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Half of humanity about 3 billion people are still relying on solid fuels for cooking and heating. Of that, about 2.5 billion people depend on traditional biomass fuels (wood, charcoal, agricultural waste, and animal dung), while about 400 million people use coal as their primary cooking and heating fuel (UNDP and WHO 2009). The majority of the population relying on solid fuels lives in Sub-Saharan Africa and in South Asia. In some countries in Central America and in East Asia and the Pacific, the use of solid fuels is also significant. The inefficient and unsustainable production and use of these fuels result in a significant public health hazard, as well as negative environmental impacts that keep people in poverty. Strategies to improve energy access to the poor have focused mainly on electricity access. They have often neglected non electricity household energy access. It is, however, estimated that about 2.8 billion people will still depend on fuel wood for cooking and heating in 2030 in a business-as-usual modus operandi (IEA 2010). The need for urgent interventions at the household level to provide alternative energy services to help improve livelihoods is becoming more and more accepted. This report's main objective is to conduct a review of the World Bank's financed operations and selected interventions by other institutions on household energy access in an attempt to examine success and failure factors to inform the new generation of upcoming interventions. First, the report provides a brief literature review to lay out the multidimensional challenge of an overwhelming reliance on solid fuels for cooking and heating. Second, it highlights how the Bank and selected governments and organizations have been dealing with this challenge. Third, it presents lessons learned to inform upcoming interventions. And finally, it indicates an outlook on the way forward.

In most Nigerian cities, there have been an increased number of trading in charcoals, firewood, and sawdust. Yet, the fast citing of cooking gas refilling stations in these areas requires much to be studied since their increasing number suggests great demand for cooking gas. The knowledge of the different household fuel choices and the drivers of this choice was lacking in Nigerian cities, thus the inability of energy policymakers to predict and plan household fuel agenda in Nigeria. The thrust of this paper was to analyze the household energy fuel choice and the pattern of consumption as well as analyze the household socioeconomic factors that influenced the fuel choice in the Abakaliki urban area of Ebonyi State, Nigeria. Stratified and simple random sampling was adopted in the study. Regression was used to consider the relationship between energy fuel choice and household socioeconomic factors. It was revealed that there was a mixture of traditional and modern energy fuel choices in the study area, with the modern energy fuel choices (gas and electricity) having higher patronage. There was a significant relationship between energy fuel choice and household socioeconomic factors. It was recommended, among others, that a clear energy fuel policy that will adopt the identified explorable household socioeconomic factors that influence the choice of energy fuel be developed.

Objective: Nearly all China's rural residents and a shrinking fraction of urban residents use solid fuels (biomass and coal) for household cooking and/or heating. Consequently, global meta-analyses of epidemiologic studies indicate that indoor air pollution from solid fuel use in China is responsible for approximately 420,000 premature deaths annually, more than the approximately 300,000 attributed to urban outdoor air pollution in the country. Our objective in this review was to help elucidate the extent of this indoor air pollution health hazard. Data Sources: We reviewed approximately 200 publications in both Chinese- and English-language journals that reported health effects, exposure characteristics, and fuel/stove intervention options. Conclusions: Observed health effects include respiratory illnesses, lung cancer, chronic obstructive pulmonary disease, weakening of the immune system, and reduction in lung function. Arsenic poisoning and fluorosis resulting from the use of \"poisonous\" coal have been observed in certain regions of China. Although attempts have been made in a few studies to identify specific coal smoke constituents responsible for specific adverse health effects, the majority of indoor air measurements include those of only particulate matter, carbon monoxide, sulfur dioxide, and/or nitrogen dioxide. These measurements indicate that pollution levels in households using solid fuel generally exceed China's indoor air quality standards. Intervention technologies ranging from simply adding a chimney to the more complex modernized bioenergy program are available, but they can be viable only with coordinated support from the government and the commercial sector.

