Biomass Combustion and Health Effects

Transcription

1 Biomass Combustion and Health Effects National Tribal Forum on Air Quality May 22-24, 2012 Tulsa, OK Curtis W. Noonan, Ph.D. Associate Professor of Epidemiology Center for Environmental Health Sciences The University of Montana

2 Overview Particulate Matter (PM) Health-based Standards Sources of Biomass Combustion-derived PM Vegetative Fires Respiratory versus cardiovascular health effects Global Health Burden and Biomass Smoke Cookstoves and Health Wood stoves and Health Ambient Biomass Smoke and Health Indoor Biomass Smoke Intervention Effectiveness Are there effective and sustainable interventions for wood stove homes?

3 PM 2.5 ( g/m 3 ) National Ambient Air Quality Standards for PM Hour (1997) 24-Hour (2006) Annual

4 National Ambient Air Quality Standards for PM2.5

5 Biomass Smoke Sources of PM2.5

6 Particulate pollution affects more people globally on a continuing basis than any other air pollutant. WHO, Health Guidelines for Vegetation Fire Events 2000.

7 PM 2.5 ( g/m 3 ) National Ambient Air Quality Standards for PM Hour (1997) 24-Hour (2006) Annual 2000 Fire, Daily Avg, Missoula 2003 Fire, Daily Avg, Missoula 0

8 Jan-00 Apr-00 Jul-00 Oct-00 Jan-01 Apr-01 Jul-01 Oct-01 Jan-02 Apr-02 Jul-02 Oct-02 Jan-03 Apr-03 Jul-03 Oct-03 May-00 Sep-00 Jan-01 Monthly Asthma Visits May-01 Sep-01 Jan-02 May-02 Sep-02 Jan-03 May-03 Sep-03 Monthly Average PM2.5 (ug/m3) Monthly Average PM2.5 (ug/m3) 50 Study Design: Time Series 40 Monthly visits 30 for asthma and average monthly PM 2.5, 20 Missoula, MT Fire 10 Fire Asthma PM

9 Relative risk for hospital visits per 10 g/m 3 increase in PM 2.5

10 Vegetative Fires and Health Outcomes: Selected Studies Geographic Location Respiratory Health Cardiovascular Health California Duclos et al., 1990 Delfino et al., Incr. respiratory (ED visits) - No assn. IHD, HF (Hosp ad) British Columbia Moore et al., 2006 Henderson et al., Incr. respiratory (MD visits) - No assn. CVD (MD visits) - No assn. CVD (MD or Hosp) Australia Copper et al., 1994 Smith et al., 1996 Johnston et al., 2002 Johnston et al., 2007 Morgan et al., No assn. asthma (ED visits) - No assn. asthma (ED visits) + Incr. asthma (ED visits) - No assn. CVD (Hosp ad) - No assn. CVD (Hosp ad)

11 Challenges for studies of fire events Small numbers Episodic PM events Missing some PM 2.5 data Limited reliability of hospital record data Minimal individual-level data (e.g., zip code)

12 Other sources of exposure to biomass smoke: indoor cooking and heating Cookstoves, primarily in developing country settings. Wood stoves, used throughout the world and common in rural U.S. and some Native American communities.

13 Cookstoves: an important source of biomass smoke exposure and related health effects More than half of world s population uses biomass for energy needs Primarily impacts women and infants Smith et al., Comparative risk assessment. World Health Organization.

14 Household solid fuel use Smith et al., Comparative risk assessment. World Health Organization.

15 PM 2.5 ( g/m 3 ) Estimated Indoor PM 2.5 in Cookstove Homes 3, Hour (1997) 24-Hour (2006) Annual Daily Average (e.g., Kenya, India, Guatemala) Naeher et al., Inhalation Tox

16 Cookstoves: an important source of biomass smoke exposure and related health effects Demonstrated health effects: Lower respiratory tract infections (e.g., pneumonia) Chronic obstructive pulmonary disease (COPD) Other potential health effects: Low birth weight Blood pressure or heart disease? Cognitive effects? Cancer Ocular disease Smith et al., Comparative risk assessment. World Health Organization.

