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
people have signed
Piotr Popowski
Gdański Uniwersytet Meyczny
Zgadzam się z celami Manifestu
Armando Ruiz
FENAER
I believe we need to work for a healthy indoor air quality in Europe
Alice Chapman-Hatchett
The Health and Europe Centre
Lucilla Piccari
Hospital del Mar
Christine Magend
ECPCP
Indoor air pollution is a significant health risk for the unborn, very young and also older child!
Saray Gonzalez Troiteiro
SEPAR
Sonia Moar Ullaoa
SEPAR
Iñaki Morán Fernández
EPOC ESPAÑA
Fátima Elena Morante Velez
A Tot Pulmó
Violeta Irene Gemma
ALERMA Asociación de Enfermos <Respiratorios de Málag
Sandeep Pal Kaur Pattar
Asociación Española de Pacientes de Tos Crónica.
Irantzu Muerza
ASMABI
Para la salud respiratoria mundial
Charo García Alvarez
Asma Grave de Alicante (AAA)
Maria del Carmen Cosme Pereira
Asociacion de Asma Grave de Alicante (AAA)
Alicia Gonzalez-Nicolas López
Asociacion de asma grave de Alicante
Alba Ulzurrun de asanza
Universidad de Valencia
Claudia Hesse
Universidad Oberta de Catalunya
Maksym Kupchyk Tiurin
UCIMV
Amparo Brull
UCIM
Tadeusz Jędrzejczyk
Medical University of Gdańsk
The health is value
Weronika Kamińska-Skrzyńska
PTPZ
Elżbieta Czapka
University of Gdańsk
Gas cookers have negative effect on health. It is evidence based. I am a researcher and it convinced me that we need an action!
Cristina Martinez
separ
Noemí Mengual Macenlle
Complejo hospitalaria universitario de Ferrol
Marta Iscar
SEPAR
Daniel Segura
Hospital general universitario de Castellón
Mario Andújar Llamazares
Neumologia
It matters.
Sergio Salgado Aranda
Hospital Universitario del Tajo
Ignacio Gayá García-Manso
Hospital General Universitario Dr Balmis de Alicante
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
Polskie Towarzystwo Programów Zdrowotnych
Poland
Food & Water Action Europe
European organisation
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
- 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
- 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
- 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
- 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/
- 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
- 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/
- United States Environmental Protection Agency. n.d. Nitrogen Dioxide (NO2) Pollution: Nitrogen Dioxide Basics. https://www.epa.gov/no2-pollution/basic-information-about-no2
- 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
- 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
- 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
- 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
- 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/
- 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