Lung Effects of Household Air Pollution

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.

Predicting Behaviors to Reduce Toxic Chemical Exposures Among New and Expectant Mothers: The Role of Distal Variables Within the Integrative Model of Behavioral Prediction

There is a growing body of evidence linking childhood exposure to environmental toxins and a range of adverse health outcomes, including preterm birth, cognitive deficits, and cancer. Little is known, however, about what drives mothers to engage in health behaviors to reduce such risks. Guided by the integrative model of behavioral prediction, this study surveyed women who were pregnant and/or had children younger than 7 years (N = 819) to identify the factors that determine engagement in behaviors to reduce childhood exposure to toxic chemicals in the environment. Structural equation modeling pertaining to three different environmental toxins-bisphenol A, arsenic, and pesticides-demonstrated that perceived normative pressure was the primary determinant of behavior across all three models. Additionally, we identified two key distal variables-perceived risk and information seeking-that not only increased the model's predictive power but also consistently and positively predicted perceived social norms regarding exposure reduction behaviors. Findings also suggest important differences across these behaviors. Implications for health communication researchers and practitioners developing interventions, communication campaigns, and persuasive messages to promote prenatal and pediatric environmental health are discussed.