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Short M, Dobson J, Day G, Lefferts B, Singleton R, Keck J. "You can feel the fresh air … " Rural Alaska Native household perceptions of home air purifiers and health. Int J Circumpolar Health 2024; 83:2335702. [PMID: 38546171 PMCID: PMC10984226 DOI: 10.1080/22423982.2024.2335702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/22/2024] [Indexed: 04/04/2024] Open
Abstract
Alaska Native and American Indian children experience frequent respiratory illness. Indoor air quality is associated with the severity and frequency of respiratory infections in children. High efficiency particulate air (HEPA) purifiers effectively improve indoor air quality and may protect respiratory health. In 2019, the Yukon-Kuskokwim Health Corporation implemented a pilot programme that provided education and HEPA purifiers to households of children with chronic lung conditions. The team evaluated HEPA purifier acceptability and use by interviewing representatives from 11 households that participated in the pilot programme. All interviewees reported improvement in their child's health, and some believed that the health of other household members was also improved because of the HEPA purifier. Interviewees reported that the HEPA purifiers were easy to use, quiet, and not expensive to run. Five of 11 households were still using the HEPA purifier at the time of the interview, which was about three years after receipt of the unit. The most common reasons for discontinuing use were equipment failure and lack of replacement filter, suggesting that programme support could increase sustainability. Our evaluation suggests that HEPA purifiers are acceptable and feasible for use in rural Alaska Native households.
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Affiliation(s)
- Madilyn Short
- WWAMI School of Medical Education, University of Alaska Anchorage, Anchorage, AK, USA
- Department of Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Jennifer Dobson
- Department of Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
- Office of Environmental Health and Engineering, Yukon-Kuskokwim Health Corporation, Bethel, AK, USA
| | - Gretchen Day
- Department of Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Brian Lefferts
- Office of Environmental Health and Engineering, Yukon-Kuskokwim Health Corporation, Bethel, AK, USA
| | - Rosalyn Singleton
- Department of Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - James Keck
- WWAMI School of Medical Education, University of Alaska Anchorage, Anchorage, AK, USA
- Department of Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Cowan K, Semmens EO, Lee JY, Walker ES, Smith PG, Fu L, Singleton R, Cox SM, Faiella J, Chassereau L, Lawrence L, Ying J, Baldner J, Garza M, Annett R, Chervinskiy SK, Snowden J. Bronchiolitis recovery and the use of High Efficiency Particulate Air (HEPA) Filters (The BREATHE Study): study protocol for a multi-center, parallel, double-blind, randomized controlled clinical trial. Trials 2024; 25:197. [PMID: 38504367 PMCID: PMC10953277 DOI: 10.1186/s13063-024-08012-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/23/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Acute viral bronchiolitis is the most common reason for hospitalization of infants in the USA. Infants hospitalized for bronchiolitis are at high risk for recurrent respiratory symptoms and wheeze in the subsequent year, and longer-term adverse respiratory outcomes such as persistent childhood asthma. There are no effective secondary prevention strategies. Multiple factors, including air pollutant exposure, contribute to risk of adverse respiratory outcomes in these infants. Improvement in indoor air quality following hospitalization for bronchiolitis may be a prevention opportunity to reduce symptom burden. Use of stand-alone high efficiency particulate air (HEPA) filtration units is a simple method to reduce particulate matter ≤ 2.5 µm in diameter (PM2.5), a common component of household air pollution that is strongly linked to health effects. METHODS BREATHE is a multi-center, parallel, double-blind, randomized controlled clinical trial. Two hundred twenty-eight children < 12 months of age hospitalized for the first time with bronchiolitis will participate. Children will be randomized 1:1 to receive a 24-week home intervention with filtration units containing HEPA and carbon filters (in the child's sleep space and a common room) or to a control group with units that do not contain HEPA and carbon filters. The primary objective is to determine if use of HEPA filtration units reduces respiratory symptom burden for 24 weeks compared to use of control units. Secondary objectives are to assess the efficacy of the HEPA intervention relative to control on (1) number of unscheduled healthcare visits for respiratory complaints, (2) child quality of life, and (3) average PM2.5 levels in the home. DISCUSSION We propose to test the use of HEPA filtration to improve indoor air quality as a strategy to reduce post-bronchiolitis respiratory symptom burden in at-risk infants with severe bronchiolitis. If the intervention proves successful, this trial will support use of HEPA filtration for children with bronchiolitis to reduce respiratory symptom burden following hospitalization. TRIAL REGISTRATION NCT05615870. Registered on November 14, 2022.
