Study on the health impact from beehive coal stoveusage in households in Hoan Kiem, Ha Noi
Vietnam Journal of Science and Technology 58 (3A) (2020) 222-229
doi:10.15625/2525-2518/58/3A/14354
STUDY ON THE HEALTH IMPACT FROM BEEHIVE COAL
STOVEUSAGE IN HOUSEHOLDS IN HOAN KIEM, HA NOI
Vo Thi Le Ha1, Van Dieu Anh1,*, Bich Thuy Ly1, Nguyen Thi Thu Hien1,
Dang Viet Lam2, Le Thanh Thuy3, Nghiem Trung Dung1
1School of Environmental Science and Technology, Hanoi University of Science and
Technology, 1 Dai Co Viet Rd. Hai Ba Trung Dist. Ha Noi, Viet Nam
2Quality assurance and testing centre 1, Ministry of Science and Technology,
8 Hoang Quoc Viet St. Cau Giay Dist. Ha Noi, Viet Nam
3Hanoi Department of Natural Resource and Environment, 17 Trung Yen 3,
Trung Hoa, Cau Giay Dist., Ha Noi
Received: 25 August 2019; Accepted for publication: 27 April 2020
Abstract. The combustion of biomass and coal significantly contributes to the total health
burden due to the emission of gaseous pollutants and particulate matter. To determine the
personal exposure related to beehive coal stove cooking in Hanoi, an assessment study on 120
females in three wards (Tran Hung Dao, Phuc Tan, and Chuong Duong) of Ha Noi city, Viet
Nam was conducted. Personal and ambient concentrations of PM2.5 and CO (upwind, near-
source, far-source) were simultaneously measured twice a day at each household by PATS++
equipment developed by Berkeley Air Monitoring group. The concentrations of PM2.5 in the
three wards were in the range of 10-186, 12-441, 9-59, 3-271, and 9-260 µg/m3 while those of
CO varied from 100-3,000, 300-260,000, 200-29,000, 300-255,000, and 2,000-36,000 µg/m3, for
upwind, near-source, far-source, indirect exposure, and direct exposure samples, respectively.
The estimated COHb% for the directly exposed group was higher than the indirectly exposed
group in the three wards. Consequently, the directly exposed group was suffering a higher risk.
All directly exposed respondents and 75 % of indirect ones were experienced COHb%
calculated in blood exceeding the safe threshold for the health of WHO guidelines. There has
been increased risk for both exposed groups if the coal beehive stove placed indoor. The
calculated levels of incremental life cancer risk (ILCR) posed by PM2.5 in the three wards varied
from 1.5E-06 to 3.6E-06 daily, indicating moderate cancer risk to the community that should be
studied further to protect public health.
Keywords: beehive coal stove, health risk, COHb saturation, PM2.5, carbon monoxide.
Classification numbers: 3.6.2, 3.4.5.
1. INTRODUCTION
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Study on health impact from using beehive coal stoves in households in Hoan Kiem, Hanoi
Nowadays, Viet Nam has been under urbanization. However, more than 60 % of the
population lives in rural areas, where biomass (mostly wood and crop residues) and fossil fuels
are still partly used in a simple stove, producing substantial air pollutant [1]. Besides, many
urban communities continue to use coal for cooking. The combustion of biomass and coal is the
dominant source of indoor air pollution (IAP) in the country and contributes significantly to the
total burden of disease [2]. Cooking activities can emit gaseous pollutants (e.g. CO) and
particulate matter (e.g. PM2.5). PM2.5 has been associated with respiratory problems, lung cancer
and cardiopulmonary deaths [3, 4]. Space heating in winter also contributes to indoor air
pollution with more solid fuel combustion and worse ventilation. CO is produced by incomplete
combustion of carbonaceous fuels such as wood, petrol, coal, natural gas, and kerosene [5, 6].
