Carlos Gould

All Publications

• Using high-frequency household surveys to describe energy use in rural North India during the COVID-19 pandemic NATURE ENERGY Gould, C. F., Pillarisetti, A., Thompson, L. M., Saluja, S., Nandan, V., Urpelainen, J. 2023

  View details for DOI 10.1038/s41560-022-01187-3

  View details for Web of Science ID 000919729100001

• Variability in the household use of cooking fuels: The importance of dishes cooked, non-cooking end uses, and seasonality in understanding fuel stacking in rural and urban slum communities in six north Indian states WORLD DEVELOPMENT Gould, C. F., Jha, S., Patnaik, S., Agrawal, S., Zhang, A., Saluja, S., Nandan, V., Mani, S., Urpelainen, J. 2022; 159

  View details for DOI 10.1016/j.worlddev.2022.106051

  View details for Web of Science ID 000838474300004

• Using time-resolved monitor wearing data to study the effect of clean cooking interventions on personal air pollution exposures. Journal of exposure science & environmental epidemiology Gould, C. F., Mujtaba, M. N., Yang, Q., Boamah-Kaali, E., Quinn, A. K., Manu, G., Lee, A. G., Ae-Ngibise, K. A., Carrion, D., Kaali, S., Kinney, P. L., Jack, D. W., Chillrud, S. N., Asante, K. P. 2022

  Abstract

  BACKGROUND: Personal monitoring can estimate individuals' exposures to environmental pollutants; however, accuracy depends on consistent monitor wearing, which is under evaluated.OBJECTIVE: To study the association between device wearing and personal air pollution exposure.METHODS: Using personal device accelerometry data collected in the context of a randomized cooking intervention in Ghana with three study arms (control, improved biomass, and liquified petroleum gas (LPG) arms; N=1414), we account for device wearing to infer parameters of PM2.5 and CO exposure.RESULTS: Device wearing was positively associated with exposure in the control and improved biomass arms, but weakly in the LPG arm. Inferred community-level air pollution was similar across study arms (~45mug/m3). The estimated direct contribution of individuals' cooking to PM2.5 exposure was 64mug/m3 for the control arm, 74mug/m3 for improved biomass, and 6mug/m3 for LPG. Arm-specific average PM2.5 exposure at near-maximum wearing was significantly lower in the LPG arm as compared to the improved biomass and control arms. Analysis of personal CO exposure mirrored PM2.5 results.CONCLUSIONS: Personal monitor wearing was positively associated with average air pollution exposure, emphasizing the importance of high device wearing during monitoring periods and directly assessing device wearing for each deployment.SIGNIFICANCE: We demonstrate that personal monitor wearing data can be used to refine exposure estimates and infer unobserved parameters related to the timing and source of environmental exposures.IMPACT STATEMENTS: In a cookstove trial among pregnant women, time-resolved personal air pollution device wearing data were used to refine exposure estimates and infer unobserved exposure parameters, including community-level air pollution, the direct contribution of cooking to personal exposure, and the effect of clean cooking interventions on personal exposure. For example, in the control arm, while average 48 h personal PM2.5 exposure was 77 mug/m3, average predicted exposure at near-maximum daytime device wearing was 108 mug/m3 and 48 mug/m3 at zero daytime device wearing. Wearing-corrected average 48 h personal PM2.5 exposures were 50% lower in the LPG arm than the control and improved biomass and inferred direct cooking contributions to personal PM2.5 from LPG were 90% lower than the other arms. Our recommendation is that studies assessing personal exposures should examine the direct association between device wearing and estimated mean personal exposure.

  View details for DOI 10.1038/s41370-022-00483-0

  View details for PubMedID 36274187

• Daily Local-Level Estimates of Ambient Wildfire Smoke PM2.5 for the Contiguous US. Environmental science & technology Childs, M. L., Li, J., Wen, J., Heft-Neal, S., Driscoll, A., Wang, S., Gould, C. F., Qiu, M., Burney, J., Burke, M. 2022

  Abstract

  Smoke from wildfires is a growing health risk across the US. Understanding the spatial and temporal patterns of such exposure and its population health impacts requires separating smoke-driven pollutants from non-smoke pollutants and a long time series to quantify patterns and measure health impacts. We develop a parsimonious and accurate machine learning model of daily wildfire-driven PM2.5 concentrations using a combination of ground, satellite, and reanalysis data sources that are easy to update. We apply our model across the contiguous US from 2006 to 2020, generating daily estimates of smoke PM2.5 over a 10 km-by-10 km grid and use these data to characterize levels and trends in smoke PM2.5. Smoke contributions to daily PM2.5 concentrations have increased by up to 5 mug/m3 in the Western US over the last decade, reversing decades of policy-driven improvements in overall air quality, with concentrations growing fastest for higher income populations and predominantly Hispanic populations. The number of people in locations with at least 1 day of smoke PM2.5 above 100 mug/m3 per year has increased 27-fold over the last decade, including nearly 25 million people in 2020 alone. Our data set can bolster efforts to comprehensively understand the drivers and societal impacts of trends and extremes in wildfire smoke.

