1
|
Zheng J, Wang Y, Mao B, Li Y, Li J, Yang J, Meng Z, Luo B. The psychological status mediates the effect of indoor air pollution on recurrent spontaneous abortion. ENVIRONMENTAL RESEARCH 2022; 215:114220. [PMID: 36049508 DOI: 10.1016/j.envres.2022.114220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 07/30/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Indoor air pollution (IAP) exposure and psychological status have been recognized as important risk factors for adverse pregnancy outcomes, but their mediating effects on recurrent spontaneous abortion (RSA) have not been analyzed. Therefore, the purpose of this study is to explore the association between IAP and RSA and to examine the mediating effect of psychological status on their association. METHODS This study included 830 RSA cases and 2156 controls in Gansu province, China. The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) questionnaires were used to collect information on participants' psychological status. The IAP exposure was collected by the survey on cooking fuel use, kitchen ventilation characteristics, cooking styles, and indoor smoking, etc. Multivariable logistic regression was used to examine the associations between IAP exposure and RSA. The mediation analysis was used to evaluate the mediation effects of IAP and psychological status on RSA while controlling for confounding. RESULTS Among these cases, 16.87% cooked with unclean cooking fuel (UCF) and 37.00% lacked cooking ventilation, which was much higher than the controls. Active smoking and the use of UCF were associated with RSA, with an odds ratio (OR) of 3.374 [95% confidence interval (CI): 1.510-7.541] and 1.822 (95% CI: 1.328-2.500), respectively. We found that the use of a range hood was a protective factor for RSA, with an OR of 0.590 (95% CI: 0.463-0.752). There was a significant mediation effect of depression on the association between IAP and RSA, which accounted for 5.61%-9.22% of the total effect of IAP on RSA. CONCLUSION The IAP may be an important risk factor for RSA, which may be intensified by the poor psychological status, and the use of ventilation equipment when cooking is a protective factor for RSA.
Collapse
Affiliation(s)
- Jie Zheng
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, PR China
| | - Yanxia Wang
- Department of Scientific Research Center of Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, 730030, PR China
| | - Baohong Mao
- Department of Scientific Research Center of Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, 730030, PR China
| | - Yamei Li
- Department of Scientific Research Center of Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, 730030, PR China
| | - Jing Li
- Department of Scientific Research Center of Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, 730030, PR China
| | - Jie Yang
- Department of Reproductive Medicine Center of Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, 730030, PR China
| | - Zhaoyan Meng
- Department of Reproductive Medicine Center of Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, 730030, PR China.
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, PR China.
| |
Collapse
|
2
|
Lim S, Bassey E, Bos B, Makacha L, Varaden D, Arku RE, Baumgartner J, Brauer M, Ezzati M, Kelly FJ, Barratt B. Comparing human exposure to fine particulate matter in low and high-income countries: A systematic review of studies measuring personal PM 2.5 exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 833:155207. [PMID: 35421472 PMCID: PMC7615091 DOI: 10.1016/j.scitotenv.2022.155207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 04/02/2022] [Accepted: 04/08/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Due to the adverse health effects of air pollution, researchers have advocated for personal exposure measurements whereby individuals carry portable monitors in order to better characterise and understand the sources of people's pollution exposure. OBJECTIVES The aim of this systematic review is to assess the differences in the magnitude and sources of personal PM2.5 exposures experienced between countries at contrasting levels of income. METHODS This review summarised studies that measured participants personal exposure by carrying a PM2.5 monitor throughout their typical day. Personal PM2.5 exposures were summarised to indicate the distribution of exposures measured within each country income category (based on low (LIC), lower-middle (LMIC), upper-middle (UMIC), and high (HIC) income countries) and between different groups (i.e. gender, age, urban or rural residents). RESULTS From the 2259 search results, there were 140 studies that met our criteria. Overall, personal PM2.5 exposures in HICs were lower compared to other countries, with UMICs exposures being slightly lower than exposures measured in LMICs or LICs. 34% of measured groups in HICs reported below the ambient World Health Organisation 24-h PM2.5 guideline of 15 μg/m3, compared to only 1% of UMICs and 0% of LMICs and LICs. There was no difference between rural and urban participant exposures in HICs, but there were noticeably higher exposures recorded in rural areas compared to urban areas in non-HICs, due to significant household sources of PM2.5 in rural locations. In HICs, studies reported that secondhand smoke, ambient pollution infiltrating indoors, and traffic emissions were the dominant contributors to personal exposures. While, in non-HICs, household cooking and heating with biomass and coal were reported as the most important sources. CONCLUSION This review revealed a growing literature of personal PM2.5 exposure studies, which highlighted a large variability in exposures recorded and severe inequalities in geographical and social population subgroups.
