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Andrade-Rivas F, Okpani AI, Lucumí DI, Castillo MD, Karim ME. Epidemiological insights into neonatal deaths: The role of cooking fuel pollution in Colombia. Int J Hyg Environ Health 2024; 261:114429. [PMID: 39047381 DOI: 10.1016/j.ijheh.2024.114429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 07/17/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE Household air pollution is one of the leading causes of death and disease globally. Emerging evidence of elevated risk of neonatal death has been reported in Africa and South Asia. However, evidence on the extent of the problem in Latin America is limited despite the persistent use of highly polluting cooking fuels. We assessed whether the use of high-polluting household cooking fuels increases the risk of neonatal death compared to low-polluting fuels in Colombia. METHODS We used cross-sectional data from the 2005-2015 Colombian Demographic Health Survey and performed a survey-featured multivariate logistic regression. We selected adjustment covariates based on a causal diagram, addressed missing data through multiple imputation, and conducted several sensitivity analysis, such as propensity score matching. RESULT We found evidence suggesting an increased risk of neonatal death in households using high-polluting fuels (OR: 1.48; 95% CI: 0.91, 2.39). The sensitivity analyses were consistent with the main analysis. CONCLUSION We observed increased odds of neonatal death associated with using high-polluting household cooking fuels compared to low-polluting fuels, although this association was not statistically significant. This study contributes evidence to a region where the issue is not yet a priority and should be included in national-level discussions and interventions that impact cooking fuel use patterns.
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Affiliation(s)
- Federico Andrade-Rivas
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada; Instituto de Salud y Ambiente, Universidad El Bosque, Bogotá, Colombia.
| | - Arnold Ikedichi Okpani
- Global Health Research Program, School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Diego I Lucumí
- School of Government Alberto Lleras Camargo, Universidad de los Andes, Bogotá, Colombia
| | - Maria D Castillo
- MIT Department of Urban Studies and Planning, Cambridge, MA, USA
| | - Mohammad Ehsanul Karim
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada; Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, Canada
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He J, Zhong K, Yang R, Wen C, Liu S, Yang Y, Zhong Q. Solid fuel use and low birth weight: a systematic review and meta-analysis. REVIEWS ON ENVIRONMENTAL HEALTH 2024; 0:reveh-2024-0055. [PMID: 38963124 DOI: 10.1515/reveh-2024-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 06/10/2024] [Indexed: 07/05/2024]
Abstract
Solid fuel use is increasingly linked to low birth weight (LBW), but conclusions were inconsistent. We aimed to summarize the association between solid fuel use and LBW. Twenty-one studies that met the inclusion criteria were identified through PubMed, Qvid Medline, and Web of Science databases. The final search occurred on March 20, 2024. Summary relative effect and 95 % confidence intervals were estimated with a random-effects model. Subgroup analyses and sensitivity analyses were performed to investigate possible sources of heterogeneity and to test the stability of the results. Nineteen studies evaluated the association between solid fuel use in pregnant woman and LBW (1.188 for solid fuels: 1.055 to 1.322). No significant heterogeneity was identified among the included studies (p=0.010, Tau2=0.02, I2=48.1 %). Subgroup analysis found positive correlations for Asia, data years prior to 2014, and rural studies (1.245 for Asia: 1.077 to 1.412; Tau2=0.03, I2=56.0 %; 1.243 for data years prior to 2014: 1.062 to 1.424; Tau2=0.04, I2=60.98 %; 1.514 for rural: 1.258 to 1.771; Tau2=0.00, I2=0.0 %). Our meta-analysis showed that solid fuel use in pregnant women had an impact on LBW. Measures and policies are also needed to promote energy conversion and to limit and reduce the use of solid fuels.
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Affiliation(s)
- Jie He
- School of Public Health, 12485 Anhui Medical University , Hefei, Anhui, P.R. China
| | - Kangkang Zhong
- School of Public Health, 12485 Anhui Medical University , Hefei, Anhui, P.R. China
| | - Rui Yang
- School of Public Health, 12485 Anhui Medical University , Hefei, Anhui, P.R. China
| | - Chuanting Wen
- School of Public Health, 12485 Anhui Medical University , Hefei, Anhui, P.R. China
| | - Shubo Liu
- School of Public Health, 12485 Anhui Medical University , Hefei, Anhui, P.R. China
| | - Yiping Yang
- School of Public Health, 12485 Anhui Medical University , Hefei, Anhui, P.R. China
| | - Qi Zhong
- School of Public Health, 12485 Anhui Medical University , Hefei, Anhui, P.R. China
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Daba C, Asmare L, Demeke Bayou F, Arefaynie M, Mohammed A, Tareke AA, Keleb A, Kebede N, Tsega Y, Endawkie A, Kebede SD, Mesfin K, Abeje ET, Bekele Enyew E. Exposure to indoor air pollution and adverse pregnancy outcomes in low and middle-income countries: a systematic review and meta-analysis. Front Public Health 2024; 12:1356830. [PMID: 38841656 PMCID: PMC11151685 DOI: 10.3389/fpubh.2024.1356830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/08/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Exposure to indoor air pollution such as biomass fuel and particulate matter is a significant cause of adverse pregnancy outcomes. However, there is limited information about the association between indoor air pollution exposure and adverse pregnancy outcomes in low and middle-income countries. Therefore, this meta-analysis aimed to determine the association between indoor air pollution exposure and adverse pregnancy outcomes in low and middle-income countries. Methods International electronic databases such as PubMed, Science Direct, Global Health, African Journals Online, HINARI, Semantic Scholar, and Google and Google Scholar were used to search for relevant articles. The study was conducted according to the updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A random effect model at a 95% confidence interval was used to determine the association between indoor air pollution exposure and adverse pregnancy outcomes using STATA version 14. Funnel plot and Higgs I2 statistics were used to determine the publication bias and heterogeneity of the included studies, respectively. Results A total of 30 articles with 2,120,228 study participants were included in this meta-analysis. The pooled association between indoor air pollution exposure and at least one adverse pregnancy outcome was 15.5% (95%CI: 12.6-18.5), with significant heterogeneity (I2 = 100%; p < 0.001). Exposure to indoor air pollution increased the risk of small for gestational age by 23.7% (95%CI: 8.2-39.3) followed by low birth weight (17.7%; 95%CI: 12.9-22.5). Exposure to biomass fuel (OR = 1.16; 95%CI: 1.12-1.2), particulate matter (OR = 1.28; 95%CI: 1.25-1.31), and kerosene (OR = 1.38; 95%CI: 1.09-1.66) were factors associated with developing at least one adverse pregnancy outcomes. Conclusions We found that more than one in seven pregnant women exposed to indoor air pollution had at least one adverse pregnancy outcome. Specifically, exposure to particulate matter, biomass fuel, and kerosene were determinant factors for developing at least one adverse pregnancy outcome. Therefore, urgent comprehensive health intervention should be implemented in the area to reduce adverse pregnancy outcomes.
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Affiliation(s)
- Chala Daba
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Lakew Asmare
- Department of Epidemiology and Biostatistics School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Fekade Demeke Bayou
- Department of Epidemiology and Biostatistics School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Mastewal Arefaynie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Anissa Mohammed
- Department of Epidemiology and Biostatistics School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Abiyu Abadi Tareke
- Amref Health in Africa, West Gondar Zonal Health Department, Gondar, Ethiopia
| | - Awoke Keleb
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Natnael Kebede
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yawkal Tsega
- Department of Health System and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abel Endawkie
- Department of Epidemiology and Biostatistics School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Shimels Derso Kebede
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Kaleab Mesfin
- Department of Health System and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Eyob Tilahun Abeje
- Department of Epidemiology and Biostatistics School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Ermias Bekele Enyew
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Rasel SM, Siddique AB, Nayon MFS, Suzon MSM, Amin S, Mim SS, Hossain MS. Assessment of the association between health problems and cooking fuel type, and barriers towards clean cooking among rural household people in Bangladesh. BMC Public Health 2024; 24:512. [PMID: 38369457 PMCID: PMC10875881 DOI: 10.1186/s12889-024-17971-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/03/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND In low- and middle-income countries, households mainly use solid fuels like wood, charcoal, dung, agricultural residues, and coal for cooking. This poses significant public health concerns due to the emission of harmful particles and gases. To address these issues and support Sustainable Development Goals (SDGs), adopting cleaner cooking fuels like electricity and gas are acknowledged as a viable solution. However, access to these cleaner fuels is limited, especially in rural areas. METHODS This study conducted a face-to-face survey with 1240 individuals in rural Bangladesh to explore the link between health issues and cooking fuel type, as well as barriers to transitioning to clean cooking. Using a convenient sampling technique across four divisions/regions, the survey gathered socio-demographic and health data, along with information on clean cooking barriers through a semi-structured questionnaire. Binary and multivariable logistic regression analyses were then employed to identify significant associations between cooking fuel type and health problems. RESULTS The study revealed that a majority of participants (73.3%) relied on solid fuel for cooking. The use of solid fuel was significantly correlated with factors such as lower education levels, reduced family income, location of residence, and the experience of health issues such as cough, chest pressure while breathing, eye discomfort, diabetes, asthma, and allergies. Economic challenges emerged as the foremost obstacle to the adoption of clean cooking, accompanied by other contributing factors. CONCLUSION The use of solid fuel in rural Bangladeshi households poses substantial health risks, correlating with respiratory, eye, cardiovascular, and metabolic issues. Lower education and income levels, along with specific residential locations, were associated with higher solid fuel usage. Economic challenges emerged as the primary obstacle to adopting clean cooking practices. These findings emphasize the need for implementing strategies to promote clean cooking, address barriers, and contribute to achieving Sustainable Development Goal targets for health and sustainable energy access in Bangladesh.
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Affiliation(s)
- Sayed Mohammad Rasel
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
- Air Pollution, Climate Change and Health (ACH) Lab, Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Abu Bakkar Siddique
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
- Centre for Advanced Research Excellence in Public Health, Savar, Dhaka, 1342, Bangladesh
| | - Md Fahad Shahariar Nayon
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
- Air Pollution, Climate Change and Health (ACH) Lab, Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Md Shakil Mahmud Suzon
- Department of Public Health, School of Pharmacy and Public Health, Independent University, Bangladesh (IUB), Dhaka, Bangladesh
| | - Sanzida Amin
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Sadia Sultana Mim
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Md Shakhaoat Hossain
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
- Air Pollution, Climate Change and Health (ACH) Lab, Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
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Dwivedi S, Zehra F, Masih J, Gupta T, Lawrence A. Investigating the temporal dynamics of sub-micron particles and particle-bound transition metals in indoor air of a metropolitan city. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:49. [PMID: 38227135 DOI: 10.1007/s10653-023-01786-3] [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: 03/31/2023] [Accepted: 11/13/2023] [Indexed: 01/17/2024]
Abstract
The present study portrays an association between particle-bound transition metals and children's health. The indoor air quality of the urban metropolitan city households was monitored for four PM sizes, namely PM1.0-2.5, PM0.50-1.0, PM0.25-0.50 and PM<0.25, in major seasons observed in the city; summer and winter. Further transition/heavy metals, viz. Cr, Cu, Fe, Mn, Ni, Pb and Zn, were analysed in PM1-2.5 samples. In order to evaluate the effect, health risk assessment was performed using mathematical and computational model for assessing dermal exposure and dose estimation (multiple path particle dosimetry model version3.0). The study principally targeted the children aged 2-15 years for the health risk assessment. According to the results, for the largest particle size i.e. PM1.0-2.5 the highest deposition was in the head region (49.1%) followed by pulmonary (43.6%) and tracheobronchial region (7.2%), whereas, for the smallest particle size i.e. PM<0.25 the highest deposition was obtained in the pulmonary region (73.0%) followed by the head (13.6%) and TB region (13.2%). Also, the most imperilled group of children with highest dose accumulation was found to be children aged 8-9 years for all particle sizes. Moreover, the dermal exposure dose as evaluated was found to be preeminent for Ni, Zn and Pb. Besides, seasonal variation gesticulated towards elevated concentrations in winter relative to the summer season. Altogether, the study will provide a conception to the researchers in the fields mounting season-specific guidelines and mitigation approaches. Conclusively, the study commends future work focussing on defining the effects of other chemical components on particles and associated transition metal composition along with proper extenuation of the same.
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Affiliation(s)
- Samridhi Dwivedi
- Department of Chemistry, Isabella Thoburn College, Lucknow, India
| | - Farheen Zehra
- Department of Chemistry, Isabella Thoburn College, Lucknow, India
| | - Jamson Masih
- Department of Chemistry, Wilson College, Mumbai, India
| | - Tarun Gupta
- Department of Civil Engineering, Indian Institute of Technology, Kanpur, India
| | - Alfred Lawrence
- Department of Chemistry, Isabella Thoburn College, Lucknow, India.
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Habtamu D, Abebe B, Seid T. Health risk perceptions of household air pollution and perceived benefits of improved stoves among pregnant women in rural Ethiopia: a mixed method study. BMJ Open 2023; 13:e072328. [PMID: 37648392 PMCID: PMC10471873 DOI: 10.1136/bmjopen-2023-072328] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVE Since community perceptions of the risk of biomass smoke and the benefits of improved stoves play a critical role in behaviour change to the uptake and sustainable utilisation of improved stoves, we aimed to assess the level of health risk perception on kitchen smoke and benefits of using improved stoves among pregnant women. DESIGN A community-based cross-sectional mixed method study. SETTING In six kebeles of a low-income rural community of South Gondar Zone, Northwestern Ethiopia. PARTICIPANTS All 455 households with pregnant women aged 18-38 years, in their first-trimester or second-trimester gestation, exclusively use traditional biomass-fuelled or locally modified mud stoves, and the primary cook in her household were included. But completed data were obtained only from 422 households. RESULT From 422 completed data, more than half, 63% (95% CI 58% to 68%) had high-level health risk perception of household air pollution, and nearly three-fourths, 74% (95% CI 70% to 79%) of the respondents perceived that using improved stove had benefits for their families. Participants in the 32-38 years age group, rich in asset index, presence of under-five children, being a member of any women group and large family size were positively associated with high-level health risk perception. Whereas respondents in the 18-24 years age group, presence of under-five children, husbands of primary or higher education, high health risk perception and not happy with the current stove were positively associated with perceived benefits of using an improved stove. CONCLUSION The observed level of health risk perception of biomass smoke and the benefits of using improved stoves may help to adopt effective intervention measures. This study also suggests that for successful intervention, clean cooking programmes and policies must consider many local factors influencing health risk perception and benefits of using improved stoves. TRIAL REGISTRATION NUMBER ACTR202111534227089.
