Ensuring future generations have access to antimicrobials is high on the agenda for many heads of state, and almost all Ministers of Health. Following the UN General Assembly's 2016 highlevel meeting on antimicrobial resistance (AMR), an ad hoc Interagency Coordination Group (IACG), co-chaired by the UN Deputy Secretary-General and the Director-General of WHO, was tasked with providing guidance to political leaders on approaches needed to promote sustainable action on AMR. 1
Exposure to indoor air pollution from household energy use depends on fuel, stove, housing characteristics, and stove use behavior. We monitored three important indoor air pollutants-respirable particles (RPM), carbon monoxide (CO), and sulfur dioxide (SO2)-for a total of 457 household-days in four poor provinces in China (Gansu, 129 household-days; Guizhou, 127 household-days; Inner Mongolia, 65 household-days; and Shaanxi, 136 household-days), in two time intervals during the heating season to investigate spatial and temporal patterns of pollution. The two provinces where biomass is the primary fuel (Inner Mongolia and Gansu) had the highest RPM concentrations (719 microg/m3 in the single cooking/living/bedroom in Inner Mongolia in December and 351-661 microg/m3 in different rooms and months in Gansu); lower RPM concentration were observed in the primarily coal-burning provinces of Guizhou and Shaanxi (202-352 microg/m3 and 187-361 microg/m3 in different rooms and months in Guizhou and Shaanxi, respectively). Inner Mongolia and Gansu also had higher CO concentrations (7.4 ppm in the single cooking/living/bedroom in Inner Mongolia in December and 4.8-11.3 ppm in different rooms and months in Gansu). Among the two primarily coal-burning provinces, Guizhou had lower concentrations of CO than Shaanxi (1.2-1.8 ppm in Guizhou vs 2.0-13.3 ppm in different rooms and months in Shaanxi). In the two coal-burning provinces, SO2 concentrations were substantially higher in Shaanxi than in Guizhou. Relative concentrations in different rooms and provinces indicate that in the northern provinces heating is an important source of exposure to indoor pollutants from energy use. Day-to-day variability of concentrations within individual households, although substantial, was smaller than variation across households. The implications of the findings for designing environmental health interventions in each province are discussed.
Enis Baris and colleagues observe that a political commitment to universal health coverage together with a significant investment in health has seen Turkey’s health indicators catch up and surpass other middle income countries
Most previous studies on indoor air pollution from household use of solid fuels have used either indirect proxies for human exposure or measurements of individual pollutants at a single point, as indicators of (exposure to) the mixture of pollutants in solid fuel smoke. A heterogeneous relationship among pollutant-location pairs should be expected because specific fuel-stove technology and combustion and dispersion conditions such as temperature, moisture, and air flow are likely to affect the emissions and dispersion of the various pollutants differently. We report on a study for monitoring multiple pollutants--including respirable particles (RPM), carbon monoxide, sulfur dioxide, fluoride, and arsenic--at four points inside homes that used coal and/or biomass fuels in Guizhou and Shaanxi provinces of China. All pollutants exhibited large variability in emissions and spatial dispersion within and between provinces and were generally poorly correlated. RPM, followed by SO2, was generally higher than common health-based guidelines/standards and provided sufficient resolution for assessing variations within and between households in both provinces. Indoor heating played an important role in the level and spatial patterns of pollution inside homes, possibly to an extent more important than cooking. The findings indicate the need for monitoring of RPM and selected other pollutants in longer-term health studies, with focus on both cooking and living/sleeping areas.
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