17 Global burden of disease World Health Organization estimated Disabilityadjusted Life Years (DALYs) for specific risk factors. Indoor smoke from solid fuels fell was among the top 10 contributors to global DALYs. Exposure to indoor smoke from solid fuels may be responsible to 1.6 million + deaths. The majority of mortality and DALY attributed to indoor smoke from solid fuels is due to the risk of pneumonia among children under 5 years in developing countries. Smith, K. R., and Ezzati, M Annual Rev. of Energy and Resources 30:

18 Wood stoves: A community intervention

19 Policy: 2003 PM 2.5 Nonattainment Areas

20 PM 2.5 ( g/m 3 ) National Ambient Air Quality Standards for PM Hour (1997) 24-Hour (2006) Annual Libby Winter 24- Hour Highs Libby Annual

21 Community scale wood stove intervention: Libby, MT June 2005 to June 2007: Initial phase, 260 old woodstoves replaced for free with new woodstoves January 2006 to March 2008: Voucher program Approved appliance: $700 Other Installation: $300 Furnace : $1,400 Stove removal: $200 MT tax credit: $500 Early incentive: $100 Total funding: $2.1 million Grant and equipment from HPBA: $1 million Senate appropriation: $1 million EPA grant: $100,000

22 8/1/ /1/2003 2/1/2004 5/1/2004 8/1/ /1/2004 2/1/2005 5/1/2005 8/1/ /1/2005 2/1/2006 5/1/2006 8/1/ /1/2006 2/1/2007 5/1/2007 8/1/ /1/2007 2/1/2008 5/1/2008 8/1/ /1/2008 2/1/2009 Ambient PM 2.5 (µg/m 3 ) Cumulative Wood Stove Changeouts Ambient PM 2.5 and cumulative changeout of wood stoves in Libby, MT µg/m µg/m Noonan et al., Report #162. Health Effects Institute.

23 Noonan et al., Occupational and Environmental Medicine, 69:

24 Adjusted odds ratio (95% CI) for effects of PM 2.5 and wood stove on parent-reported symptoms and infections over a four winter period. Noonan et al., OEM, 69:

25 How did the stove changeout program impact indoor air quality?

26 Issue: Can we intervene in woodstove homes to reduce indoor exposures and improve health?

27 PM 2.5 ( g/m 3 ) Policy: Indoor PM Exposure? Hour (1997) 24-Hour (2006) Libby WS Homes, 24-Hour Average Annual 0

28 Average indoor PM 2.5 (µg/m 3 ) Indoor PM 2.5 Following Wood Stove Change Pre Change Mean (sd) = 45.0 (33.0) µg/m 3 Post Change Mean (sd) = 21.0 (19.2) µg/m Homes Noonan et al., Indoor Air 2012.

29 Inconsistent impact of wood stove upgrade on indoor air quality Study Area No. Homes Prechange median PM 2.5 Postchange Median PM 2.5 Proportion of Homes with No Reduction Libby, MT * 33% Nez Perce Reservation * 33% Northern BC % Western MT and Idaho % * Significant average reduction. 1 Noonan et al., Indoor Air Allen et al., Atmos Environ Semmens et al., ISEE Ward et al., Sci Total Environ 2011.

30 What about in-home filter interventions? 59% Reduction

31 Kw/Hr per month Air Filter Intervention: Cost and Compliance Common Room Bedroom Survey of usage in winter following participation (n=17) 9/17 still using continuously /17 partial use Compliant Homes /17 no use Main complaints Noise Cost Poor compliance with rec. filter replacement Semmens et al., ISEE 2012.

