BY BRITA E. LUNDBERG, MD, MMS ENVIRONMENTAL AND OCCUPATIONAL HEALTH COMMITTEE
Dr. Brita E. Lundberg
A robust body of research has been quietly accumulating for 30 years pointing to the connection between pediatric asthma and natural gas stove use, and that threat last year caught the attention of the Massachusetts Medical Society.
In December 2019, the Massachusetts Medical Society House of Delegates approved policy to raise physician and public awareness of the connection between indoor air pollution from cooking with natural gas and pediatric asthma. The goal of the resolution
is to help disseminate this information broadly among health professionals and the public, including simple interventions that can help mitigate this risk.
Many physicians and even health departments do not know about the association between natural gas cooking and pediatric asthma, says T. Stephen Jones, MD, MPH, co-author of the MMS resolution-turned-policy and a retired epidemiologist with the Centers
for Disease Control and Prevention.
Many experts, the resolution authors contend, are unaware that cooking indoors with gas results in air pollution. “The problem is that few people recognize that cooking with gas creates indoor air pollution that increases the risk of childhood asthma,”
says resolution co-author and associate professor of medicine at Harvard Medical School, Regina LaRocque, MD, MPH.
Children, especially those who are very young, often spend a great deal of time indoors, particularly in kitchens, and because of their small size, are particularly vulnerable to indoor air pollution. In addition, as architects have worked to make the
“envelopes” of houses tight, houses are less well ventilated, magnifying the problem.
According to researchers at the Lawrence Berkeley National Laboratory in California, cooking with a gas stove has been shown to “expose 12 million Californians to pollutant levels that would be illegal outdoors.”
Children are easily exposed by a simple mechanism, according to Dr. Jones, who explains, “Burning gas in a cooking stove releases several known respiratory irritants, including nitrogen dioxide, ultrafine particulate matter (PM 2.5) and carbon monoxide
into the air.”
Nitrogen dioxide has been shown to cause asthma in children in a dose-response manner — the higher the level, the worse the asthma symptoms.
The good news is that research shows there are simple actions people can take to reduce this risk. These include using adequate ventilation. The Environmental Protection Agency (EPA) recommends the following:
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Using exhaust fans that ventilate to the outdoors when cooking with a gas stove
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Using electric appliances to cook (including induction stove tops, toaster ovens, microwaves, etc.)
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Using HEPA air purifiers with carbon filters
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Selecting an electric or induction stove instead of gas when it is time to replace a gas stove
A fan that merely recirculates air around the kitchen is not a proven effective measure toward reducing the amount of pollutants in the air.
The burden of asthma is significant in Massachusetts. According to a 2019 study from the Asthma and Allergy Foundation, Massachusetts is home to three of the 15 cities with the highest rates of asthma nationwide — Springfield, Boston, and Worcester. Because
about half of Massachusetts households use a gas stove to cook, this simple public health intervention has the potential to make a big difference here.
There are, of course, many triggers for asthma, including viral infections, cold temperatures, and allergens. But indoor emissions from burning gas is one that patients can take simple actions to mitigate, provided they are made aware of the connection.
Heightened awareness — among both physicians and the public — that pediatric asthma is associated with gas stove use and that simple strategies exist to mitigate that risk, has the potential to improve the health of children and our communities.
Brita E. Lundberg, MD, is a co-author of the resolution.
