Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis:...
Transcript of Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis:...
![Page 1: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/1.jpg)
Woodstoveinterventionsandchildrespiratoryinfectionsinruralcommunities
University of New Mexico (Justina Yazzie and Josey Watson)University of Montana (Tony Ward)
October 19, 2017
![Page 2: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/2.jpg)
Woodstoves
Across the US, ~11 million homes report the use of wood as either a primary or secondary heating fuel.
Over 80% of these woodstoves are old and inefficient.
![Page 3: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/3.jpg)
PM2.5 healtheffects• PM2.5 exposure is associated with many adverse health outcomes, including a greater than three‐fold increased risk of lower respiratory tract infections (LRTIs) in children.
• Acute LRTIs account for more than 27% of all hospitalizations among US children <5 years of age.
• Poor indoor air quality may be related to risk of lower respiratory tract infections (LRTI) among children.
![Page 4: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/4.jpg)
Indoor woodsmoke exposures
![Page 5: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/5.jpg)
IndoorresidentialPM2.5 samplingprograms
‐ Northern Rockies / Fairbanks, AK intervention study (97 homes).‐ Avg (sd) indoor PM2.5 across all homes was 34.8 ± 56.5 µg/m3.
‐ Indoor PM2.5 concentrations often exceed health based standards such as WHO and EPA NAAQS.
![Page 6: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/6.jpg)
Libby 2006/2007 Residential PM2.5 ProgramPM2.5 Mass - Home 4A
0100
200300
400500
600700
800
1
Time
Con
cent
ratio
n (u
g/m
3 )
15:22
19:53
06:30
End Sampling:10/26/06 @ 14:00
Avg = 131.8 μg/m3
Before Changeout
Start Sampling:10/25/06 @ 14:00
![Page 7: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/7.jpg)
Interventions– indoorair
Our team has evaluated:
• wood stove changeouts• use of filtration units
![Page 8: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/8.jpg)
Woodstovechangeout
Old stove40-60 g smoke/hr
EPA-certified stove2-5 g smoke/hr
![Page 9: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/9.jpg)
WoodStoveChangeouts
• Promoted by EPA to reduce wood smoke.
• Expensive (~$1500 ‐ $4500).
• Effective in reducing ambient PM2.5.
• Results can be variable for indoor air.
• Learning curve.
![Page 10: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/10.jpg)
Indoorintervention‐ airfiltrationunits‐
Monitor compliance(KiloWatt meter).
![Page 11: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/11.jpg)
Filtrationunits
• ~60% improvement in air quality.
• Expenses: costs of the unit (~$200), yearly filter replacement (~$100), and energy usage (~$100‐$200/year).
• Noise, filter replacement, etc.
• Compliance issues.
![Page 12: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/12.jpg)
Whatabouteducationonbest‐burnpractices?
• Can education be used as an effective, economical, and sustainable intervention to improve indoor air quality and health effects?
• Education coupled with the use of inexpensive tools.
![Page 13: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/13.jpg)
Educationintervention• Videos on Best Burn Practices.
• Training on simple tools: moisture meter stove thermometer firestarter
![Page 14: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/14.jpg)
“KidsAIR”
• Wood Stove Interventions and Child Respiratory Infections in Rural Communities.
• Curtis Noonan and Tony Ward (co‐PIs).
• 5‐year R01 funded by the NIEHS.
• Project Period: 06/19/2014 – 03/31/2019.
• Study areas include western MT, Alaska Native Villages (Univ Alaska Fairbanks, CANHR), and the Navajo Reservation (Univ New Mexico).
![Page 15: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/15.jpg)
![Page 16: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/16.jpg)
OverviewofKidsAir• Hypothesis: a low‐cost, educational intervention targeting indoor wood smoke (PM2.5) exposures will be an efficacious, sustainable strategy for reducing children’s risk of LRTI in underserved Native and rural communities.
• Interventions:• Household‐level strategies, including 1) filtration units, 2) placebo filtration, and 3) education (randomized trial).
• Participants 324 homes with an anticipated 486 children <5 years (108 homes at Navajo Nation, 162 children in total).
![Page 17: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/17.jpg)
HealthOutcomes• The primary health outcome will be occurrence of LRTI among children.
• Identification of LRTI episodes will occur through a three step process: • (1) parent reporting of symptoms• (2) Collection of confirmatory and severity data• (3) physician classification of case status (medical records).
![Page 18: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/18.jpg)
HealthMeasures• Identification of symptoms consistent with LRTI (wheeze and cough, fever/temperature, elevated respiratory rate, saturated oxygen, and evaluate the child for presence of chest indrawing (retractions)).
• Parents asked to contact their Community Coordinator when such symptoms are present in household children <five years.
• Home visits will occur within 48 hours of parent notification of signs and symptoms of LRTI.
• Continue to track this child’s symptoms.
![Page 19: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/19.jpg)
ExposureOutcomes• Indoor PM2.5 Monitoring. A stationary DustTrak (TSI) is used to continuously measure PM2.5 mass with 60‐second time intervals for 6 day periods.
• Stove temperature. We monitor stove use throughout the winter using a LogTag.
• Activity logs.
![Page 20: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/20.jpg)
Results• Enrolled through winter three of grant:
• 49 homes, 74 kids.
• Target Winter 4 (2017/18 winter)• 33 homes, 50 kids.
• Data analysis is in progress.
![Page 21: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/21.jpg)
Recruitingandotherchallenges
![Page 22: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/22.jpg)
Conclusions• Residential wood combustion is a large source of PM2.5 within the indoor environment during the winter months.
• Education on best‐burn practices shows promise in reducing ambient and indoor air pollution, but needs to be comprehensively evaluated.
• Benefits of research: A low‐cost, educational intervention targeting indoor wood smoke PM2.5 exposures will be sustainable, and can reduce children’s risk of LRTI in underserved Native and rural communities.
![Page 23: Wood stove interventions and child respiratory infections ......Overview of KidsAir • Hypothesis: a low‐cost, educational interventiontargeting indoor wood smoke (PM2.5) exposures](https://reader033.fdocuments.us/reader033/viewer/2022042323/5f0e1b867e708231d43da5f5/html5/thumbnails/23.jpg)
AcknowledgementsFunding• NIEHS (1R01ES022649, Program Officer Symma Finn)
• UM (Curtis Noonan, Annie Belcourt, Erin Semmens, Emily Weiler, Carolyn Hester, Desirae Ware, Dr. Paul Smith)
• UAF (Bert Boyer and Scarlett Hopkins)• UNM (Johnnye Lewis, Becky Smith, Eszter Erdei)
Thank you.