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Affiliation(s)
| | - Beyene Abebe
- Department of Environmental Health Science and Technology, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Tiku Seid
- Department of Environmental Health Science and Technology, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
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Kaali S, Jack DW, Mujtaba MN, Chillrud SN, Ae-Ngibise KA, Kinney PL, Boamah Kaali E, Gennings C, Colicino E, Osei M, Wylie BJ, Agyei O, Quinn A, Asante KP, Lee AG. Identifying sensitive windows of prenatal household air pollution on birth weight and infant pneumonia risk to inform future interventions. ENVIRONMENT INTERNATIONAL 2023; 178:108062. [PMID: 37392730 PMCID: PMC10911234 DOI: 10.1016/j.envint.2023.108062] [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: 01/25/2023] [Revised: 06/02/2023] [Accepted: 06/22/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Prenatal household air pollution impairs birth weight and increases pneumonia risk however time-varying associations have not been elucidated and may have implications for the timing of public health interventions. METHODS The Ghana Randomized Air Pollution and Health Study (GRAPHS) enrolled 1,414 pregnant women from Kintampo, Ghana and measured personal carbon monoxide (CO) exposure four times over pregnancy. Birth weight was measured within 72-hours of birth. Fieldworkers performed weekly pneumonia surveillance and referred sick children to study physicians. The primary pneumonia outcome was one or more physician-diagnosed severe pneumonia episode in the first year of life. We employed reverse distributed lag models to examine time-varying associations between prenatal CO exposure and birth weight and infant pneumonia risk. RESULTS Analyses included n = 1,196 mother-infant pairs. In models adjusting for child sex; maternal age, body mass index (BMI), ethnicity and parity at enrollment; household wealth index; number of antenatal visits; and evidence of placental malaria, prenatal CO exposures from 15 to 20 weeks gestation were inversely associated with birth weight. Sex-stratified models identified a similar sensitive window in males and a window at 10-weeks gestation in females. In models adjusting for child sex, maternal age, BMI and ethnicity, household wealth index, gestational age at delivery and average postnatal child CO exposure, CO exposure during 34-39 weeks gestation were positively associated with severe pneumonia risk, especially in females. CONCLUSIONS Household air pollution exposures in mid- and late- gestation are associated with lower birth weight and higher pneumonia risk, respectively. These findings support the urgent need for deployment of clean fuel stove interventions beginning in early pregnancy.
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Affiliation(s)
- Seyram Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana.
| | - Darby W Jack
- Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, 722 W 168(th) Street, New York, NY 10032, USA
| | - Mohammed N Mujtaba
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory at Columbia University, Palisades, NY, USA
| | - Kenneth A Ae-Ngibise
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Ellen Boamah Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Musah Osei
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Blair J Wylie
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Oscar Agyei
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Ashlinn Quinn
- Berkeley Air Monitoring Group, Fort Collins, CO, USA
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Bono East Region, Kintampo, Ghana
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Akselrod S, Banerjee A, Collins TE, Acharya S, Artykova N, Askew I, Berdzuli N, Diorditsa S, Eggers R, Farrington J, Jakab Z, Ferreira-Borges C, Mikkelsen B, Azzopardi-Muscat N, Olsavszky V, Park K, Sobel H, Tran H, Vujnovic M, Weber M, Were W, Yaqub N, Berlina D, Dunlop CL, Allen LN. Integrating maternal, newborn, child health and non-communicable disease care in the sustainable development goal era. Front Public Health 2023; 11:1183712. [PMID: 37483915 PMCID: PMC10362386 DOI: 10.3389/fpubh.2023.1183712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023] Open
Abstract
Noncommunicable diseases (NCDs) and maternal newborn and child health (MNCH) are two deeply intertwined health areas that have been artificially separated by global health policies, resource allocations and programming. Optimal MNCH care can provide a unique opportunity to screen for, prevent and manage early signs of NCDs developing in both the woman and the neonate. This paper considers how NCDs, NCD modifiable risk factors, and NCD metabolic risk factors impact MNCH. We argue that integrated management is essential, but this faces challenges that manifest across all levels of domestic health systems. Progress toward Sustainable Development targets requires joined-up action.
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Affiliation(s)
| | - Anshu Banerjee
- Maternal, Newborn, Child and Adolescent Health, and Ageing, World Health Organization, Geneva, Switzerland
| | - Téa E. Collins
- Global NCD Platform, World Health Organization, Geneva, Switzerland
| | - Shambhu Acharya
- Country Strategy and Support, World Health Organization, Geneva, Switzerland
| | - Nazira Artykova
- WHO European Region Country Office in Kyrgyzstan, Bishkek, Kyrgyzstan
| | - Ian Askew
- Sexual and Reproductive Health, World Health Organization, Geneva, Switzerland
| | - Nino Berdzuli
- Division of Country Health Programmes, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Sergey Diorditsa
- WHO Representative's Office, WHO European Region Country Office in Belarus, Minsk, City of Minsk, Belarus
| | - Rudolf Eggers
- Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Jill Farrington
- Deputy Director-General Office, World Health Organization, Geneva, Switzerland
| | - Zsuzsanna Jakab
- Deputy Director-General Office, World Health Organization, Geneva, Switzerland
| | - Carina Ferreira-Borges
- Division of Country Health Programmes, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Bente Mikkelsen
- NCD Department, World Health Organization, Geneva, Switzerland
| | - Natasha Azzopardi-Muscat
- Division of Country Health Policies and Systems, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Victor Olsavszky
- WHO European Region Tajikistan Country Office, Dushanbe, Tajikistan
| | - Kidong Park
- Data, Strategy and Innovation Group, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Howard Sobel
- WHO Regional Office for the Western Pacific Country Office in the Solomon Islands, Manila, Philippines
| | - Huong Tran
- Division of Programmes for Disease Control, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Melita Vujnovic
- WHO European Region Office for the Russian Federation, Moscow, Russia
| | - Martin Weber
- Division of Country Health Policies and Systems, World Health Organization Regional Office for Europe Country Office in Greece, Copenhagen, Denmark
| | - Wilson Were
- Child Health and Development, World Health Organization, Geneva, Switzerland
| | - Nuhu Yaqub
- Child Health and Development, World Health Organization, Geneva, Switzerland
| | - Daria Berlina
- Global NCD Platform, World Health Organization, Geneva, Switzerland
| | - Catherine L. Dunlop
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
| | - Luke N. Allen
- Global NCD Platform, World Health Organization, Geneva, Switzerland
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9
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Jabin N, Rahman MM, Salam MT, Sharna TI, Franklin M, Bailey MJ, Alderete TL, Ahmed A, Quaiyum MA, Islam T. Cohort profile: Bangladesh Cook Stove Pregnancy Cohort Study (CSPCS). BMJ Open 2023; 13:e068539. [PMID: 37164456 PMCID: PMC10174037 DOI: 10.1136/bmjopen-2022-068539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
PURPOSE The Cook Stove Pregnancy Cohort Study (CSPCS) was designed to assess the effects of biomass fuel use on household air pollution (HAP) as well as the effects of HAP (fine particulate matter, PM2.5) on birth outcomes and acute lower respiratory infection (ALRI) among infants in Bangladesh. PARTICIPANTS We recruited 903 women within 18 weeks of pregnancy from rural and semiurban areas of Bangladesh between November 2016 and March 2017. All women and their infants (N=831 pairs) were followed until 12 months after delivery and a subset have undergone respiratory and gut microbiota analysis. METHODS Questionnaires were administered to collect detailed sociodemographic, medical, nutritional and behavioural information on the mother-child dyads. Anthropometric measurements and biological samples were also collected, as well as household PM2.5 concentrations. FINDINGS TO DATE Published work in this cohort showed detrimental effects of biomass fuel and health inequity on birth outcomes. Current analysis indicates high levels of household PM2.5 being associated with cooking fuel type and infant ALRI. Lastly, we identified distinct gut and respiratory microbial communities at 6 months of age. FUTURE PLANS This study provides an economical yet effective framework to conduct pregnancy cohort studies determining the health effects of adverse environmental exposures in low-resource countries. Future analyses in this cohort include assessing the effect of indoor PM2.5 levels on (1) physical growth, (2) neurodevelopment, (3) age of first incidence and frequency of ALRI in infants and (4) the development of the respiratory and gut microbiome. Additional support has allowed us to investigate the effect of in utero exposure to metals on infant neurodevelopment in the first year of life.
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Affiliation(s)
- Nusrat Jabin
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Md Mostafijur Rahman
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Muhammad T Salam
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
- Department of Psychiatry, Kern Medical Center, Bakersfield, California, USA
| | | | - Meredith Franklin
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
- Department of Statistical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Maximilian J Bailey
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Tanya L Alderete
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Anisuddin Ahmed
- International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - M A Quaiyum
- Projohnmo Research Foundation (PRF), Dhaka, Bangladesh
| | - Talat Islam
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
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10
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Chowdhury S, Pillarisetti A, Oberholzer A, Jetter J, Mitchell J, Cappuccilli E, Aamaas B, Aunan K, Pozzer A, Alexander D. A global review of the state of the evidence of household air pollution's contribution to ambient fine particulate matter and their related health impacts. ENVIRONMENT INTERNATIONAL 2023; 173:107835. [PMID: 36857905 PMCID: PMC10378453 DOI: 10.1016/j.envint.2023.107835] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/24/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Direct exposure to household fine particulate air pollution (HAP) associated with inefficient combustion of fuels (wood, charcoal, coal, crop residues, kerosene, etc.) for cooking, space-heating, and lighting is estimated to result in 2.3 (1.6-3.1) million premature yearly deaths globally. HAP emitted indoors escapes outdoors and is a leading source of outdoor ambient fine particulate air pollution (AAP) in low- and middle-income countries, often being a larger contributor than well-recognized sources including road transport, industry, coal-fired power plants, brick kilns, and construction dust. We review published scientific studies that model the contribution of HAP to AAP at global and major sub-regional scales. We describe strengths and limitations of the current state of knowledge on HAP's contribution to AAP and the related impact on public health and provide recommendations to improve these estimates. We find that HAP is a dominant source of ambient fine particulate matter (PM2.5) globally - regardless of variations in model types, configurations, and emission inventories used - that contributes approximately 20 % of total global PM2.5 exposure. There are large regional variations: in South Asia, HAP contributes ∼ 30 % of ambient PM2.5, while in high-income North America the fraction is ∼ 7 %. The median estimate indicates that the household contribution to ambient air pollution results in a substantial premature mortality burden globally of about 0.77(0.54-1) million excess deaths, in addition to the 2.3 (1.6-3.1) million deaths from direct HAP exposure. Coordinated global action is required to avert this burden.
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Affiliation(s)
| | | | | | - James Jetter
- United States Environmental Protection Agency, Washington, D.C., USA
| | - John Mitchell
- United States Environmental Protection Agency, Washington, D.C., USA
| | - Eva Cappuccilli
- United States Environmental Protection Agency, Washington, D.C., USA
| | - Borgar Aamaas
- CICERO Center for International Climate Research, Oslo, Norway
| | - Kristin Aunan
- CICERO Center for International Climate Research, Oslo, Norway
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11
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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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12
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Chiarello DI, Ustáriz J, Marín R, Carrasco-Wong I, Farías M, Giordano A, Gallardo FS, Illanes SE, Gutiérrez J. Cellular mechanisms linking to outdoor and indoor air pollution damage during pregnancy. Front Endocrinol (Lausanne) 2023; 14:1084986. [PMID: 36875486 PMCID: PMC9974835 DOI: 10.3389/fendo.2023.1084986] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
Pregnancies are a critical window period for environmental influences over the mother and the offspring. There is a growing body of evidence associating indoor and outdoor air pollution exposure to adverse pregnancy outcomes such as preterm birth and hypertensive disorders of pregnancy. Particulate matter (PM) could trigger oxi-inflammation and could also reach the placenta leading to placental damage with fetal consequences. The combination of strategies such as risk assessment, advise about risks of environmental exposures to pregnant women, together with nutritional strategies and digital solutions to monitor air quality can be effective in mitigating the effects of air pollution during pregnancy.
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Affiliation(s)
- Delia I. Chiarello
- Cellular Signaling and Differentiation Laboratory (CSDL), School of Medical Technology, Faculty of Medicine and Science, Universidad San Sebastián, Santiago, Chile
- *Correspondence: Delia I. Chiarello, ; Jaime Gutiérrez,
| | - Javier Ustáriz
- Department of Chemical and Bioprocess Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Reinaldo Marín
- Center for Biophysics and Biochemistry (CBB), Venezuelan Institute for Scientific Research (IVIC), Caracas, Venezuela
| | - Ivo Carrasco-Wong
- Cellular Signaling and Differentiation Laboratory (CSDL), School of Medical Technology, Faculty of Medicine and Science, Universidad San Sebastián, Santiago, Chile
| | - Marcelo Farías
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ady Giordano
- Inorganic Chemistry Department, Faculty of Chemistry and of Pharmacy, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Felipe S. Gallardo
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sebastián E. Illanes
- Reproductive Biology Program, Center for Biomedical Research and Innovation (CiiB), Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universidad de los Andes, Santiago, Chile
| | - Jaime Gutiérrez
- Cellular Signaling and Differentiation Laboratory (CSDL), School of Medical Technology, Faculty of Medicine and Science, Universidad San Sebastián, Santiago, Chile
- *Correspondence: Delia I. Chiarello, ; Jaime Gutiérrez,
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13
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Li N, Guo X, Wu Y, Yau V, Song Q, Su W, Wang H, Liang Q, Liang M, Ding X, Lowe S, Li Y, Bentley R, King B, Zhou Q, Qu G, Sun C. Association between household air pollution and all-cause and cause-specific mortality: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:5312-5346. [PMID: 36409413 DOI: 10.1007/s11356-022-24222-y] [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: 09/19/2022] [Accepted: 11/10/2022] [Indexed: 06/16/2023]
Abstract
Recently, a growing number of epidemiological studies have examined the relationship between household air pollution (HAP) and all-cause and cause-specific mortality. While the results were not entirely consistent, the current study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol to conduct a comprehensive review and meta-analysis. Data sources were PubMed, Web of Science, Embase, and Cochrane Library for studies published up to 12 May 2022. The pooled relative risks (RRs) with 95% confidence intervals (CI) were used to estimate the effect of household air pollution on all-cause and cause-special mortality. Then I square value (I2) was used to assess heterogeneity, and random-effects model was used as the pooling method. Seventeen studies were included in the quantitative analysis. Our results showed a significant association between household air pollution and increased risks of all-cause mortality (RR = 1.12, 95% CI = 1.06-1.19) and cardiovascular disease mortality (RR = 1.13, 95% CI = 1.04-1.24). Similarly, the associations between household air pollution and mortality from other specific causes (respiratory, ischemic heart disease, stroke, and total cancer) were positive, although they were not statistically significant. The study suggests that exposure to household air pollution increases the risk of all-cause mortality and cardiovascular disease mortality. In addition, our results found a trend of increased mortality from the respiratory system, ischemic heart disease, stroke, and total cancer, with household air pollution.