Collapse
Affiliation(s)
- Shanon Lim
- MRC Centre for Environment and Health, Imperial College London, UK.
| | - Eridiong Bassey
- MRC Centre for Environment and Health, Imperial College London, UK
| | - Brendan Bos
- MRC Centre for Environment and Health, Imperial College London, UK
| | - Liberty Makacha
- MRC Centre for Environment and Health, Imperial College London, UK; Place Alert Labs, Department of Surveying and Geomatics, Faculty of Science and Technology, Midlands State University, Zimbabwe; Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, UK
| | - Diana Varaden
- MRC Centre for Environment and Health, Imperial College London, UK; NIHR-HPRU Environmental Exposures and Health, School of Public Health, Imperial College London, UK
| | - Raphael E Arku
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, USA
| | - Jill Baumgartner
- Institute for Health and Social Policy, and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Michael Brauer
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada; Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Majid Ezzati
- MRC Centre for Environment and Health, Imperial College London, UK; Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, UK; Regional Institute for Population Studies, University of Ghana, Legon, Ghana
| | - Frank J Kelly
- MRC Centre for Environment and Health, Imperial College London, UK; NIHR-HPRU Environmental Exposures and Health, School of Public Health, Imperial College London, UK
| | - Benjamin Barratt
- MRC Centre for Environment and Health, Imperial College London, UK; NIHR-HPRU Environmental Exposures and Health, School of Public Health, Imperial College London, UK
| |
Collapse
|
3
|
Estimating long-term average household air pollution concentrations from repeated short-term measurements in the presence of seasonal trends and crossover. Environ Epidemiol 2022; 6:e188. [PMID: 35169666 PMCID: PMC8835562 DOI: 10.1097/ee9.0000000000000188] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/26/2021] [Indexed: 11/26/2022] Open
Abstract
Estimating long-term exposure to household air pollution is essential for quantifying health effects of chronic exposure and the benefits of intervention strategies. However, typically only a small number of short-term measurements are made. We compare different statistical models for combining these short-term measurements into predictions of a long-term average, with emphasis on the impact of temporal trends in concentrations and crossover in study design. We demonstrate that a linear mixed model that includes time adjustment provides the best predictions of long-term average, which have lower error than using household averages or mixed models without time, for a variety of different study designs and underlying temporal trends. In a case study of a cookstove intervention study in Honduras, we further demonstrate how, in the presence of strong seasonal variation, long-term average predictions from the mixed model approach based on only two or three measurements can have less error than predictions based on an average of up to six measurements. These results have important implications for the efficiency of designs and analyses in studies assessing the chronic health impacts of long-term exposure to household air pollution.
Collapse
|
4
|
Sambandam S, Mukhopadhyay K, Sendhil S, Ye W, Pillarisetti A, Thangavel G, Natesan D, Ramasamy R, Natarajan A, Aravindalochanan V, Vinayagamoorthi A, Sivavadivel S, Uma Maheswari R, Balakrishnan L, Gayatri S, Nargunanathan S, Madhavan S, Puttaswamy N, Garg SS, Quinn A, Rosenthal J, Johnson M, Liao J, Steenland K, Piedhrahita R, Peel J, Checkley W, Clasen T, Balakrishnan K. Exposure contrasts associated with a liquefied petroleum gas (LPG) intervention at potential field sites for the multi-country household air pollution intervention network (HAPIN) trial in India: results from pilot phase activities in rural Tamil Nadu. BMC Public Health 2020; 20:1799. [PMID: 33243198 PMCID: PMC7690197 DOI: 10.1186/s12889-020-09865-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/09/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The Household Air Pollution Intervention Network (HAPIN) trial aims to assess health benefits of a liquefied petroleum gas (LPG) cookfuel and stove intervention among women and children across four low- and middle-income countries (LMICs). We measured exposure contrasts for women, achievable under alternative conditions of biomass or LPG cookfuel use, at potential HAPIN field sites in India, to aid in site selection for the main trial. METHODS We recruited participants from potential field sites within Villupuram and Nagapattinam districts in Tamil Nadu, India, that were identified during a feasibility assessment. We performed. (i) cross-sectional measurements on women (N = 79) using either biomass or LPG as their primary cookfuel and (ii) before-and-after measurements on pregnant women (N = 41), once at baseline while using biomass fuel and twice - at 1 and 2 months - after installation of an LPG stove and free fuel intervention. We involved participants to co-design clothing and instrument stands for personal and area sampling. We measured 24 or 48-h personal exposures and kitchen and ambient concentrations of fine particulate matter (PM2.5) using gravimetric samplers. RESULTS In the cross-sectional analysis, median (interquartile range, IQR) kitchen PM2.5 concentrations in biomass and LPG using homes were 134 μg/m3 [IQR:71-258] and 27 μg/m3 [IQR:20-47], while corresponding personal exposures were 75 μg/m3 [IQR:55-104] and 36 μg/m3 [IQR:26-46], respectively. In before-and-after analysis, median 48-h personal exposures for pregnant women were 72 μg/m3 [IQR:49-127] at baseline and 25 μg/m3 [IQR:18-35] after the LPG intervention, with a sustained reduction of 93% in mean kitchen PM2.5 concentrations and 78% in mean personal PM2.5 exposures over the 2 month intervention period. Median ambient concentrations were 23 μg/m3 [IQR:19-27). Participant feedback was critical in designing clothing and instrument stands that ensured high compliance. CONCLUSIONS An LPG stove and fuel intervention in the candidate HAPIN trial field sites in India was deemed suitable for achieving health-relevant exposure reductions. Ambient concentrations indicated limited contributions from other sources. Study results provide critical inputs for the HAPIN trial site selection in India, while also contributing new information on HAP exposures in relation to LPG interventions and among pregnant women in LMICs. TRIAL REGISTRATION ClinicalTrials.Gov. NCT02944682 ; Prospectively registered on October 17, 2016.
