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Mentes D, Jordán A, Farkas L, Muránszky G, Fiser B, Viskolcz B, Póliska C. Evaluating emissions and air quality implications of residential waste incineration. Sci Rep 2024; 14:21314. [PMID: 39266580 PMCID: PMC11393318 DOI: 10.1038/s41598-024-72173-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 09/04/2024] [Indexed: 09/14/2024] Open
Abstract
In Europe mainly at winter season the PM levels exceed air quality limits, which correlated with the operation of solid-fired boilers. More and more people are returning to using these devices due to energy shortage caused by the pandemic and regional conflicts. In addition, the phenomena of co-burning fuels and municipal waste in residential boilers in primarily fuel poverty households increases further the amount of pollutants in the atmosphere. This study aims to correlate the quantity and quality of air pollutants with the type of fuel (wood and wastes) burned. Combustion experiments were conducted using oak fuel mixed with three waste groups: (1) plastics (PP, HDPE, PET); (2) textiles (polyester-PES, cotton-COT); and (3) papers (cardboard-CARD, glossy coated paper-GCP, 84C/PAP). The addition of waste to wood fuel altered the morphology of emitted particles. While waste burning doesn't always increase particle quantity, it significantly raises PAH concentrations. A strong relationship exists between waste type, particle morphology, and PAH quality, where with lower molecular weight PAHs linked to tar agglomerates and higher ones to soot agglomerates with inorganic crystals.
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Affiliation(s)
- Dóra Mentes
- Institute of Energy and Quality, University of Miskolc, 3515, Miskolc, Miskolc-Egyetemváros, Hungary.
- Higher Education and Industrial Cooperation Centre, University of Miskolc, 3515, Miskolc-Egyetemváros, Hungary.
- Institute of Chemistry, University of Miskolc, 3515, Miskolc, Miskolc-Egyetemváros, Hungary.
| | - Anikó Jordán
- Higher Education and Industrial Cooperation Centre, University of Miskolc, 3515, Miskolc-Egyetemváros, Hungary
- Institute of Chemistry, University of Miskolc, 3515, Miskolc, Miskolc-Egyetemváros, Hungary
| | - László Farkas
- Higher Education and Industrial Cooperation Centre, University of Miskolc, 3515, Miskolc-Egyetemváros, Hungary
| | - Gábor Muránszky
- Institute of Chemistry, University of Miskolc, 3515, Miskolc, Miskolc-Egyetemváros, Hungary
| | - Béla Fiser
- Institute of Chemistry, University of Miskolc, 3515, Miskolc, Miskolc-Egyetemváros, Hungary.
- Department of Physical Chemistry, Faculty of Chemistry, University of Lodz, Lodz, Poland.
- Ferenc Rakoczi II Transcarpathian Hungarian College of Higher Education, Beregszász, 90200, Transcarpathia, Ukraine.
| | - Béla Viskolcz
- Higher Education and Industrial Cooperation Centre, University of Miskolc, 3515, Miskolc-Egyetemváros, Hungary
- Institute of Chemistry, University of Miskolc, 3515, Miskolc, Miskolc-Egyetemváros, Hungary
| | - Csaba Póliska
- Institute of Energy and Quality, University of Miskolc, 3515, Miskolc, Miskolc-Egyetemváros, Hungary
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Shupler M, Tawiah T, Nix E, Baame M, Lorenzetti F, Betang E, Chartier R, Mangeni J, Upadhya A, Anderson de Cuevas R, Sang E, Piedrahita R, Johnson M, Wilson D, Amenga-Etego S, Twumasi M, Ronzi S, Menya D, Puzzolo E, Quansah R, Asante KP, Pope D, Mbatchou Ngahane BH. Household concentrations and female and child exposures to air pollution in peri-urban sub-Saharan Africa: measurements from the CLEAN-Air(Africa) study. Lancet Planet Health 2024; 8:e95-e107. [PMID: 38331535 PMCID: PMC10864747 DOI: 10.1016/s2542-5196(23)00272-3] [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: 02/07/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Relatively clean cooking fuels such as liquefied petroleum gas (LPG) emit less fine particulate matter (PM2·5) and carbon monoxide (CO) than polluting fuels (eg, wood, charcoal). Yet, some clean cooking interventions have not achieved substantial exposure reductions. This study evaluates determinants of between-community variability in exposures to household air pollution (HAP) across sub-Saharan Africa. METHODS In this measurement study, we recruited households cooking primarily with LPG or exclusively with wood or charcoal in peri-urban Cameroon, Ghana, and Kenya from previously surveyed households. In 2019-20, we conducted monitoring of 24 h PM2·5 and CO kitchen concentrations (n=256) and female cook (n=248) and child (n=124) exposures. PM2·5 measurements used gravimetric and light scattering methods. Stove use monitoring and surveys on cooking characteristics and ambient air pollution exposure (eg, walking time to main road) were also administered. FINDINGS The mean PM2·5 kitchen concentration was five times higher among households cooking with charcoal than those using LPG in the Kenyan community (297 μg/m3, 95% CI 216-406, vs 61 μg/m3, 49-76), but only 4 μg/m3 higher in the Ghanaian community (56 μg/m3, 45-70, vs 52 μg/m3, 40-68). The mean CO kitchen concentration in charcoal-using households was double the WHO guideline (6·11 parts per million [ppm]) in the Kenyan community (15·81 ppm, 95% CI 8·71-28·72), but below the guideline in the Ghanaian setting (1·77 ppm, 1·04-2·99). In all communities, mean PM2·5 cook exposures only met the WHO interim-1 target (35 μg/m3) among LPG users staying indoors and living more than 10 min walk from a road. INTERPRETATION Community-level variation in the relative difference in HAP exposures between LPG and polluting cooking fuel users in peri-urban sub-Saharan Africa might be attributed to differences in ambient air pollution levels. Thus, mitigation of indoor and outdoor PM2·5 sources will probably be critical for obtaining significant exposure reductions in rapidly urbanising settings of sub-Saharan Africa. FUNDING UK National Institute for Health and Care Research.