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Affiliation(s)
- Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Yuyan Wu
- The First People's Hospital of Hefei, 390 N. Huaihe Road, Luyang District, Hefei, 230061, China
| | - Vicky Yau
- Division of Oral and Maxillofacial Surgery, Columbia University Irving Medical Center, 622W 168Th St, New York, NY, 10032, USA
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- Anhui Provincial Children's Hospital/Children's Hospital of Anhui Medical University, Hefei, 230051, Anhui, People's Republic of China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Yaru Li
- Internal Medicine, Swedish Hospital, 5140 N California Ave, Chicago, IL, 60625, USA
| | - Rachel Bentley
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Bethany King
- Internal Medicine, MercyOne Des Moines Medical Center, 1111 6Th Avenue, Des Moines, IA, 50314, USA
| | - Qin Zhou
- Radiation Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, IL, 60657, USA.
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14
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Luo M, Liu T, Ma C, Fang J, Zhao Z, Wen Y, Xia Y, Zhao Y, Ji C. Household polluting cooking fuels and adverse birth outcomes: An updated systematic review and meta-analysis. Front Public Health 2023; 11:978556. [PMID: 36935726 PMCID: PMC10020710 DOI: 10.3389/fpubh.2023.978556] [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: 06/26/2022] [Accepted: 02/06/2023] [Indexed: 03/06/2023] Open
Abstract
Background and aim The current study aimed to clarify the association between household polluting cooking fuels and adverse birth outcomes using previously published articles. Methods In this systematic review and meta-analysis, a systematic literature search in PubMed, Embase, Web of Science, and Scopus databases were undertaken for relevant studies that had been published from inception to 16 January 2023. We calculated the overall odds ratio (OR) and 95% confidence interval (CI) for adverse birth outcomes [low birth weight (LBW), small for gestational age (SGA), stillbirth, and preterm birth (PTB)] associated with polluting cooking fuels (biomass, coal, and kerosene). Subgroup analysis and meta-regression were also conducted. Results We included 16 cross-sectional, five case-control, and 11 cohort studies in the review. Polluting cooking fuels were found to be associated with LBW (OR: 1.37, 95% CI: 1.24, 1.52), SGA (OR: 1.48, 95% CI: 1.13, 1.94), stillbirth (OR: 1.38, 95% CI: 1.23, 1.55), and PTB (OR: 1.27, 95% CI: 1.19, 1.36). The results of most of the subgroup analyses were consistent with the main results. In the meta-regression of LBW, study design (cohort study: P < 0.01; cross-sectional study: P < 0.01) and sample size (≥ 1000: P < 0.01) were the covariates associated with heterogeneity. Cooking fuel types (mixed fuel: P < 0.05) were the potentially heterogeneous source in the SGA analysis. Conclusion The use of household polluting cooking fuels could be associated with LBW, SGA, stillbirth, and PTB. The limited literature, observational study design, exposure and outcome assessment, and residual confounding suggest that further strong epidemiological evidence with improved and standardized data was required to assess health risks from particular fuels and technologies utilized.
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Affiliation(s)
- Mengrui Luo
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tiancong Liu
- Department of Otorhinolaryngology - Head and Neck Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Changcheng Ma
- Department of Clinical Laboratory, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jianwei Fang
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhiying Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu Wen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Yuhong Zhao
| | - Chao Ji
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Chao Ji
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15
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Machava NE, Mulaudzi FM, Salvador EM. Household Factors of Foodborne Diarrhea in Children under Five in Two Districts of Maputo, Mozambique. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15600. [PMID: 36497675 PMCID: PMC9739694 DOI: 10.3390/ijerph192315600] [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: 09/08/2022] [Revised: 11/07/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
Household factors involved in the disease of diarrhea are multifaceted. This study aimed to explore and describe the household factors affecting foodborne diarrhea in children younger than 5 years old using structured questionnaire data based on quantitative tools. The sample size was calculated based on a binomial distribution. A total of 300 children, together with their caregivers, participated, and the data were descriptively and mathematically analyzed using Epi Info modelling. The caregivers were mostly female and included 93.3% rural and 84% urban dwellers of ages between 18 and 38, who were single but living with someone. Of the children who were under six months of age, 23.3% in rural areas and 16.6% in urban areas had diarrhea, while of the children between 12 and 23 months of age, 36.6% in urban areas and 30% in rural areas had diarrhea. The relatives had similar symptoms before the child became ill, with 12.6% of relatives in rural areas and 13.3% in urban areas reporting this. Before receiving medical assistance, 51.3% of children in rural areas and 16% of children in urban areas were treated with traditional medication. Water was not treated before drinking in 48% of rural cases and 45.3% of urban cases. A total of 24.6% of infants in urban areas and 12.6% of infants in rural areas used a bottle for feeding. The factors affecting foodborne diarrhea were the use of traditional medication in rural areas, bottle feeding in urban areas and untreated water used for drinking in both areas.
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Affiliation(s)
- Nórgia Elsa Machava
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Fhumulani Mavis Mulaudzi
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Elsa Maria Salvador
- Department of Biological Sciences, Faculty of Science, Eduardo Mondlane University, Maputo P.O. Box 257, Mozambique
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16
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Dhital S, Rupakheti D, Rupakheti M, Yin X, Liu Y, Mafiana JJ, Alareqi MM, Mohamednour H, Zhang B. A scientometric analysis of indoor air pollution research during 1990-2019. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 320:115736. [PMID: 35932736 DOI: 10.1016/j.jenvman.2022.115736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 01/26/2022] [Accepted: 07/09/2022] [Indexed: 06/15/2023]
Abstract
Indoor air pollution (IAP) is one of the leading risk factors for various adverse health outcomes including premature deaths globally. Even though research related to IAP has been carried out, bibliometric studies with particular emphasis on this topic have been lacking. Here, we investigated IAP research from 1990 to 2019 retrieved from the Web of Science database through a comprehensive and systematic scientometric analysis using the CiteSpace 5.7.R2, a powerful tool for visualizing structural, temporal patterns and trends of a scientific field. There was an exponential increase in publications, however, with a stark difference between developed and developing countries. The journals publishing IAP related research had multiple disciplines; 'Indoor Air' journal that focuses solely on IAP issues ranked fifth among top-cited journals. The terms like 'global burden', 'comparative risk assessment,' 'household air pollution (HAP)', 'ventilation', 'respiratory health', 'emission factor', 'impact,' 'energy', 'household', 'India' were the current topical subject where author Kirk R. Smith was identified with a significant contribution. Research related to rural, fossil-fuel toxicity, IAP, and exposure-assessment had the highest citation burst signifying the particular attention of scientific communities to these subjects. Overall, this study examined the evolution of IAP research, identified the gaps and provided future research directions.
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Affiliation(s)
- Sushma Dhital
- School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Dipesh Rupakheti
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Nanjing 210044, China
| | | | - Xiufeng Yin
- State Key Laboratory of Cryospheric Science, Northwest Institute of Eco-Environment and Resources, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Yanli Liu
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | | | | | | | - Benzhong Zhang
- School of Public Health, Lanzhou University, Lanzhou 730000, China.
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17
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Alam MB, Acharjee S, Mahmud SA, Tania JA, Ali Khan MM, Islam MS, Khan MN. Household air pollution from cooking fuels and its association with under-five mortality in Bangladesh. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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18
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Household Air Pollution from Cooking Fuels Increases the Risk of Under-Fives Acute Respiratory Infection: Evidence from Population-Based Cross-Sectional Surveys in Tanzania. Ann Glob Health 2022; 88:46. [PMID: 35854920 PMCID: PMC9249002 DOI: 10.5334/aogh.3650] [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: 11/29/2021] [Accepted: 04/07/2022] [Indexed: 11/20/2022] Open
Abstract
Background and Aims: Increased risk of acute respiratory infection (ARI) in children has been linked with exposure to household air pollution (HAP) from solid biomass fuels. However, information is limited on the trend use of biomass fuels and their association with ARI among children in Tanzania. The current study analysed nationally representative data from the Tanzania Demographic Health Surveys of the years 2004, 2010, and 2015–16 to explore the prevalence of the trend of cooking fuels and ARI as well as ascertain their association among under-fives. Methods: A total sample of 20,323 under-fives were included in the current analysis. A mixed-effects multilevel logistic regression was fitted to assess the association between unclean fuels (solid biomass fuels and kerosene) and ARI among under-fives. Results: The use of solid biomass fuels has remained persistent high (98.6%) while ARI among under-fives has declined from 16% in 2004 to 9% in 2016; p < 0.001. Furthermore, under-fives exposed to unclean fuel combustion had a significantly higher incidence of ARI (AOR = 3.47; 95% CI, 1.31–9.21). Conclusion: Efforts should be made to switch to alternative sources of clean energy such as natural gas and biogas in Tanzania and other countries with similar settings.
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19
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Kanno GG, Geremew T, Diro T, Musarapasi SV, Wyk RV, Seboka BT, Alembo A, Hussen R, Soboksa NE, Aregu MB. The link between indoor air pollution from cooking fuels and anemia status among non-pregnant women of reproductive age in Ethiopia. SAGE Open Med 2022; 10:20503121221107466. [PMID: 35814308 PMCID: PMC9260590 DOI: 10.1177/20503121221107466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 05/30/2022] [Indexed: 11/17/2022] Open
Abstract
Objective: The effect of indoor air pollution from different fuel types on the anemia
status among non-pregnant women is rarely studied. This study aimed to
assess the link between indoor air pollution from different fuel types and
anemia among non-pregnant women of reproductive ages in Ethiopia. Method: The secondary data from the 2016 Ethiopian Demographic and Health Survey data
have been employed for this study. The anemia status of women in
reproductive age was the outcome variable with multiple outcomes as
(moderate to severe, mild, and no anemia) and households using biomass fuel
and clean fuel were selected for this study. Multinomial logistic regression
was employed to estimate the association of biomass fuel use with the anemia
status controlling for the predictor variables. Relative risk ratio was
calculated at 95% confidence interval. An independent-sample t-test was used
to assess the mean difference in blood hemoglobin level (g/dL) between the
two fuel users. A p value < 0.05 was considered significant. Result: From the total of 10,961 participants included in this study, the proportion
of anemia in women of non-reproductive age was 41.8% and 19.4% among biomass
fuel and clean fuel users, respectively, with a mean blood hemoglobin level
of 12.71 (±1.81) g/dL. In the final model, women using biomass fuel for
cooking were 47% more likely to have mild anemia than households who use
cleaner fuels, whereas the association was insignificant for moderate to
severe anemia. Biomass fuel users were also found to have 5.8 g/dL lower
blood hemoglobin level than the clean fuel user (p < 0.001). Conclusion: The use of biomass fuel was associated with reduced blood hemoglobin levels
and significantly associated with mild anemia levels in women of
reproductive age in Ethiopia. National efforts should be in place to reduce
indoor air pollution from biomass fuels.
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Affiliation(s)
- Girum Gebremeskel Kanno
- College of Medicine and Health Sciences, Department of Environmental Health, Dilla University, Dilla, Ethiopia
| | - Temesgen Geremew
- Austrian Red Cross International Cooperation, Addis Ababa, Ethiopia
| | - Tesfaye Diro
- International Organization for Migration, Addis Ababa, Ethiopia
| | | | - Renay Van Wyk
- Department of Environmental Health, University of Johannesburg, South Africa
| | - Binyam Tariku Seboka
- College of Medicine and Health Sciences, School of Public Health, Dilla University, Dilla, Ethiopia
| | - Awash Alembo
- College of Medicine and Health Sciences, Department of Environmental Health, Dilla University, Dilla, Ethiopia
| | - Robel Hussen
- College of Medicine and Health Sciences, School of Public Health, Dilla University, Dilla, Ethiopia
| | - Negasa Eshete Soboksa
- College of Medicine and Health Sciences, Department of Environmental Health, Dilla University, Dilla, Ethiopia
| | - Mekonnen Birhane Aregu
- College of Medicine and Health Sciences, Department of Environmental Health, Dilla University, Dilla, Ethiopia
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20
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Kana MA, Shi M, Ahmed J, Ibrahim JM, Ashir AY, Abdullahi K, Bello-Manga H, Taingson M, Mohammed-Durosinlorun A, Shuaibu M, Tabari AM, London SJ. Biomass fuel use and birth weight among term births in Nigeria. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000419. [PMID: 36962417 PMCID: PMC10022098 DOI: 10.1371/journal.pgph.0000419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 04/22/2022] [Indexed: 11/18/2022]
Abstract
Despite the high burden of household air pollution from biomass fuel in sub-Saharan Africa, the association of prenatal biomass fuel exposure and birth weight as a continuous variable among term births has not been extensively studied. In this study, our primary aim is to estimate the association between biomass cooking fuel and birth weight among term births in Kaduna, northwestern Nigeria. For replication, we also evaluated this association in a larger and nationally representative sample from the 2018 Nigerian Demographic and Health Survey (DHS). Our primary analysis included 1,514 mother-child pairs recruited from Kaduna, in northwestern Nigeria, using the Child Electronic Growth Monitoring System (CEGROMS). Replication analysis was conducted using data from 6,975 mother-child pairs enrolled in 2018 Nigerian DHS. The outcome variable was birth weight, and the exposure was cooking fuel type, categorized in CEGROMS as liquefied petroleum gas, kerosene, or biomass fuel, and in the DHS as low pollution fuel, kerosene, or biomass fuel. We estimated covariate adjusted associations between birth weight and biomass fuel exposure in CEGROMS using linear regression and using linear mixed model in the DHS. In CEGROMS, adjusting for maternal age, education, parity, BMI at birth, and child sex, mothers exposed to biomass fuel gave birth to infants who were on average 113g lighter (95% CI -196 to -29), than those using liquified petroleum gas. In the 2018 Nigeria DHS data, compared to low pollution fuel users, mothers using biomass had infants weighing 50g (95% CI -103 to 2) lower at birth. Exposure to biomass cooking fuel was associated with lower birth weight in our study of term newborns in Kaduna, Nigeria. Data from the nationally representative DHS provide some support for these findings.