Collapse
Affiliation(s)
- Sankar Sambandam
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - Krishnendu Mukhopadhyay
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - Saritha Sendhil
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - Wenlu Ye
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ajay Pillarisetti
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Gurusamy Thangavel
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - Durairaj Natesan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - Rengaraj Ramasamy
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - Amudha Natarajan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - Vigneswari Aravindalochanan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - A Vinayagamoorthi
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - S Sivavadivel
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - R Uma Maheswari
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - Lingeswari Balakrishnan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - S Gayatri
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - Srinivasan Nargunanathan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - Sathish Madhavan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - Naveen Puttaswamy
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - Sarada S Garg
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India
| | - Ashlinn Quinn
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Josh Rosenthal
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | | | - Jiawen Liao
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kyle Steenland
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Jennifer Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Thomas Clasen
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research (Deemed University), Porur, Chennai, 600116, India.
| |
Collapse
|
5
|
Grajeda LM, Thompson LM, Arriaga W, Canuz E, Omer SB, Sage M, Azziz-Baumgartner E, Bryan JP, McCracken JP. Effectiveness of Gas and Chimney Biomass Stoves for Reducing Household Air Pollution Pregnancy Exposure in Guatemala: Sociodemographic Effect Modifiers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217723. [PMID: 33105825 PMCID: PMC7660060 DOI: 10.3390/ijerph17217723] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/16/2020] [Accepted: 10/17/2020] [Indexed: 12/18/2022]
Abstract
Household air pollution (HAP) due to solid fuel use during pregnancy is associated with adverse birth outcomes. The real-life effectiveness of clean cooking interventions has been disappointing overall yet variable, but the sociodemographic determinants are not well described. We measured personal 24-h PM2.5 (particulate matter <2.5 µm in aerodynamic diameter) thrice in pregnant women (n = 218) gravimetrically with Teflon filter, impactor, and personal pump setups. To estimate the effectiveness of owning chimney and liquefied petroleum gas (LPG) stoves (i.e., proportion of PM2.5 exposure that would be prevented) and to predict subject-specific typical exposures, we used linear mixed-effects models with log (PM2.5) as dependent variable and random intercept for subject. Median (IQR) personal PM2.5 in µg/m3 was 148 (90-249) for open fire, 78 (51-125) for chimney stove, and 55 (34-79) for LPG stoves. Adjusted effectiveness of LPG stoves was greater in women with ≥6 years of education (49% (95% CI: 34, 60)) versus <6 years (26% (95% CI: 5, 42)). In contrast, chimney stove adjusted effectiveness was greater in women with <6 years of education (50% (95% CI: 38, 60)), rural residence (46% (95% CI: 34, 55)) and lowest SES (socio-economic status) quartile (59% (95% CI: 45, 70)) than ≥6 years education (16% (95% CI: 22, 43)), urban (23% (95% CI: -164, 42)) and highest SES quartile (-44% (95% CI: -183, 27)), respectively. A minority of LPG stove owners (12%) and no chimney owner had typical exposure below World Health Organization Air Quality guidelines (35 μg/m3). Although having a cleaner stove alone typically does not lower exposure enough to protect health, understanding sociodemographic determinants of effectiveness may lead to better targeting, implementation, and adoption of interventions.
Collapse
Affiliation(s)
- Laura M. Grajeda
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala; (E.C.); (J.P.M.)
- Correspondence:
| | - Lisa M. Thompson
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA;
| | - William Arriaga
- Regional Hospital, Ministry of Public Health Social Assistance of Guatemala, Quetzaltenango 09001, Guatemala;
| | - Eduardo Canuz
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala; (E.C.); (J.P.M.)
| | - Saad B. Omer
- Yale Institute for Global Health, Schools of Public Health & Medicine, Yale University, New Haven, CT 06510, USA;
| | - Michael Sage
- Division of Environmental Hazards and Health Effects, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA;
| | | | - Joe P. Bryan
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA;
- Centers for Disease Control and Prevention, Central American Regional Office, Guatemala City 01015, Guatemala
| | - John P. McCracken
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala; (E.C.); (J.P.M.)