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Affiliation(s)
- Kelly Cowan
- Department of Pediatrics, Larner College of Medicine at the University of Vermont, 111 Colchester Ave, Smith 5, Burlington, VT, 05403, USA.
| | - Erin O Semmens
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Jeannette Y Lee
- University of Arkansas for Medical Sciences, 4301 West Markham, #781, Little Rock, AR, 72205, USA
| | - Ethan S Walker
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Paul G Smith
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Linda Fu
- National Institutes of Health Environmental Influences On Child, Health Outcomes (ECHO) Program, 11601, Landsdown Street, Rockville, MD, 20852, USA
| | - Rosalyn Singleton
- Alaska Native Tribal Health Consortium, AIP-CDC, 4055 Tudor Centre Drive, Anchorage, AK, 99508, USA
| | - Sara McClure Cox
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Jennifer Faiella
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Laurie Chassereau
- University of Vermont, Given C421, 89 Beaumont Ave, Burlington, VT, 05405, USA
| | - Lora Lawrence
- IDeA States Pediatric Network Data Coordination and Operations Center, 13 Children's Way, Slot 512-35, Little Rock, AR, 72202, USA
| | - Jun Ying
- Department of Family Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Mail Stop F496, Academic Office One L15-3407, 12631 E 17th Avenue, Aurora, CO, 80045, USA
| | - Jaime Baldner
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, 4301 W Markham Street, Little Rock, AR, 72205, USA
| | - Maryam Garza
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, 4301 W Markham Street, Little Rock, AR, 72205, USA
| | - Robert Annett
- University of New Mexico Health Sciences Center, Albuquerque, NM, 87106, USA
| | - Sheva K Chervinskiy
- Cook Children's Department of Immunology, 1500 Cooper St, Fort Worth, TX, 76104, USA
| | - Jessica Snowden
- IDeA States Pediatric Network Data Coordination and Operations Center, 13 Children's Way, Slot 512-35, Little Rock, AR, 72202, USA
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Socio-ecological determinants of under-five mortality in Nigeria: exploring the roles of neighbourhood poverty and use of solid cooking fuel. J Biosoc Sci 2023; 55:22-34. [PMID: 34743767 DOI: 10.1017/s0021932021000614] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Globally, despite the decline in under-five mortality rate from 213 per 1000 live births in 1990 to 132 per 1000 live births in 2018, the pace of decline has been slow, and this can be attributed to poor progress in child survival interventions, including those aimed at reducing children's exposure to household pollution. This study examined the influence of neighbourhood poverty and the use of solid cooking fuels on under-five mortality in Nigeria. Data for the study comprised a weighted sample of 124,442 birth histories of childbearing women who reported using cooking fuels in the kitchens located within their house drawn from the 2018 Nigeria Demographic and Health Survey. Descriptive and analytical analyses were carried out, including frequency tables, Pearson's chi-squared test and multivariate analysis using a Cox proportional regression model. The results showed that the risk of under-five mortality was significantly associated with mothers residing in areas of high neighbourhood poverty (HR: 1.44, CI: 1.34-1.54) and the use of solid cooking fuels within the house (HR: 2.26, CI: 2.06-2.49). Government and non-governmental organizations in Nigeria should initiate strategic support and campaigns aimed at empowering and enlightening mothers on the need to reduce their use of solid cooking fuels within the house to reduce harmful emissions and their child health consequences.