Exposure to CO leads to various health problems through affecting the cardiovascular system,
lung and blood, and the central nervous systems depending on the health and physiological
status of the exposed person, pollutant concentration and exposure time [5]. An extensive report
published on indoor pollution from solid biomass fuel and health damage in a rural area of
Burdwan, West Bengal highlighted that the varieties of fuel released different CO concentration
following the sequence: coal cake > dry leaf > cow dung > twigs > wood straw > gas stove.
Biomass study revealed that LPG gas is the least contributor of CO than biomass fuel.
Symptoms like eye irritation, shortness of breath, cough, and dizziness were highly prevalent
among biomass users [6]. Quantification of indoor air pollution from using cookstoves and
estimation of its health effects on adult women was also studied in Northwest Bangladesh [7].
Although previous studies on concentrations of CO and PM2.5 have been conducted in other
developing countries, there is limited information on CO and PM2.5 exposures during cooking to
the householders in Viet Nam, especially during beehive coal burning. Furthermore, the
awareness of the potential risk associated with CO and PM2.5 is not well addressed. This study
aims at assessing the CO and PM2.5 exposures in and near beehive coal cooking areas as well as
the associated potential health risk.
2. METHODOLOGY
2.1. Monitoring design
An investigation was conducted at three wards (Tran Hung Dao, Chuong Duong, and Phuc
Tan) in Hoan Kiem District, Ha Noi, Viet Nam. These wards were observed with high numbers
of beehive coal use. Twenty sampling sites were chosen to conduct in one hour in the morning
and one hour in the afternoon each ward. The sites were chosen based on criteria of high space
coverage, and typical characteristics (outdoor versus indoor; open versus close space; near a big
or small road versus far from the road; residential use versus commercial use). The sample sites
were presented in Figure 1. Ambient and personally expose levels were monitored
simultaneously at each site from October to November 2018 using portable PATS++ sensors,
developed by Berkeley Air Monitoring group. Ambient air samples included upwind samples (>
5 meters from the stove, regarded as background samples); near-source samples (50 cm around
the stove); far-source samples (3 - 5 m from the stove). The air quality samples were measured
at 1.5 m height above the ground. All personal exposure measurement was conducted by
handing PATS++ sensors near armpit within the breathing zone during beehive coal stove in
use. Personal exposure samples are divided into two groups: direct exposure samples (near-
source: 50 cm from the stove) and indirect exposure samples (far-source: 3 - 5 m far from the
stove). PM2.5, CO, relative humidity (RH) and temperature (T) were measured continuously by
PATS++ sensors, which measured and recorded every five seconds. Real-time data from PAT++
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Vo Thi Le Ha, et al.
were calculated to hourly average concentrations. The detection limit for mass concentration is
10 µg/m3 for PM2.5 and range of 0-500 mg/m3 for CO. Before the sampling campaign, PM2.5
sensors were synchronized and calibrated with the gravimetric method at the laboratory to
guarantee proper instrument operations. Before each sampling day, the PM2.5 sensor was
calibrated with zero gas (N2 > 99.9 %). Before each sampling campaign, CO sensors were
calibrated with zero gas (N2 > 99.9 %) and determined five CO samples with concentration of
2.7; 5.3; 6.5; 10.0; and 14.3 ppm. After the campaign, the sensors were checked with determined
CO concentrations.
a) Tran Hung Dao ward
b) Phuc Tan ward
c) Chuong Duong ward
Figure 1. Monitoring sites: (a) Tran Hung Dao ward, (b) Phuc Tan ward, (c) Chuong Duong ward.
2.2. Health risk assessment
2.2.1. Health risk assessment from CO exposure
Blood COHb were determinant for toxic assessment of CO and be used widely in previous
studies [7, 8]. In this study, a linear equation obtained from the work of Lee et al. was applied to
assess the risk [8]. In that study, CO-COHb relationship was conducted for 13 nonsmokers in the
USA who exposed 9 ppm CO for 1 hour and 8 hours and compared to baseline value at 0 hour.