| |
Collapse
|
6
|
Kephart JL, Fandiño-Del-Rio M, Williams KN, Malpartida G, Steenland K, Naeher LP, Gonzales GF, Chiang M, Checkley W, Koehler K. Nitrogen dioxide exposures from biomass cookstoves in the Peruvian Andes. INDOOR AIR 2020; 30:735-744. [PMID: 32064681 PMCID: PMC8884918 DOI: 10.1111/ina.12653] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/28/2020] [Accepted: 02/12/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND Household air pollution from biomass cookstoves is a major contributor to global morbidity and mortality, yet little is known about exposures to nitrogen dioxide (NO2 ). OBJECTIVE To characterize NO2 kitchen area concentrations and personal exposures among women with biomass cookstoves in the Peruvian Andes. METHODS We measured kitchen area NO2 concentrations at high-temporal resolution in 100 homes in the Peruvian Andes. We assessed personal exposure to NO2 in a subsample of 22 women using passive samplers. RESULTS Among 97 participants, the geometric mean (GM) highest hourly average NO2 concentration was 723 ppb (geometric standard deviation (GSD) 2.6) and the GM 24-hour average concentration was 96 ppb (GSD 2.6), 4.4 and 2.9 times greater than WHO indoor hourly (163 ppb) and annual (33 ppb) guidelines, respectively. Compared to the direct-reading instruments, we found similar kitchen area concentrations with 48-hour passive sampler measurements (GM 108 ppb, GSD 3.8). Twenty-seven percent of women had 48-hour mean personal exposures above WHO annual guidelines (GM 18 ppb, GSD 2.3). In univariate analyses, we found that roof, wall, and floor type, as well as higher SES, was associated with lower 24-hour kitchen area NO2 concentrations. PRACTICAL IMPLICATIONS Kitchen area concentrations and personal exposures to NO2 from biomass cookstoves in the Peruvian Andes far exceed WHO guidelines. More research is warranted to understand the role of this understudied household air pollutant on morbidity and mortality and to inform cleaner-cooking interventions for public health.
Collapse
Affiliation(s)
- Josiah L. Kephart
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
| | - Magdalena Fandiño-Del-Rio
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
| | - Kendra N. Williams
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Gary Malpartida
- Molecular Biology and Immunology Laboratory, Research Laboratory of Infectious Diseases, Department of Cell and Molecular Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Perú
- Biomedical Research Unit, Asociación Benéfica PRISMA, Lima, Perú
| | - Kyle Steenland
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Luke P. Naeher
- Environmental Health Science Department, College of Public Health, University of Georgia, Athens, GA, USA
| | - Gustavo F. Gonzales
- Laboratories of Investigation and Development, Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Perú
- High Altitude Research Institute, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Marilú Chiang
- Biomedical Research Unit, Asociación Benéfica PRISMA, Lima, Perú
| | - William Checkley
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Kirsten Koehler
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | |
Collapse
|
7
|
Carrasco-Escobar G, Schwarz L, Miranda JJ, Benmarhnia T. Revealing the air pollution burden associated with internal Migration in Peru. Sci Rep 2020; 10:7147. [PMID: 32346063 PMCID: PMC7188878 DOI: 10.1038/s41598-020-64043-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 04/05/2020] [Indexed: 11/09/2022] Open
Abstract
This study aims to quantify changes in outdoor (ambient) air pollution exposure from different migration patterns within Peru and quantify its effect on premature mortality. Data on ambient fine particulate matter (PM2.5) was obtained from the National Aeronautics and Space Administration (NASA). Census data was used to calculate rates of within-country migration at the district level. We calculated differences in PM2.5 exposure between "current" (2016-2017) and "origin" (2012) districts for each migration patterns. Using an exposure-response relationship for PM2.5 extracted from a meta-analysis, and mortality rates from the Peruvian Ministry of Health, we quantified premature mortality attributable to each migration pattern. Changes in outdoor PM2.5 exposure were observed between 2012 and 2016 with highest levels of PM2.5 in the Department of Lima. A strong spatial autocorrelation of outdoor PM2.5 values (Moran's I = 0.847, p-value=0.001) was observed. In Greater Lima, rural-to-urban and urban-to-urban migrants experienced 10-fold increases in outdoor PM2.5 exposure in comparison with non-migrants. Changes in outdoor PM2.5 exposure due to migration drove 137.1 (95%CI: 93.2, 179.4) premature deaths related to air pollution, with rural-urban producing the highest risk of mortality from exposure to higher levels of ambient air pollution. Our results demonstrate that the rural-urban and urban-urban migrant groups have higher rates of air pollution-related deaths.
Collapse
Affiliation(s)
- Gabriel Carrasco-Escobar
- Health Innovation Lab, Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru.
- Division of Infectious Diseases, Department of Medicine, University of California, San Diego, CA, USA.
