, p = 0.486) or children (ß = -0.228, p = 0.127). The main limitations of this trial include the unblinded nature of the intervention, limited PM2.5 exposure measurement, and a reliance on reported intervention use and reported health outcomes. CONCLUSIONS: Our findings indicate that the intervention improved household drinking water quality and reduced caregiver-reported diarrhea among children <5 years. It also reduced caregiver-reported ARI despite no evidence of improved air quality. Further research is necessary to ascertain longer-term intervention use and benefits and to explore the potential synergistic effects between diarrhea and ARI. TRIAL REGISTRATION: Clinical Trials.gov NCT02239250.

A usability assessment of riding lawn-mowing equipment with varying levels of design standards compliance.

The use of riding lawn equipment (RLE) is related to a significant number of accidents every year. To provide basis for product design and enhance user performance and safety, a usability and performance assessment of modern riding lawn-mowing tractor designs and features was conducted in a real-world test environment. Five current commercially available RLEs were tested with response measures including task performance time and accuracy, physiological workload, system usability scores (SUS), and subjective rankings of RLE models. This data was used to identify sensitivity of responses to variations in RLE design features and functionality. The data was also used to assess the validity of new tractor design standard conformance tool, the RLEval methodology. This tool made comprehensive evaluation of RLE models compliance with over 70 specific design standards and was applied by human factors experts. Experiment results revealed sensitivity of all response measures to design differences among the five RLE models, except the objective workload measures. Response measures including task performance, SUSs and subjective rankings showed partial agreement with the RLEval scores. In general, the study results demonstrated a comprehensive experimental methodology for usability and performance evaluations of RLEs as well as merit of using the RLEval as preliminary method to compare design features. Some aspects of the usability experimentation and the RLEval method appear to be complementary.

Determining the Enablers and Barriers for the Adoption of Clean Cookstoves in the Middle Belt of Ghana-A Qualitative Study.

Despite its benefits and espousal in developed counties, the adoption of clean cookstoves is reportedly low in less developed countries, especially in Sub-Saharan Africa. This qualitative study aimed at exploring and documenting the enablers and barriers for adoption of clean cookstove in the middle belt of Ghana. The findings showed convenience of clean cookstove use, reduced firewood usage, less smoke emission and associated health problems resulting from indoor air pollution and time for firewood gathering and cooking, good smell and taste of food as enabling factors for clean cookstove adoption. Factors such as safety, financial constraint (cost), non-availability of spare parts on the open market to replace faulty stove accessories, stove size and household size were the potential barriers to clean cookstove adoption. These findings help us to understand the factors promoting and inhibiting the adoption of clean cook stoves, especially in rural settings.

Burns and fires in South Africa's informal settlements: Have approved kerosene stoves improved safety?

This study is a follow-on to an intervention project that implemented South African Bureau of Standards approved kerosene stoves and safety education in 150 households of a Johannesburg informal settlement. An investigation conducted 12 months later established that 43 stoves had operational defects, yet 23 households continued using the faulty appliances. This study focuses on (1) the psychological and behavioural factors associated with continued use of faulty stoves by the 23 households, and (2), the specific technical failures of these stoves. The study involved one-on-one recall interviews with the households using defective stoves (N=21) and laboratory-based stove tests for seven of the affected appliances. The results indicate that the stoves had defects in critical safety features such as flame control and the self-extinguishing mechanism. Four stove malfunctions of minor burn affect were reported in the study. Continued use of the damaged stoves was significantly associated with the time from receipt of the stove to detection of first failure: stoves that failed later on were more significantly likely to remain in use as compared to those that failed sooner. The findings point to the need for strengthening enforcement of appliance standards, public education on kerosene stove use, and structural change for the energy-poor.

Comfort, Energy Efficiency and Adoption of Personal Cooling Systems in Warm Environments: A Field Experimental Study.

It is well known that personal cooling improves thermal comfort and save energy. This study aims to: (1) compare different personal cooling systems and (2) understand what influences users' willingness to adopt them. A series of experiments on several types of personal cooling systems, which included physical measurements, questionnaires and feedback, was conducted in a real office environment. The obtained results showed that personal cooling improved comfort of participants in warm environments. Then an improved index was proposed and used to compare different types of personal cooling systems in terms of comfort and energy efficiency simultaneously. According to the improved index, desk fans were highly energy-efficient, while the hybrid personal cooling (the combination of radiant cooling desk and desk fan) consumed more energy but showed advantages of extending the comfortable temperature range. Moreover, if personal cooling was free, most participants were willing to adopt it and the effectiveness was the main factor influencing their willingness, whereas if participants had to pay, they probably refused to adopt it due to the cost and the availability of conventional air conditioners. Thus, providing effective and free personal cooling systems should be regarded as a better way for its wider application.