The linear equation for the relationship between breath CO concentration and blood COHb
saturation was expressed as follows: X = 0.01 + 0.26(Y) for mean, R2 = 0.999, where X is the
percent of COHb in blood and Y is the breath CO concentration.
2.2.2. Health risk assessment from PM2.5 exposure
Health risk assessment method adopted by US-EPA guidelines was divided into four stages:
hazard identification, dose-response assessment, exposure assessment, and risk assessment. The
assessment of the health risk posed by the contaminants can be split into the carcinogenic/non-
carcinogenic health risk assessment [9]. The In-depth interviews were conducted to investigate
the demographic information via 300 questionnaires (lifetime styles, personal behaviors and
others) for householders who used beehive coal stove for cooking. The results from
questionnaires were used to estimate the daily intake of PM2.5 for the householders to assess the
potential health risk assessment. The assessment of PM2.5 inhalation can be based on lifetime
average daily dose (LADD), slope factor (SF) and the excess lifetime cancer risk (ELCR) factor
following in Equation (1-3) [10 - 12]
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Study on health impact from using beehive coal stoves in households in Hoan Kiem, Hanoi
(2)
(3)
where, C: PM2.5 concentration(µg/m3) [this study]; IR: inhalation rate (14.3 m3/day) [13]; D
hour: exposure duration (6 hours/day) [questionnaire]; Dday: (7 days) [12]; Dweek: 52 weeks
[13]; Dyear: exposure years (5 years) [questionnaire]; BW: body weight (50 kg) [questionnaire];
AT: averaging time (AT = 70 years × 365 days/year = 25550 days) [12]; UR: unit risk (0.008
µg/m3) [11]: ELCR is classified in categories (< 10-6: low; > 10-4: high and in range of 10-6 to 10-4:
moderate) [11].
3. RESULTS AND DISCUSSION
3.1. PM2.5 and CO concentrations in beehive coal stove burning area
The statistical values of PM2.5 are presented in Table 1. The PM2.5 concentrations of upwind
vary in the range of 10 - 186 µg/m3 with the mean value observed at 47 µg/m3. This finding is
corresponding to the previous report in Ha Noi [14]. The average level of PM2.5 near-source is 77
µg/m3, which is about double than in upwind. The mean level of PM2.5 far source is 59 µg/m3 that
is 1.5 times higher than in upwind. The highest concentration of PM2.5 near-source of 441 µg/m3
is observed in this study. The mean concentration of PM2.5 near-source is highest and decreases
in the order: near source > far source > direct exposure > indirect exposure > upwind. CO
concentrations of upwind vary in range of 1,000 – 30,000 µg/m3 with the mean value of 3,000
µg/m3. These mean values are consistent with previous research in Ha Noi [15].
Table 1. Statistical values of PM2.5 and CO in three wards (n=120), µg/m3.
Indirect
exposure
Upwind
Near stove
Far stove
Direct exposure
Values
PM2.5
CO
1,000
30,000
3,000
2,000
PM2.5
CO
PM2.5
CO
2,000
29,000
6,000
5,000
PM2.5
9
CO
PM2.5
CO
Min
Max
10
186
47
12
441
77
3,000
9
3,000
3
2,000
36,000
4,000
3,000
260,000 257
260
55
255,000 271
Mean
23,000
13,000
59
48
21,000
9,000
53
40
Medium
34
64
47
The mean concentration of CO at near-source is 23,000 µg/m3 that is almost 7 times higher
than the upwind one. The highest mean concentration of CO is observed in near-source, and the
lowest concentration is seen in upwind. These mean values of CO decrease in the order: near-
source> direct exposure > far-source > indirect exposure > upwind. In this study, upwind
samples are considered as background samples; even this background can be affected by multi-
sources such as transportation and the others. Comparing to the national Technical Regulation
on Ambient Air Quality (QCVN 05:2013/BTNMT), the concentrations of CO at near-source
might comply with the required value of 30,000 µg/m3 (it must be noted that some samples are
indoor; therefore this comparison is mainly for illustration). Notably, the maximum level of the
near-source is 260,000 µg/m3, much higher than the required levels. Attention should be paid to
this high CO level at the near-source. The high concentrations of PM2.5 and CO have likely
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Vo Thi Le Ha, et al.