| | - Lara Schwarz
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - J Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| |
Collapse
|
8
|
Evangelopoulos D, Katsouyanni K, Keogh RH, Samoli E, Schwartz J, Barratt B, Zhang H, Walton H. PM 2.5 and NO 2 exposure errors using proxy measures, including derived personal exposure from outdoor sources: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2020; 137:105500. [PMID: 32018132 DOI: 10.1016/j.envint.2020.105500] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/30/2019] [Accepted: 01/15/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND The use of proxy exposure estimates for PM2.5 and NO2 in air pollution studies instead of personal exposures, introduces measurement error, which can produce biased epidemiological effect estimates. Most studies consider total personal exposure as the gold standard. However, when studying the effects of ambient air pollution, personal exposure from outdoor sources is the exposure of interest. OBJECTIVES We assessed the magnitude and variability of exposure measurement error by conducting a systematic review of the differences between personal exposures from outdoor sources and the corresponding measurements for ambient concentrations in order to increase understanding of the measurement error structures of the pollutants. DATA SOURCES AND ELIGIBILITY CRITERIA We reviewed the literature (ISI Web of Science, Medline, 2000-2016) for English language studies (in any age group in any location (NO2) or Europe and North America (PM2.5)) that reported repeated measurements over time both for personal and ambient PM2.5 or NO2 concentrations. Only a few studies reported personal exposure from outdoor sources. We also collected data for infiltration factors and time-activity patterns of the individuals in order to estimate personal exposures from outdoor sources in every study. STUDY APPRAISAL AND SYNTHESIS METHODS Studies using modelled rather than monitored exposures were excluded. Type of personal exposure monitor was assessed. Random effects meta-analysis was conducted to quantify exposure error as the mean difference between "true" and proxy measures. RESULTS Thirty-two papers for PM2.5 and 24 for NO2 were identified. Outdoor sources were found to contribute 44% (range: 33-55%) of total personal exposure to PM2.5 and 74% (range: 57-88%) to NO2. Overall estimates of personal exposure (24-hour averages) from outdoor sources were 9.3 μg/m3 and 12.0 ppb for PM2.5 and NO2 respectively, while the corresponding difference between these exposures and the ambient concentrations (i.e. the measurement error) was 5.72 μg/m3 and 7.17 ppb. Our findings indicated also higher error variability for NO2 than PM2.5. Large heterogeneity was observed which was not explained sufficiently by geographical location or age group of the study sample. LIMITATIONS, CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Relying only on information available in published studies led to some limitations: the contribution of outdoor sources to total personal exposure for NO2 had to be inferred, individual variation in exposure misclassification was unavailable and instrument error could not be addressed. The larger magnitude and variability of errors for NO2 compared with PM2.5 has implications for biases in the health effect estimates of multi-pollutant epidemiological models. Results suggest that further research is needed regarding personal exposure studies and measurement error bias in epidemiological models.
Collapse
Affiliation(s)
- Dimitris Evangelopoulos
- NIHR HPRU Health Impact of Environmental Hazards, Analytical, Environmental & Forensic Sciences, King's College London, UK.
| | - Klea Katsouyanni
- NIHR HPRU Health Impact of Environmental Hazards, Analytical, Environmental & Forensic Sciences, King's College London, UK
| | - Ruth H Keogh
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Str, 115 27 Athens, Greece
| | - Joel Schwartz
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ben Barratt
- NIHR HPRU Health Impact of Environmental Hazards, Analytical, Environmental & Forensic Sciences, King's College London, UK
| | - Hanbin Zhang
- NIHR HPRU Health Impact of Environmental Hazards, Analytical, Environmental & Forensic Sciences, King's College London, UK
| | - Heather Walton
- NIHR HPRU Health Impact of Environmental Hazards, Analytical, Environmental & Forensic Sciences, King's College London, UK
| |
Collapse
|
9
|
Misra A, Longnecker MP, Dionisio KL, Bornman RMS, Travlos GS, Brar S, Whitworth KW. Household fuel use and biomarkers of inflammation and respiratory illness among rural South African Women. ENVIRONMENTAL RESEARCH 2018; 166:112-116. [PMID: 29885612 PMCID: PMC6110960 DOI: 10.1016/j.envres.2018.05.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 04/16/2018] [Accepted: 05/12/2018] [Indexed: 05/24/2023]
Abstract
Though literature suggests a positive association between use of biomass fuel for cooking and inflammation, few studies among women in rural South Africa exist. We included 415 women from the South African Study of Women and Babies (SOWB), recruited from 2010 to 2011. We obtained demographics, general medical history and usual source of cooking fuel (wood, electricity) via baseline questionnaire. A nurse obtained height, weight, blood pressure, and blood samples. We measured plasma concentrations of a suite of inflammatory markers (e.g., interleukins, tumor necrosis factor-α, C-reactive protein). We assessed associations between cooking fuel and biomarkers of inflammation and respiratory symptoms/illness using crude and adjusted linear and logistic regression models. We found little evidence of an association between fuel-use and biomarkers of inflammation, pre-hypertension/hypertension, or respiratory illnesses. Though imprecise, we found 41% (95% confidence interval (CI) = 0.72-2.77) higher odds of self-reported wheezing/chest tightness among wood-users compared with electricity-users. Though studies among other populations report positive findings between biomass fuel use and inflammation, it is possible that women in the present study experience lower exposures to household air pollution given the cleaner burning nature of wood compared with other biomass fuels (e.g., coal, dung).
