Clean Cooking for Public Health

Manifesto

As members of the health, medical and scientific community, we have joined together under the banner of Clean Cooking for Public Health to voice our concerns regarding the impact on human health and wellbeing of the continued use of gas for cooking.

All gas cooking appliances release pollutants that are harmful to human health and the environment, leading to an increased disease burden and societal costs.
We therefore call upon European, national and local decision-makers to establish policies that:



set strict nitrogen dioxide (NO2) emission limits for appliances and phase out the sale of gas cooking appliances;



support an equitable green transition, by mitigating the costs of switching to clean electric alternatives, especially for vulnerable population groups;



educate medical professionals and inform consumers on the health dangers of cooking with gas.

Gas burning appliances release a number of dangerous pollutants, such as carbon monoxide, nitrogen dioxide (NO2), and particulate matter.

The use of a gas stove in the household has been associated with increased risk of childhood asthma and asthma severity1, adverse effects on the cognitive function and higher risk of developing ADHD symptoms2, and reduced lung function in children3. 

Children are known to be particularly vulnerable to environmental health threats such as air pollution, because of their higher breathing rate and still developing respiratory and immune systems4. 

According to recent research, 12% of the current paediatric asthma cases in the EU could be avoided if gas cookers were removed – that is an estimated 700 000 children who would not suffer from asthma symptoms in the absence of gas stoves5. Globally, children living in households that cook with gas have a 32% increased likelihood of having current and lifetime asthma6. 

Additionally, exposure to pollutants from cooking with gas is a matter of health equity. Marginalised groups are likely to live in smaller and more poorly ventilated houses, while people with pre-existing chronic diseases may be more likely to spend longer periods of time indoors, thus being at risk of breathing in higher concentrations of pollutants from indoor sources. Even short-term exposure to increased levels of NO2 is dangerous for people living with respiratory disease, as it may lead to respiratory problems such as coughing, wheezing or difficulty breathing, and even to hospital admissions; meanwhile, long-term exposure can potentially increase susceptibility to respiratory infections7.

NO2 is one of the main pollutants of concern in the case of cooking with gas, especially as it is associated with negative health outcomes at levels lower than previously thought. The NO2 annual recommended values saw the most significant change across all pollutants in the latest World Health Organization Air Quality Guidelines (AQG), being lowered by a factor of 48. At the same time, the WHO recognises gas appliances as one of the major factors in people’s overall exposure to nitrogen dioxide9. Indeed, households cooking with gas are likely to reach NO2 levels that exceed WHO Air Quality Guidelines and would be illegal outdoors under the EU Ambient Air Quality Directives10.

Ventilation – if used properly – may be a helpful, temporary, individual-level exposure reduction strategy. However, the risks of indoor gas cooking cannot be eliminated and, at the societal level, policies need to aim at replacing sources of air pollution with clean alternatives, such as electric cooking appliances.

We caution against the use of hydrogen-blended gas. Research shows that hydrogen is not a viable cooking solution, due to both potential increases in harmful pollutants while cooking11, and because of indirect emissions that result from the production of hydrogen12.

Finally, the scientific consensus is clear that the climate crisis now represents the biggest health threat facing humanity. With gas cooking contributing to climate change, including due to methane leaks13, phasing it out is one of the clearest cases of the potential of health and climate co-benefits.

Despite the evidence, current European policies do not protect people from the dangers of gas cooking. While Europeans spend about 90% of our time indoors, and air pollution is recognised as the single largest environmental health risk in Europe, sources of indoor air pollution are underregulated.

In this context, we add our voices to the growing movement of medical associations, health and environmental NGOs for the phase out of gas cooking appliances and for clean air in our kitchens.