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Affiliation(s)
- Musa Abubakar Kana
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, North Carolina, United States of America
- Department of Epidemiology and Community Medicine, Federal University of Lafia, Lafia, Nasarawa State, Nigeria
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Min Shi
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, North Carolina, United States of America
| | - Jennifer Ahmed
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Jimoh Muhammad Ibrahim
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | | | | | - Halima Bello-Manga
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Matthew Taingson
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Amina Mohammed-Durosinlorun
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Musa Shuaibu
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Abdulkadir Musa Tabari
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Stephanie J. London
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, North Carolina, United States of America
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21
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Best R, Malava J, Dube A, Katundu C, Kalobekamo F, Mortimer K, Gordon SB, Nyirenda M, Crampin A, McLean E. A secondary data analysis of a cluster randomized controlled trial: improved cookstoves associated with reduction in incidence of low birthweight in rural Malawi. Int J Epidemiol 2022; 51:1803-1812. [PMID: 35653696 PMCID: PMC9749713 DOI: 10.1093/ije/dyac093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 05/30/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND In northern rural Malawi, the majority of households cook using open fires and there is also a high burden of adverse birth outcomes. The use of open fires or highly polluting cookstoves is associated with low birthweight in babies. There is mixed evidence on whether implementation of cleaner burning cookstoves reduces the number of babies born with low birthweight. METHODS This is a secondary analysis of a cluster randomized control trial in Malawi, conducted over 2014-17. Households were randomized to receive improved cookstoves or to continue current practices. For this analysis, the primary outcome was low birthweight in households under routine demographic surveillance, among births occurring within the trial time frame (N = 4010). A subset of data with stricter exposure definitions respecting the original randomized allocation was also analysed (N = 1050). A causal, forwards modelling approach was used. RESULTS The main dataset showed evidence of effect of the intervention on low birthweight [adjusted odds ratio (aOR) 0.69; 95% CI 0.48-0.99, n = 2788). The subset analysis lacked power to provide evidence of association between improved cookstoves and low birthweight in the stricter exposure definition (aOR 0.62; 95% CI 0.35-1.09, n = 932). CONCLUSIONS This study provides some evidence that an improved cookstove intervention in rural Malawi reduced the number of babies born with low birthweight by 30%. This direction of the effect was also seen in the subset analysis. The analysis suggests that the intervention reduced the number of infants born prematurely or with intra-uterine growth restriction, indicating that improved cookstoves could be a useful maternal health intervention.
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Affiliation(s)
- Rebecca Best
- London School of Hygiene and Tropical Medicine, London, UK
| | - Jullita Malava
- Malawi Epidemiology and Intervention Research Unit, Karonga, Malawi
| | - Albert Dube
- Malawi Epidemiology and Intervention Research Unit, Karonga, Malawi
| | - Cynthia Katundu
- Malawi Epidemiology and Intervention Research Unit, Karonga, Malawi
| | | | | | | | | | - Amelia Crampin
- London School of Hygiene and Tropical Medicine, London, UK,Malawi Epidemiology and Intervention Research Unit, Karonga, Malawi
| | - Estelle McLean
- Corresponding author. London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. E-mail:
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22
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Flanagan E, Oudin A, Walles J, Abera A, Mattisson K, Isaxon C, Malmqvist E. Ambient and indoor air pollution exposure and adverse birth outcomes in Adama, Ethiopia. ENVIRONMENT INTERNATIONAL 2022; 164:107251. [PMID: 35533531 DOI: 10.1016/j.envint.2022.107251] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 06/14/2023]
Abstract
Air pollution poses a threat to human health, with pregnant women and their developing fetuses being particularly vulnerable. A high dual burden of ambient and indoor air pollution exposure has been identified in Ethiopia, but studies investigating their effects on adverse birth outcomes are currently lacking. This study explores the association between ambient air pollution (NOX and NO2) and indoor air pollution (cooking fuel type) and fetal and neonatal death in Adama, Ethiopia. A prospective cohort of mothers and their babies was used, into which pregnant women were recruited at their first antenatal visit (n = 2085) from November 2015 to February 2018. Previously developed land-use regression models were utilized to assess ambient concentrations of NOX and NO2 at the residential address, whereas data on cooking fuel type was derived from questionnaires. Birth outcome data was obtained from self-reported questionnaire responses during the participant's postnatal visit or by phone if an in-person meeting was not possible. Binary logistic regression was employed to assess associations within the final study population (n = 1616) using both univariate and multivariate models; the latter of which adjusted for age, education, parity, and HIV status. Odds ratios (OR) and their corresponding 95% confidence intervals (CI) were reported. Within the cohort, 69 instances of fetal death (n = 16 miscarriages; n = 53 stillbirths) and 16 cases of neonatal death were identified. The findings suggest a tendency towards an association between ambient NOX and NO2 exposure during pregnancy and an increased risk of fetal death overall as well as stillbirth, specifically. However, statistical significance was not observed. Results for indoor air pollution and neonatal death were inconclusive. As limited evidence on the effects of exposure to ambient air pollution on adverse birth outcomes exists in Sub-Saharan Africa and Ethiopia, additional studies with larger study populations should be conducted.
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Affiliation(s)
- Erin Flanagan
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Anna Oudin
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, Sweden
| | - John Walles
- Clinical Infection Medicine, Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Asmamaw Abera
- Ethiopia Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kristoffer Mattisson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, Sweden
| | - Christina Isaxon
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Faculty of Engineering, LTH, Lund University, Lund, Sweden
| | - Ebba Malmqvist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, Sweden
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Household Microenvironment and Under-Fives Health Outcomes in Uganda: Focusing on Multidimensional Energy Poverty and Women Empowerment Indices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116684. [PMID: 35682268 PMCID: PMC9180902 DOI: 10.3390/ijerph19116684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 11/17/2022]
Abstract
Young children in low- and middle-income countries (LMICs) are vulnerable to adverse effects of household microenvironments. The UN Sustainable Development Goals (SDGs)-specifically SDG 3 through 7-urge for a comprehensive multi-sector approach to achieve the 2030 goals. This study addresses gaps in understanding the health effects of household microenvironments in resource-poor settings. It studies associations of household microenvironment variables with episodes of acute respiratory infection (ARI) and diarrhoea as well as with stunting among under-fives using logistic regression. Comprehensive data from a nationally representative, cross-sectional demographic and health survey (DHS) in Uganda were analysed. We constructed and applied the multidimensional energy poverty index (MEPI) and the three-dimensional women empowerment index in multi-variate regressions. The multidimensional energy poverty was associated with higher risk of ARI (OR = 1.32, 95% CI 1.10 to 1.58). Social independence of women was associated with lower risk of ARI (OR= 0.91, 95% CI 0.84 to 0.98), diarrhoea (OR = 0.93, 95% CI 0.88 to 0.99), and stunting (OR = 0.83, 95% CI 0.75 to 0.92). Women's attitude against domestic violence was also significantly associated with episodes of ARI (OR = 0.88, 95% CI 0.82 to 0.93) and diarrhoea (OR = 0.89, 95% CI 0.84 to 0.93) in children. Access to sanitation facilities was associated with lower risk of ARI (OR = 0.55, 95% CI 0.45 to 0.68), diarrhoea (OR = 0.83, 95% CI 0.71 to 0.96), and stunting (OR = 0.64, 95% CI 0.49 to 0.86). Investments targeting synergies in integrated energy and water, sanitation and hygiene, and women empowerment programmes are likely to contribute to the reduction of the burden from early childhood illnesses. Research and development actions in LMICs should address and include multi-sector synergies.
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Pan D, Liu S, Huang D, Zeng X, Zhang Y, Pang Q, Wu H, Tan HJJ, Liang J, Sheng Y, Qiu X. Effects of household environmental exposure and ventilation in association with adverse birth outcomes: A prospective cohort study in rural China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 822:153519. [PMID: 35101501 DOI: 10.1016/j.scitotenv.2022.153519] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 12/27/2021] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
Prenatal exposure to outdoor air pollution have been associated with birth outcomes. However, there is limited evidence on the adverse effects of household indoor air pollution worldwide, much less in rural areas of China. This study aimed to explore the associations of household environmental factors (primary cooking fuel, housing renovation, and home ventilation) with four adverse birth outcomes (preterm birth (PTB), small for gestational age (SGA), low birth weight (LBW), and term low birth weight (T-LBW)). We conducted a cohort study involving 10,324 pregnancies in women who delivered a live-born infant from 2015 to 2018 in Guangxi, China. Risk ratios and 95% confidence intervals (CI) were estimated with control for reproductive history, lifestyle, home environmental confounders, and other potential confounders. A total of 5.4% of the infants were PTB, 10.7% were SGA, 5.5% had LBW, and 3.0% had T-LBW. Household-use induction cookers as the primary cooking fuel during pregnancy was associated with SGA (RR = 1.31, 95% CI: 1.07-1.60), LBW (1.41, 1.09-1.82), and T-LBW(1.62, 1.16-2.26), as compared with household-use gas as the primary cooking fuel. Housing renovation within one year before pregnancy was associated with PTB (1.45, 1.06-1.98) and LBW (1.56, 1.17-2.09), while housing renovation during pregnancy was associated with a higher risk of SGA only in moderate home ventilation conditions (3.74, 1.69-8.28). Our findings suggested that household-use induction cookers as the primary cooking fuel increased the risks of SGA, LBW, and T-LBW. In addition, housing renovation within one year before pregnancy increased the risks of PTB and LBW. Proper home ventilation may reduce the effect on the association between housing renovation during pregnancy and SGA.
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Affiliation(s)
- Dongxiang Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Shun Liu
- Department of Child and Adolescent Health & Maternal and Child Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Dongping Huang
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Xiaoyun Zeng
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Yuanxiao Zhang
- Obstetrical Department, Pingguo Maternal and Child Health Hospital, Pingguo 531400, Guangxi, China
| | - Qiang Pang
- Department of Cardiology, Debao Maternal and Child Health Hospital, Debao 533700, Guangxi, China
| | - Huiping Wu
- Obstetrical Department, Jingxi People's Hospital, Jingxi 533800, Guangxi, China
| | - Hui Juan Jennifer Tan
- Yong Loo Lin School of Medicine, National University of Singapore, 117597 Singapore, Singapore
| | - Jun Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Yonghong Sheng
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Xiaoqiang Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China.
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25
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Jabin N, Salam MT, Rahman MM, Sharna TI, Franklin M, Ahmed A, Quaiyum MA, Islam T. Social inequality influences the impact of household air pollution on birth outcomes. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 822:153405. [PMID: 35092774 PMCID: PMC8969117 DOI: 10.1016/j.scitotenv.2022.153405] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND Studies demonstrated associations between maternal exposure to household air pollution from cooking and increased risk of adverse birth outcomes in offspring; however, the modifying effect of socioeconomic status (SES) on this association has not been explored. OBJECTIVES In a cohort of pregnant women with 800 single live births between 2016 and 2017 in rural and semi urban areas of Bangladesh, we tested the hypotheses that kitchen location and cooking fuel type affect birth outcomes (birth weight, low birth weight [LBW] and small for gestational age [SGA]) and these associations vary by SES. METHODS Demographic characteristics including SES, kitchen location and fuel type were assessed in prenatal visits. Neonatal anthropometric measurements were recorded within 72 h of births. We performed multivariable linear and logistic regressions adjusting for potential confounders to test the study hypotheses. RESULTS For newborns from households with indoor kitchens, adjusted mean birth weight was 65.13 g (95% confidence interval [CI]: -118.37, -11.90) lower and the odds of LBW and SGA were 58% (odds ratio [OR]:1.58, 95% CI: 1.12, 2.24) and 41% (OR: 1.41, 95% CI: 1.05, 1.92) higher compared to those born in households with outdoor kitchens. We found SES significantly modified the associations between kitchen location and birth outcomes in households using biomass fuels. Newborns from low SES households with indoor kitchens had 89 g lower birth weight and a higher odds of being born with LBW (OR: 2.08, 95% CI 1.23, 3.58), and SGA (OR: 1.70, 95% CI 1.06, 2.76) than those born in high SES households using outdoor kitchens. CONCLUSIONS In areas with poor access or affordability to clean fuel such as in our study population, cooking in an outdoor kitchen can reduce the burden of LBW and SGA, particularly for low SES households. Promoting outdoor kitchens is a possible intervention strategy to mitigate adverse birth outcomes.
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Affiliation(s)
- Nusrat Jabin
- Department of Population and Public Health Sciences, University of Southern California, USA
| | - Muhammad T Salam
- Department of Population and Public Health Sciences, University of Southern California, USA; Department of Psychiatry, Kern Medical, Bakersfield, CA, USA
| | - Md Mostafijur Rahman
- Department of Population and Public Health Sciences, University of Southern California, USA
| | - Tasnia Ishaque Sharna
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, (icddr,b), Bangladesh
| | - Meredith Franklin
- Department of Population and Public Health Sciences, University of Southern California, USA
| | - Anisuddin Ahmed
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, (icddr,b), Bangladesh
| | - M A Quaiyum
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, (icddr,b), Bangladesh
| | - Talat Islam
- Department of Population and Public Health Sciences, University of Southern California, USA.
