The killer in the kitchen

CSU professor, students combat indoor air pollution in Nicaragua

Tied to her mother’s back, a small child sleeps as her mother prepares tortillas in the family’s enclosed, cinder block kitchen.  Utilizing a plastic bag and wood, the mother starts a fire in the stove filling the kitchen with smoke, dangerous levels of carbon monoxide, and particulate matter. Weeks later the child suffers from pneumonia and an eye infection.

Smoke fills a Nicaraguan family's kitchen as they cook over a traditional wood burning stove. More than 80 percent of families cook on traditional wood burning stoves.

Indoor air pollution has been called “the killer in the kitchen.”  The World Health Organization (WHO) estimates that 1 million children and 600,000 women die every year from the effects of indoor air pollution and millions more are chronically sickened – that’s one life lost every 20 seconds. The amount of smoke from these fires is the equivalent to consuming two packs of cigarettes a day.

Throughout Central America more than 80 percent of families cook their meals on open wood fires because they either do not have access to safe, alternative fuel sources or they cannot afford to buy electric or gas stoves.  When exposed to open wood fires people are at risk for lung cancer, chronic obstructive pulmonary disease, tuberculosis, eye diseases and acute respiratory infections, including pneumonia. 

Recognizing the global health effects of indoor air pollution, two years ago a group of students approached Dr. Jennifer Peel, a Colorado School of Public Health professor at Colorado State University, to be their faculty advisor on an indoor air pollution project in Central America. 

“Three billion people worldwide are affected by this issue, but there haven’t been enough studies conducted or successful interventions implemented to combat the problem,” says Dr. Peel.  “We need to know the total burden of disease from indoor air pollution, but we really don’t know that yet.”

With little knowledge of where they would carry out their indoor air pollution project, Dr. Peel and the students partnered with Trees, Water & People, a Fort Collins-based nonprofit organization, who has implemented cook stove projects in El Salvador, Guatemala, Nicaragua, Honduras and Haiti.  Previously, Trees, Water & People worked with one of Dr. Peel’s PhD students on her dissertation research in Honduras. 

“Based on our experience with another student, we decided to take on a longer study,” says Stuart Conway, international director of Trees, Water & People.  “We knew we could get better information if we studied the same women over time rather than comparing a group of women with new stoves to a group of women with traditional, open fire stoves.”

Through the connections of Trees, Water & People and those of several project volunteers, the students were matched with Casa de la Mujer, a women’s organization in El Fortin, a barrio outside of Granada, Nicaragua.  With health assessments and pollution testing tools in hand, the students travelled to Nicaragua in the summer of 2008. That summer, they conducted a baseline health assessment on 125 households.

Around her neck, a local mother wears a personal air pollution monitor as part of the project's baseline health assessment.

The students measured pollutants inside the house and also the personal pollution exposure levels on the women.  They found that the carbon monoxide and particulate matter levels were 10 to 500 times the levels of pollution in the United States, says Dr. Peel.   Obesity and hypertension were also high in the community.

Once the assessments were complete, the group worked with Trees, Water & People’s partner, PROLENA to install new cook stoves in all of the participants homes.  PROLENA is a Nicaraguan non-profit that manufactures the Eco Stove, a fuel-efficient cook stove.

“With our stoves, we’re reducing fuel use by 80 percent which saves families $1 to $5 a day,” explains Conway.  “That’s a big boast in income for these families.  We’re also eliminating indoor air pollution from the homes and helping to reduce child mortality and acute respiratory infections.”

A year later, another group of students returned to Nicaragua to conduct a follow-up health assessment.  The results from this health assessment are currently being analyzed, however, Dr. Peel says based on preliminary results they are seeing less eye irritations, headaches and wheezing than previously reported in the baseline assessment.  The group is also looking at the correlation between particulate air pollution and indicators of cardiovascular disease since members of the community showed high risk markers. 

“Having this data will be useful in getting additional funding for more projects and raising more awareness of the problem internationally,” states Conway. “This is the fourth worst health problem in the world, but no one knows about it.”

In the past two years, 14 CSU undergraduate students have participated in the Nicaragua Cook Stove Project with Dr. Peel.  After the group finishes analyzing the data from the health assessment, Dr. Peel says their work is not complete. She says it is important to either find a lower cost cook stove for the families or train members of the community to repair and maintain the stoves. 

 “We’re only addressing one little piece of the many issues this community faces every day,” says Dr. Peel.  “These families are very poor and cannot afford to buy new stoves once they wear out; we need to find a way to make this project sustainable in the years to come.”

To donate to the Nicaragua Cook Stove Project, please visit: http://www.cvmbs.colostate.edu/erhs/Nicaragua/index.htm.  For more information, please contact Dr. Jennifer Peel at jennifer.peel@colostate.edu.

Dr. Jennifer Peel is an assistant professor at the Colorado School of Public Health and assistant professor in the College of Veterinary Medicine & Biomedical Sciences’ Department of Environmental & Radiological Health Sciences at CSU.  Dr. Peel’s research focuses on the health effects of ambient air pollution. Ongoing projects include studies of ambient air pollution in relation to several health outcomes, including emergency department visits for respiratory and cardiovascular  conditions, arrhythmic events in patients equipped with implanted defibrillators, apnea and bradycardia in high-risk infants on home cardiorespiratory monitors, and adverse birth outcomes such as preterm birth and low birth weight. Currently, Dr. Peel is researching the health effects and characterization of particulate matter in Denver and Greeley, Colorado.