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Qiu AY, Leng S, McCormack M, Peden DB, Sood A. Lung Effects of Household Air Pollution. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2807-2819. [PMID: 36064186 DOI: 10.1016/j.jaip.2022.08.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Biomass fuel smoke, secondhand smoke, and oxides of nitrogen are common causes of household air pollution (HAP). Almost 2.4 billion people worldwide use solid fuels for cooking and heating, mostly in low- and middle-income countries. Wood combustion for household heating is also common in many areas of high-income countries, and minorities are particularly vulnerable. HAP in low- and middle-income countries is associated with asthma, acute respiratory tract infections in adults and children, chronic obstructive pulmonary disease, lung cancer, tuberculosis, and respiratory mortality. Although wood smoke exposure levels in high-income countries are typically lower than in lower-income countries, it is similarly associated with accelerated lung function decline, higher prevalence of airflow obstruction and chronic bronchitis, and higher all-cause and respiratory cause-specific mortality. Household air cleaners with high-efficiency particle filters have mixed effects on asthma and chronic obstructive pulmonary disease outcomes. Biomass fuel interventions in low-income countries include adding chimneys to cookstoves, improving biomass fuel combustion stoves, and switching fuel to liquid petroleum gas. Still, the impact on health outcomes is inconsistent. In high-income countries, strategies for reducing biomass fuel-related HAP are centered on community-level woodstove changeout programs, although the results are again inconsistent. In addition, initiatives to encourage home smoking bans have mixed success in households with children. Environmental solutions to reduce HAP have varying success in reducing pollutants and health problems. Improved understanding of indoor air quality factors and actions that prevent degradation or improve polluted indoor air may lead to enhanced environmental health policies, but health outcomes must be rigorously examined.
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Affiliation(s)
- Anna Y Qiu
- Johns Hopkins University, School of Medicine, Baltimore, Md
| | - Shuguang Leng
- University of New Mexico School of Medicine, Albuquerque, NM; University of New Mexico Comprehensive Cancer Center, Albuquerque, NM
| | | | - David B Peden
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Akshay Sood
- University of New Mexico School of Medicine, Albuquerque, NM; Miners Colfax Medical Center, Raton, NM.
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Walker ES, Noonan CW, Belcourt A, Boulafentis J, Garcia C, Graham J, Hoskie N, Quintana E, Semmens EO, Simpson J, Smith P, Teasley H, Ware D, Weiler E, Ward TJ. Efficacy of air filtration and education interventions on fine particulate matter among rural Native American homes heated with wood stoves: Results from the EldersAIR randomized trial. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 843:157029. [PMID: 35777562 PMCID: PMC9829403 DOI: 10.1016/j.scitotenv.2022.157029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Native Americans living in rural areas often rely upon wood stoves for home heating that can lead to elevated indoor concentrations of fine particulate matter (PM2.5). Wood stove use is associated with adverse health outcomes, which can be a particular risk in vulnerable populations including older adults. OBJECTIVES We assessed the impact of portable air filtration units and educational approaches that incorporated elements of traditional knowledge on indoor and personal PM2.5 concentrations among rural, Native American elder households with wood stoves. METHODS EldersAIR was a three-arm, pre-post randomized trial among rural households from the Navajo Nation and Nez Perce Tribe in the United States. We measured personal and indoor PM2.5 concentrations over 2-day sampling periods on up to four occasions across two consecutive winter seasons in elder participant homes. We assessed education and air filtration intervention efficacy using linear mixed models. RESULTS Geometric mean indoor PM2.5 concentrations were 50.5 % lower (95 % confidence interval: -66.1, -27.8) in the air filtration arm versus placebo, with similar results for personal PM2.5. Indoor PM2.5 concentrations among education arm households were similar to placebo, although personal PM2.5 concentrations were 33.3 % lower for the education arm versus placebo (95 % confidence interval: -63.2, 21.1). SIGNIFICANCE The strong partnership between academic and community partners helped facilitate a culturally acceptable approach to a clinical trial intervention within the study communities. Portable air filtration units can reduce indoor PM2.5 that originates from indoor wood stoves, and this finding was supported in this study. The educational intervention component was meaningful to the communities, but did not substantially impact indoor PM2.5 relative to placebo. However, there is evidence that the educational interventions reduced indoor PM2.5 in some subsets of the study households. More study is required to determine ways to optimize educational interventions within Native American communities.