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26
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Attributable risk of household solid fuel use and second-hand smoke associated with under-5 mortality in 46 low- and lower-middle-income countries, 2010-2020. Int J Hyg Environ Health 2022; 243:113986. [PMID: 35561570 DOI: 10.1016/j.ijheh.2022.113986] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/14/2022] [Accepted: 04/28/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Household solid fuel use (including indoor and outdoor) and second-hand smoke (SHS) are considered to be major contributors of under-5 mortality (U5M) in low- and lower-middle-income countries (LMICs). This study provides a comprehensive assessment of their odds ratios and attributable mortality in LMICs. METHODS We used the Demographic Health Surveys data for under-5 children in 46 LMICs (n = 778,532) from 2010 to 2020. Mixed effect multilevel logistic regressions were conducted to estimate the pooled adjusted odds ratio (aOR) for U5M due to solid fuel use, SHS and their combination compared to no exposure to them in 46 LMICs. The attributable mortality of solid fuel use, SHS, and their combination were assessed for each LMIC. FINDINGS The pooled aOR of solid fuel use and SHS for U5M was estimated to be 1.27 (95% Confidence Interval (CI): 1.19-1.36) and 1.13 (95%CI: 1.06-1.25), respectively, whereas those of their combination was 1.40 (95%CI: 1.31-1.50). U5M attributable to indoor and outdoor solid fuel use was the highest in Myanmar (18.0%) and the Gambia (16.5%), respectively, while those attributable to SHS was the highest in Indonesia (9.8%). U5M attributable to the combination of solid fuel use and SHS was the highest in Timor-Leste (22.7%). INTERPRETATION The combined effect of exposure to solid fuel and SHS had a higher risk of U5M than the individual risk. The use of clean fuel and tobacco control measures should be integrated with other child health promotion policies. FUNDING This research was partially supported by a research grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan (21H03203).
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27
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Lee MS, Eum KD, Golam M, Quamruzzaman Q, Kile ML, Mazumdar M, Christiani DC. Household use of crop residues and fuelwood for cooking and newborn birth size in rural Bangladesh. Occup Environ Med 2022; 79:333-338. [PMID: 35228261 PMCID: PMC9010366 DOI: 10.1136/oemed-2021-107908] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 01/29/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We aimed to investigate the association between type of cooking biomass fuels (crop residues vs fuelwood) and newborn birth outcomes in Bangladeshi children. METHODS In this birth cohort study, pregnant women who were 18 years or older with ultrasound confirmed singleton pregnancy of ≤16 weeks of gestation were enrolled from two Bangladesh clinics between January 2008 and June 2011. Exposure to cooking biomass fuels during pregnancy was assessed by an administered questionnaire. The newborn size metrics were measured at the time of delivery. We used multiple linear regression and logistic regression to assess the associations between the type of cooking biomass fuels and birth outcomes after adjusting for covariates. RESULTS A total of 1137 participants were using biomass fuels, including crop residues (30.3%) and fuelwood (69.7%), respectively, for cooking. After adjusting for covariates, the use of crop residues for cooking was associated with a 0.13 SD decrease in birth length (95% CI 0.25 to -0.01), a 0.14 SD decrease in head circumference (95% CI -0.27 to -0.02), and increased risk of low birth weight (LBW, OR 1.52, 95% CI 1.07 to 2.15) compared with the use of fuelwood. CONCLUSION The use of crop residues for cooking was associated with reduced birth size and increased risk for LBW in Bangladeshi children, implying that the use of crop residues during pregnancy may have a detrimental effect on fetal growth.
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Affiliation(s)
- Mi-Sun Lee
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ki-Do Eum
- Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts, USA
| | | | | | - Molly L Kile
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Maitreyi Mazumdar
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Massachusetts General Hospital, Boston, Massachusetts, USA
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Raynes-Greenow C, Alam A, Billah SM, Islam S, Agho K, Rokonuzzaman SM, Thornburg J, El Arifeen S, Chowdhury AI, Jalaludin B, Goodwin N, Hayes A, Huda T, Jaman MJ, Khan J, Dibley MJ. Protocol for a cluster randomised controlled trial of LPG cookstoves compared to usual cooking practices to reduce perinatal mortality and morbidity in rural Bangladesh called Poriborton: the CHANge trial. Trials 2022; 23:325. [PMID: 35436950 PMCID: PMC9014282 DOI: 10.1186/s13063-022-06146-7] [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: 12/06/2021] [Accepted: 03/04/2022] [Indexed: 12/30/2022] Open
Abstract
Background Household air pollution is a leading health risk for global morbidity and mortality and a major health risk in South Asia. However, there are no prospective investigations of the impact of household air pollution on perinatal morbidity and mortality. Our trial aims to assess the impact of liquefied petroleum gas (LPG) for cooking to reduce household air pollution exposure on perinatal morbidity and mortality compared to usual cooking practices in Bangladesh. Hypothesis In a community-based cluster randomised controlled trial of pregnant women cooking with LPG throughout pregnancy, perinatal mortality will be reduced by 35% compared with usual cooking practices in a rural community in Bangladesh. Methods A two-arm community-based cluster randomised controlled trial will be conducted in the Sherpur district, Bangladesh. In the intervention arm, pregnant women receive an LPG cookstove and LPG in cylinders supplied throughout pregnancy until birth. In the control or usual practice arm, pregnant women continue their usual cooking practices, predominately traditional stoves with biomass fuel. Eligible women are pregnant women with a gestational age of 40–120 days, aged between 15 and 49 years, and permanent residents of the study area. The primary outcome is the difference in perinatal mortality between the LPG arm and the usual cooking arm. Secondary outcomes include (i) preterm birth and low birth weight, (ii) personal level exposure to household air pollution, (iii) satisfaction and acceptability of the LPG stove and stove use, and (iv) cost-effectiveness and cost-utility in reducing perinatal morbidity and mortality. We follow up all women and infants to 45 days after the birth. Personal exposure to household air pollution is assessed at three-time points in a sub-sample of the study population using the MicroPEM™. The total required sample size is 4944 pregnant women. Discussion This trial will produce evidence of the effectiveness of reduced exposure to household air pollution through LPG cooking to reduce perinatal morbidity and mortality compared to usual cooking practices. This evidence will inform policies for the adoption of clean fuel in Bangladesh and other similar settings. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618001214224. Prospectively registered on 19 July 2019 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06146-7.
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Epuitai J, Woolley KE, Bartington SE, Thomas GN. Association between Wood and Other Biomass Fuels and Risk of Low Birthweight in Uganda: A Cross-Sectional Analysis of 2016 Uganda Demographic and Health Survey Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4377. [PMID: 35410058 PMCID: PMC8999071 DOI: 10.3390/ijerph19074377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022]
Abstract
In utero exposure to household air pollution (HAP) from polluting cooking fuels has been linked to adverse pregnancy outcomes including low birthweight (LBW). No previous study in Uganda has attempted to investigate the association between the different types of biomass cooking fuels and LBW. This study was conducted to investigate the association between wood and other biomass cooking fuel use with increased risk of LBW, using the 2016 Uganda Demographic and Health Survey for 15,270 live births within five years prior to interview. LBW, defined as birthweight of <2500 g, was estimated from maternal recall and health cards. Association between household exposure to the different solid biomass cooking fuels and LBW was determined using multivariable logistic regression. Biomass cooking fuels were used in 99.6% of the households, with few (0.3%) using cleaner fuels and 0.1% with no cooking, while the prevalence of LBW was 9.6% of all live-births. Although the crude analysis suggested an association between wood fuel use and LBW compared to other biomass and kerosene fuel use (AOR: 0.82; 95% CI: 0.67−1.00), after adjusting for socio-demographic and obstetric factors, no association was observed (AOR: 0.94; 95% CI: 0.72−1.22). LBW was significantly more likely among female neonates (AOR: 1.32 (95% CI: 1.13−1.55) and neonates born to mothers living in larger households (AOR: 1.03; 95% CI: 1.00−1.07). LBW was significantly less likely among neonates delivered at term (AOR: 0.39; 95% CI: 0.31−0.49), born to women with secondary or tertiary level of education (AOR: 0.80; 95% CI: 0.64−1.00), living in households with a higher wealth index (AOR: 0.69; 95% CI: 0.50−0.96), Eastern (AOR: 0.76; 95% CI:0.59−0.98) and Northern (AOR: 0.75; 95% CI: 0.57−0.99) regions. The study findings suggest inconclusive evidence regarding the association between the use of wood compared to other biomass and kerosene cooking fuels and risk of LBW. Given the close observed association between socioeconomic status and LBW, the Ugandan government should prioritize public health actions which support female education and broader sustainable development to improve household living standards in this setting.
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Affiliation(s)
- Joshua Epuitai
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (J.E.); (K.E.W.); (S.E.B.)
- Department of Nursing, Faculty of Health Sciences, Busitema University, Mbale P.O. Box 1460, Uganda
| | - Katherine E. Woolley
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (J.E.); (K.E.W.); (S.E.B.)
| | - Suzanne E. Bartington
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (J.E.); (K.E.W.); (S.E.B.)
| | - G. Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (J.E.); (K.E.W.); (S.E.B.)
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Kumar P, Hama S, Abbass RA, Nogueira T, Brand VS, Wu HW, Abulude FO, Adelodun AA, Anand P, Andrade MDF, Apondo W, Asfaw A, Aziz KH, Cao SJ, El-Gendy A, Indu G, Kehbila AG, Ketzel M, Khare M, Kota SH, Mamo T, Manyozo S, Martinez J, McNabola A, Morawska L, Mustafa F, Muula AS, Nahian S, Nardocci AC, Nelson W, Ngowi AV, Njoroge G, Olaya Y, Omer K, Osano P, Sarkar Pavel MR, Salam A, Santos ELC, Sitati C, Shiva Nagendra SM. In-kitchen aerosol exposure in twelve cities across the globe. ENVIRONMENT INTERNATIONAL 2022; 162:107155. [PMID: 35278800 DOI: 10.1016/j.envint.2022.107155] [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: 12/17/2021] [Revised: 02/13/2022] [Accepted: 02/18/2022] [Indexed: 06/14/2023]
Abstract
Poor ventilation and polluting cooking fuels in low-income homes cause high exposure, yet relevant global studies are limited. We assessed exposure to in-kitchen particulate matter (PM2.5 and PM10) employing similar instrumentation in 60 low-income homes across 12 cities: Dhaka (Bangladesh); Chennai (India); Nanjing (China); Medellín (Colombia); São Paulo (Brazil); Cairo (Egypt); Sulaymaniyah (Iraq); Addis Ababa (Ethiopia); Akure (Nigeria); Blantyre (Malawi); Dar-es-Salaam (Tanzania) and Nairobi (Kenya). Exposure profiles of kitchen occupants showed that fuel, kitchen volume, cooking type and ventilation were the most prominent factors affecting in-kitchen exposure. Different cuisines resulted in varying cooking durations and disproportional exposures. Occupants in Dhaka, Nanjing, Dar-es-Salaam and Nairobi spent > 40% of their cooking time frying (the highest particle emitting cooking activity) compared with ∼ 68% of time spent boiling/stewing in Cairo, Sulaymaniyah and Akure. The highest average PM2.5 (PM10) concentrations were in Dhaka 185 ± 48 (220 ± 58) μg m-3 owing to small kitchen volume, extensive frying and prolonged cooking compared with the lowest in Medellín 10 ± 3 (14 ± 2) μg m-3. Dual ventilation (mechanical and natural) in Chennai, Cairo and Sulaymaniyah reduced average in-kitchen PM2.5 and PM10 by 2.3- and 1.8-times compared with natural ventilation (open doors) in Addis Ababa, Dar-es-Salam and Nairobi. Using charcoal during cooking (Addis Ababa, Blantyre and Nairobi) increased PM2.5 levels by 1.3- and 3.1-times compared with using natural gas (Nanjing, Medellin and Cairo) and LPG (Chennai, Sao Paulo and Sulaymaniyah), respectively. Smaller-volume kitchens (<15 m3; Dhaka and Nanjing) increased cooking exposure compared with their larger-volume counterparts (Medellin, Cairo and Sulaymaniyah). Potential exposure doses were highest for Asian, followed by African, Middle-eastern and South American homes. We recommend increased cooking exhaust extraction, cleaner fuels, awareness on improved cooking practices and minimising passive occupancy in kitchens to mitigate harmful cooking emissions.