The transition toward cleaner fuels is considered an essential component to achieve sustainable economic development due to its environmental and health-related implications. However, the disarray among academicians on the explanatory power of existing models of energy transition has restrained its practical implementation. This study develops an alternative to explain energy transition at the household level by proposing “6Es” framework to rank various fuels and formulate a household energy transition index. This index includes the virtues of both the energy ladder and the energy stacking models. Multinomial logit model has been employed to test the traditional energy ladder hypothesis, and OLS has been used to estimate household energy transition index at the aggregated level as well as at the disaggregated provincial level in Pakistan. Contrary to the previously developed indices, the estimated results of the energy transition index significantly explain the changes in fuel consumption. The results indicate that income is not the only factor that affects energy transition. Household-specific factors such as prices, size, education, profession, and area also play an imperative role. Our estimates suggest that rural households are 22 percent more likely to consume primitive fuels. The findings suggest that prices of primitive fuels affect energy transition index in rural areas. Variable such as education and female bargaining power are positively linked with energy transition.

To examine the association of household fuel use with prehypertension regression among middle-aged and older people based on the China Health and Retirement Longitudinal Study (CHARLS), we included a total of 3501 participants with prehypertension at baseline, and they were followed up from 2011–2012 to 2015–2016 with information on blood pressure and household solid fuel use (heating and cooking fuels). Cox proportional hazards regression models were used to explore the hazard ratio (HR) and 95% confidence interval (CI) between fuel use and prehypertension regression. Additionally, we investigated the impact of switching fuels (2011–2013) on the regression to normotension during the 4-year follow-up. Linear regression was used to examine the effect of household fuel use on changes in blood pressure. Compared to solid fuel users, those who used clean fuel for heating at baseline had a positive effect on the regression of prehypertension (HR: 1.28, 95% CI: 1.08–1.53). Participants who used clean fuels for both heating and cooking had increased odds for the regression of prehypertension (HR: 1.32, 95% CI: 1.09–1.60). Compared to consistent solid fuel users, those who consistently used clean fuel for heating had a higher likelihood of transitioning from prehypertension to normotension (HR: 1.36, 95% CI: 1.06–1.73) and exhibited 2.45 mmHg lower systolic blood pressure. In conclusion, household clean fuel use for heating was positively associated with the regression of prehypertension to normotension. Furthermore, switching from solid fuel to clean fuel for heating could reduce the risk of prehypertension in Chinese middle-aged and older adults.

Background Although recent research evidence suggests an association between household air pollution from solid fuel use, such as coal or biomass, and cardiovascular events such as hypertension, little epidemiologic data are available concerning such exposure effects on cardiovascular endpoints other than hypertension. We explored the association between in-home solid fuel use and self-reported diagnoses of cardiovascular endpoints, such as hypertension, coronary heart disease (CHD), stroke, and diabetes. Methods We analyzed 14,068 Chinese adults, aged 18 years and older. Odds ratios (OR) and the corresponding 95% confidence intervals (CI) were estimated using logistic regression models for the risk of each outcome after adjusting for potential confounders. Results The use of solid fuel in home was significantly associated with an increased risk for hypertension (OR 1.70, 95% CI 1.40 to 2.07), CHD (OR 2.58, 95% CI 1.53 to 4.32), and diabetes (OR 2.48, 95% CI 1.59 to 3.86), after adjusting for potential confounders. Compared with individuals in the lowest tertile of the duration of solid fuel exposure, those in the highest tertile of the duration of solid fuel exposure had an increased odds of hypertension (OR 1.73, 95% CI 1.45 to 2.06), stroke (OR 1.87, 95% CI 1.03 to 3.38), and diabetes (OR 3.18, 95% CI 2.11 to 4.78). Conclusions Our data suggest that in-home solid fuel exposure maybe associated with increased risk for hypertension, CHD, stroke, and diabetes in the Chinese adult population. Further large-scale longitudinal studies are warranted to confirm these findings.

Objectives: To investigate whether lower hypertension prevalence or blood pressure was associated with cleaner household fuel usage for cooking and heating among Chinese adults. Methods: We enrolled 44,862 Chinese adults at the baseline of the prospective urban and rural epidemiology (PURE) study in China during 2005–2009, as a subset of the PURE-global China site. Multilevel logistic regression and generalized linear mixed models were conducted to estimate the adjusted odds ratio (AOR) and regression coefficient for hypertension and blood pressure respectively, while subgroup analysis by ambient PM2.5 concentration and location was also examined. Results: Compared with the least clean household solid fuel group, gas (AOR = 0.91, 95% CI: 0.83, 0.99) or electricity (AOR = 0.72, 95% CI: 0.60, 0.87) was associated with significantly lower levels of hypertension prevalence and blood pressure, and a similar pattern of the association was consistently observed among participants with high ambient PM2.5 exposure and those living in urban areas. Conclusion: Household utility of cleaner fuel type was associated with lower hypertension prevalence and blood pressure in Chinese adults. Our study urges the utilization of cleaner household energy to mitigate the burden of hypertension.