attributed to the combustion of coal beehive stoves and other sources. It was further found that
the concentrations of PM2.5 and CO vary significantly among the three observed wards. The
highest mean concentrations of PM2.5 (78, 120, 75, 60, 81 µg/m3 ) are seen in Chuong Duong
Ward, followed by Phuc Tan Ward (60, 74, 71, 60, 59 µg/m3) and Tran Hung Dao Ward (27, 66,
55, 60, 43 µg/m3) for upwind, near-source, far source, direct exposure and indirect exposure
samples, respectively. The mean highest concentrations of CO appeared in Tran Hung Dao Ward
(4,000, 27,000, 7,000, 48,000, 7,000 µg/m3), followed by Phuc Tan Ward (4,000, 26,000, 5,000,
14,000, 4,000 µg/m3) and Chuong Duong Ward (3,000, 23,000, 7,000, 14,000, 5,000 µg/m3) for
upwind, near-source, far source, direct exposure and indirect exposure samples, respectively.
3.2. Health risk assessment
3.2.1. Assessment of the health risk posed by CO
a) Chuong Duong ward
c) Tran Hung Dao ward
Figure 2. Percentage of blood COHb
saturation equivalent at different sites:
(a) Chuong Duong ward, (b) Phuc Tan ward,
(c) Tran Hung Dao ward.
b) Phuc Tan ward
In this study, the toxic assessment was done via a determinant factor as COHb, which was
widely applied for some previous studies [8, 16]. The mean exposure CO concentrations
yielding COHb saturation for suffering householders, who are exposed directly and indirectly
during cooking, are depicted in Figure 2. There is a significant difference in COHb values at the
three studied wards in the morning (AM) and afternoon (PM). The observed COHb values at
AM are prevailing at PM for the two groups (direct and indirect exposure). Obviously, the direct
exposure group is more exposed to CO than the indirect exposure group, resulting in higher
health risk. The results of this study showed that the percentage of COHb significantly exceed
the WHO guidelines for safe health (COHb < 2.5 %) in all wards. Hundred percent of direct
exposure and 75 % of indirect exposure group surpassing WHO guidelines on health safety are
overserved at Chuong Duong ward at AM. The individual numbers suffering COHb exceeding
WHO guideline at AM was higher than PM due to more beehive coal in use at AM. Likely, the
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Study on health impact from using beehive coal stoves in households in Hoan Kiem, Hanoi
meteorological conditions at AM do not facilitate air dispersion. It can be inferred that these
householders might suffer from the above listed mild symptoms associated with CO poisoning
during their daily cooking activities. A similar trend occurs in Tran Hung Dao ward. The number
of direct exposure groups at risk is increasing in the order: Phuc Tan Ward < Tran Hung Dao
ward < Chuong Duong ward, because of more coal beehive stoves in use in each ward. These
findings are consistent with a previous study in Bangladesh in 2012 [7]. The study showed that
50 % of householders using coal beehive stove for living activities exceeded the safety threshold
of WHO) [3]. The result of exposure concentrations of CO in this study is lower than that
observed in Tanzania in 2013 during coal burning [16]. In the case of indirect exposure group,
30 - 40 % of individuals in Tran Hung Dao ward are suffering risk, and the results of all directly
exposed people in Chuong Duong and Phuc Tan ward are under the safe level of WHO
guidelines. CO emission is relatively typical from coal burning during cooking, especially the
long-term incubation of coal in the absence of O2 leading significant CO release. Therefore,
regular CO exposure can cause both acute and chronic effects for individuals.