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Affiliation(s)
- Prashant Kumar
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; Department of Civil, Structural & Environmental Engineering, Trinity College Dublin, Dublin, Ireland; School of Architecture, Southeast University, Nanjing, China.
| | - Sarkawt Hama
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom
| | - Rana Alaa Abbass
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom
| | - Thiago Nogueira
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; Departamento de Ciências Atmosféricas - Instituto de Astronomia, Geofísica e Ciências Atmosféricas - IAG, Universidade de São Paulo, São Paulo, Brazil
| | - Veronika S Brand
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; Departamento de Ciências Atmosféricas - Instituto de Astronomia, Geofísica e Ciências Atmosféricas - IAG, Universidade de São Paulo, São Paulo, Brazil
| | - Huai-Wen Wu
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; School of Architecture, Southeast University, Nanjing, China
| | | | - Adedeji A Adelodun
- Department of Marine Science and Technology, The Federal University of Technology Akure, 340001, Nigeria
| | - Partibha Anand
- Department of Civil Engineering, Indian Institute of Technology Delhi, India
| | - Maria de Fatima Andrade
- Departamento de Ciências Atmosféricas - Instituto de Astronomia, Geofísica e Ciências Atmosféricas - IAG, Universidade de São Paulo, São Paulo, Brazil
| | | | - Araya Asfaw
- Physics Department, Addis Ababa University, Ethiopia
| | - Kosar Hama Aziz
- Department of Chemistry, College of Science, University of Sulaimani, Kurdistan Region, Iraq
| | - Shi-Jie Cao
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; School of Architecture, Southeast University, Nanjing, China
| | - Ahmed El-Gendy
- Department of Construction Engineering, School of Sciences and Engineering, The American University in Cairo, New Cairo 11835, Egypt
| | - Gopika Indu
- Department of Civil Engineering, Indian Institute of Technology Madras, Chennai, India
| | | | - Matthias Ketzel
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Mukesh Khare
- Department of Civil Engineering, Indian Institute of Technology Delhi, India
| | - Sri Harsha Kota
- Department of Civil Engineering, Indian Institute of Technology Delhi, India
| | - Tesfaye Mamo
- Physics Department, Addis Ababa University, Ethiopia
| | | | | | - Aonghus McNabola
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; Department of Civil, Structural & Environmental Engineering, Trinity College Dublin, Dublin, Ireland
| | - Lidia Morawska
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, Surrey, United Kingdom; International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Australia
| | - Fryad Mustafa
- Department of Chemistry, College of Science, University of Sulaimani, Kurdistan Region, Iraq
| | | | - Samiha Nahian
- Department of Chemistry, Faculty of Science, University of Dhaka, Dhaka 1000, Bangladesh
| | | | - William Nelson
- Department of Environmental and Occupational Health, Muhimbili University of Health and Allied Sciences, Tanzania
| | - Aiwerasia V Ngowi
- Department of Environmental and Occupational Health, Muhimbili University of Health and Allied Sciences, Tanzania
| | | | - Yris Olaya
- Universidad Nacional de Colombia, Colombia
| | - Khalid Omer
- Department of Chemistry, College of Science, University of Sulaimani, Kurdistan Region, Iraq
| | | | - Md Riad Sarkar Pavel
- Department of Chemistry, Faculty of Science, University of Dhaka, Dhaka 1000, Bangladesh
| | - Abdus Salam
- Department of Chemistry, Faculty of Science, University of Dhaka, Dhaka 1000, Bangladesh
| | - Erik Luan Costa Santos
- Department of Environmental Health - School of Public Health - University of São Paulo, Brazil
| | | | - S M Shiva Nagendra
- Department of Civil Engineering, Indian Institute of Technology Madras, Chennai, India
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Rana J, Luna-Gutiérrez P, Haque SE, Ignacio Nazif-Muñoz J, Mitra DK, Oulhote Y. Associations between household air pollution and early child development among children aged 36-59 months in Bangladesh. J Epidemiol Community Health 2022; 76:667-676. [PMID: 35332101 PMCID: PMC9209676 DOI: 10.1136/jech-2021-217554] [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: 06/27/2021] [Accepted: 03/11/2022] [Indexed: 11/15/2022]
Abstract
Background Household air pollution (HAP) from solid fuel use (SFU) for cooking may impact child health in low-resources countries. This study examined the associations between HAP and early childhood development (ECD) outcomes among children under 5 years of age in Bangladesh and explored potential effect modification by sex and urbanicity. Methods The study sample consisted of 9395 children aged 36–59 months in the households from the Bangladesh Multiple Indicator Cluster Survey 2019. SFU and levels of exposure to SFU (unexposed, moderately exposed and highly exposed) were used as proxies of HAP exposure. We estimated the covariate-adjusted prevalence ratios (aPRs) and 95% CIs for the associations between HAP and ECD outcomes using multilevel mixed-effects Poisson regression models with a robust variance estimator. Results 81.4% of children were exposed to SFU, and the prevalence of developmental delay (in Early Childhood Development Index) was 25.3%. Children exposed to SFU were 1.47 times more likely to have developmental delays (95% CI: 1.25, 1.73; p<0.001) compared with children with no SFU exposure. SFU was significantly associated with developmental delay in socioemotional (aPR: 1.17; 95% CI: 1.01, 1.36; p=0.035) and learning-cognitive (aPR: 1.90; 95% CI: 1.39, 2.60; p<0.001) domains. Similarly, children moderately exposed and highly exposed to HAP had higher prevalence of developmental delays than unexposed children. We did not observe effect modification by sex or urbanicity. Conclusion Public health policies should promote the use of clean cooking fuels and cookstoves to reduce the high burden of HAP exposure in low-resource countries for helping younger children to meet their developmental milestones.
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Affiliation(s)
- Juwel Rana
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada .,Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh.,Research and Innovation, South Asian Institute for Social Transformation, Dhaka, Bangladesh
| | | | - Syed Emdadul Haque
- UChicago Research Bangladesh, The University of Chicago, Chicago, Illinois, USA
| | - José Ignacio Nazif-Muñoz
- Programmes d'études et de recherche en toxicomanie, Faculté de Médecine et des Sciences de la Santé, Universite de Sherbrooke, Sherbrooke, Quebec, Canada.,Department of Environmental Health, T. H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA
| | - Dipak Kumar Mitra
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh
| | - Youssef Oulhote
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
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Schwinger C, Kvestad I, Chandyo RK, Ulak M, Shrestha M, Ranjitkar S, Strand TA. The association between biomass fuel use for cooking and linear growth in young children in Bhaktapur, Nepal. ENVIRONMENT INTERNATIONAL 2022; 161:107089. [PMID: 35063791 DOI: 10.1016/j.envint.2022.107089] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 01/06/2022] [Accepted: 01/10/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND There are still many people in the world who prepare their meals on open fires or stoves using solid fuels from biomass, especially in low-and middle-income countries. Although biomass cooking fuels have been associated with adverse health impacts and diseases, the association with child linear growth remains unclear. OBJECTIVES In a cohort design, we aimed to describe the association between the use of biomass cooking fuels and linear growth in children aged 18-23 months living in the urban and peri-urban community of Bhaktapur, situated in the Kathmandu valley in Nepal. METHODS Caretakers of 600 marginally stunted children aged 6-11 months were interviewed about their source of cooking fuel and other socio-demographic characteristics at enrolment into a randomized controlled trial. Children's body length was measured when children were 18-23 months old. In linear regression models, we estimated the association between the use of biomass fuel and length-for-age Z-scores (LAZ), adjusted for relevant confounders. We repeated these analyses in pre-defined sub-groups and different percentiles of LAZ using quantile regression models. RESULTS Among study participants, 101 (18%) used biomass as cooking fuel. The association between biomass fuel and LAZ was not statistically significant in the full sample (adjusted regression coefficient: -0.14, 95% CI: -0.28, 0.00). The association was stronger in some of the sub-groups and in the lower tail of the LAZ distribution (those who are stunted), but neither reached statistical significance. DISCUSSION Children from households in poor, urban neighborhoods in Nepal which used biomass fuel for cooking were on average slightly shorter than other children, although the association only approached statistical significance. As this was an observational study, residual confounding cannot be excluded. Further studies are needed to confirm these associations, in particular those seen in certain sub-groups.
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Affiliation(s)
- Catherine Schwinger
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway; Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
| | - Ram K Chandyo
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Manjeswori Ulak
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Merina Shrestha
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Suman Ranjitkar
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Tor A Strand
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Research, Innlandet Hospital Trust, Lillehammer, Norway.
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Amegah AK, Sewor C, Obeng AA, Coker ES, Eliason S. Vitamin D intake modifies the association of household air pollution exposure with maternal disorders of pregnancy. INDOOR AIR 2022; 32:e12963. [PMID: 34837417 DOI: 10.1111/ina.12963] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 10/07/2021] [Accepted: 11/06/2021] [Indexed: 06/13/2023]
Abstract
To date, only three studies have investigated the association of household air pollution (HAP) exposure with pregnancy disorders. The ameliorating role of diet and nutrition in the association has never been explored. We conducted a cross-sectional study among 799 mothers who had recently given singleton birth in the Cape Coast Metropolis, Ghana. Structured questionnaire and semi-quantitative food frequency questionnaire were used to assess HAP exposure (from use of biomass fuels for cooking and garbage burning at home) and vitamin D (vitD) intake, respectively. Multivariable binary logistic regression was used to investigate the association between HAP exposure and pregnancy disorders. HAP exposure due to cooking with biomass fuels and garbage burning at home was associated with two fold (AOR = 2.15; 95% confidence interval [CI]: 1.05, 4.43) and six fold (AOR = 6.35; 95% CI: 2.43, 16.58) increased odds of hypertensive disorders of pregnancy (HDP). For gestational diabetes (GDM), the increased odds were two folds for both exposures but the 95% CI included the null value. Stove stacking was also associated with two folds increased odds of GDM (AOR = 1.83; 95% CI: 0.91, 3.68). In stratified analysis, the odds of HDP and GDM associated with biomass fuels use decreased with increasing vitD intake. All the interaction p values were, however, greater than 0.05. We provide the first evidence on the ameliorating role of vitD intake on the effect of HAP exposure on pregnancy disorders. In LMICs where solid fuel use and garbage burning at home is widespread, health workers should advise mothers during antenatal care visits to increase intake of vitamin D rich foods.
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Affiliation(s)
- Adeladza K Amegah
- Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Christian Sewor
- Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Akua A Obeng
- Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Eric S Coker
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Sebastian Eliason
- Department of Community Medicine, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
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Ding R, Li J, Zhang Q, Zhang C, Li N, Sun S, Li C, Shen C, Zhao Q, Chen H, Hao J, Cao J. Vitamin D 3 protects intrauterine growth restriction induced by cooking oil fume derived fine particulate matters. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 229:113103. [PMID: 34929501 DOI: 10.1016/j.ecoenv.2021.113103] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Cooking oil fume (COF) is an important source of indoor air pollution which severely affects human health, and sufficient vitamin D3 (VitD3) is necessary for maternal and child health. However, the effects of cooking oil fume-derived PM2.5 (COF-PM2.5) on birth outcomes and whether VitD3 could protect from adverse effects caused by COFs-PM2.5 are still unclear. METHODS Twenty-four pregnant rats were divided into 4 groups and treated with various treatments: normal feeding, COFs-PM2.5 intratracheal instillation, VitD3 intragastric administration, and COFs-PM2.5 and VitD3 co-treatment, respectively. The fetal rats were obtained in pregnant 21 days and the development of them was recorded. Morphological changes in umbilical cord were measured with HE staining, and the oxidative stress and inflammatory levels were also investigated. Western blotting and RT-PCR was used to detect the expression of angiogenesis related factors. RESULTS We successfully established an intrauterine growth restriction model in rats induced by COFs-PM2.5 where fetus weight significantly decreased after COFs-PM2.5 exposure. As for the umbilical cord vasculature, the wall thickened and the lumen narrowed down, and the contractility of the umbilical cord vasculature enhanced after COFs-PM2.5 exposure. COFs-PM2.5 exposure also increased the oxidative stress and inflammation level and activated the HIF-1α/eNOS/NO and VEGF/VEGFR2/eNOS signaling pathway. Interestingly, VitD3 intervention significantly increased the fetus weight and attenuated the injury of umbilical cord vascular, and partly or completely reversed the changes in the ROS/eNOS/ET-1 axis caused by COF-PM2.5. CONCLUSIONS The findings of this study suggested that COF-PM2.5 exposure could contribute to intrauterine growth restriction through disturbing the ROS/eNOS/ET-1 axis, while VitD3 supplementation could be an effective prophylactic measurement.
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Affiliation(s)
- Rui Ding
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
| | - Jing Li
- Anqing Medical College, Anqing, Anhui, China.
| | - Qi Zhang
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
| | - Chao Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
| | - Na Li
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
| | - Shu Sun
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
| | - Changlian Li
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
| | - Chaowei Shen
- Department of Hospital Infection Management Office, Lu'an People's Hospital, Lu'an, Anhui, China.
| | - Qihong Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
| | - Hongbo Chen
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China.
| | - Jiahu Hao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
| | - Jiyu Cao
- Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
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Shezi B, Jafta N, Asharam K, Tularam H, Jeena P, Naidoo RN. Maternal exposure to indoor PM 2.5 and associated adverse birth outcomes in low socio-economic households, Durban, South Africa. INDOOR AIR 2022; 32:e12934. [PMID: 34546595 DOI: 10.1111/ina.12934] [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: 03/01/2021] [Revised: 08/30/2021] [Accepted: 09/11/2021] [Indexed: 06/13/2023]
Abstract
The association between in utero exposure to indoor PM2.5 and birth outcomes is not conclusive. We assessed the association between in utero exposure to indoor PM2.5 , birth weight, gestational age, low birth weight, and/or preterm delivery. Homes of 800 pregnant women were assessed using a structured walkthrough questionnaire. PM2.5 measurements were undertaken in 300 of the 800 homes for a period of 24 h. Repeated sampling was conducted in 30 of these homes to determine PM2.5 predictors that can reduce within-and/or between-home variability. A predictive model was used to estimate PM2.5 levels in unmeasured homes (n = 500). The mean (SD) for PM2.5 was 37 µg/m3 (29) with a median of 28µg/m3 . The relationship between PM2.5 exposure, birth weight, gestational age, low birth weight, and preterm delivery was assessed using multivariate linear and logistic regression models. We explored infant sex as a potential effect modifier, by creating an interaction term between PM2.5 and infant sex. The odds ratio of low birth weight and preterm delivery was 1.75 (95%CI: 1.47, 2.09) and 1.21 (95%CI: 1.06, 1.39), respectively, per interquartile increase (18 µg/m3 ) in PM2.5 exposure. The reduction in birth weight and gestational age was 75 g (95%CI: 107.89, 53.15) and 0.29 weeks (95%CI: 0.40, 0.19) per interquartile increase in PM2.5 exposure. Infant sex was an effect modifier for PM2.5 on birth weight and gestational age, and the reduction in birth weight and gestational age was 103 g (95%CI: 142.98, 64.40) and 0.38 weeks (95% CI: 0.53, 0.23), respectively, for boys, and 54 g (95%CI: 91.78,15.62) and 0.23 weeks (95%CI:0.37, 0.08), respectively, for girls. Exposure to PM2.5 is associated with adverse pregnancy outcomes. To protect the population during their reproductive period, public health policy should focus on indoor PM2.5 levels.