Join Clean Cooking for Public Health and make your voice heard

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people have signed

Mr.Babacar Ndiaye

Expert African civil society of development

La sécurité alimentaire et la biosecurite sont des droits humains durables de 3e et 4e génération surtout pour les citoyens bénéficiaires vulnérables

Mr.Babacar Ndiaye

Expert African civil society of development

Je suis Expert de la société civile africaine de développement, impliqué dans les réflexions sur les questions de développement durable et de croissance économique soutenue. La sécurité alimentaire et nutritionnel, le droit à la nourriture saine, la biosecurité humaine et anima

Perla Valenzuela Reyes

SEPAR

Im a pulmonologist and EROM member

Marco Grippa

ECOS

Diarmuid O’Fionnaill

TCD

Sabrina Vassia

Health Service Executive

Sabrina Llop

FISABIO

Ana Esplugues

University of Valencia

Juan B. Bellido-Blasco

Centro de Salud Pública de Castellón. Conselleria de Sanitat. Generalitat Valenciana

MARIA BARBERA

Castellon Public Health Centre

Isabel Almodóvar

Universitat Jaume I

CARLOS ALFARO PÉREZ

Universidad Jaume I

Paula Carrasco

Universitat Jaume I

Óscar Navarrete

Jaume I University

Aurea Cartanya

Universitat Jaume I

Vicente José Esteve-Cano

Universitat Jaume I

Rosa de Llanos

Jaume I University

Juana Maria Delgado Saborit

Universitat Jaume I

I am aware that gas cooking affects indoor air quality, and it is associated with health effects, specially an increase in the prevalence of paediatric asthma. Policies should be implemented promoting good indoor air quality that will reduce human health effects.

Michael Scholand

Consultant to ECOS

Everyone deserves to breathe clean air and there is simply no justification to keep using fossil gas for cooking - its an outdated, polluting, inefficient technology that doesn't belong in our homes and restaurants, especially when clean, safe, cost-effective alternatives exist.

Francesca Cigala Filgosi

Retired

Sascha Verbruggen

ErasmusMC Sophia Children Hospital

Carmen Calvo

Asociación enfermos respiratorios

Eliminar toxicos respiratorios

Iñaki Morán

Epic España

Irantzu Muerza

ASMABI EUSKADI

Soy asmática y creo en la importancia de estas iniciativas para mejorar la calidad de vida de pacientes respiratorios

Alessandra Gadaldi

ISDE Italia

Sandra Green

Irish Doctors for the Environment

I want to prevent childhood asthma. I want to see equal access to clean cooking methods.

paola baldini

ISDE

Daniele Faccioli

None

Maria Carmela Coppola

Medico per l'ambiente

Agostino Cinquepalmi

Nessuna

Anna Guzzardo

STUDIO MEDICO

Edi Cudicio

member of ISDE

I want to influence governments to make laws about this matter.

Daniel Dîrul

International Federation of Medical Students' Associations (IFMSA)

Lucia Borruso

Private consultant

Ruggero Maria Spinazzola

nessuna

Mario Frusi

ISDE Italy

Martino Abrate

ISDE

Maria Angela Vigotti

nessuna

Stefano Benzone

Private

Rosalinda Vitali

Aidm

Credo in lui

Mario Fiumene

ISDE

Importante

Francesca Cigals Fulgosi

SSN Retired

DAVIDE RAGNOLI

ISDE

Laura Reali

Primary Care Paediatrician

children's health is crucial and their future must be our first committment

Elena Goyanes

Alpha-1 Spain

I am involved in a rare disease patient association. Good air quality is essential for affected people to maintain their lung health.

Tomas de Jong

European Public Health Alliance

Dieter Lehmkuhl

German Alliance for Health and Climate Change (KLUG)

Rik van de Weerdt

Public health Services

We need clean air!

Piotr Popowski

Polish Society for Health Programs / Medical Universiti of Gdańsk

Good idea to support mainstream

Cale Lawlor

European Public Health Alliance (EPHA)

This is a preventable environmental exposure, management of which can avert poor health outcomes

Armando Ruiz

FENAER

A transition is necessary especially in houses with economic problems to make the change.

