Adoption of a semi-gasifier cookstove intervention and its impact on air pollution and cardiovascular health in southwestern China
Bibliographic record
Abstract
Almost half of the world's households burn biomass and coal fuel as their primary energy source for cooking, heating, and other household needs. Household air pollution from inefficient biomass burning is a leading contributor to the global burden of cardiovascular disease, particularly in China. Replacing traditional biomass stoves with lower-polluting biomass stoves and fuels can potentially reduce air pollution exposures and the resulting health burden, though the evidence is limited, particularly for high-performing gasifier stove interventions. I evaluated the adoption and use of a semi-gasifier cooking and water-heating stove and pelletized biomass fuel intervention and its impact on exposures to air pollution and cardiovascular health among 205 rural Chinese women. Over a three year pre- and post-intervention study (n=125 intervention, n=80 control women), we measured women's brachial and central systolic and diastolic blood pressure (bSBP, cSBP, bDBP, cDBP), carotid-femoral pulse wave velocity (cfPWV), and central pulse pressure (cPP), women's personal exposures to air pollution, and a range of other risk factors for cardiovascular disease. I assessed the effect of the intervention on cardiovascular markers over time and between intervention groups with mixed-effects multivariable linear regression models using Bayesian inference procedures. I also collected information on stove use patterns by placing temperature sensors (stove use monitors, "SUM") on stoves for short- (48-h) and long-term (5 or 13 months) periods and administered a survey at 5-8 months after intervention. Multivariable probit and hurdle regression models were built to estimate the associations between intervention uptake (yes/no), 48-h stove use (yes/no), and 48-h duration of use (minutes). Pre- to post-intervention, blood pressure and cPP decreased on average for the intervention and control group, though reductions were slightly greater for the controls resulting in positive non-significant intervention effects for bSBP (mean posterior effect 1.44 mmHg [95% posterior credible interval (CIe) -2.5, 5.2]), cSBP (0.55 mmHg [95% CIe-3.0, 4.1]), bDBP (1.73 mmHg [95% CIe -0.2, 3.5]), cDBP (1.19 mmHg [95% CIe -0.8, 3.1]), cPP (0.23 mmHg [95% CIe -1.8, 1.1]), and no difference for pulse wave velocity (0.03 log-m/s [95% CIe -0.03, 0.08]). The lack of an observed intervention effect on cardiovascular markers was likely due to the fact that air pollution exposures decreased for both intervention and control women on average (range: -19% to -59%) and the intervention was only used a modest amount of the time (mean 40% [95% CI 34, 47] of days per month, 1-5 months post-intervention). Household intervention use was positively associated with reported cooking needs, and negatively associated with age of the main cook, household socioeconomic status, and ownership of other non-biomass stoves. As China and other countries create policies and promote interventions to reduce the burden of cardiovascular disease caused by household air pollution, my thesis provides useful and timely information on the lack of an impact that a high-performing gasifier stove intervention had on reducing air pollution and improving cardiovascular makers in a rural Chinese setting.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".