This study also addresses the influence of the coal stove position (inside and outside of
home) on public health risk. The results are showed that values of COHb is 1.35 % and 5.32 %
when beehive coal stoves located inside home and in term of 0.81 % and 1.35 % when the stoves
located outside home for direct and indirect exposure groups, respectively. Higher COHb values
are documented inside homes for target groups in this study. This means that the combustion of
coal burning in enclosed spaces poses a higher probabilistic risk for health due to higher CO
inhalation than outside combustion. Indoor combustion activities have a higher potentiality to
accumulate CO. Additionally, inadequate ventilation reduces pollutants dispersion capacity,
particularly in some householders that coal is incubated indoor overnight. It offers strong
recommendations for coal beehive stoves usage for the daily cook in observed wards.
3.2.2. Assessment of the health risk posed by PM2.5
Human risk assessment quantifies the lifetime effects of exposure to PM2.5 through
inhalation. It is found that there is a significant difference between daily dose intake for both
direct and indirect exposure groups. However, the daily dose intake varies slightly at AM and
PM. It is evident that the daily dose of direct exposure group is prevailing than the indirect
exposure group in Phuc Tan ward and Tran Hung Dao ward. The PM2.5 increment may be due to
beehive coal stove combustion and traffic emission. Consequently, the calculated value of
incremental life cancer risk (ILCR) in the three wards show that, the values of ILCR is 1.6E-06
and 2.1E-06 for Tran Hung Dao ward, 1.7E-06 and 2.2 E-06 for Phuc Tan ward, and 2.5E-06
and 3.6 E-06 for Chuong Duong ward for indirect and direct exposure group, respectively. The
cancer risk index is classified by ILCR adopted by the US-EPA benchmark. If the probabilistic
case is in range of 10-6-10-4, the suffers pose a moderate risk. These findings represent that for
direct exposure group, 2 to 4 out of one million people are probably suffering from cancer risk,
whereas 2 to 3 out of one million people are able suffering from cancer risk for the indirect
group in the studied wards.
The monitored results have a good agreement with the clinical examination results, which
took place during the sampling period. The survey was taken at the three wards for 300
householders to get the questionnaires, in which, 120 females were prioritized to check up health
via clinical examination. These householders used regular beehive coal stoves for cooking and
regarded as the direct exposure group. The health status examined on respiratory, eye problems
as well as systolic and diastolic blood pressure for studied householders. The clinical results of
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Vo Thi Le Ha, et al.
acute manifestations such as respiratory, eye allergy, reduced blood circulation ability
(cardiovascular effects) appeared clearly in 120 females who were exposed to CO and PM2.5
during regular cooking activities in the above three wards. Symptoms like eye irritation,
shortness of breath, cough, and dizziness were highly prevalent among biomass users in a rural
area in Burdwan, West Bengal. Both systolic and diastolic blood pressure showed a strong
positive relationship with the age of biomass users due to CO and PM2.5 exposures [6].
4. CONCLUSIONS
The findings revealed the CO and PM2.5 levels in the ambient air and breathing zone of
exposed females around beehive coal cooking areas at Tran Hung Dao Ward, Phuc Tan Ward,
and Chuong Duong Ward was enriched. The direct and indirect exposure group is obviously
suffering significant acute risk from CO. More than 75 % of exposed groups were experienced
COHb% calculated in blood exceeding the safe threshold for health of WHO guidelines. The
quantitative health risk assessment for PM2.5 based on incremental life cancer risk (ILCR)
highlighted that, two out of one million to four out of one million people are probably suffering
from cancer risk in three wards. Symptoms like eye irritation, shortness of breath, cough,
dizziness, respiratory, eye allergy, reduced blood circulation are highly predominant among
beehive coal stove users. The direct exposure group is more sensitive with a higher risk than the
indirect exposure group. These observations should be initially scientific basis for making
recommendations to protect public health at three wards, which have been utilizing traditional
open beehive coal stoves.
Acknowledgment. The authors acknowledge financial support from Ha Noi DONRE in the Contract
number 14/2019/HNEPA: Project: Study to monitoring for environment and health risk assessment from
beehive coal burning, 2018.
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