Global estimations indicate that 3 billion people solely depend on solid fuels (coal, crop wastes, animal dung and wood) for their everyday heating and cooking especially in developing countries 1 . Additionally, the utilization of most of these solid fuels occurs in poorly- ventilated structures which contribute to the high levels of indoor air pollution. Exposure to solid fuels is related with causing respiratory infections such as lower respiratory infections, lung cancer, prenatal mortality, asthma and tuberculosis to name but a few. World Health Organization report indicates that acute lower respiratory infections (ALRI) are considered as the single most source of most deaths of children who are below the age of five years which are said to claim approximately 20% of all children death globally each year 2 . Unfortunately, this trend of using solid fuels or biomass is likely to go on for many centuries considering that most of the world’s population is below the poverty line 3 .
Research findings indicate that homes that use open fire for cooking and heating purposes are exposing themselves to deplorable high levels of air pollution which are considered 100 times greater than the EPA recommended standards. Informed and proper control and reduction of indoor pollution caused by the pollutants in these solid fuels can go a long way in reducing as well as alleviating the risks posed by the constant exposure to these solid fuels. This is specifically the case with the Mayans in Guatemala who are at a higher threat of exposure to indoor air pollution compared to those in the countries in Central America due to differences in socioeconomic, environmental and cultural factors. This research paper aims at bringing to an awareness of the extent of this exposure to indoor air pollution in Guatemala by focusing on the interventions that have been put in place, their impacts and limitations. Further, this research paper will make recommendations aiming at drastically reducing indoor air pollution and consequently the respiratory infections that are thereby caused by indoor air pollution. Furthermore, this article will discuss the type of database used during my research to come to the findings.
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Methodology
The research employed both quantitative and qualitative methods of collecting and analyzing data. This qualitative and quantitative data was found in various sources that are available and which cover the topic under study in great details since this is an issue of concern to environmentalists, the government and the medical practitioners. The research relied heavily on previously done research by global organizations such as World Health Organization, universities both from Guatemala and from outside Guatemala as well as public and private institutions with interest in the topic under study. Further, there was the use of environmental case studies, medical research, government publications, as well as other research documents relevant to this study.
These secondary sources were found to be quite helpful since they give detailed and concrete information revolving around indoor air pollution, its causes, effects, intervention procedures, findings, conclusions as well as recommendations. These sources also provide statistical as well as descriptive data which proved quite useful in creating a deeper understanding or indoor air pollution. This research tapped a lot of this information which was used to come up with a more elaborate explanation derived from the comparisons of the various available research.
Environmental Exposure
The Mayan population in Guatemala primarily relies on solid fuels to meet their energy needs which reflect the global trend where about three billion people use inefficient stoves (open fires) for cooking. Unfortunately, smoke exposure from stoves kills two million people worldwide every year due to the exposure of toxic fumes which are responsible for creating susceptibility to respiratory illnesses (guatemalastoveproject.org par.1). There is an estimation that about 77% of Guatemala’s total population use wood as their main fuel source which results in depletion of forest in Guatemala by 2 percent annually due to the increased demand for fuel. This reality has necessitated the Guatemala Stove Project to come up with necessary measures that will help alleviate the problem by coming up with a stove which is adaptable to the Mayan cooking methods 4 .
Indoor Air Pollution affects the population’s health as a result of the constant exposure to the pollutants emitted by the biomass fuels used in cooking lighting and heating activities. Indoor air pollution affects the environment by increasing acid rain, haze and eutrophication. The acid rain which is precipitation comprising of unsafe amounts of sulfuric acid and nitric acids occurs mainly due to the burning of fossil fuels since they produce pollutants that are detrimental to the environment 5 . In addition, acid rain can damage the environments’ lakes, rivers, soils, and wildlife. Eutrophication, on the other hand, refers to a state where water bodies with high nutrient concentrations lead to increase in algae which in turn leads to the loss of plant and animal diversity 6 .
Environmental Case Studies
Guatemala, just like in the case of most developing countries is faced with air pollution which can largely be contributed to the pollutants from biomass fuels. As a result, there is an increase in exposure levels of about 10-20 times higher than the guidelines which have been put in place by the World Health Organization 7 . This high exposure level leads to an increase in incidences of disease and death in the Mayan population with most of the victims being women and their youngest children since they are the ones who do a lot of domestic chores involving these fuels. As a result, these women and children end up contracting respiratory diseases such as pneumonia, bronchitis, emphysema, heart disease, lung cancer and respiratory irritation 8 .
