Environmental Health and Traditional Fuel Use in Guatemala

Acknowledgments viii Abbreviations and Acronyms x Units of Measure xii Executive Summary xiii 1. Introduction 1 2. Indoor Air Pollution and Health: Evidence from the Demographic and Health Survey and the Living Standards Measurement Study 11 3. Estimating Health Impacts 28 4. The Evolution of Improved Stoves in Guatemala: Lessons from Three Programs 49 5. The Role of LPG 81 6. Policy Recommendations 93 Bibliography 104 Index 110 Tables 1.1 Five Principal Causes of General Morbidity and Five Principal Causes of Mortality in Guatemala, 1997–2000 3 1.2 Comparison of Indoor Pollution Levels from Open Fire, Plancha, and LPG Stove in the Guatemalan Highlands 6 2.1 Sample Distribution: Guatemala 1998–1999 DHS 13 2.2 Sample Distribution: Guatemala 2000 LSMS 15 v 2.3 Guatemalan Households with Electricity 17 2.4 Distribution of Main or Single Fuels Used for Cooking in Guatemala from 1998–1999 DHS 18 2.5 Summary of All Fuels Used for Cooking by Guatemalan Households 20 2.6 Combination of Fuels and Kitchen Facilities in Guatemalan Homes 22 2.7 Respiratory Symptoms in Children by Fuel and Cooking Space from 1998–1999 DHS 24 2.8 Respiratory Symptoms in Children by Fuel and Cooking Space from 2000 LSMS 25 3.1 Percentage of Rural Households Using Fuelwood, Conditional on House Characteristics 31 3.2 Personal and Daily Average Kitchen Measurements of Particulate Matter in the Guatemalan Highlands 33 3.3 Adjusted Odds Ratios for ARI and ALRI in Children under Age Five Estimated with a Logistic Model 36 3.4 Excess Cases of ALRI Morbidity and Mortality in the Guatemalan Highlands Associated with IAP 38 3.5 Number of Children under Age Five and ALRI Incidence Rates 39 3A.1 Biomass Fuel Use and ALRI in Children under Age Five in Developing Countries 42 4.1 Stages in the Development of Stove Technology 51 4.2 Communities Selected for the Study 56 4.3 Typical Subsidies of Three Programs in Rural Guatemala, 2002 64 4.4 Comparisons of Stove Issues for Six Villages in Three Improved Stove Projects 67 4.5 Problems with Improved Stove Chimneys in Guatemala, 2002 68 4.6 The Benefits of Improved Stoves in Two Programs in Guatemala, 2002 69 4.7 Positive Aspects of the Improved Stoves Project Case Studies 73 4.8 Weaknesses of the Improved Stoves Project Case Studies 75 5.1 Household Fuel Use Patterns for Cooking and Heating 82 5.2 LPG Availability and Uptake by Households 83 5.3 Cylinder Sizes in Guatemala 84 5.4 Retail Cost of LPG Cylinder and Stove 85 5.5 Mean Monthly per Capita and Household Expenditures 85 5.6 Retail Prices of LPG Sold in 25 lb (11.4 kg) Cylinders, April 22–28, 2002 86 vi TABLE OF CONTENTS Figures 1.1 Energy Options, Ranked by Increasing Effectiveness in Mitigating the Health Impacts of IAP 2 4.1 Typical Plancha Stove Promoted by the Social Fund in Guatemala 54 4.2 The Tezulutlلn Stove 59 4.3 Varieties of Intervida-Type Stove 60 4.4 Stoves in Rural Households 62 4.5 Firebox Differences between Stoves 65 5.1 Comparison of LPG Prices (exclusive of taxes) 88 5.2 Price of LPG Sold in 25 lb (11.4 kg) Cylinder in Guatemala City 89