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Affiliation(s)
- Ethan S Walker
- Center for Population Health Research, University of Montana, Missoula, MT, USA; School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA.
| | - Curtis W Noonan
- Center for Population Health Research, University of Montana, Missoula, MT, USA; School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Annie Belcourt
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | | | | | - Jon Graham
- Center for Population Health Research, University of Montana, Missoula, MT, USA
| | - Nolan Hoskie
- Navajo Nation Environmental Protection Agency, Window Rock, AZ, USA
| | - Eugenia Quintana
- Navajo Nation Environmental Protection Agency, Window Rock, AZ, USA
| | - Erin O Semmens
- Center for Population Health Research, University of Montana, Missoula, MT, USA; School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Julie Simpson
- Nez Perce Tribe Air Quality Program, Lapwai, ID, USA
| | - Paul Smith
- Center for Population Health Research, University of Montana, Missoula, MT, USA; School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Howard Teasley
- Nez Perce Tribe Forestry and Fire Management Division, Lapwai, ID, USA
| | - Desirae Ware
- Center for Population Health Research, University of Montana, Missoula, MT, USA; School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Emily Weiler
- Center for Population Health Research, University of Montana, Missoula, MT, USA; School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Tony J Ward
- Center for Population Health Research, University of Montana, Missoula, MT, USA; School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
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Leng S, Picchi MA, Meek PM, Jiang M, Bayliss SH, Zhai T, Bayliyev RI, Tesfaigzi Y, Campen MJ, Kang H, Zhu Y, Lan Q, Sood A, Belinsky SA. Wood smoke exposure affects lung aging, quality of life, and all-cause mortality in New Mexican smokers. Respir Res 2022; 23:236. [PMID: 36076291 PMCID: PMC9454202 DOI: 10.1186/s12931-022-02162-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background The role of wood smoke (WS) exposure in the etiology of chronic obstructive pulmonary disease (COPD), lung cancer (LC), and mortality remains elusive in adults from countries with low ambient levels of combustion-emitted particulate matter. This study aims to delineate the impact of WS exposure on lung health and mortality in adults age 40 and older who ever smoked. Methods We assessed health impact of self-reported “ever WS exposure for over a year” in the Lovelace Smokers Cohort using both objective measures (i.e., lung function decline, LC incidence, and deaths) and two health related quality-of-life questionnaires (i.e., lung disease-specific St. George's Respiratory Questionnaire [SGRQ] and the generic 36-item short-form health survey). Results Compared to subjects without WS exposure, subjects with WS exposure had a more rapid decline of FEV1 (− 4.3 ml/s, P = 0.025) and FEV1/FVC ratio (− 0.093%, P = 0.015), but not of FVC (− 2.4 ml, P = 0.30). Age modified the impacts of WS exposure on lung function decline. WS exposure impaired all health domains with the increase in SGRQ scores exceeding the minimal clinically important difference. WS exposure increased hazard for incidence of LC and death of all-cause, cardiopulmonary diseases, and cancers by > 50% and shortened the lifespan by 3.5 year. We found no evidence for differential misclassification or confounding from socioeconomic status for the health effects of WS exposure. Conclusions We identified epidemiological evidence supporting WS exposure as an independent etiological factor for the development of COPD through accelerating lung function decline in an obstructive pattern. Time-to-event analyses of LC incidence and cancer-specific mortality provide human evidence supporting the carcinogenicity of WS exposure. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-02162-y.
