Although we cannot see it, air pollution surrounds us and precipitates a seriously high burden of disease across the globe. Air quality surveillance is severely underfunded and often disregarded by policymakers and researchers, especially within developing countries; Dr. Richard Peltier’s work at the University of Massachusetts Amherst aims to change that. He contests that it is up to global environmental health researchers like himself to call attention to health disparities caused by air pollution in under-resourced countries. The scientist believes in incorporating activism into his position as an associate professor of environmental health sciences, stating, “Part of my challenge as a professor at UMass is to make sure that these people do not go unnoticed, and part of it is having to be the squeaky wheel.” Dr. Peltier is passionate about addressing the burden of disease related to air pollution and calling attention to preventative, risk-reducing practices.
In many developing countries, it is common for families of low socioeconomic status (SES) to use inexpensive, accessible biofuels such as coal, straws, wood, and animal dung to cook meals and heat homes. This solid fuel use (SFU) generates dangerous indoor air pollutants (IAP), such as carbon monoxide, that circulate through households. Research suggests that there is a causal link between exposure to harmful toxins and life-threatening conditions including acute respiratory infections (ARI), pulmonary, and cardiovascular diseases, especially among women and children. Published in 2019, Dr. Peltier contributed to a study that assessed the relationship between IAP exposure and ARI risk among a nationally representative sample of ever-married women and children under five years old in Afghanistan. The study authors, including Dr. Juwel Rana and Dr. Youssef Oulhote of UMass, are primarily epidemiologists working to investigate health data and make a causal link between exposure to IAP and ARI among underserved populations. Headed by Dr. Rana, the goal of the study was to interpret air pollution information through the creation of models and provide guidance for future research. The investigators address the lack of literature concerning the relationship between IAP and ARI, particularly regarding SFU in the home, in a developing nation.
Using data gathered from Afghanistan’s 2015 Demographic and Health Survey (AfDHS), the research team measured ARI status and exposure to IAP in a de-identified sample of 27,565 women of reproductive age and 31,063 children of varying SES. The researchers took the location of the house’s kitchen into account when determining IAP severity; if the kitchen was inside, subjects were indicated as having a higher exposure to SFU than those with kitchens outside. The final analysis of the sample accounted for child age and sex, maternal age at birth and education, parental occupation, household wealth quintile, season, region, and maternal smoking and breastfeeding status. These covariates were then compared to the main outcome variables of IAP exposure and ARI status; the results acknowledge the burden of air pollution in Afghanistan and establish a robust argument for environmental health policy change throughout the country.
Out of the total number of under-five children included in the study, the majority were from households that reported SFU (70.2%), while the prevalence of ARI in the two weeks preceding the survey was 17.6%. High IAP exposure was reported in 40.2% of children while moderate exposure was reported in 30% of the sample. A higher prevalence of ARI was observed among children from households with an indoor kitchen (19.1%), exposure to SFU (18.7%), and high exposure to IAP (20.8%) compared to children from households with an outdoor kitchen, no SFU exposure, and moderate to no IAP exposure respectively. After adjusting for confounders, the model showed a significantly higher risk of ARI among children from SFU households compared to those from non-SFU households. When an analysis of IAP exposure was conducted, which took into account of SFU and kitchen location, a higher rate of ARI was found among children who were highly exposed to IAP compared to unexposed children. SES was identified as an effect modifier of IAP exposure and ARI risk with the strongest association occurring among children in the middle wealth quintile.
The results indicate that among under-five children in Afghanistan, children from the middle wealth quintile and children who are highly exposed to IAP bear the greatest burden of ARI in this region. The findings of this study have several implications for policymaking to address ARI risk and IAP exposure among this vulnerable population in developing countries. One of the first steps Dr. Peltier suggests is for governments to acknowledge air pollution as a public health issue. The next step is to focus on interventions that do not necessarily seek to completely eliminate IAP exposure immediately, but rather incrementally reduce the exposure over time. “Science by definition is slow. We’d rather get it right than get it done fast.” While finding a solution to a health issue both quickly and accurately is ideal, most of the time it can prove to be quite difficult. “We have to go at the speed of science and policymakers are also quite slow in how they implement policy changes in communities, and so you have to acknowledge that this is not an overnight success story,” Dr. Peltier emphasized. Some interventions discussed include the electrification of communities that lack electricity and the expansion of programs aimed at increasing access to cleaner fuels. In addition to such efforts, Dr. Peltier highlights the importance of monitoring as a means to track and assess the impact that these changes may have on society. “In doing so, if you find that there's a positive relationship between these interventions and improved health, then perhaps that will accelerate these interventions.”
Today, Dr. Peltier continues to devote his research to supporting air pollution surveillance throughout the world. Most of his investigations focus on gathering air quality data in underserved populations outside of the United States. Through the implementation and evaluation of modern, low-cost sensors, the researcher aims to understand the effects of air pollution in low-income countries such as Ghana and Fiji. He was recently nominated to serve as a member of the Clean Air Scientific Advisory Committee (CASAC) Ozone Review Panel, which advises the U.S. Environmental Protection Agency (EPA) Administrator in the management of the EPA’s National Ambient Air Quality Standards. Dr. Peltier is a crucial player in the enhancement of global air quality standards and remains committed to conducting vital research in understudied nations.
About the Interviewers
Grace Newfield '22MPH recently earned her MPH degree in the Health Policy and Management program. She will be traveling to Europe after graduation and is excited to join the public health workforce in the near future.
Vi Pham '23 recently completed her third year of her undergraduate program at UMass Amherst, pursuing a Bachelor of Science dual degree in Microbiology and Public Health Sciences. She is looking to combine the two disciplines to better understand the infection process of microorganisms and explore ways to address the health burden of infectious disease on a local and global scale.