Collapse
Affiliation(s)
- Ankita Misra
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health in San Antonio, San Antonio, TX, USA
| | - Matthew P Longnecker
- Epidemiology Branch, National Institute for Environmental Health Sciences, National Institutes of Health, DHHS, Research Triangle Park, NC, USA
| | - Kathie L Dionisio
- National Exposure Research Laboratory, Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Riana M S Bornman
- Department of Urology, University of Pretoria, Pretoria, South Africa; Cellular and Molecular Pathology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA; The University of Pretoria Centre for Sustainable Malaria Control, University of Pretoria, Pretoria, South Africa
| | - Gregory S Travlos
- Cellular and Molecular Pathology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA
| | - Sukhdev Brar
- Cellular and Molecular Pathology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA
| | - Kristina W Whitworth
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health in San Antonio, San Antonio, TX, USA; Southwest Center for Occupational and Environmental Health, UTHealth School of Public Health, Houston, TX, USA.
| |
Collapse
|
10
|
Elf JL, Kinikar A, Khadse S, Mave V, Suryavanshi N, Gupte N, Kulkarni V, Patekar S, Raichur P, Breysse PN, Gupta A, Golub JE. Sources of household air pollution and their association with fine particulate matter in low-income urban homes in India. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2018; 28:400-410. [PMID: 29789668 PMCID: PMC6013356 DOI: 10.1038/s41370-018-0024-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 11/16/2017] [Accepted: 12/17/2017] [Indexed: 05/19/2023]
Abstract
INTRODUCTION Household air pollution (HAP) is poorly characterized in low-income urban Indian communities. MATERIALS AND METHODS A questionnaire assessing sources of HAP and 24 h household concentrations of particulate matter less than 2.5 microns in diameter (PM2.5) were collected in a sample of low-income homes in Pune, India. RESULTS In 166 homes, the median 24 h average concentration of PM2.5 was 167 μg/m3 (IQR: 106-294). Although kerosene and wood use were highly prevalent (22% and 25% of homes, respectively), primarily as secondary fuel sources, high PM2.5 concentrations were also found in 95 (57%) homes reporting LPG use alone (mean 141 μg/m3; IQR: 92-209). In adjusted linear regression, log PM2.5 concentration was positively associated with wood cooking fuel (GMR 1.5, 95% CI: 1.1-2.0), mosquito coils (GMR 1.5, 95% CI: 1.1-2.1), and winter season (GMR 1.7, 95% CI: 1.4-2.2). Households in the highest quartile of exposure were positively associated with wood cooking fuel (OR 1.3, 95% CI: 1.1-1.5), incense (OR 1.1, 95% CI: 1.0-1.3), mosquito coils (OR 1.3, 95% CI: 1.1-1.6), and winter season (OR 1.2, 95% CI: 1.1-1.4). DISCUSSION We observed high concentrations of PM2.5 and identified associated determinants in urban Indian homes.
Collapse
Affiliation(s)
- Jessica L Elf
- Johns Hopkins School of Medicine, Baltimore, MD, USA.
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.
| | | | - Sandhya Khadse
- Byramjee Jeejeebhoy Government Medical College and Sassoon Government Hospitals, Pune, India
| | - Vidya Mave
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Nikhil Gupte
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Vaishali Kulkarni
- Byramjee Jeejeebhoy Government Medical College and Sassoon Government Hospitals, Pune, India
| | - Sunita Patekar
- Byramjee Jeejeebhoy Government Medical College and Sassoon Government Hospitals, Pune, India
| | - Priyanka Raichur
- Byramjee Jeejeebhoy Government Medical College and Sassoon Government Hospitals, Pune, India
| | | | - Amita Gupta
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | |
Collapse
|
11
|
Curto A, Donaire-Gonzalez D, Barrera-Gómez J, Marshall JD, Nieuwenhuijsen MJ, Wellenius GA, Tonne C. Performance of low-cost monitors to assess household air pollution. ENVIRONMENTAL RESEARCH 2018; 163:53-63. [PMID: 29426028 DOI: 10.1016/j.envres.2018.01.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/11/2018] [Accepted: 01/19/2018] [Indexed: 06/08/2023]
Abstract
Exposure to household air pollution is a leading cause of morbidity and mortality globally. However, due to the lack of validated low-cost monitors with long-lasting batteries in indoor environments, most epidemiologic studies use self-reported data or short-term household air pollution assessments as proxies of long-term exposure. We evaluated the performance of three low-cost monitors measuring fine particulate matter (PM2.5) and carbon monoxide (CO) in a wood-combustion experiment conducted in one household of Spain for 5 days (including the co-location of 2 units of HAPEX and 3 units of TZOA-R for PM2.5 and 3 units of EL-USB-CO for CO; a total of 40 unit-days). We used Spearman correlation (ρ) and Concordance Correlation Coefficient (CCC) to assess accuracy of low-cost monitors versus equivalent research-grade devices. We also conducted a field study in India for 1 week (including HAPEX in 3 households and EL-USB-CO in 4 households; a total of 49 unit-days). Correlation and agreement at 5-min were moderate-high for one unit of HAPEX (ρ = 0.73 / CCC = 0.59), for one unit of TZOA-R (ρ = 0.89 / CCC = 0.62) and for three units of EL-USB-CO (ρ = 0.82-0.89 / CCC = 0.66-0.91) in Spain, although the failure or malfunction rate among low-cost units was high in both settings (60% of unit-days in Spain and 43% in India). Low-cost monitors tested here are not yet ready to replace more established exposure assessment methods in long-term household air pollution epidemiologic studies. More field validation is needed to assess evolving sensors and monitors with application to health studies.