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Affiliation(s)
- Shuguang Leng
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA. .,Cancer Control and Population Sciences, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, 87131, USA. .,Lung Cancer Program, Lovelace Biomedical Research Institute, Albuquerque, NM, 87108, USA.
| | - Maria A Picchi
- Lung Cancer Program, Lovelace Biomedical Research Institute, Albuquerque, NM, 87108, USA
| | - Paula M Meek
- College of Nursing, University of Utah, Salt Lake City, UT, 84112, USA
| | - Menghui Jiang
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Samuel H Bayliss
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Ting Zhai
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Ruslan I Bayliyev
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Yohannes Tesfaigzi
- Pulmonary and Critical Care Medicine Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 01255, USA
| | - Matthew J Campen
- Cancer Control and Population Sciences, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, 87131, USA.,College of Pharmacy, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Huining Kang
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA.,Cancer Control and Population Sciences, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, 87131, USA
| | - Yiliang Zhu
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Akshay Sood
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Steven A Belinsky
- Cancer Control and Population Sciences, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, 87131, USA.,Lung Cancer Program, Lovelace Biomedical Research Institute, Albuquerque, NM, 87108, USA
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Walker ES, Semmens EO, Belcourt A, Boyer BB, Erdei E, Graham J, Hopkins SE, Lewis JL, Smith PG, Ware D, Weiler E, Ward TJ, Noonan CW. Efficacy of Air Filtration and Education Interventions on Indoor Fine Particulate Matter and Child Lower Respiratory Tract Infections among Rural U.S. Homes Heated with Wood Stoves: Results from the KidsAIR Randomized Trial. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:47002. [PMID: 35394807 PMCID: PMC8992966 DOI: 10.1289/ehp9932] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 02/18/2022] [Accepted: 03/18/2022] [Indexed: 05/24/2023]
Abstract
BACKGROUND Millions of rural U.S. households are heated with wood stoves. Wood stove use can lead to high indoor concentrations of fine particulate matter [airborne particles ≤2.5μm in aerodynamic diameter (PM2.5)] and is associated with lower respiratory tract infection (LRTI) in children. OBJECTIVES We assessed the impact of low-cost educational and air filtration interventions on childhood LRTI and indoor PM2.5 in rural U.S. homes with wood stoves. METHODS The Kids Air Quality Interventions for Reducing Respiratory Infections (KidsAIR) study was a parallel three-arm (education, portable air filtration unit, control), post-only randomized trial in households from Alaska, Montana, and Navajo Nation (Arizona and New Mexico) with a wood stove and one or more children <5 years of age. We tracked LRTI cases for two consecutive winter seasons and measured indoor PM2.5 over a 6-d period during the first winter. We assessed results using two analytical frameworks: a) intervention efficacy on LRTI and PM2.5 (intent-to-treat), and b) association between PM2.5 and LRTI (exposure-response). RESULTS There were 61 LRTI cases from 14,636 child-weeks of follow-up among 461 children. In the intent-to-treat analysis, children in the education arm [odds ratio (OR)=0.98; 95% confidence interval (CI): 0.35, 2.72] and the filtration arm (OR=1.23; 95% CI: 0.46, 3.32) had similar odds of LRTI vs. control. Geometric mean PM2.5 concentrations were similar to control in the education arm (11.77% higher; 95% CI: -16.57, 49.72) and air filtration arm (6.96% lower; 95% CI: -30.50, 24.55). In the exposure-response analysis, odds of LRTI were 1.45 times higher (95% CI: 1.02, 2.05) per interquartile range (25 μg/m3) increase in mean indoor PM2.5. DISCUSSION We did not observe meaningful differences in LRTI or indoor PM2.5 in the air filtration or education arms compared with the control arm. Results from the exposure-response analysis provide further evidence that biomass air pollution adversely impacts childhood LRTI. Our results highlight the need for novel, effective intervention strategies in households heated with wood stoves. https://doi.org/10.1289/EHP9932.