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Affiliation(s)
- Busisiwe Shezi
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Environment and Health Research Unit, South African Medical Research Council, Durban, South Africa
| | - Nkosana Jafta
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Kareshma Asharam
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Hasheel Tularam
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Prakash Jeena
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Rajen N Naidoo
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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Ambient temperature and stillbirth risks in northern Sweden, 1880-1950. Environ Epidemiol 2021; 5:e176. [PMID: 34909556 PMCID: PMC8663868 DOI: 10.1097/ee9.0000000000000176] [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: 04/22/2021] [Accepted: 09/28/2021] [Indexed: 11/26/2022] Open
Abstract
Background Climate vulnerability of the unborn can contribute to adverse birth outcomes, in particular, but it is still not well understood. We investigated the association between ambient temperature and stillbirth risk among a historical population in northern Sweden (1880-1950). Methods We used digitized parish records and daily temperature data from the study region covering coastal and inland communities some 600 km north of Stockholm, Sweden. The data included 141,880 births, and 3,217 stillbirths, corresponding to a stillbirth rate of 22.7 (1880-1950). The association between lagged temperature (0-7 days before birth) and stillbirths was estimated using a time-stratified case-crossover design. Incidence risk ratios (IRR) with 95% confidence intervals were computed, and stratified by season and sex. Results We observed that the stillbirth risk increased both at low and high temperatures during the extended summer season (April to September), at -10°C, and the IRR was 2.3 (CI 1.28, 4.00) compared to the minimum mortality temperature of +15°C. No clear effect of temperature during the extended winter season (October to March) was found. Climate vulnerability was greater among the male fetus compared to the female counterparts. Conclusion In this subarctic setting before and during industrialization, both heat and cold during the warmer season increased the stillbirth risk. Urbanization and socio-economic development might have contributed to an uneven decline in climate vulnerability of the unborn.
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Martins T, Barreto AC, Souza FM, Souza AM. Fossil fuels consumption and carbon dioxide emissions in G7 countries: Empirical evidence from ARDL bounds testing approach. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 291:118093. [PMID: 34543957 DOI: 10.1016/j.envpol.2021.118093] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/02/2021] [Accepted: 08/31/2021] [Indexed: 06/13/2023]
Abstract
This research determines the intertemporal relationships caused by the coal, oil, and natural gas consumption in the carbon dioxide emission by the G7 countries from 1965 to 2018. Auto-regressive and Distributed Lags models and Bound test were used to detect cointegration and understand the dynamic effect. Due to structural breaks occurred in the variables, two dummy variables for the periods of breaks, 1978 and 1990 were incorporated respectively. Positive causality was identified, in the sense that the consumption of fossil fuels provides an increase in carbon dioxide emissions. Short-term elasticities indicate that an increase of 1 percentage point in the consumption of oil, coal, and natural gas will cause, respectively, an increase of 0.4823%, 0.3140%, and 0.1717% in carbon dioxide emissions. In the long run, the increase of 1 percentage point in the consumption of oil, coal, and natural gas will cause, respectively, an increase of 0.4924%, 0.2692%, and 0.1829% in carbon dioxide emissions. The error correction model (ECM = -0.4739) indicates that 47.39% of a shock in the carbon dioxide emissions variable is resolved in one year and after 2 years, carbon dioxide emissions return to long term equilibrium.
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Affiliation(s)
- Tailon Martins
- Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
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Adjei-Mantey K, Takeuchi K. The effect of in utero exposure to household air pollution on child health: Evidence from Ghana. HEALTH POLICY OPEN 2021. [DOI: 10.1016/j.hpopen.2020.100029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Low birth weight and birth weight status in Bangladesh: A systematic review and meta-analysis. ANTHROPOLOGICAL REVIEW 2021. [DOI: 10.2478/anre-2021-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The prevalence of low birth weight (LBW) is high in Bangladesh, but no study has collated recent estimates of LBW prevalence from throughout the country. The aim of this meta-analysis was to evaluate the prevalence of LBW and birth weight status in Bangladesh. We searched PubMed, Medline, Ovo and Google Scholar to find published articles in national and international journals from 2000–2020 and reviewed for relevance. Meta-analysis and Q test were performed to estimate the prevalence and heterogeneity of LBW from all included articles. Meta-regression was done to quantify associations with sample size and study year. Stratified analysis was conducted and effect size calculated for differences in LBW prevalence by sex, division and urban/rural area. In total 48 studies with 166,520 births were found and included in this meta-analysis. The pooled prevalence of LBW was 29.1% (95% CI, 28.9–29.3%) in overall, 29.9% (29.7–30.2%) in rural and 15.7% (14.9–16.6%) in urban areas. There was no significant difference in average birth weight between boys and girls (SD, 0.71; 95% CI, −0.43–1.83). Prevalence of LBW was higher in north-east Bangladesh compared to other zones (p<0.05). The pooled prevalence of LBW did not change significantly for last two decades. The prevalence of LBW in Bangladesh remains high. Lack of improvement suggests an urgent need for scaled up maternal and prenatal interventions and services known to reduce LBW. Urban/rural and divisional differences in rates suggest areas of greatest need.
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Quinn AK, Adjei IA, Ae-Ngibise KA, Agyei O, Boamah-Kaali EA, Burkart K, Carrión D, Chillrud SN, Gould CF, Gyaase S, Jack DW, Kaali S, Kinney PL, Lee AG, Mujtaba MN, Oppong FB, Owusu-Agyei S, Yawson A, Wylie BJ, Asante KP. Prenatal household air pollutant exposure is associated with reduced size and gestational age at birth among a cohort of Ghanaian infants. ENVIRONMENT INTERNATIONAL 2021; 155:106659. [PMID: 34134048 PMCID: PMC8628363 DOI: 10.1016/j.envint.2021.106659] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/06/2021] [Accepted: 05/18/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND Low birth weight and prematurity are important risk factors for death and disability, and may be affected by prenatal exposure to household air pollution (HAP). METHODS We investigate associations between maternal exposure to carbon monoxide (CO) during pregnancy and birth outcomes (birth weight, birth length, head circumference, gestational age, low birth weight, small for gestational age, and preterm birth) among 1288 live-born infants in the Ghana Randomized Air Pollution and Health Study (GRAPHS). We evaluate whether evidence of malaria during pregnancy, as determined by placental histopathology, modifies these associations. RESULTS We observed effects of CO on birth weight, birth length, and gestational age that were modified by placental malarial status. Among infants from pregnancies without evidence of placental malaria, each 1 ppm increase in CO was associated with reduced birth weight (-53.4 g [95% CI: -84.8, -21.9 g]), birth length (-0.3 cm [-0.6, -0.1 cm]), gestational age (-1.0 days [-1.8, -0.2 days]), and weight-for-age Z score (-0.08 standard deviations [-0.16, -0.01 standard deviations]). These associations were not observed in pregnancies with evidence of placental malaria. Each 1 ppm increase in maternal exposure to CO was associated with elevated odds of low birth weight (LBW, OR 1.14 [0.97, 1.33]) and small for gestational age (SGA, OR 1.14 [0.98, 1.32]) among all infants. CONCLUSIONS Even modest reductions in exposure to HAP among pregnant women could yield substantial public health benefits, underscoring a need for interventions to effectively reduce exposure. Adverse associations with HAP were discernible only among those without evidence of placental malaria, a key driver of impaired fetal growth in this malaria-endemic area.
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Affiliation(s)
- Ashlinn K Quinn
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Oscar Agyei
- Kintampo Health Research Centre, Kintampo, Ghana
| | | | | | - Daniel Carrión
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Steven N Chillrud
- Mailman School of Public Health, Columbia University, New York, NY, USA; Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | - Carlos F Gould
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Darby W Jack
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Seyram Kaali
- Kintampo Health Research Centre, Kintampo, Ghana
| | | | - Alison G Lee
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Kintampo, Ghana; Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Abena Yawson
- Kintampo Health Research Centre, Kintampo, Ghana
| | - Blair J Wylie
- Beth Israel Deaconess Medical Center, Boston, MA, USA.
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Ravindra K, Kaur-Sidhu M, Mor S. Transition to clean household energy through an application of integrated model: Ensuring sustainability for better health, climate and environment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 775:145657. [PMID: 33621873 DOI: 10.1016/j.scitotenv.2021.145657] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
Sustained use and adoption of clean cooking fuels have become an important concern for developing countries due to the enormous burden of diseases attributable to household air pollution (HAP). The transition and adoption of clean household energy involve various socio-economic, behavioral, and technological barriers at different community levels. Hence, the present paper aims to scrutinize the factors, key determinants, and other interventions among rural households that limit clean cookstoves' sustained uses. The study proposes an integrated model to enhance clean cooking fuel uptake and uses based on the available evidence. The health, climate and environmental factors were identified as the key to trigger the adoption of clean cooking fuel alternatives. The model comprises the integration of components for targeted clean fuel policy interventions and promotes green recovery. The elements include Knowledge, Housing characteristics, Awareness, Interventions, Willingness to pay, Adoption, Lower emissions and Gender Equality (THE KHAIWAL model) to ascertain the intervention focus regions. Integration of model components in policy implementation will promote clean household energy to reduce emissions, leading to improve quality of life, good health, women empowerment, better air quality and climate.
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Affiliation(s)
- Khaiwal Ravindra
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.
| | - Maninder Kaur-Sidhu
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India
| | - Suman Mor
- Department of Environment Studies, Panjab University, Chandigarh 160014, India
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Association between household air pollution and child mortality in Myanmar using a multilevel mixed-effects Poisson regression with robust variance. Sci Rep 2021; 11:12983. [PMID: 34155250 PMCID: PMC8217172 DOI: 10.1038/s41598-021-92193-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/02/2021] [Indexed: 12/25/2022] Open
Abstract
Household air pollution (HAP) from solid fuel use (SFU) for cooking is a major public health threat for women and children in low and middle-income countries. This study investigated the associations between HAP and neonatal, infant, and under-five child mortality in Myanmar. The study consisted of 3249 sample of under-five children in the households from the first Myanmar Demographic and Health Survey 2016. Fuel types and levels of exposure to SFU (no, moderate and high) were proxies for HAP. We estimated covariate-adjusted relative risks (aRR) of neonatal, infant, and under-five child mortality with 95% confidence intervals, accounting for the survey design. The prevalence of SFU was 79.0%. The neonatal, infant, and under-five child mortality rates were 26, 45, and 49 per 1000 live births, respectively. The risks of infant (aRR 2.02; 95% CI 1.01-4.05; p-value = 0.048) and under-five mortality (aRR 2.16; 95% CI 1.07-4.36; p-value = 0.031), but not neonatal mortality, were higher among children from households with SFU compared to children from households using clean fuel. Likewise, children highly exposed to HAP had higher risks of mortality than unexposed children. HAP increases the risks of infant and under-five child mortality in Myanmar, which could be reduced by increasing access to clean cookstoves and fuels.
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Islam S, Mohanty SK. Maternal exposure to cooking smoke and risk of low birth weight in India. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 774:145717. [PMID: 33609837 DOI: 10.1016/j.scitotenv.2021.145717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/22/2021] [Accepted: 02/04/2021] [Indexed: 06/12/2023]
Abstract
Over half of the households in India are using unclean cooking fuels (UCF) and exposed to harmful pollutants that has adverse effects on weight of new born baby. Though studies examined the contextual determinants of birth weight, the association of cooking practices and kitchen location with low birth weight (LBW) is limited in India. This paper investigates the comprehensive effects of household air pollution (HAP) on LBW, mean birth weight (MBW) and birth size in India. Data from 93,721 full-term singleton births from the fourth round of National Family Health Survey, conducted during 2015-16 is used in the analyses. Binary logistic and linear regression methods were used to assess the effect of cooking practices on the outcome variables. Children born in households using clean cooking fuels (CCF) (2877 g, 95% CI: 2876-2877) had 80 g higher birth weight compared with UCF (2797 g, 95% CI: 2796-2798). Households using UCF and cooking without separate kitchen (2779 g, 95% CI:2778-2780) had 59 g and 98 g lower MBW as compared to the households using UCF and cooking in separate kitchen (2817 g, 95% CI:2816-2818) and CCF respectively. Significant associations of LBW observed with the place of cooking and cooking practices but no significant association found for cooking fuels. The HAP from poor cooking practices is associated with risks of LBW in India. Transition from unclean to clean fuels, provision of the separate kitchen should be encouraged to reduce the maternal exposure to HAP and improve birth outcomes.
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Affiliation(s)
- Samarul Islam
- International Institute for Population Sciences (IIPS), Mumbai, India.
| | - Sanjay K Mohanty
- International Institute for Population Sciences (IIPS), Mumbai, India.
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Wimalasena NN, Chang-Richards A, Wang KIK, Dirks KN. Housing Risk Factors Associated with Respiratory Disease: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062815. [PMID: 33802036 PMCID: PMC7998657 DOI: 10.3390/ijerph18062815] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 02/03/2023]
Abstract
Cold, damp and mouldy housing arises from the degradation of the housing stock over time due to weathering and a lack of maintenance. Living in such houses is associated with many adverse impacts on human health, especially for those with existing health issues. This paper presents a systematic review, using the PRISMA protocol, consisting of an exploratory analysis of housing-related risk factors associated with respiratory disease. The review consisted of 360 studies investigating 19 risk factors associated with respiratory conditions. Each fall into one of four categories, namely, (1) outdoor environment-related factors; (2) indoor air pollution-related factors; (3) housing non-structure-related factors; or (4) housing structure-related factors. The results show that effects of poor housing conditions on occupants’ respiratory health is a growing research field, where poor indoor air quality, mainly due to a lack of adequate ventilation, was found to be the most influential risk factor. Usage of solid fuel and living in an urban area without a pollutant-free air filtration system are the main risk factors related to inadequate ventilation. Therefore, an adequate and reliable ventilation system with air-infiltration was considered to be the main mitigation solution to improve indoor air quality. It is suggested that government organisations and health practitioners could use the identified risk factors to measure the healthiness of existing dwellings and take measures to improve existing conditions and develop regulations for new housing construction to promote the healthy home concept. Further research is needed for risk mitigation strategies to reduce the respiratory health burden attributed to housing.
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Affiliation(s)
- Nipuni Nilakshini Wimalasena
- Department of Civil and Environmental Engineering, Faculty of Engineering, The University of Auckland, 0600 Auckland, New Zealand; (A.C.-R.); (K.N.D.)
- Correspondence: ; Tel.: +64-225-311-863
| | - Alice Chang-Richards
- Department of Civil and Environmental Engineering, Faculty of Engineering, The University of Auckland, 0600 Auckland, New Zealand; (A.C.-R.); (K.N.D.)
| | - Kevin I-Kai Wang
- Department of Electrical, Computer and Software Engineering, Faculty of Engineering, The University of Auckland, 0600 Auckland, New Zealand;
| | - Kim N. Dirks
- Department of Civil and Environmental Engineering, Faculty of Engineering, The University of Auckland, 0600 Auckland, New Zealand; (A.C.-R.); (K.N.D.)