Characterizing Particulate Matter Exfiltration Estimates for Alternative Cookstoves in a Village-Like Household in Rural Nepal.

Alternative stoves are an intervention option to reduce household air pollution. The amount of air pollution exiting homes when alternative stoves are utilized is not known. In this paper, particulate matter exfiltration estimates are presented for four types of alternative stoves within a village-like home, which was built to reflect the use of local materials and common size, in rural Nepal. Four alternative stoves with chimneys were examined, which included an alternative mud brick stove, original Envirofit G3355 model, manufacture altered Envirofit G3355, and locally altered Envirofit G3355. Multiple linear regression was utilized to determine estimates of PM2.5 exfiltration. Overall exfiltration fraction average (converted to a percent) for the four stoves were: alternative mud brick stove with chimney 56%, original Envirofit G3355 model with chimney 87%, manufacture altered Envirofit G3355 model with chimney 69%, and locally altered Envirofit G3355 model with chimney 69%. Alternative cookstoves resulted in higher overall average exfiltration due to direct and indirect ventilation relative to traditional, mud-based stoves. This contrast emphasizes the need for an improved understanding of the climate and health implications that are believed to come from implementing alternative stoves on a large scale and the resultant shift of exposure burden from indoors to outdoors.

Screening for perfluoroalkyl acids in consumer products, building materials and wastes.

Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are a large group of important chemical compounds with unique and useful physico-chemical properties, widely produced and used in many applications. However, due to the toxicity, bioaccumulation and long-range transport potential of certain PFASs, they are of significant concern to scientists and policy makers. To assess human exposure to PFASs, it is necessary to understand the concentrations of these emerging contaminants in our environment, and particularly environments where urban population spend most of their time, i.e. buildings and vehicles. A total of 126 samples of building materials, consumer products, car interior materials and wastes were therefore analyzed for their content of key PFASs - 15 perfluoroalkyl acids (PFAAs). At least one of the target PFAAs was detected in 88% of all samples. The highest concentration of Σ15PFAAs was found in textile materials (77.61 µg kg-1), as expected, since specific PFAAs are known to be used for textile treatment during processing. Surprisingly, PFAAs were also detected in all analyzed composite wood building materials, which were dominated by perfluoroalkyl carboxylic acids with 5-8 carbons in the chain (Σ4PFCAs up to 32.9 µg kg-1). These materials are currently widely used for building refurbishment, and this is the first study to find evidence of the presence of specific PFASs in composite wood materials. Thus, in addition to consumer products treated with PFASs, materials used in the construction of houses, schools and office buildings may also play an important role in human exposure to PFASs.

[ESTIMATION OF THE EFFICIENCY OF THE TREATMENT OF SPLIT-SYSTEMS IN RESIDENTIAL AREAS IN ORDER TO REDUCE THE LEVEL OF THE PREVALENCE OF DISEASES OF THE RESPIRATORY SYSTEM].

UNLABELLED: The purpose of work: comparison of prevalence among residents, which use or fail to use to clean split systems. MATERIALS AND METHODS: Collected information about morbidity rate in 235 cases people during 3 years. RESULTS: The usage of split-systems without their regular cleaning leads to the gain in the level of the prevalence of respiratory diseases by 172.7% if compared with persons, who have no air conditioning systems at home. Also, the average number of disability days increases by 218.1%) and average time of the duration of the disease increases by 71.9%. The annual treatment of split-systems and regular cleaning of filters allowed to reduce the number of diseases. In comparison with the group of people, who fail to clean air conditioning systems, the drop of morbidity rate by 56.6%, average number of disability days by 63.3% and average time of diseases by 30.9% was observed. Regular treatment of air conditioning systems cannot completely repay the morbidity rates to the level of the control group. In comparison with the people, who use no air conditioning systems, the owners of split-systems with regular treatment have lung diseases by 18.4% more often. The average number of disability days and the average time of diseases increased by 16.9% and 18.8%. These changes can be explained by the impact of unfavorable (cooling) microclimate. CONCLUSIONS: The impact of split-systems on the health of the population requires a comprehensive study and the subsequent development of normative documents regulating their safe use.