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Affiliation(s)
- Ethan S. Walker
- Center for Population Health Research, University of Montana, Missoula, Montana, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Erin O. Semmens
- Center for Population Health Research, University of Montana, Missoula, Montana, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Annie Belcourt
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Bert B. Boyer
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Alaska, USA
- Oregon Health & Science University, Portland, Oregon, USA
| | - Esther Erdei
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - Jon Graham
- Center for Population Health Research, University of Montana, Missoula, Montana, USA
| | - Scarlett E. Hopkins
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Alaska, USA
- Oregon Health & Science University, Portland, Oregon, USA
| | - Johnnye L. Lewis
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - Paul G. Smith
- Center for Population Health Research, University of Montana, Missoula, Montana, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Desirae Ware
- Center for Population Health Research, University of Montana, Missoula, Montana, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Emily Weiler
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Tony J. Ward
- Center for Population Health Research, University of Montana, Missoula, Montana, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Curtis W. Noonan
- Center for Population Health Research, University of Montana, Missoula, Montana, USA
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
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Thompson LM. Invited Perspective: Household Air Pollution-Can Randomized Controlled Trials Provide the Answers to Complex Intervention Questions? ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:41301. [PMID: 35394811 PMCID: PMC8992968 DOI: 10.1289/ehp11096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Lisa M. Thompson
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
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Study of Operation of the Thermoelectric Generators Dedicated to Wood-Fired Stoves. ENERGIES 2021. [DOI: 10.3390/en14196264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Thermoelectric generators are devices that harvest waste heat and convert it into useful power. They are considered as an additional power source in the domestic sector, but they can also be installed in off-grid objects. In addition, they are a promising solution for regions where there is a lack of electricity. Since biomass heating and cooking stoves are widely used, it is very appropriate to integrate thermoelectric generators with wood-fired stoves. This paper shows the experimental analysis of a micro-cogeneration system equipped with a wood-fired stove and two prototypical constructions of thermoelectric generators dedicated to mounting on the flue gas channel. The first version was equipped with one basic thermoelectric module and used to test various cooling methods, while the second construction integrated four basic thermoelectric modules and a water-cooling system. During the tests conducted, the electricity generated in the thermoelectric generators was measured by the electronic load, which allowed the simulation of various operating conditions. The results obtained confirm the possibility of using thermoelectric generators to generate power from waste heat resulting from the wood-fired stove. The maximum power obtained during the discussed combustion process was 15.4 W (if this value occurred during the entire main phase, the energy generated would be at a level of approximately 30 Wh), while the heat transferred to the water was ca. 750 Wh. Furthermore, two specially introduced factors (CPC and CPTC) allowed the comparison of developed generators, and the conclusion was drawn that both developed constructions were characterized by higher CPC values compared to available units in the market. By introducing thermoelectric modules characterized by higher performance, a higher amount of electricity generated may be provided, and sufficient levels of current and voltage may be achieved.
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Shaw JL, Semmens E, Okihiro M, Lewis JL, Hirschfeld M, VanWagoner TM, Stephens L, Easa D, Ross JL, Graham N, Watson SE, Szyld EG, Dillard DA, Pyles LA, Darden PM, Carlson JC, Smith PG, McCulloh RJ, Snowden JN, Adeky SH, Singleton R. Best Practices for Conducting Clinical Trials With Indigenous Children in the United States. Am J Public Health 2021; 111:1645-1653. [PMID: 34436921 PMCID: PMC8494399 DOI: 10.2105/ajph.2021.306372] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 11/04/2022]
Abstract
We provide guidance for conducting clinical trials with Indigenous children in the United States. We drew on extant literature and our experience to describe 3 best practices for the ethical and effective conduct of clinical trials with Indigenous children. Case examples of pediatric research conducted with American Indian, Alaska Native, and Native Hawaiian communities are provided to illustrate these practices. Ethical and effective clinical trials with Indigenous children require early and sustained community engagement, building capacity for Indigenous research, and supporting community oversight and ownership of research. Effective engagement requires equity, trust, shared interests, and mutual benefit among partners over time. Capacity building should prioritize developing Indigenous researchers. Supporting community oversight and ownership of research means that investigators should plan for data-sharing agreements, return or destruction of data, and multiple regulatory approvals. Indigenous children must be included in clinical trials to reduce health disparities and improve health outcomes in these pediatric populations. Establishment of the Environmental Influences on Child Health Outcomes Institutional Development Award States Pediatric Clinical Trials Network (ECHO ISPCTN) in 2016 creates a unique and timely opportunity to increase Indigenous children's participation in state-of-the-art clinical trials.