The associations between meteorological factors, air pollutant indicators, and latent tuberculosis infection (LTBI) have not yet been confirmed. This study aimed to assess the association of meteorological factors, air pollutant indicators, and other factors with LTBI among college students. We selected 5,193 freshmen randomly who originated from key tuberculosis areas in nine colleges in Nanjing. We ranked the importance of independent variables using Least Absolute Shrinkage and Selection Operator (LASSO) regression and random forest models. We then conducted a multi-model analysis after incorporating them into the prediction model. In addition, we adopted a calibration curve to determine the quality of the model. A nomogram was used to evaluate the possibility of using multiple models to predict LTBI risk. We found that higher outdoor PM concentrations (OR: 1.35; 95% CI: 1.10-1.65) was associated with LTBI. A history of allergies (OR: 1.37; 95% CI: 1.16-1.62) and coal-based fuels (OR: 1.44; 95% CI: 1.11-1.87) had a positive correlation with the occurrence of LTBI. Taking vitamin D supplements (OR: 0.82; 95% CI: 0.69-0.98) could reduce the risk of LTBI. Besides, age (OR: 1.11; 95% CI: 1.00-1.22) were significantly associated with strong positive populations. Higher outdoor PM concentration, history of allergies, and use of coal-based fuels were positively correlated with the occurrence of LTBI. Vitamin D supplementation might reduce the risk of LTBI. Besides, older people were more likely to contribute to strong positive results.

The purpose of this paper is to analyze the correlations among per capita gross domestic product (GDP), household fuel (natural gas and liquefied petroleum gas) consumption, and carbon dioxide (CO2) emissions through the environmental Kuznets curve (EKC) at the regional and national level in China using data from 2003 to 2015. The results validate the EKC assumption and show that per capita GDP is positively related to CO2 emissions; per capita natural gas consumption has a negative impact on CO2 emissions; however, per capita liquefied petroleum gas (LPG) consumption has a positive effect on CO2 emissions. Therefore, increasing natural gas consumption can effectively slow down the environmental degradation of China. Given rapid economic growth, changing the energy structure can improve the environment.

Background Asthma is a chronic inflammatory disorder characterized by airway obstruction and hyper-responsiveness. Studies suggest that household fuel exposure and housing characteristics are associated with air way related allergy. But there remains to be a considerable uncertainty about whether that reflects an association with asthma. This study endeavored to bridge the gap by identifying factors associated with asthma, with special reference to household fuel exposure and housing characteristics in selected public hospitals in Addis Ababa, Ethiopia. Methods We conducted a hospital-based matched case-control study. A total of 483 study participants were selected from two Ethiopian referral hospitals using a sequential sampling technique, with 161 cases and 322 controls. Standard questionnaire from the European Community Respiratory Health Survey II (ECRHS II) and the American Thoracic Society Division of Lung Disease (ATS-DLD-78) were used to collect household related data. Conditional logistic regression model was applied to identify the determinants of asthma. Both crude and adjusted odds ratios with 95% confidence interval (CI) were used to identify predictors of asthma. Results The response rate for both cases and controls was 99.17%. The odds of developing asthma was about four times higher among those who used agricultural residues for cooking (AOR: 3.81, 95% CI: 1.05, 13.79)., about five times higher among those who used wood for cooking (AOR: 4.95, 95% CI: 2.1, 11.69), nearly five times higher among those who had family history of asthma (AOR: 4.72, 95% CI: 1.54, 14.45), just over six times higher among those who smoke tobacco (AOR: 6.16, 95% CI: 1.31, 29.09) and over ten times higher among those who do not practice door opening, while cooking (AOR: 10.25, 95% CI: 3.97, 26.49). Conclusion Family history of asthma, tobacco smoking, use of solid fuels including, woods and agricultural residues were associated with development of asthma. To reduce the risk of asthma, people should practice door opening, while cooking, and must avoid using wood and agricultural residues for cooking and should also refrain from tobacco smoking.