Sandra Dorado Arenas

Osakidetza. SEPAR

Alessandro Gallina

European Public Health Alliance

Olaia Bronte

Anónimo

ECOS

Global organisation

Forum dell'aria

Italy

European Public Health Alliance

European organisation

Ride for their Lives

Global organisation

ANES, Asociación Nacional de Enfermos de Sarcoidosis

Spain

SEPAR - Área EROM (Enfermedades Respiratorias de origen Ocupacional y Medioambiental)

Spain

SEVILLA RESPIRA

Spain

EPOC ESPAÑA / Asociación Española de Pacientes y Cuidadores de EPOC

Spain

ASMABI EUSKADI

Spain

European Academy of Paediatrics

European organisation

International Federation of Medical Students' Associations (IFMSA)

Denmark

FENAER, Federación Española de Asociaciones de Pacientes Alérgicos y con Enfermedades Respiratorias

Spain

Alpha-1 Spain

Spain

AzerMDS

European organisation

ISDE, International Society of Doctors for Environment Italy

Italy

A.N.G.E.V. OdV

Italy

POLSKIE TOWARZYSTWO PROGRAMOW ZDROWOTNYCH /Polish Society for Health Programs

Poland

References

  1. American Medical Association House of Delegates. Report of Reference Committee D (A-22). 2022. https://www.ama-assn.org/system/files/a22-refcmte-d-report-annotated.pdf
  2. Morales, E. et al. Association of Early-life Exposure to Household Gas Appliances and Indoor Nitrogen Dioxide with Cognition and Attention Behavior in Preschoolers. American Journal of Epidemiology. 2009, 169(11): 1327–1336. https://doi.org/10.1093/aje/kwp067
  3. Moshammer H. et al. Gas cooking is associated with small reductions in lung function in children. European Respiratory Journal. 2010, 36 (2): 249-254. https://erj.ersjournals.com/content/early/2009/12/23/09031936.00102409
  4. Bateson TF, Schwartz J., Children’s response to air pollutants. J Toxicol Environ Health. 2007. 71(3): 238–243. https://pubmed.ncbi.nlm.nih.gov/18097949/
  5. Jacobs, P., and Kornaat, W. Health effects in EU and UK from cooking on gas, TNO Report R12249. 2022. https://repository.tno.nl/islandora/object/uuid%3Ac422c014-3509-4a4a-a3e6-85faeced883c
  6. Lin, W. et al. Meta-analysis of the effects of indoor nitrogen dioxide and gas cooking on asthma and wheeze in children. Int. J. Epidemiol. 2013, 42(6) : 1724–1737. https://pubmed.ncbi.nlm.nih.gov/23962958/
  7. United States Environmental Protection Agency. n.d. Nitrogen Dioxide (NO2) Pollution: Nitrogen Dioxide Basics. https://www.epa.gov/no2-pollution/basic-information-about-no2
  8. World Health Organization. WHO Global Air Quality Guidelines: Particulate Matter (‎PM2.5 and PM10)‎, Ozone, Nitrogen Dioxide, Sulfur Dioxide And Carbon Monoxide. 2021. https://www.who.int/publications/i/item/9789240034228
  9. World Health Organization Regional Office for Europe. Review of evidence on health aspects of air pollution – REVIHAAP. 2013. https://www.euro.who.int/__data/assets/pdf_file/0020/182432/e96762-final.pdf
  10. Jacobs, P., and Kornaat, W. Health effects in EU and UK from cooking on gas, TNO Report R12249. 2022. https://repository.tno.nl/islandora/object/uuid%3Ac422c014-3509-4a4a-a3e6-85faeced883c
  11. Jacobs, P., and Cornelissen, H.J.M. Effect of hydrogen gas mixes on gas hob emissions. TNO Report R12248. 2022. https://repository.tno.nl/islandora/object/uuid%3Ae574a592-ca6f-4355-a269-2510a724ce5f
  12. CE Delft. Health-related social costs of air pollution due to residential heating and cooking. In the EU27 and UK. 2022. https://cedelft.eu/publications/health-related-social-costs-of-air-pollution-due-to-residential-heating-and-cooking/ 
  13. Jacobs, P., and Cornelissen, H.J.M. Effect of hydrogen gas mixes on gas hob emissions. TNO Report R12248. 2022. https://repository.tno.nl/islandora/object/uuid%3Ae574a592-ca6f-4355-a269-2510a724ce5f
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