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Affiliation(s)
- Jennifer L Shaw
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Erin Semmens
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - May Okihiro
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Johnnye L Lewis
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Matthew Hirschfeld
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Timothy M VanWagoner
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Lancer Stephens
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - David Easa
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Judith L Ross
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Niki Graham
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Sara E Watson
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Edgardo G Szyld
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Denise A Dillard
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Lee A Pyles
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Paul M Darden
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - John C Carlson
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Paul G Smith
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Russell J McCulloh
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Jessica N Snowden
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Sarah H Adeky
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Rosalyn Singleton
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
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Walker ES, Noonan CW, Semmens EO, Ware D, Smith P, Boyer BB, Erdei E, Hopkins SE, Lewis J, Belcourt A, Ward TJ. Indoor fine particulate matter and demographic, household, and wood stove characteristics among rural US homes heated with wood fuel. INDOOR AIR 2021; 31:1109-1124. [PMID: 33620109 PMCID: PMC8217112 DOI: 10.1111/ina.12808] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 05/31/2023]
Abstract
Household heating using wood stoves is common practice in many rural areas of the United States (US) and can lead to elevated concentrations of indoor fine particulate matter (PM2.5 ). We collected 6-day measures of indoor PM2.5 during the winter and evaluated household and stove-use characteristics in homes at three rural and diverse study sites. The median indoor PM2.5 concentration across all homes was 19 µg/m3 , with higher concentrations in Alaska (median = 30, minimum = 4, maximum = 200, n = 10) and Navajo Nation homes (median = 29, minimum = 3, maximum = 105, n = 23) compared with Montana homes (median = 16, minimum = 2, maximum = 139, n = 59). Households that had not cleaned the chimney within the past year had 65% higher geometric mean PM2.5 compared to those with chimney cleaned within 6 months (95% confidence interval [CI]: -1, 170). Based on a novel wood stove grading method, homes with low-quality and medium-quality stoves had substantially higher PM2.5 compared to homes with higher-quality stoves (186% higher [95% CI: 32, 519] and 161% higher; [95% CI:27, 434], respectively). Our findings highlight the need for, and complex nature of, regionally appropriate interventions to reduce indoor air pollution in rural wood-burning regions. Higher-quality stoves and behavioral practices such as regular chimney cleaning may help improve indoor air quality in such homes.