  View details for DOI 10.1021/acs.est.2c02934

  View details for PubMedID 36134580

• Exposures and behavioural responses to wildfire smoke. Nature human behaviour Burke, M., Heft-Neal, S., Li, J., Driscoll, A., Baylis, P., Stigler, M., Weill, J. A., Burney, J. A., Wen, J., Childs, M. L., Gould, C. F. 2022

  Abstract

  Pollution from wildfires constitutes a growing source of poor air quality globally. To protect health, governments largely rely on citizens to limit their own wildfire smoke exposures, but the effectiveness of this strategy is hard to observe. Using data from private pollution sensors, cell phones, social media posts and internet search activity, we find that during large wildfire smoke events, individuals in wealthy locations increasingly search for information about air quality and health protection, stay at home more and are unhappier. Residents of lower-income neighbourhoods exhibit similar patterns in searches for air quality information but not for health protection, spend less time at home and have more muted sentiment responses. During smoke events, indoor particulate matter (PM2.5) concentrations often remain 3-4* above health-based guidelines and vary by 20* between neighbouring households. Our results suggest that policy reliance on self-protection to mitigate smoke health risks will have modest and unequal benefits.

  View details for DOI 10.1038/s41562-022-01396-6

  View details for PubMedID 35798884

• Evidence of multidimensional gender inequality in energy services from a large-scale household survey in India NATURE ENERGY Zhang, A., Patnaik, S., Jha, S., Agrawal, S., Gould, C. F., Urpelainen, J. 2022

  View details for DOI 10.1038/s41560-022-01044-3

  View details for Web of Science ID 000811990400001

• Poor early childhood growth is associated with impaired lung function: Evidence from a Ghanaian pregnancy cohort. Pediatric pulmonology Kaali, S., Jack, D. W., Prah, R. K., Chillrud, S. N., Mujtaba, M. N., Kinney, P. L., Tawiah, T., Yang, Q., Oppong, F. B., Gould, C. F., Osei, M., Wylie, B. J., Agyei, O., Perzanowski, M. S., Asante, K., Lee, A. G. 2022

  Abstract

  OBJECTIVES: Nearly 40% of African children under five are stunted. We leveraged the Ghana Randomized Air Pollution and Health Study (GRAPHS) cohort to examine whether poorer growth was associated with worse childhood lung function.STUDY DESIGN: GRAPHS measured infant weight and length at birth and three, six, nine and twelve months and four years of age. At age four years, n=567 children performed impulse oscillometry (IOS). We employed multivariable linear regression to estimate associations between birth and age anthropometry and lung function. Next, we employed Latent Class Growth Analysis (LCGA) to generate growth trajectories through age four years. We employed linear regression to examine associations between growth trajectory assignment and lung function.RESULTS: Birth weight and age four weight-for-age and height-for-age z-scores were inversely associated with airway resistance [for example, R5 , or total airway resistance: birth weight beta = -0.90cmH2O/L/s, 95% CI -1.64, -0.16 per 1-kilogram increase; and R20 , or large airway resistance: age four height-for-age beta = -0.40 cmH2O/L/s, 95% CI -0.57, -0.22 per 1-unit z-score increase]. Impaired growth trajectories identified through LCGA were associated with higher airway resistance. For example, children assigned to a persistently stunted trajectory had higher R5 ( beta =2.71 cmH20/L/s, 95% CI 1.07, 4.34) and R20 ( beta =1.43 cmH20/L/s, 95% CI 0.51, 2.36) as compared to normal.CONCLUSIONS: Children with poorer anthropometrics through to age 4 years had higher airway resistance in early childhood. These findings have implications for lifelong lung health, including pneumonia risk in childhood and reduced maximally attainable lung function in adulthood. This article is protected by copyright. All rights reserved.

  View details for DOI 10.1002/ppul.26015

  View details for PubMedID 35614550

• Environmental Factors Influencing COVID-19 Incidence and Severity. Annual review of public health Weaver, A. K., Head, J. R., Gould, C. F., Carlton, E. J., Remais, J. V. 2022

  Abstract

  Emerging evidence supports a link between environmental factors-including air pollution and chemical exposures, climate, and the built environment-and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and coronavirus disease 2019 (COVID-19) susceptibility and severity. Climate, air pollution, and the built environment have long been recognized to influence viral respiratory infections, and studies have established similar associations with COVID-19 outcomes. More limited evidence links chemical exposures to COVID-19. Environmental factors were found to influence COVID-19 through four major interlinking mechanisms: increased risk of preexisting conditions associated with disease severity; immune system impairment; viral survival and transport; and behaviors that increase viral exposure. Both data and methodologic issues complicate the investigation of these relationships, including reliance on coarse COVID-19 surveillance data; gaps in mechanistic studies; and the predominance of ecological designs. We evaluate the strength of evidence for environment-COVID-19 relationships and discuss environmental actions that might simultaneously address the COVID-19 pandemic, environmental determinants of health, and health disparities. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

  View details for DOI 10.1146/annurev-publhealth-052120-101420

  View details for PubMedID 34982587

• Prenatal and Postnatal Household Air Pollution Exposure and Infant Growth Trajectories: Evidence from a Rural Ghanaian Pregnancy Cohort. Environmental health perspectives Boamah-Kaali, E., Jack, D. W., Ae-Ngibise, K. A., Quinn, A., Kaali, S., Dubowski, K., Oppong, F. B., Wylie, B. J., Mujtaba, M. N., Gould, C. F., Gyaase, S., Chillrud, S., Owusu-Agyei, S., Kinney, P. L., Asante, K. P., Lee, A. G. 2021; 129 (11): 117009

  Abstract

  BACKGROUND: The exposure-response association between prenatal and postnatal household air pollution (HAP) and infant growth trajectories is unknown.OBJECTIVES: To evaluate associations between prenatal and postnatal HAP exposure and stove interventions on growth trajectories over the first year of life.METHODS: The Ghana Randomized Air Pollution and Health Study enrolled n=1,414 pregnant women at ≤24wk gestation from Kintampo, Ghana, and randomized them to liquefied petroleum gas (LPG), improved biomass, or open fire (control) stoves. We quantified HAP exposure by repeated, personal prenatal and postnatal carbon monoxide (CO) and, in a subset, fine particulate matter [PM with an aerodynamic diameter of ≤2.5mum (PM2.5)] assessments. Length, weight, mid-upper arm circumference (MUAC) and head circumference (HC) were measured at birth, 3, 6, 9, and 12 months; weight-for-age, length-for-age (LAZ), and weight-for-length z (WLZ)-scores were calculated. For each anthropometric measure, we employed latent class growth analysis to generate growth trajectories over the first year of life and assigned each child to a trajectory group. We then employed ordinal logistic regression to determine associations between HAP exposures and growth trajectory assignments. Associations with stove intervention arm were also considered.RESULTS: Of the 1,306 live births, 1,144 had valid CO data and anthropometric variables measured at least once. Prenatal HAP exposure increased risk for lower length [CO odds ratio(OR)= 1.17, 95% CI: 1.01, 1.35 per 1-ppm increase; PM2.5 OR= 1.07, 95% CI: 1.02, 1.13 per10-mug/m3 increase], lower LAZ z-score (CO OR= 1.15, 95% CI: 1.01, 1.32 per 1-ppm increase) and stunting (CO OR= 1.25, 95% CI: 1.08, 1.45) trajectories. Postnatal HAP exposure increased risk for smaller HC (CO OR= 1.09, 95% CI: 1.04, 1.13 per 1-ppm increase), smaller MUAC and lower WLZ-score (PM2.5 OR= 1.07, 95% CI: 1.00, 1.14 and OR= 1.09, 95% CI: 1.01, 1.19 per10-mug/m3 increase, respectively) trajectories. Infants in the LPG arm had decreased odds of having smaller HC and MUAC trajectories as compared with those in the open fire stove arm (OR= 0.58, 95% CI: 0.37, 0.92 and OR= 0.45, 95% CI: 0.22, 0.90, respectively).DISCUSSION: Higher early life HAP exposure (during pregnancy and through the first year of life) was associated with poorer infant growth trajectories among children in rural Ghana. A cleaner-burning stove intervention may have improved some growth trajectories. https://doi.org/10.1289/EHP8109.

  View details for DOI 10.1289/EHP8109

  View details for PubMedID 34842444

• Prenatal household air pollutant exposure is associated with reduced size and gestational age at birth among a cohort of Ghanaian infants ENVIRONMENT INTERNATIONAL Quinn, A. K., Adjei, I., Ae-Ngibise, K., Agyei, O., Boamah-Kaali, E., Burkart, K., Carrion, D., Chillrud, S. N., Gould, C. F., Gyaase, S., Jack, D. W., Kaali, S., Kinney, P. L., Lee, A. G., Mujtaba, M., Oppong, F., Owusu-Agyei, S., Yawson, A., Wylie, B. J., Asante, K. 2021; 155: 106659

  Abstract

  Low birth weight and prematurity are important risk factors for death and disability, and may be affected by prenatal exposure to household air pollution (HAP).We investigate associations between maternal exposure to carbon monoxide (CO) during pregnancy and birth outcomes (birth weight, birth length, head circumference, gestational age, low birth weight, small for gestational age, and preterm birth) among 1288 live-born infants in the Ghana Randomized Air Pollution and Health Study (GRAPHS). We evaluate whether evidence of malaria during pregnancy, as determined by placental histopathology, modifies these associations.We observed effects of CO on birth weight, birth length, and gestational age that were modified by placental malarial status. Among infants from pregnancies without evidence of placental malaria, each 1 ppm increase in CO was associated with reduced birth weight (-53.4 g [95% CI: -84.8, -21.9 g]), birth length (-0.3 cm [-0.6, -0.1 cm]), gestational age (-1.0 days [-1.8, -0.2 days]), and weight-for-age Z score (-0.08 standard deviations [-0.16, -0.01 standard deviations]). These associations were not observed in pregnancies with evidence of placental malaria. Each 1 ppm increase in maternal exposure to CO was associated with elevated odds of low birth weight (LBW, OR 1.14 [0.97, 1.33]) and small for gestational age (SGA, OR 1.14 [0.98, 1.32]) among all infants.Even modest reductions in exposure to HAP among pregnant women could yield substantial public health benefits, underscoring a need for interventions to effectively reduce exposure. Adverse associations with HAP were discernible only among those without evidence of placental malaria, a key driver of impaired fetal growth in this malaria-endemic area.

  View details for DOI 10.1016/j.envint.2021.106659

  View details for Web of Science ID 000679253400001

  View details for PubMedID 34134048

• A cluster randomised trial of cookstove interventions to improve infant health in Ghana. BMJ global health Jack, D. W., Ae-Ngibise, K. A., Gould, C. F., Boamah-Kaali, E., Lee, A. G., Mujtaba, M. N., Chillrud, S., Kaali, S., Quinn, A. K., Gyaase, S., Oppong, F. B., Carrion, D., Agyei, O., Burkhart, K., Ana-Aro, J. A., Liu, X., Berko, Y. A., Wylie, B. J., Etego, S. A., Whyatt, R., Owusu-Agyei, S., Kinney, P., Asante, K. P. 2021; 6 (8)

  Abstract

  INTRODUCTION: Household air pollution from solid fuel combustion for cooking and heating is a leading cause of childhood morbidity and mortality worldwide. We hypothesised that clean cooking interventions delivered during pregnancy would improve child health.METHODS: We conducted a cluster randomised trial in rural Ghana to test whether providing pregnant women liquefied petroleum gas (LPG) cookstoves or improved biomass cookstoves would reduce personal carbon monoxide and fine particulate pollution exposure, increase birth weight and reduce physician-assessed severe pneumonia in the first 12 months of life, compared with control participants who continued to cook with traditional stoves. Primary analyses were intention-to-treat. The trial was registered with ClinicalTrials.gov and follow-up is complete.RESULTS: Enrolment began on 14 April 2014, and ended on 20 August 2015. We enrolled 1414 pregnant women; 361 in the LPG arm, 527 in the improved biomass cookstove arm and 526 controls. We saw no improvement in birth weight (the difference in mean birth weight for LPG arm births was 29 g lighter (95% CI -113 to 56, p=0.51) and for improved biomass arm births was 9 g heavier (95% CI -64 to 82, p=0.81), compared with control newborns) nor severe child pneumonia (the rate ratio for pneumonia in the LPG arm was 0.98 (95% CI 0.58 to 1.70; p=0.95) and for the improved biomass arm was 1.21 (95% CI 0.78 to 1.90; p=0.52), compared with the control arm). Air pollution exposures in the LPG arm remained above WHO health-based targets (LPG median particulate matter less than 2.5 microns in diameter (PM2.5) 45 g/m; IQR 32-65 vs control median PM2.5 67 g/m, IQR 46-97).CONCLUSIONS: Neither prenatally-introduced LPG nor improved biomass cookstoves improved birth weight or reduced severe pneumonia risk in the first 12 months of life. We hypothesise that this is due to lower-than-expected exposure reductions in the intervention arms.TRIAL REGISTRATION NUMBER: NCT01335490.

  View details for DOI 10.1136/bmjgh-2021-005599

  View details for PubMedID 34452940

• Firewood, forests, and fringe populations: Exploring the inequitable socioeconomic dimensions of Liquified Petroleum Gas (LPG) adoption in India ENERGY RESEARCH & SOCIAL SCIENCE Khanwilkar, S., Gould, C. F., DeFries, R., Habib, B., Urpelainen, J. 2021; 75

  Abstract

  Liquified petroleum gas (LPG) is an important clean fuel alternative for households that rely on burning biomass for daily cooking needs. In India, Pradhan Mantri Ujjwala Yojana (PMUY) has provided poor households with LPG connections since 2016. We investigate cooking fuel use in households to determine the impact of the policy in the Central Indian Highlands Landscape (CIHL). The CIHL has a large population of marginalized social groups, including Indigenous, Scheduled Tribe, Schedule Caste, and Other Backward Caste people. We utilize survey data from 4,994 households within 500 villages living in forested regions collected in 2018 and a satellite-derived measure of forest availability to investigate the household and ecological determinants of LPG adoption and the timing of this adoption (pre- or post-2016). In addition, we document patterns of firewood collection and evaluate the extent to which households acquiring LPG change these activities. The probability of cooking with LPG was lowest for marginalized social groups. We observe that households recently adopting LPG, likely through PMUY, are poorer, more socially marginalized, less educated, and have more forest available nearby than their early-adopter counterparts. While 90% of LPG-using households continue to use firewood, households that have owned LPG for more years report spending less time collecting firewood, indicating a waning reliance on firewood over time. Policies targeting communities with marginalized social groups living near forests can further accelerate LPG adoption and displace firewood use. Despite overall growth in LPG use, disparities in access to clean cooking fuels remain between socioeconomic groups in India.

  View details for DOI 10.1016/j.erss.2021.102012

  View details for Web of Science ID 000647782500012

  View details for PubMedID 33959474

  View details for PubMedCentralID PMC8095680

• The effect of clean cooking interventions on mother and child personal exposure to air pollution: results from the Ghana Randomized Air Pollution and Health Study (GRAPHS) JOURNAL OF EXPOSURE SCIENCE AND ENVIRONMENTAL EPIDEMIOLOGY Chillrud, S. N., Ae-Ngibise, K., Gould, C. F., Owusu-Agyei, S., Mujtaba, M., Manu, G., Burkart, K., Kinney, P. L., Quinn, A., Jack, D. W., Asante, K. 2021; 31 (4): 683-698

  Abstract

  Clean cooking interventions to reduce air pollution exposure from burning biomass for daily cooking and heating needs have the potential to reduce a large burden of disease globally.The objective of this study is to evaluate the air pollution exposure impacts of a fan-assisted efficient biomass-burning cookstove and a liquefied petroleum gas (LPG) stove intervention in rural Ghana.We randomized 1414 households in rural Ghana with pregnant mothers into a control arm (N = 526) or one of two clean cooking intervention arms: a fan-assisted efficient biomass-burning cookstove (N = 527) or an LPG stove and cylinder refills as needed (N = 361). We monitored personal maternal carbon monoxide (CO) at baseline and six times after intervention and fine particulate matter (PM2.5) exposure twice after intervention. Children received three CO exposure monitoring sessions.We obtained 5655 48-h maternal CO exposure estimates and 1903 for children, as well as 1379 maternal PM2.5 exposure estimates. Median baseline CO exposures in the control, improved biomass, and LPG arms were 1.17, 1.17, and 1.30 ppm, respectively. Based on a differences-in-differences approach, the LPG arm showed a 47% reduction (95% confidence interval: 34-57%) in mean 48-h CO exposure compared to the control arm. Mean maternal PM2.5 exposure in the LPG arm was 32% lower than the control arm during the post-intervention period (52 ± 29 vs. 77 ± 44 μg/m3). The biomass stove did not meaningfully reduce CO or PM2.5 exposure.We show that LPG interventions lowered air pollution exposure significantly compared to three-stone fires. However, post-intervention exposures still exceeded health-relevant targets.In a large controlled trial of cleaner cooking interventions, an LPG stove and fuel intervention reduced air pollution exposure in a vulnerable population in a low-resource setting.

  View details for DOI 10.1038/s41370-021-00309-5

  View details for Web of Science ID 000624370600001

  View details for PubMedID 33654272

  View details for PubMedCentralID PMC8273075

• Jointly modeling the adoption and use of clean cooking fuels in rural India ENVIRONMENTAL RESEARCH COMMUNICATIONS Gould, C. F., Hou, X., Richmond, J., Sharma, A., Urpelainen, J. 2020; 2 (8)

  View details for DOI 10.1088/2515-7620/abaca9

  View details for Web of Science ID 000566454700001

• Sustained LPG use requires progress on broader development outcomes NATURE ENERGY Mani, S., Jain, A., Tripathi, S., Gould, C. F. 2020; 5 (6): 430-431

  View details for DOI 10.1038/s41560-020-0635-4

  View details for Web of Science ID 000538229900001

• Long-standing LPG subsidies, cooking fuel stacking, and personal exposure to air pollution in rural and peri-urban Ecuador JOURNAL OF EXPOSURE SCIENCE AND ENVIRONMENTAL EPIDEMIOLOGY Gould, C. F., Schlesinger, S. B., Molina, E., Bejarano, M., Valarezo, A., Jack, D. W. 2020; 30 (4): 707-720

  Abstract

  Ecuador presents a unique case study for evaluating personal air pollution exposure in a middle-income country where a clean cooking fuel has been available at low cost for several decades. We measured personal PM2.5 exposure, stove use, and participant location during a 48-h monitoring period for 157 rural and peri-urban households in coastal and Andean Ecuador. While nearly all households owned a liquefied petroleum gas (LPG) stove and used it as their primary cooking fuel, one-quarter of households utilized firewood as a secondary fuel and 10% used induction stoves secondary to LPG. Stove use monitoring demonstrated clear within- and across-meal fuel stacking patterns. Firewood-owning participants had higher distributions of 48-h and 10-min PM2.5 exposure as compared with primary LPG and induction stove users, and this effect became more pronounced with firewood use during monitoring.Accounting for within-subject clustering, contemporaneous firewood stove use was associated with 101 μg/m3 higher 10-min PM2.5 exposure (95% CI: 94-108 μg/m3). LPG and induction cooking events were largely not associated with contemporaneous PM2.5 exposure. Our results suggest that firewood use is associated with average and short-term personal air pollution exposure above the WHO interim-I guideline, even when LPG is the primary cooking fuel.

  View details for DOI 10.1038/s41370-020-0231-5

  View details for Web of Science ID 000533035400002

  View details for PubMedID 32415299

  View details for PubMedCentralID PMC7316622

• The drivers of sustained use of liquified petroleum gas in India NATURE ENERGY Mani, S., Jain, A., Tripathi, S., Gould, C. F. 2020; 5 (6): 450-457

  Abstract

  Ninety-five per cent of Indian households now have access to liquified petroleum gas (LPG), with 80 million acquiring it under the Pradhan Mantri Ujjwala Yojana (PMUY) since 2016. Still, having a connection is not enough to eliminate household air pollution. Studying panel data from rural households in six major states from 2014-2015 and 2018, we assess the determinants of cooking energy transition from solid fuels to LPG. We find that PMUY beneficiaries have much lower odds of using LPG as the primary or exclusive fuel compared with general customers, irrespective of their economic status. Village-level penetration of LPG as a primary fuel and the years of LPG use positively influence its sustained use, while ease of access to freely available biomass and reliance on uncertain and irregular income sources hinder LPG use. The findings highlight the need to interlace cooking fuel policies with rural development, to enable a complete transition towards cleaner cooking fuels.

  View details for DOI 10.1038/s41560-020-0596-7

  View details for Web of Science ID 000529011400001

  View details for PubMedID 32719732

  View details for PubMedCentralID PMC7384753

• The role of education and attitudes in cooking fuel choice: Evidence from two states in India ENERGY FOR SUSTAINABLE DEVELOPMENT Gould, C. F., Urpelainen, J., Sais, J. 2020; 54: 36-50

  Abstract

  Widespread adoption of clean cooking fuels is a necessary step toward reducing household air pollution and improving population health. Here we use large-scale surveys (10,000 households) from two Indian states, Kerala and Rajasthan, to examine how education and attitudes toward cooking associate with the adoption of liquefied petroleum gas (LPG), India's most popular clean cooking fuel. We report three main results. First, education is a strong predictor of LPG adoption. Second, perceptions that LPG is good and affordable and progressive health-related perceptions are associated with LPG ownership. Third, and surprisingly, education does not predict positive attitudes toward clean cooking fuels. These results suggest that education leads to LPG adoption, but not through attitudinal changes. Further research should examine the mediators of the observed robust education-adoption association.

  View details for DOI 10.1016/j.esd.2019.09.003

  View details for Web of Science ID 000507929900004

  View details for PubMedID 32669760

  View details for PubMedCentralID PMC7363404

• Household fuel mixes in peri-urban and rural Ecuador: Explaining the context of LPG, patterns of continued firewood use, and the challenges of induction cooking ENERGY POLICY Gould, C. F., Schlesinger, S. B., Molina, E., Lorena Bejarano, M., Valarezo, A., Jack, D. W. 2020; 136

  Abstract

  Nationwide transitions from cooking with solid fuels to clean fuels promise substantial health, climate, and environmental benefits. For decades, Ecuador has invested heavily in consumption subsidies for liquified petroleum gas (LPG), a leading clean fuel. With the goal of understanding household energy use in a context where LPG is ubiquitous and cheap, we administered 808 household surveys in peri-urban and rural communities in Coastal and Andean Ecuadorian provinces. We assess cooking fuel patterns after long-term LPG access and the reach of induction stoves promoted through a recent government program. Nearly all participants reported using LPG for more than a decade and frequent, convenient access to highly subsidized LPG. Nonetheless, half of rural households and 20% of peri-urban households rely on firewood to meet specific household energy needs, like space heating or heating water for bathing. Induction was rare and many induction owners reported zero use because the required equipment had never been installed by electricity companies, their stove had broken, or due to fears of high electricity costs. Our discussion is instructive for other countries because of Ecuador's long-standing clean fuel policies, robust LPG market and standardized cylinder recirculation model, and promotion of induction stoves.

  View details for DOI 10.1016/j.enpol.2019.111053

  View details for Web of Science ID 000505104100020

  View details for PubMedID 32675905

  View details for PubMedCentralID PMC7365656

• The Gendered Nature of Liquefied Petroleum Gas Stove Adoption and Use in Rural India JOURNAL OF DEVELOPMENT STUDIES Gould, C. F., Urpelainen, J. 2019: 1309-1329

  Abstract

  Clean cooking fuels promise substantial health benefits for rural households, but almost three billion people continue to rely on traditional biomass for their cooking needs. We explore the role of gender in the adoption of LPG, a clean cooking fuel, in rural India. Given that women are responsible for most households' cooking needs, we propose that gender inequality is an obstacle to LPG adoption because men may fail to appreciate the full benefits of clean cooking fuels. Using data for 8,563 households from the ACCESS survey, we demonstrate that households where women participant in decison-making are more likely to adopt LPG for cooking than households in which a man is the sole decision-maker. We extend our analytic framework to evaluate the relationship between household characteristics and LPG and firewood use. Access and cylinder costs were both negatively associated with LPG use and while LPG adoption reduced firewood use, fuel stacking remains the norm in study households. This study has implications for future policy designs to increase LPG adoption and use to obtain the multiple benefits of cleaner cooking.

  View details for DOI 10.1080/00220388.2019.1657571

  View details for Web of Science ID 000486182700001

  View details for PubMedID 32508360

  View details for PubMedCentralID PMC7274193

• LPG as a clean cooking fuel: Adoption, use, and impact in rural India ENERGY POLICY Gould, C. F., Urpelainen, J. 2018; 122: 395-408

  Abstract

  Liquefied petroleum gas (LPG) is by far the most popular clean cooking fuel in rural India, but how rural households use it remains poorly understood. Using the 2014-2015 ACCESS survey with over 8,500 households from six energy-poor Indian states, we offer a broad but detailed survey of LPG use in rural India. We find that (i) fuel costs are a critical obstacle to widespread adoption, (ii) fuel stacking is the prevailing norm as few households stop using firewood when adopting LPG, and (iii) both users and non-users have highly positive views of LPG as a convenient and clean cooking fuel. These findings show that expanding LPG use offers great promise in rural India, but affordability prevents a complete transition from traditional biomass to clean cooking fuels.

  View details for DOI 10.1016/j.enpol.2018.07.042

  View details for Web of Science ID 000447576700037

  View details for PubMedID 32581420

  View details for PubMedCentralID PMC7314235

• Government policy, clean fuel access, and persistent fuel stacking in Ecuador ENERGY FOR SUSTAINABLE DEVELOPMENT Gould, C. F., Schlesinger, S., Toasa, A., Thurber, M., Waters, W. F., Graham, J. P., Jack, D. W. 2018; 46: 111-122

  Abstract

  After more than three decades of access to low-cost liquefied petroleum gas (LPG) financed by large direct government subsidies, more than 90% of Ecuadorian households cook primarily with LPG. Due to the large fiscal burden of the LPG subsidy, increases in electricity from hydropower, and other sociopolitical factors, the Government of Ecuador launched a major induction stove program (PEC) to reduce the demand for LPG. We assess the effects of the LPG subsidies and PEC using government records, interviews, academic literature, newspaper reports, household surveys, and focus groups. Household surveys, conducted in rural, northern Ecuadorian households (n=383), characterized cooking patterns and fuel access. Focus groups (n=6) were carried out with a subset of surveyed households to better characterize survey findings. The LPG subsidy was developed as part of broad social support reforms in the early 1970s, without specific aims to reduce the health impacts of household air pollution from woodfuel or provide economic benefits as part of the transition to a clean cooking fuel. Nonetheless, the subsidy has resulted in nearly all Ecuadorian households cooking primarily with LPG. PEC has generated the sale of 740,000 induction stoves since its inception in 2014, short of the goal of 3.5 million. Among the rural households surveyed, LPG use, acceptance, and satisfaction was high, however, more than three-quarters of those surveyed reported weekly woodfuel use. Induction stove ownership (17%) and use as a primary cooking fuel (1%) was low among the rural households surveyed; furthermore, households owning induction stoves reported very low satisfaction with the stoves. Here we show that nationally-representative surveys reporting only "primary cooking fuef" use may underestimate solid fuel use as a supplemental household cooking energy, particularly in rural areas where fuel availability issues play a stronger role in decisions about what fuels to use.

  View details for DOI 10.1016/j.esd.2018.05.009

  View details for Web of Science ID 000440968400012

  View details for PubMedID 30294142

  View details for PubMedCentralID PMC6173323

• Prevalent degradation and patterns of use, maintenance, repair, and access to post-acquisition services for biomass stoves in Peru ENERGY FOR SUSTAINABLE DEVELOPMENT Gould, C. F., Jagoe, K., Isabel Moreno, A., Verastegui, A., Pilco, V., Garcia, J., Fort, A., Johnson, M. 2018; 45: 79-87

  View details for DOI 10.1016/j.esd.2018.05.004

  View details for Web of Science ID 000442691200007

• Soot and the city: Evaluating the impacts of Clean Heat policies on indoor/outdoor air quality in New York City apartments PLOS ONE Gould, C. F., Chillrud, S. N., Phillips, D., Perzanowski, M. S., Hernandez, D. 2018; 13 (6): e0199783

  Abstract

  New York City has had a long history of implementing local policies to reduce air pollution. Enacted as a part of PlaNYC, the Clean Heat policies aim to lower wintertime ambient air pollution by phasing out dirty No. 6 heating fuel oil and transitioning to comparatively cleaner No. 4, No. 2, or natural gas. This study evaluates the impacts of policies on ambient air pollution and, given that people spend the majority of their time inside, importantly, indoor air pollution. Using a natural experiment, we evaluate the effects of the policies by measuring average two-week levels of indoor and outdoor black carbon (BC) and fine particulate matter (PM2.5) in 48 upper Manhattan apartments in successive winter heating seasons before and after mandated fuel transition. We failed to observe systematic improvements in indoor BC and PM2.5 concentrations in follow-up. However, outdoor levels of PM2.5 did improve, with statistical differences observed among buildings converting to the cleanest fuels. Non-statistical improvements were observed for outdoor BC. However, when accounting for meteorological differences, apartment characteristics, and behavioral patterns that may have influenced air pollution measurements, these differences were not significant. The study results have important policy and equity implications considering the differential improvements in air quality by conversion to No. 4 oil as compared to the cleaner No. 2 oil and natural gas.

  View details for DOI 10.1371/journal.pone.0199783

  View details for Web of Science ID 000436645400067

  View details for PubMedID 29953529

  View details for PubMedCentralID PMC6023219

• Association of exercise-induced wheeze and other asthma symptoms with emergency department visits and hospitalizations in a large cohort of urban adolescents RESPIRATORY MEDICINE Gould, C. F., Perzanowski, M. S., Evans, D., Bruzzese, J. 2018; 135: 42-50

  Abstract

  Exercise-induced wheeze (EIW) has been found to be associated with asthma-related urgent care in school-aged children. Despite asthma's high prevalence and morbidity among adolescents, this association has not been examined in adolescents. We tested the association of EIW and other asthma symptoms to asthma-related ED visits and hospitalizations in urban adolescents with probable asthma. We hypothesized that EIW would be associated with urgent care.In this cross-sectional study 30,467 high school students (mean age = 16.0) from 49 NYC schools completed two brief validated measures, one assessing probable asthma and the other the frequency of six asthma symptoms over the past year. Adolescents also reported if in the past year they had an asthma-related ED visit or hospitalization. Analyses presented here included students with probable asthma (n = 9149). Using logistic regression, we modeled each asthma symptom as a function of ED visits and hospitalizations adjusting for sex, age, race/ethnicity and asthma severity. Multivariable models included all symptoms to account for the potential interaction between symptoms.Among adolescents with probable asthma, EIW was associated with ED visits and hospitalizations. In multivariable models wheeze without a cold, chest tightness, night wakening, but not EIW, were significantly associated with both ED visits and hospitalizations.Unlike findings with younger children, EIW does not appear to be associated with ED visits and hospitalizations among urban adolescents with probable asthma. Instead, symptoms, such as chest tightness and night wakening, appear to be important at identifying adolescents at risk for asthma-related urgent care.

  View details for DOI 10.1016/j.rmed.2018.01.005

  View details for Web of Science ID 000425287400008

  View details for PubMedID 29414452

  View details for PubMedCentralID PMC5806151