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Islam S, Mohanty SK. Understanding the association between gradient of cooking fuels and low birth weight in India. SSM Popul Health 2021; 13:100732. [PMID: 33511265 PMCID: PMC7815993 DOI: 10.1016/j.ssmph.2021.100732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/14/2020] [Accepted: 12/20/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Birth weight is positively associated with physical and cognitive development of children and adversely associated with the use of unclean cooking fuels. Though studies have examined the contextual determinants of birth weight, no attempt has been made to understand the association of gradient of cooking fuels with birth weight in India. The objective of this paper is to understand the association of type of cooking fuel with low birth weight in India. METHODS Unit data from the fourth round of the National Family Health Survey (NFHS) (2015-16), covering 8206 singleton births from four states of India, was used in the analysis. These states reported more than 80% of birth weights by way of health cards issued by a public authority. Linear regression analysis was used to estimate mean birth weight, adjusting for confounders. We computed a new wealth index, excluding electricity and cooking fuels, using principal component analysis to capture the economic gradient of cooking fuel. RESULTS Our results suggest a strong gradient of cooking fuels on mean birth weight. The adjusted mean birth weight in households using electricity was 2957 g (95% CI: 2939-2975). It was 2908 g (95% CI: 2907-2910) for LPG, 2792 g (95% CI: 2784-2801) for biogas, 2819 g (95% CI: 2809-2829) for kerosene, 2841 g (95% CI: 2816-2866) for coal/lignite/charcoal, and 2834 g (95% CI: 2831-2836) in households using biomass. A difference of 165 g in predicted mean birth weight was found among children born in households that used electricity in relation to those that used biogas. The difference in relation to kerosene, coal/lignite/charcoal, and biomass was 138 g, 116 g, and 123 g respectively. Significant differences in mean birth weight were also observed by wealth quintiles, mother's underweight, social groups, birth interval, and mother's anemia status. CONCLUSION Findings from the study suggest to strengthen the policies on access to clean fuels and meet the interconnected goals of sustainable development.
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Affiliation(s)
- Samarul Islam
- International Institute for Population Sciences (IIPS), Mumbai, India
| | - Sanjay K Mohanty
- International Institute for Population Sciences (IIPS), Mumbai, India
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Odo DB, Yang IA, Knibbs LD. A Systematic Review and Appraisal of Epidemiological Studies on Household Fuel Use and Its Health Effects Using Demographic and Health Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1411. [PMID: 33546363 PMCID: PMC7913474 DOI: 10.3390/ijerph18041411] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 12/12/2022]
Abstract
The domestic combustion of polluting fuels is associated with an estimated 3 million premature deaths each year and contributes to climate change. In many low- and middle-income countries (LMICs), valid and representative estimates of people exposed to household air pollution (HAP) are scarce. The Demographic and Health Survey (DHS) is an important and consistent source of data on household fuel use for cooking and has facilitated studies of health effects. However, the body of research based on DHS data has not been systematically identified, nor its strengths and limitations critically assessed as a whole. We aimed to systematically review epidemiological studies using DHS data that considered cooking fuel type as the main exposure, including the assessment of the extent and key drivers of bias. Following PRISMA guidelines, we searched PubMed, Web of Science, Scopus and the DHS publication portal. We assessed the quality and risk of bias (RoB) of studies using a novel tool. Of 2748 records remaining after removing duplicates, 63 were read in full. A total of 45 out of 63 studies were included in our review, spanning 11 different health outcomes and representing 50 unique analyses. In total, 41 of 45 (91%) studies analysed health outcomes in children <5 years of age, including respiratory infections (n = 17), death (all-cause) (n = 14), low birthweight (n = 5), stunting and anaemia (n = 5). Inconsistencies were observed between studies in how cooking fuels were classified into relatively high- and low-polluting. Overall, 36/50 (80%) studies reported statistically significant adverse associations between polluting fuels and health outcomes. In total, 18/50 (36%) of the analyses were scored as having moderate RoB, while 16/50 (32%) analyses were scored as having serious or critical RoB. Although HAP exposure assessment is not the main focus of the DHS, it is the main, often only, source of information in many LMICs. An appreciable proportion of studies using it to analyse the association between cooking fuel use and health have potential for high RoB, mostly related to confounder control, exposure assessment and misclassification, and outcome ascertainment. Based on our findings, we provide some suggestions for ways in which revising the information collected by the DHS could make it even more amenable to studies of household fuel use and health, and reduce the RoB, without being onerous to collect and analyse.
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Affiliation(s)
- Daniel B. Odo
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia;
- College of Health Sciences, Arsi University, Oromia, Asella P.O. Box 193, Ethiopia
| | - Ian A. Yang
- Thoracic Program, The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside, QLD 4032, Australia;
- UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Brisbane QLD 4032, Australia
| | - Luke D. Knibbs
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia;
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Roberman J, Emeto TI, Adegboye OA. Adverse Birth Outcomes Due to Exposure to Household Air Pollution from Unclean Cooking Fuel among Women of Reproductive Age in Nigeria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E634. [PMID: 33451100 PMCID: PMC7828613 DOI: 10.3390/ijerph18020634] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/01/2021] [Accepted: 01/08/2021] [Indexed: 11/16/2022]
Abstract
Exposure to household air pollution (HAP) from cooking with unclean fuels and indoor smoking has become a significant contributor to global mortality and morbidity, especially in low- and middle-income countries such as Nigeria. Growing evidence suggests that exposure to HAP disproportionately affects mothers and children and can increase risks of adverse birth outcomes. We aimed to quantify the association between HAP and adverse birth outcomes of stillbirth, preterm births, and low birth weight while controlling for geographic variability. This study is based on a cross-sectional survey of 127,545 birth records from 41,821 individual women collected as part of the 2018 Nigeria Demographic and Health Survey (NDHS) covering 2013-2018. We developed Bayesian structured additive regression models based on Bayesian splines for adverse birth outcomes. Our model includes the mother's level and household characteristics while correcting for spatial effects and multiple births per mother. Model parameters and inferences were based on a fully Bayesian approach via Markov Chain Monte Carlo (MCMC) simulations. We observe that unclean fuel is the primary source of cooking for 89.3% of the 41,821 surveyed women in the 2018 NDHS. Of all pregnancies, 14.9% resulted in at least one adverse birth outcome; 14.3% resulted in stillbirth, 7.3% resulted in an underweight birth, and 1% resulted in premature birth. We found that the risk of stillbirth is significantly higher for mothers using unclean cooking fuel. However, exposure to unclean fuel was not significantly associated with low birth weight and preterm birth. Mothers who attained at least primary education had reduced risk of stillbirth, while the risk of stillbirth increased with the increasing age of the mother. Mothers living in the Northern states had a significantly higher risk of adverse births outcomes in 2018. Our results show that decreasing national levels of adverse birth outcomes depends on working toward addressing the disparities between states.
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Affiliation(s)
- Jamie Roberman
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia; (J.R.); (T.I.E.)
| | - Theophilus I. Emeto
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia; (J.R.); (T.I.E.)
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Oyelola A. Adegboye
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia; (J.R.); (T.I.E.)
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
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Shezi B, Jafta N, Naidoo RN. Exposure assessment of indoor particulate matter during pregnancy: a narrative review of the literature. REVIEWS ON ENVIRONMENTAL HEALTH 2020; 35:427-442. [PMID: 32598324 DOI: 10.1515/reveh-2020-0009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/03/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The aim of this review was to summarize the evidence of the exposure assessment approaches of indoor particulate matter (PM) during pregnancy and to recommend future focus areas. CONTENT Exposure to indoor PM during pregnancy is associated with adverse birth outcomes. However, many questions remain about the consistency of the findings and the magnitude of this effect. This may be due to the exposure assessment methods used and the challenges of characterizing exposure during pregnancy. Exposure is unlikely to remain constant over the nine-month period. Pregnant females' mobility and activities vary - for example, employment status may be random among females, but among those employed, activities are likely to be greater in the early pregnancy than closer to the delivery of the child. SUMMARY Forty three studies that used one of the five categories of indoor PM exposure assessment (self-reported, personal air monitoring, household air monitoring, exposure models and integrated approaches) were assessed. Our results indicate that each of these exposure assessment approaches has unique characteristics, strengths, and weaknesses. While questionnaires and interviews are based on self-report and recall, they were a major component in the reviewed exposure assessment studies. These studies predominantly used large sample sizes. Precision and detail were observed in studies that used integrated approaches (i. e. questionnaires, measurements and exposure models). OUTLOOK Given the limitations presented by these studies, exposure misclassification remains possible because of personal, within and between household variability, seasonal changes, and spatiotemporal variability during pregnancy. Therefore, using integrated approaches (i. e. questionnaire, measurements and exposure models) may provide better estimates of PM levels across trimesters. This may provide precision for exposure estimates in the exposure-response relationship.
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Affiliation(s)
- Busisiwe Shezi
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- South African Medical Research Council, Environment and Health Research Unit, Durban, South Africa
| | - Nkosana Jafta
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Rajen N Naidoo
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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Shezi B, Mathee A, Cele N, Ndabandaba S, Street RA. Occupational Exposure to Fine Particulate Matter (PM 4 and PM 2.5) during Hand-Made Cookware Operation: Personal, Indoor and Outdoor Levels. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7522. [PMID: 33081113 PMCID: PMC7602743 DOI: 10.3390/ijerph17207522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 01/04/2023]
Abstract
(1) Exposure of informal artisanal cookware makers to fine particles has not yet been characterized. The aim of this study was to characterize occupational exposure to fine particulate matter (PM4 and PM2.5) levels and fine particulate matter (PM2.5) elemental components; (2) Artisanal cookware makers were recruited from five cookware making sites. Exposure to fine particulate matter was measured for 17 male participants. SidePak personal aerosol monitors (AM520) were used to measure personal exposure to PM4, while a DustTrak monitor and an E-sampler were used to assess indoor and outdoor PM2.5 levels, respectively. A questionnaire was administered to capture information on demographic characteristics. The chemical characterization of indoor and outdoor PM2.5 filter mass was conducted using Wavelength Dispersive X-ray Fluorescence. Time series record of 15-min averages for indoor and outdoor PM2.5 levels were assessed; (3) The median (range) was 124 µg/m3 (23-100,000), 64 µg/m3 (1-6097) and 12 µg/m3 (4-1178), respectively, for personal PM4, indoor and outdoor PM2.5. The highest levels for many of the elemental components of PM2.5 were found in the outdoor PM2.5 filter mass and (4). The information generated during this study may assist in extending occupational health and safety strategies to artisanal cookware makers and developing targeted prevention initiatives.
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Affiliation(s)
- Busisiwe Shezi
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2094, South Africa;
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa
| | - Angela Mathee
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2094, South Africa;
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa
- Department of Environmental Health, Nelson Mandela University, Port Elizabeth 6019, South Africa
| | - Nokulunga Cele
- Environment and Health Research Unit, South African Medical Research Council, Durban 4001, South Africa; (N.C.); (S.N.); (R.A.S.)
| | - Sipho Ndabandaba
- Environment and Health Research Unit, South African Medical Research Council, Durban 4001, South Africa; (N.C.); (S.N.); (R.A.S.)
| | - Renee A. Street
- Environment and Health Research Unit, South African Medical Research Council, Durban 4001, South Africa; (N.C.); (S.N.); (R.A.S.)
- University of KwaZulu-Natal, Discipline of Occupational and Environmental Health, School of Nursing and Public Health, Durban 4001, South Africa
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Katz J, Tielsch JM, Khatry SK, Shrestha L, Breysse P, Zeger SL, Kozuki N, Checkley W, LeClerq SC, Mullany LC. Impact of Improved Biomass and Liquid Petroleum Gas Stoves on Birth Outcomes in Rural Nepal: Results of 2 Randomized Trials. GLOBAL HEALTH, SCIENCE AND PRACTICE 2020; 8:372-382. [PMID: 32680912 DOI: 10.9745/ghsp-d-2000011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/26/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND Few randomized trials have assessed the impact of reducing household air pollution from biomass stoves on adverse birth outcomes in low-income countries. METHODS Two sequential trials were conducted in rural low-lying Nepal. Trial 1 was a cluster-randomized step-wedge trial comparing traditional biomass stoves and improved biomass stoves vented with a chimney. Trial 2 was a parallel household-randomized trial comparing vented biomass stoves and liquid petroleum gas (LPG) stoves with a year's supply of gas. Kitchen particulate matter of 2.5 μm or less (PM2.5) and carbon monoxide (CO) were assessed before and after stove installation. Prevalent and incident pregnancies were enrolled at baseline and throughout the trials. Birth anthropometry was compared across differing exposure times in pregnancy. RESULTS In trial 1, the mean 20-hour kitchen PM2.5 concentration was reduced from 1380 µg/m3 to 936 µg/m3. Among infants born before the intervention, mean birth weight and gestational age were 2627 g (SD=443) and 38.8 weeks (SD=3.1), and 39% were low birth weight (LBW), 22% preterm, and 55% small for gestational age (SGA). Adverse birth outcomes were not significantly different with increasing exposure to improved stoves during pregnancy. In trial 2, the mean 20-hour PM2.5 concentration was 885 µg/m3 in households with vented biomass and 442 µg/m3 in those with LPG stoves. Mean birth weight was 2780 g (SD=427) and 2742 g (SD=431), among households with vented and LPG stoves, respectively. Respective percentages for LBW, SGA, and preterm were 23%, 13%, and 42% in the vented stove group and not statistically different from 31%, 17%, and 42% in the LPG group. CONCLUSIONS Improved biomass or LPG stoves did not reduce adverse birth outcomes. PM2.5 and CO following improved stove installation remained well above the World Health Organization indoor air standard of 25 µg/m3 or intermediate air quality guideline of 37.5 µg/m3. Trials that lower indoor air pollution further are needed.
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Affiliation(s)
- Joanne Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - James M Tielsch
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | - Laxman Shrestha
- Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Patrick Breysse
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Scott L Zeger
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Naoko Kozuki
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - William Checkley
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Steven C LeClerq
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Luke C Mullany
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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