[HYGIENIC ASPECTS OF ELECTROMAGNETIC POLLUTION OF INDOOR ENVIRONMENT].

There is presented an overview of studies devoted to the assessment of 50 Hz electromagnetic the radiations in the indoor environment and their impact on the human body. The classification of household appliances depending on their location has been proposed. The levels of intensity of electric and magnetic fields generated by power-frequency (50 Hz) current from a variety of household appliances have been determined. The ranking of household appliances in dependence on the intensity of electromagnetic the radiations has been made. There was performed an estimation of the intensity of electromagnetic fields in dependence on the regimen of the usage of appliances.

Ultraviolet safety assessments of insect light traps.

Near-ultraviolet (UV-A: 315-400 nm), "black-light," electric lamps were invented in 1935 and ultraviolet insect light traps (ILTs) were introduced for use in agriculture around that time. Today ILTs are used indoors in several industries and in food-service as well as in outdoor settings. With recent interest in photobiological lamp safety, safety standards are being developed to test for potentially hazardous ultraviolet emissions. A variety of UV "Black-light" ILTs were measured at a range of distances to assess potential exposures. Realistic time-weighted human exposures are shown to be well below current guidelines for human exposure to ultraviolet radiation. These UV-A exposures would be far less than the typical UV-A exposure in the outdoor environment. Proposals are made for realistic ultraviolet safety standards for ILT products.

Use of Temperature Sensors to Determine Exclusivity of Improved Stove Use and Associated Household Air Pollution Reductions in Kenya.

Household air pollution (HAP) contributes to 3.5-4 million annual deaths globally. Recent interventions using improved cookstoves (ICS) to reduce HAP have incorporated temperature sensors as stove use monitors (SUMs) to assess stove use. We deployed SUMs in an effectiveness study of 6 ICSs in 45 Kenyan rural homes. Stove were installed sequentially for 2 weeks and kitchen air monitoring was conducted for 48 h during each 2-week period. We placed SUMs on the ICSs and traditional cookstoves (TCS), and the continuous temperature data were analyzed using an algorithm to examine the number of cooking events, days of exclusive use of ICS, and how stove use patterns affect HAP. Stacking, defined as using both a TCS and an ICS in the same day, occurred on 40% of the study days, and exclusive use of the ICS occurred on 25% of study days. When researchers were not present, ICS use declined, which can have implications for long-term stove adoption in these communities. Continued use of TCSs was also associated with higher HAP levels. SUMs are a valuable tool for characterizing stove use and provide additional information to interpret HAP levels measured during ICS intervention studies.

User Perspectives of Characteristics of Improved Cookstoves from a Field Evaluation in Western Kenya.

Over half of the world's population uses biomass fuels; these households cook on open fires indoors, increasing their risk of adverse health effects due to household air pollution (HAP) from biomass combustion. This study evaluated six improved cookstoves (ICS) for effectiveness and acceptability in a rural community in Western Kenya. This paper describes women's views on each ICS compared to the traditional three-stone fire. Views on stove characteristics, fuel consumption, health effects and acceptability were assessed through structured interviews and focus group discussions. Data were coded and analyzed using a thematic approach. In total, 262 interviews and 11 focus groups were conducted from 43 women. Overall, women preferred the ICS over the traditional three-stone fire for various reasons including ease of use, efficiency, fuel efficiency and perceived reduction in smoke and improved health. However, there were clear preferences for specific ICS with almost half of women preferring a Philips stove. Despite acceptance and use of ICS, women used multiple stoves to meet their daily needs. Qualitative studies are essential to field evaluations to provide insight into user perspectives and acceptability of ICS and to inform research and development of technologies that are both effective in reducing HAP and practical in use.

Ergonomics and comfort in lawn mower handle positioning: An evaluation of handle geometry.

Hand operation accompanied with any combination of large forces, awkward positions and repetition may lead to upper limb injury or illness and may be exacerbated by vibration. Commercial lawn mowers expose operators to these factors during actuation of hand controls and therefore may be a health concern. A nontraditional lawn mower control system may decrease upper limb illnesses and injuries through more neutral hand and body positioning. This study compared maximum grip strength in twelve different orientations (3 grip spans and 4 positions) and evaluated self-described comfortable handle positions. The results displayed force differences between nontraditional (X) and both vertical (V) and pistol (P) positions (p < 0.0001) and among the different grip spans (p < 0.0001). Based on these results, recommended designs should incorporate a tilt between 45 and 70°, handle rotations between 48 and 78°, and reduced force requirements or decreased grip spans to improve user health and comfort.