Collapse
Affiliation(s)
- A Curto
- ISGlobal, Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
| | - D Donaire-Gonzalez
- ISGlobal, Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - J Barrera-Gómez
- ISGlobal, Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - J D Marshall
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, USA
| | - M J Nieuwenhuijsen
- ISGlobal, Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - G A Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, RI USA
| | - C Tonne
- ISGlobal, Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| |
Collapse
|
12
|
Carter E, Norris C, Dionisio KL, Balakrishnan K, Checkley W, Clark ML, Ghosh S, Jack DW, Kinney PL, Marshall JD, Naeher LP, Peel JL, Sambandam S, Schauer JJ, Smith KR, Wylie BJ, Baumgartner J. Assessing Exposure to Household Air Pollution: A Systematic Review and Pooled Analysis of Carbon Monoxide as a Surrogate Measure of Particulate Matter. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:076002. [PMID: 28886596 PMCID: PMC5744652 DOI: 10.1289/ehp767] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 12/19/2016] [Accepted: 12/20/2016] [Indexed: 05/08/2023]
Abstract
BACKGROUND Household air pollution from solid fuel burning is a leading contributor to disease burden globally. Fine particulate matter (PM2.5) is thought to be responsible for many of these health impacts. A co-pollutant, carbon monoxide (CO) has been widely used as a surrogate measure of PM2.5 in studies of household air pollution. OBJECTIVE The goal was to evaluate the validity of exposure to CO as a surrogate of exposure to PM2.5 in studies of household air pollution and the consistency of the PM2.5-CO relationship across different study settings and conditions. METHODS We conducted a systematic review of studies with exposure and/or cooking area PM2.5 and CO measurements and assembled 2,048 PM2.5 and CO measurements from a subset of studies (18 cooking area studies and 9 personal exposure studies) retained in the systematic review. We conducted pooled multivariate analyses of PM2.5-CO associations, evaluating fuels, urbanicity, season, study, and CO methods as covariates and effect modifiers. RESULTS We retained 61 of 70 studies for review, representing 27 countries. Reported PM2.5-CO correlations (r) were lower for personal exposure (range: 0.22-0.97; median=0.57) than for cooking areas (range: 0.10-0.96; median=0.71). In the pooled analyses of personal exposure and cooking area concentrations, the variation in ln(CO) explained 13% and 48% of the variation in ln(PM2.5), respectively. CONCLUSIONS Our results suggest that exposure to CO is not a consistently valid surrogate measure of exposure to PM2.5. Studies measuring CO exposure as a surrogate measure of PM exposure should conduct local validation studies for different stove/fuel types and seasons. https://doi.org/10.1289/EHP767.
Collapse
Affiliation(s)
- Ellison Carter
- Institute on the Environment, University of Minnesota , St. Paul, Minnesota, USA
| | - Christina Norris
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University , Montreal, Quebec, Canada
| | - Kathie L Dionisio
- National Exposure Research Laboratory, U.S. Environmental Protection Agency , Research Triangle Park, North Carolina, USA
| | - Kalpana Balakrishnan
- Department Environmental Health Engineering, Sri Ramachandra University , Porur, Chennai, India
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University , Baltimore, Maryland, USA
- Program in Global Disease Epidemiology and Control, Department of International Heath, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland, USA
| | - Maggie L Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University , Fort Collins, Colorado, USA
| | - Santu Ghosh
- Department Environmental Health Engineering, Sri Ramachandra University , Porur, Chennai, India
| | - Darby W Jack
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University , New York, New York, USA
| | - Patrick L Kinney
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University , New York, New York, USA
| | - Julian D Marshall
- Department of Civil and Environmental Engineering, University of Washington , Seattle, Washington, USA
| | - Luke P Naeher
- Department of Environmental Health Science, College of Public Health, The University of Georgia , Athens, Georgia, USA
| | - Jennifer L Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University , Fort Collins, Colorado, USA
| | - Sankar Sambandam
- Department Environmental Health Engineering, Sri Ramachandra University , Porur, Chennai, India
| | - James J Schauer
- Environmental Chemistry & Technology Program, University of Wisconsin-Madison , Madison, Wisconsin, USA
- Department of Civil & Environmental Engineering, University of Wisconsin-Madison , Madison, Wisconsin, USA
| | - Kirk R Smith
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley , Berkeley, California, USA
| | - Blair J Wylie
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts, USA
| | - Jill Baumgartner
- Institute on the Environment, University of Minnesota , St. Paul, Minnesota, USA
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University , Montreal, Quebec, Canada
- Institute for Health and Social Policy, McGill University , Montreal Quebec, Canada
| |
Collapse
|
13
|
Ni K, Carter E, Schauer JJ, Ezzati M, Zhang Y, Niu H, Lai AM, Shan M, Wang Y, Yang X, Baumgartner J. Seasonal variation in outdoor, indoor, and personal air pollution exposures of women using wood stoves in the Tibetan Plateau: Baseline assessment for an energy intervention study. ENVIRONMENT INTERNATIONAL 2016; 94:449-457. [PMID: 27316628 DOI: 10.1016/j.envint.2016.05.029] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 05/20/2023]
