Manish Desai, MS, PhD

GHES U.S. Fellow 2016-2017

Fellowship Site: Sri Ramachandra University, Chennai, India
U.S. Institution: UC Berkeley

Project Title: LPG Coverage and Household Air Pollution Mitigation - A Natural Experiment in Greater Chennai, India

Household air pollution from solid fuel use for cooking (HAP) remains among India’s most significant public health challenges, causing over thirty million lost DALYs and a million premature deaths annually. Much of this disease burden is borne by the country’s poorest, who have historically lacked access to less polluting energy sources. Yet the prospects for reducing HAP in India have recently improved owing to enhanced access to liquefied petroleum gas (LPG), one of the most promising technologies for clean cooking.

Several lines of evidence, considered in concert, posit that LPG may reduce exposure to HAP not only for users but also for neighbors. In turn, the efficacy of LPG may be determined by the extent of both household‑level use as well as community‑level coverage. Such coverage dependent efficacy, or a “coverage effect,” would transform how LPG and similar clean cooking technologies are studied and deployed. Thus far, however, few efforts have explored the existence or consequences of such a coverage effect.

My project endeavors to bridge this gap by utilizing a compelling natural experiment occurring within Greater Chennai in South India. My host country mentor, Professor Kalpana Balakrishnan of Sri Ramachandra University, leads a landmark cohort study on particulate matter (PM) exposure-response relationships, the Tamil Nadu Air Pollution and Health Effects project (TAPHE). Across TAPHE’s rural-to-urban continuum of field sites, households have been adopting LPG for cooking to varying degrees within different communities.

Given this development, TAPHE, with its comprehensive design, established infrastructure, and accomplished team, offers a rich environment to research a postulated coverage effect from LPG. As part of its existing goals, TAPHE has been studying cooking practices, household and ambient PM, and health outcomes associated with air pollution. Advised by Professor Balakrishnan and my U.S. mentor, Professor Kirk Smith of the University of California at Berkeley, I will learn from and draw on these efforts as I seek to complement them.

In particular, I am extending mechanistic and statistical modeling approaches towards attributing exposure to PM from household, community, and regional sources. By incorporating and interpreting results from TAPHE with tailored models, I will investigate the degree to which an appreciable coverage effect manifests, seeking to characterize and explain the relationship between LPG coverage and HAP mitigation within different contexts. Ultimately, my goal is to help inform the sound planning and evaluation of LPG programs across India.