Research findings indicate that the housing conditions in these developing countries are unhealthy, overcrowded, with dirty floors, mud walls, limited ventilation in addition to being dilapidated 9 . These poor living conditions are a major contributor to indoor air pollution since most of the smoke is trapped inside these houses which eventually affects the occupants of these houses. Kitchen location, as well as roofing materials used, is also a great contributor to indoor air pollution which eventually causes various respiratory infections that the Guatemalan population struggles with. The research further revealed that most rural Guatemalans tend to spend a lot of their time outside their homes in proximity to outdoor stoves which emit lots of smoke. This, therefore, means that the rural Guatemalans are exposed to lots of smoke both from the inside and outside of their homes which make the situation worse 10 .
Past and Current Preventative Measures
There has been a clear establishment on the correlation between exposure to indoor air pollution with various health results in both adults and children. Nonetheless, According to WHO, there is inadequate scientific substantiation supporting the effectiveness of the interventions aimed at reducing indoor air pollution. To address this limitation WHO has given support to an intervention research conducted in the rural highlands of Western Guatemala which is being spearheaded by a team drawn from Berkley University in the US, Liverpool University from UK team and Del Valle University in Guatemala. This intervention effort is being sponsored by the National Institute of Environmental Health Sciences with the aim of determining the effectiveness of improved stoves in the reduction of acute lower respiratory infections in young adults. This intervention study involves 500 households which are randomly issued with the plancha (improved stove). The houses that are not issued with the plancha are the control group with which to measure the results against indoor air pollution. In addition to the issuance of planchas, weekly visits are conducted so as to appraise the exposure levels to pollutants of toxins in each household by assessing a range of health outcomes.
In addition to this intervention, the Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) is a study that was designed in terms of a household randomized tests for measuring the effects of reduced indoor air pollution from solid fuels on respiratory health of the Guatemalan rural population 11 . This intervention measures included the installation of enhanced woodstove including a chimney (plancha) which has proved to lessen drastically indoor air pollution in kitchens. In addition, detailed measurement and assessment of exposure were conducted intensely. The evaluation was divided into several trial components that were aimed at investigating the intervention’s impacts on acute lower respiratory infections in children who are 18 months and below in addition to assessing the impact on blood pressure in older women 12 .
Research Findings
The RESPIRE Trials ranged from about 18 months of randomized control trials with replacing the stoves with planchas. These trials led to positive outcomes, and the resultant findings indicated a drastic reduction in pneumonia cases and prevalence in children 13 . Improved cooking stoves led to a more efficient combustion decrease in the fuel need, production of less smoke which in turn reduced the amount of smoke emitted into the environment. In addition, the Guatemala Stove Project has helped to drastically reduce indoor air pollution through building vented fuel saving stoves which are made of fire-bricks on the inside and cement blocks on the outside in addition to being filled with sand for insulation. The outcomes from the Guatemala Stove Project has contributed to the reduction of wood consumption and pollution caused by the pollutants by nearly 50% 14 .
Limitations to the Interventions
Research studies have revealed that these interventions that government and private institutions have tried to put in place may not be effective in the long run because of various reasons. Most of the Guatemalan rural population is poor and traditionally oriented since they hold their customs close to heart 15 . As a result, these rural Guatemalans have failed to adopt the improved stoves even after the extensive campaigns aimed at promoting their usage. The main reason for the adverse reaction is attributed to the fact that these stoves are considered expensive, inconvenient and their inability to fit in the traditional meal preparation procedures. This is in comparison with biomass fuels which are considered cheaper, affordable, convenient and readily available. Moreover, most Guatemalans showed that neither was indoor air quality an issue to them nor did it affect their day to day lives. As a result, therefore, most Guatemalans do not find it necessary to alter their current lifestyles since they are contented with using their traditional stoves 16 .
Recommendations and Conclusion
Indoor air pollution is quite a global concern considering the number of people who are constantly exposed to this kind of contamination as well as its adverse effects on the environment. As a result of indoor pollution prevalence of respiratory related diseases is on the increase which lays the burden of treatment on WHO as well as the countries whose citizens are sick. Research has indicated the various measures put in place by different institutions to help eliminate or reduce indoor air pollution. These interventions have proven to have little effect since most people are not ready to embrace them. There is a need for the concerned governments to educate its citizens through awareness campaigns aimed at promoting the need for energy conservation. In addition, there is need to reduce the cost of energy saving stoves so that it can be affordable even to the poorest of the population. Furthermore, there is a need to build energy saving stoves that are adaptable to society traditional needs to enhance its acceptability. As a result, there is the likelihood that these households will readily accept their usage which will drastically reduce indoor air pollution which will, in turn, reduce respiratory infections.