Abstract
Cooking and heating with coal and biomass is the main source of household air pollution in China and a leading contributor to disease burden. As part of a baseline assessment for a household energy intervention program, we enrolled 205 adult women cooking with biomass fuels in Sichuan, China and measured their 48-h personal exposure to fine particulate matter (PM2.5) and carbon monoxide (CO) in winter and summer. We also measured the indoor 48-h PM2.5 concentrations in their homes and conducted outdoor PM2.5 measurements during 101 (74) days in summer (winter). Indoor concentrations of CO and nitrogen oxides (NO, NO2) were measured over 48-h in a subset of ~80 homes. Women's geometric mean 48-h exposure to PM2.5 was 80μg/m(3) (95% CI: 74, 87) in summer and twice as high in winter (169μg/m(3) (95% CI: 150, 190), with similar seasonal trends for indoor PM2.5 concentrations (winter: 252μg/m(3); 95% CI: 215, 295; summer: 101μg/m(3); 95% CI: 91, 112). We found a moderately strong relationship between indoor PM2.5 and CO (r=0.60, 95% CI: 0.46, 0.72), and a weak correlation between personal PM2.5 and CO (r=0.41, 95% CI: -0.02, 0.71). NO2/NO ratios were higher in summer (range: 0.01 to 0.68) than in winter (range: 0 to 0.11), suggesting outdoor formation of NO2 via reaction of NO with ozone is a more important source of NO2 than biomass combustion indoors. The predictors of women's personal exposure to PM2.5 differed by season. In winter, our results show that primary heating with a low-polluting fuel (i.e., electric stove or wood-charcoal) and more frequent kitchen ventilation could reduce personal PM2.5 exposures. In summer, primary use of a gaseous fuel or electricity for cooking and reducing exposure to outdoor PM2.5 would likely have the greatest impacts on personal PM2.5 exposure.
Collapse
Affiliation(s)
- Kun Ni
- Department of Building Science, Tsinghua University, Beijing, China
| | - Ellison Carter
- Institute on the Environment, University of Minnesota, St. Paul, MN, USA
| | - James J Schauer
- Environmental Chemistry and Technology Program, University of Wisconsin, Madison, WI, USA; Department of Civil and Environmental Engineering, University of Wisconsin, Madison, WI, USA
| | - Majid Ezzati
- MRC-PHE Center for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK
| | - Yuanxun Zhang
- College of Resources and Environment, University of the Chinese Academy of Sciences, Beijing, China
| | - Hongjiang Niu
- Department of Building Science, Tsinghua University, Beijing, China
| | - Alexandra M Lai
- Department of Civil and Environmental Engineering, University of Wisconsin, Madison, WI, USA
| | - Ming Shan
- Department of Building Science, Tsinghua University, Beijing, China
| | - Yuqin Wang
- College of Resources and Environment, University of the Chinese Academy of Sciences, Beijing, China
| | - Xudong Yang
- Department of Building Science, Tsinghua University, Beijing, China.
| | - Jill Baumgartner
- Institute on the Environment, University of Minnesota, St. Paul, MN, USA; Institute for Health and Social Policy, Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montréal, QC, Canada.
| |
Collapse
|
14
|
Behavioral attitudes and preferences in cooking practices with traditional open-fire stoves in Peru, Nepal, and Kenya: implications for improved cookstove interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:10310-26. [PMID: 25286166 PMCID: PMC4210980 DOI: 10.3390/ijerph111010310] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 09/28/2014] [Accepted: 09/28/2014] [Indexed: 12/21/2022]
Abstract
Global efforts are underway to develop and promote improved cookstoves which may reduce the negative health and environmental effects of burning solid fuels on health and the environment. Behavioral studies have considered cookstove user practices, needs and preferences in the design and implementation of cookstove projects; however, these studies have not examined the implications of the traditional stove use and design across multiple resource-poor settings in the implementation and promotion of improved cookstove projects that utilize a single, standardized stove design. We conducted in-depth interviews and direct observations of meal preparation and traditional, open-fire stove use of 137 women aged 20-49 years in Kenya, Peru and Nepal prior in the four-month period preceding installation of an improved cookstove as part of a field intervention trial. Despite general similarities in cooking practices across sites, we identified locally distinct practices and norms regarding traditional stove use and desired stove improvements. Traditional stoves are designed to accommodate specific cooking styles, types of fuel, and available resources for maintenance and renovation. The tailored stoves allow users to cook and repair their stoves easily. Women in each setting expressed their desire for a new stove, but they articulated distinct specific alterations that would meet their needs and preferences. Improved cookstove designs need to consider the diversity of values and needs held by potential users, presenting a significant challenge in identifying a "one size fits all" improved cookstove design. Our data show that a single stove design for use with locally available biomass fuels will not meet the cooking demands and resources available across the three sites. Moreover, locally produced or adapted improved cookstoves may be needed to meet the cooking needs of diverse populations while addressing health and environmental concerns of traditional stoves.
Collapse
|