32 What other interventions could be considered in wood stove homes?

33 Components of a Best-Burn Practices Education Intervention 1. Preparing your wood supply 2. Using your wood stove 3. Maintenance 4. What and when to burn

34 Wood supply

35 Wood supply Cold Climate Housing Research Center. Wood Storage Best Practices in Fairbanks, AK. June 2011.

36 Burn Temperature Burning your stove without a thermometer is like driving without a speedometer. - Jerry Marquez, Libby, MT

37 Best-Burn Practices Education Intervention Can efficacy be tested?

38 Libby, MT Kathi Hooper (Lincoln Cnty Health) Kirby Maki (Libby School District) Helena Cassidy (Asa Wood School) Kim Edlund (Asa Wood School) Margie O Brien Johnson (Asa Wood) Ron Goodman (Libby Middle School) Keith Ivers (Libby Middle School) Gigi Scofield (Libby Middle School) Rik Rewarts (Libby High School) Montana Dept Environ Quality Bob Habeck Eric Merchant Elton Erp Nez Perce Reservation Johna Boulafentis (ERWM) Julie Simpson (ERWM) Angela Porter (NMPH) Tui Molinga (NMPH) Acknowledgments University of Montana Tony Ward Carolyn Hester Marcy McNamara Luke Montrose Erin Semmens Emily Weiler Desirae Ware Colorado School of Mines William Navidi University of Washington Lianne Sheppard This research is supported by the Health Effects Institute (#4743-RFA04-4/06-4), the National Institute of Environmental Health Sciences (1R01E ; 3R01ES S1 ), and NCRR (COBRE P20RR017670).

39 References Noonan, C., Ward, T., Navidi, W., Sheppard, L., Bergauff, M. and Palmer, C. Assessing the impact of a wood stove replacement program on air quality and children's health. Research Report 162. Health Effects Institute: Boston, MA Noonan CW, Ward TJ, Navidi W, Sheppard L. A rural community intervention targeting biomass combustion sources: effects on air quality and reporting of children s respiratory outcomes. Occupational and Environmental Medicine 2012;69: Ward T, Boulafentis J, Julie Simpson J, Hester C, Moliga T, Warden K, Noonan C. Lessons Learned from a Woodstove Changeout on the Nez Perce Reservation. Sci Total Environ 2011;409: Noonan CW, Ward TJ, Weiler EC, Semmens EO. Indoor Air Quality Improvement Following Interventions in Wood Stove Homes. Epidemiology 2011;22(1):S42. Allen R, Leckie S, Millar G, Brauer M. The impact of wood stove technology upgrades on indoor residential air quality. Atmospheric Environment 2009;43: Noonan CW, Navidi W, Sheppard L, Palmer CP, Bergauff M, Hooper K, Ward TJ. Residential indoor PM2.5 in wood stove homes: follow-up of the Libby changeout program. Indoor Air 2012 (In Press). Semmens E, Noonan C, Ward T, Hester C. Are indoor air filters a sustainable intervention for reducing indoor particulate exposures? 24th Annual Conference of the International Society for Environmental Epidemiology; 2012 Aug 26-30; Columbia, South Carolina. Semmens, E, Noonan C, Ward T, Weiler E, Boulafentis J. Effectiveness of interventions in improving indoor and outdoor air quality: preliminary results from a randomized trial of woodsmoke and asthma. Poster session presented at: Exposure assessment of air pollutants. 23rd Annual Conference of the International Society for Environmental Epidemiology; 2011 Sept 13-16; Barcelona, Spain. Cold Climate Housing Research Center. Wood Storage Best Practices in Fairbanks, AK. June Northwest Air Quality Communicators, Washington Sub-group. Wood Smoke Awareness and Behavior. July Smith, K. R., Mehta, S., and Maeusezahl-Feuz, M Indoor smoke from household solid fuels. In Comparative quantification of health risks: Global and regional burden of disease due to selected major risk factors, eds. M. Ezzati, A. D. Rodgers, A. D. Lopez and C. J. L. Murray. Vol. 2, pp Geneva:World Health Organization. Smith, K. R., and Ezzati, M Environmental health risks change with development: The epidemiologic and environmental risk transitions revisited. Annual Rev. of Energy and Resources 30: