1 Exposure reductions associated with introduction of solar lamps to kerosene lamp-using households in Busia County, Kenya. A report prepared by: Nicholas L. Lama Godfrey Muhwezib Fred Isabiryeb Kat Harrisonc,d Ilse Ruiz-Mercadoe Evans Amukoyef Tom Mokayaf Margaret Wambuaf Ian Baileyg Michael N. Batesh Affiliations a. Civil and Environmental Engineering, University of Illinois, Urbana-Champaign, IL, U.S.A. b. CIRCODU, Kampala, Uganda c. SolarAid, London, England d. Acumen, London, England e. Instituto de Investigaciones en Ecosistemas y Sustentabilidad, UNAM, Morelia, Mexico f. Kenya Medical Research Institute (KEMRI), Nairobi, Kenya g. School of Optometry, University of California, Berkeley, CA, U.S.A. h. School of Public Health, University of California, Berkeley, CA, U.S.A. Corresponding author Michael N. Bates, Ph.D., Division of Environmental Health Sciences, 783 University Hall, School of Public Health, University of California, Berkeley, CA 94720, U.S.A. Tel: +1 (510) 504-5424 Email: [email protected] Date of publication: March 17, 2017 2 Table of Contents EXPOSURE REDUCTIONS ASSOCIATED WITH INTRODUCTION OF SOLAR LAMPS TO KEROSENE LAMP-USING HOUSEHOLDS IN BUSIA COUNTY, KENYA. ................................................................. 1 EXECUTIVE SUMMARY ....................................................................................................................................................... 3 INTRODUCTION ........................................................................................................................................................................ 3 METHODS ................................................................................................................................................................................. 3 RESULTS ................................................................................................................................................................................... 4 DISCUSSION .............................................................................................................................................................................. 5 INTRODUCTION AND BACKGROUND ............................................................................................................................ 7 METHODS ............................................................................................................................................................................. 10 ETHICAL APPROVALS ............................................................................................................................................................ 10 STUDY DESIGN ....................................................................................................................................................................... 10 RECRUITMENT OF PARTICIPANTS ....................................................................................................................................... 10 STUDY COMPONENTS ........................................................................................................................................................... 11 Exposure and Health Questionnaires .......................................................................................................................... 11 Exposure Measurements.................................................................................................................................................... 12 Lighting and Cooking Device Usage Monitoring .................................................................................................... 12 Micro-environmental Monitoring ................................................................................................................................. 14 Personal Monitoring............................................................................................................................................................ 15 Visual Acuity and Illuminance ........................................................................................................................................ 16 Statistical analysis of data ............................................................................................................................................... 17 RESULTS ................................................................................................................................................................................ 18 QUESTIONNAIRE DATA. ........................................................................................................................................................ 18 LIGHTING DEVICE USAGE .................................................................................................................................................... 21 Kerosene Lamp Usage......................................................................................................................................................... 21 Solar Lamp Usage ................................................................................................................................................................. 23 Displacement of kerosene lamp usage by solar. ..................................................................................................... 26 MICRO-ENVIRONMENTAL MONITORING ........................................................................................................................... 28 PERSONAL MONITORING ..................................................................................................................................................... 34 DISCUSSION .......................................................................................................................................................................... 39 ACKNOWLEDGEMENTS .................................................................................................................................................... 45 REFERENCES ........................................................................................................................................................................ 46 APPENDICES ........................................................................................................................................................................ 49 APPENDIX 1: SOLAR LAMPS AND VOLTAGE LOGGERS ..................................................................................................... 49 APPENDIX 2: MICRO-ENVIRONMENTAL MEASUREMENTS IN THE KITCHENS AND PUPILS’ ROOMS ......................... 50 APPENDIX 3: DEVELOPMENT OF THE LIGHT TYPE DETECTOR (LTD) ....................................................................... 51 APPENDIX 4: VISUAL ACUITY MEASUREMENT PROTOCOL .............................................................................................. 54 APPENDIX 5: PERSONAL EXPOSURE PROFILE EXAMPLES ............................................................................................... 55 APPENDIX 6: INTEGRATED EXPOSURE-RESPONSE RELATIONSHIPS ............................................................................. 56 3 Executive Summary Introduction This is the report of a small study, carried out in Busia County, Kenya, and intended primarily to quantify changes in exposure to particulate matter (PM) and carbon monoxide (CO) associated with introducing solar lamps into household using kerosene lamps as their primary lighting source. Popularity and sales of solar lighting have been increasingly rapidly in developing countries, particularly in sub-Saharan Africa and South Asia. Whether there are health benefits to families using solar lamps rather than kerosene lamps has not been scientifically investigated. Evidence has been increasing, however, that uses of kerosene lighting and cooking devices in households are associated with serious health effects, particularly involving the lungs, but possibly also the eyes and to unborn babies. Evidence also suggests that these effects are caused by exposure to the pollutants emitted by these devices when they are operated. The level of pollution to which an individual is exposed is often used as an indicator of health risk. Thus, any reduction in exposure resulting from the removal of kerosene sources would provide a first approximation of potential health benefits. The size of exposure changes is also a critical input in the design of any health study intended to directly measure health impacts. Such health-focused studies typically require large sample sizes. This input on exposure changes was what the present study was intended to obtain as well as to confirm the acceptability of the solar lamps as kerosene lamp replacements and to test some questions in a questionnaire and a few other procedures that might be used in such a larger study. This research was commissioned by the London-based international non-government organization (NGO) SolarAid1 and funded by Google Ireland Limited. Methods The study had a paired “before-and-after” design in which data were collected in the households of enrolled participants before and after the introduction of solar lamps (“baseline” and “follow-up”, respectively). Households were provided 3-4 weeks of “adoption” time with the solar lamps before follow-up exposure measurements. As we were particularly interested in the impact for school pupils doing homework in the evening,