Quantitative Guidance for Stove Usage and Performance to Achieve Health and Environmental Targets.

BACKGROUND: Displacing the use of polluting and inefficient cookstoves in developing countries is necessary to achieve the potential health and environmental benefits sought through clean cooking solutions. Yet little quantitative context has been provided on how much displacement of traditional technologies is needed to achieve targets for household air pollutant concentrations or fuel savings. OBJECTIVES: This paper provides instructive guidance on the usage of cooking technologies required to achieve health and environmental improvements. METHODS: We evaluated different scenarios of displacement of traditional stoves with use of higher performing technologies. The air quality and fuel consumption impacts were estimated for these scenarios using a single-zone box model of indoor air quality and ratios of thermal efficiency. RESULTS: Stove performance and usage should be considered together, as lower performing stoves can result in similar or greater benefits than a higher performing stove if the lower performing stove has considerably higher displacement of the baseline stove. Based on the indoor air quality model, there are multiple performance-usage scenarios for achieving modest indoor air quality improvements. To meet World Health Organization guidance levels, however, three-stone fire and basic charcoal stove usage must be nearly eliminated to achieve the particulate matter target (< 1-3 hr/week), and substantially limited to meet the carbon monoxide guideline (< 7-9 hr/week). CONCLUSIONS: Moderate health gains may be achieved with various performance-usage scenarios. The greatest benefits are estimated to be achieved by near-complete displacement of traditional stoves with clean technologies, emphasizing the need to shift in the long term to near exclusive use of clean fuels and stoves. The performance-usage scenarios are also provided as a tool to guide technology selection and prioritize behavior change opportunities to maximize impact.

Simultaneous determination of bisphenol A, tetrabromobisphenol A, and perfluorooctanoic acid in small household electronics appliances of "Prohibition on Certain Hazardous Substances in Consumer Products" instruction using ultra-performance liquid chromatography-tandem mass spectrometry with accelerated solvent extraction.

Simultaneous determination of bisphenol A, tetrabromobisphenol A, and perfluorooctanoic acid in small household electronics appliances by accelerated solvent extraction-ultra-performance liquid chromatography-tandem mass spectrometry was established. Samples, heated for 5 min, were extracted by toluene/methanol (10:1, v/v) under the pressure 1500 psi at 100°C, and were extracted 3 static cycles with 20 min per cycle. And then 15 mL extractant solvent was used to wash the samples, and at last the sample was purged by nitrogen for 100 s. The partial extractant (10 mL) was concentrated by nitrogen and re-dissolved with 1 mL methanol/water (1:1, v/v). The three compounds were separated by BEH C18 column effectively in 3 min and detected by electrospray ionization mode mass spectrometry. The linear ranges for bisphenol A, perfluorooctanoic acid, and tetrabromobisphenol A were 1-100, 10-1000 ng/mL, and 0.1-10 µg/mL, respectively. The correlation coefficient was greater than 0.996. The LOD and limit of quantitation for three compounds were 0.1, 10, 1 ng/mL, and 0.5, 50, 5 ng/mL, respectively. And the recoveries were 84-92, 76-82, and 72-74%, respectively, with RSD < 5%. The method was successfully used in determining the real samples. The method and the result were confirmed by liquid chromatography-ion trap-time of flight mass spectrometry.

The influence of socio-cultural background and product value in usability testing.

This article examines the influence of socio-cultural background and product value on different outcomes of usability tests. A study was conducted in two different socio-cultural regions, Switzerland and East Germany, which differed in a number of aspects (e.g. economic power, price sensitivity and culture). Product value (high vs. low) was varied by manipulating the price of the product. Sixty-four test participants were asked to carry out five typical user tasks in the context of coffee machine usage, measuring performance, perceived usability, and emotion. The results showed that in Switzerland, high-value products were rated higher in usability than low-value products whereas in East Germany, high-value products were evaluated lower in usability. A similar interaction effect of socio-cultural background and product value was observed for user emotion. Implications are that the outcomes of usability tests do not allow for a simple transfer across cultures and that the mediating influence of perceived product value needs to be taken into consideration.