Bibliography
Bruce, Nigel, et al. “Pneumonia Case-finding in the RESPIRE Guatemala Indoor Air Pollution Trial: Standardizing Methods for Resource-poor Settings.” Bulletin of the World Health Organization, 85 no.7 (2007): 501-568.
Guatemala Stove Project. "We Are Building Stoves to Protect the Health of Mayan Families." The Guatemala Stove Project. 2017. Accessed April 20, 2017. http://www.guatemalastoveproject.org/.
Le, Audrey, Gonzalo Bearman, Kakotan Sanogo and Michael P. Stevens. “Perception and Barriers to Indoor Air quality and Perceived Impact on Respiratory Health: An Assessment in Rural Honduras.” Advances in Public Health, Article ID 105260 (2014): n.d.
Patrick, Deval L., Timothy P. Murray, Rchard K. Sullivan and Kenneth L. Kimmel. “Health & Environmental Effects of Air Pollution Health Effects.” Department of Environmental Protection. n.d. Accessed April 20, 2017. http://www.mass.gov/eea/docs/dep/air/aq/health-and-env-effects-air-pollutions.pdf.
Smith-Sivertsen, Tone et al., “Effect of Reducing Indoor Air Pollution on Women's Respiratory Symptoms and Lung Function: The RESPIRE Randomized Trial, Guatemala.” American Journal of Epidemiology 70 no. 2 (2009): 211-220.
World Health Organization, (WHO). "Indoor Air Pollution: Randomized Controlled Trial in Guatemala." 2017. Accessed April 20, 2017. http://www.who.int/indoorair/interventions/guatemala/en/.
1 Audrey Le, Gonzalo Bearman, Kakotan Sanogo and Michael P. Stevens. “Perception and Barriers to Indoor Air quality and Perceived Impact on Respiratory Health: An Assessment in Rural Honduras,” Advances in Public Health, Article ID 105260 (2014): n.d.
2 Nigel Bruce et al., “Pneumonia Case-finding in the RESPIRE Guatemala Indoor Air Pollution Trial: Standardizing Methods for Resource-poor Settings,” Bulletin of the World Health Organization, 85 no.7 (2007): 501-502.
3 World Health Organization, (WHO), "Indoor Air Pollution: Randomized Controlled Trial in Guatemala," 2017, Accessed April 20, 2017, http://www.who.int/indoorair/interventions/guatemala/en/.
4 Guatemala Stove Project, "We Are Building Stoves to Protect the Health of Mayan Families," The Guatemala Stove Project, 2017, Accessed April 20, 2017, http://www.guatemalastoveproject.org/.
5 Deval L. Patrick, Timothy P. Murray, Rchard K. Sullivan and Kenneth L. Kimmel, “Health & Environmental Effects of Air Pollution Health Effects,” Department of Environmental Protection, n.d, Accessed April 20, 2017, http://www.mass.gov/eea/docs/dep/air/aq/health-and-env-effects-air-pollutions.pdf.
6 Deval L. Patrick, Timothy P. Murray, Rchard K. Sullivan and Kenneth L. Kimmel, “Health & Environmental Effects of Air Pollution Health Effects.”
7 Tone Smith-Sivertsen et al., “Effect of Reducing Indoor Air Pollution on Women's Respiratory Symptoms and Lung Function: The RESPIRE Randomized Trial, Guatemala,” American Journal of Epidemiology 70 no. 2 (2009): 211-212.
8 Ibid, 213.
9 Audrey Le, Gonzalo Bearman, Kakotan Sanogo and Michael P. Stevens. “Perception and Barriers to Indoor Air quality and Perceived Impact on Respiratory Health.
10 Audrey Le, Gonzalo Bearman, Kakotan Sanogo and Michael P. Stevens. “Perception and Barriers to Indoor Air quality and Perceived Impact on Respiratory Health.”
11 Smith-Sivertsen, Tone et al., “Effect of Reducing Indoor Air Pollution on Women's Respiratory Symptoms and Lung Function,” 211
12 Smith-Sivertsen, Tone et al., “Effect of Reducing Indoor Air Pollution on Women's Respiratory Symptoms and Lung Function,” 211-212.
13 Ibid, 212
14 Guatemala Stove Project, "We Are Building Stoves to Protect the Health of Mayan Families."
15 Audrey Le, Gonzalo Bearman, Kakotan Sanogo and Michael P. Stevens. “Perception and Barriers to Indoor Air quality and Perceived Impact on Respiratory Health.”
16 Ibid