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Affiliation(s)
- Ethan S. Walker
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Curtis W. Noonan
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Erin O. Semmens
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Desirae Ware
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Paul Smith
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Bert B. Boyer
- Center for Alaska Native Health Research, University of Alaska Fairbanks, AK, USA
- Oregon Health & Science University, Portland, OR, USA
| | - Esther Erdei
- Community Environmental Health Program, University of New Mexico College of Pharmacy, Health Sciences Center, Albuquerque, NM, USA
| | - Scarlett E. Hopkins
- Center for Alaska Native Health Research, University of Alaska Fairbanks, AK, USA
- Oregon Health & Science University, Portland, OR, USA
| | - Johnnye Lewis
- Community Environmental Health Program, University of New Mexico College of Pharmacy, Health Sciences Center, Albuquerque, NM, USA
| | - Annie Belcourt
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Tony J. Ward
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
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Webb L, Sleeth DK, Handy R, Stenberg J, Schaefer C, Collingwood SC. Indoor Air Quality Issues for Rocky Mountain West Tribes. Front Public Health 2021; 9:606430. [PMID: 33748060 PMCID: PMC7973111 DOI: 10.3389/fpubh.2021.606430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
Native American populations face considerable health disparities, especially among those who live on reservations, where access to healthcare, education, and safe housing can be limited. Previous research on tribal housing has raised concerns about housing construction, damage, and possible linkage to adverse health effects (e.g., asthma). This community-based participatory research (CBPR) project investigated indoor air quality issues on two Rocky Mountain west reservations. At the onset of the project, the research team formed a partnership with community advisory boards (CABs) consisting of representatives from tribal councils and community members. Research design, implementation, and dissemination all took place in full collaboration with the CABs following approval through official tribal resolutions. Residential homes were monitored for particulate matter with diameter <2.5 microns (PM2.5) and radon concentrations. Low-cost air quality sensors and activated charcoal radon test kits were placed in tribal households for 6-8 days. A large amount of data were below the sensor limit of quantification (LOQ), but several homes had daily averages that exceeded suggested PM2.5 guidelines, suggestive of the potential for high exposure. Additionally, nearly half of all homes sampled had radon levels above the EPA action level, with mitigation activities initiated for the most concerning homes. Findings from this study indicate the need for future community-wide assessments to determine the magnitude and patterns of indoor air quality issues.
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Affiliation(s)
- Logan Webb
- Department of Family and Preventive Medicine, Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, United States
| | - Darrah K Sleeth
- Department of Family and Preventive Medicine, Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, United States
| | - Rod Handy
- Physician Assistant Studies, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, United States
| | - Jared Stenberg
- Department of Family and Preventive Medicine, Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, United States
| | - Camie Schaefer
- Department of Family and Preventive Medicine, Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, United States
| | - Scott C Collingwood
- Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
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Allen RW, Barn P. Individual- and Household-Level Interventions to Reduce Air Pollution Exposures and Health Risks: a Review of the Recent Literature. Curr Environ Health Rep 2020; 7:424-440. [PMID: 33241434 PMCID: PMC7749091 DOI: 10.1007/s40572-020-00296-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW We reviewed recent peer-reviewed literature on three categories of individual- and household-level interventions against air pollution: air purifiers, facemasks, and behavior change. RECENT FINDINGS High-efficiency particulate air/arresting (HEPA) filter air purifier use over days to weeks can substantially reduce fine particulate matter (PM2.5) concentrations indoors and improve subclinical cardiopulmonary health. Modeling studies suggest that the population-level benefits of HEPA filter air purification would often exceed costs. Well-fitting N95 and equivalent respirators can reduce PM2.5 exposure, with several randomized crossover studies also reporting improvements in subclinical cardiovascular health. The health benefits of other types of face coverings have not been tested and their effectiveness in reducing exposure is highly variable, depends largely on fit, and is unrelated to cost. Behavior modifications may reduce exposure, but there has been little research on health impacts. There is now substantial evidence that HEPA filter air purifiers reduce indoor PM2.5 concentrations and improve subclinical health indicators. As a result, their use is being recommended by a growing number of government and public health organizations. Several studies have also reported subclinical cardiovascular health benefits from well-fitting respirators, while evidence of health benefits from other types of facemasks and behavior changes remains very limited. In situations when emissions cannot be controlled at the source, such as during forest fires, individual- or household-level interventions may be the primary option. In most cases, however, such interventions should be supplemental to emission reduction efforts that benefit entire communities.
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Affiliation(s)
- Ryan W Allen
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
| | - Prabjit Barn
- Legacy for Airway Health, Vancouver Coastal Health, Vancouver, BC, Canada
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