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Affiliation(s)
- Matthew Shupler
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK.
| | | | - Emily Nix
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | | | - Federico Lorenzetti
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | | | | | | | - Adithi Upadhya
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | | | - Edna Sang
- School of Public Health, Moi University, Eldoret, Kenya
| | | | | | | | | | | | - Sara Ronzi
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Diana Menya
- School of Public Health, Moi University, Eldoret, Kenya
| | - Elisa Puzzolo
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | | | | | - Daniel Pope
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
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Amadu I, Seidu AA, Mohammed A, Duku E, Miyittah MK, Ameyaw EK, Hagan JE, Musah MH, Ahinkorah BO. Assessing the combined effect of household cooking fuel and urbanicity on acute respiratory symptoms among under-five years in sub-Saharan Africa. Heliyon 2023; 9:e16546. [PMID: 37346351 PMCID: PMC10279788 DOI: 10.1016/j.heliyon.2023.e16546] [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: 05/16/2022] [Revised: 05/02/2023] [Accepted: 05/18/2023] [Indexed: 06/23/2023] Open
Abstract
Background This study sought to investigate the association between urbanicity (rural-urban residency), the use of solid biomass cooking fuels and the risk of Acute Respiratory Infections (ARIs) among children under the age of 5 in sub-Saharan Africa (SSA). Methods Cross-sectional data from the most recent surveys of the Demographic and Health Survey Program conducted in 31 sub-Saharan African countries were pooled for the analysis. The outcome variables, cough and rapid short breath were derived from questions that asked mothers if their children under the age of 5 suffered from cough and short rapid breath in the past two weeks preceding the survey. To examine the associations, multivariable negative log-log regression models were fitted for each outcome variable. Results Higher odds ratios of cough occurred among children in urban households that use unclean cooking fuel (aOR = 1.05 95% CI = 1.01, 1.08). However, lower odds ratios were observed for rural children in homes that use clean cooking fuel (aOR = 0.93 95% CI = 0.87, 0.99) relative to children in urban homes using clean cooking fuel. We also found higher odds ratios of short rapid breaths among children in rural households that use unclean cooking fuel compared with urban residents using clean cooking fuel (aOR = 1.12 95% CI = 1.08, 1.17). Conclusion Urbanicity and the use of solid biomass fuel for cooking were associated with an increased risk of symptoms of ARIs among children under five years in SSA. Thus, policymakers and stakeholders need to design and implement strategies that minimize children's exposure to pollutants from solid biomass cooking fuel. Such interventions could reduce the burden of respiratory illnesses in SSA and contribute to the realization of Sustainable Development Goal 3.9, which aims at reducing the number of diseases and deaths attributable to hazardous chemicals and pollution of air, water and soil.
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Affiliation(s)
- Iddrisu Amadu
- Africa Centre of Excellence in Coastal Resilience (ACECoR)-Centre for Coastal Management, University of Cape Coast, Cape Coast, Ghana
- Department of Fisheries and Aquatic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Ghana
- Emperiks Research, NT0085, Tamale, Ghana
| | - Abdul-Aziz Seidu
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Box 256, Ghana
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Queensland, Australia
| | - Aliu Mohammed
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Eric Duku
- Africa Centre of Excellence in Coastal Resilience (ACECoR)-Centre for Coastal Management, University of Cape Coast, Cape Coast, Ghana
- Department of Fisheries and Aquatic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Ghana
- Hen Mpoano (Our Coast), Takoradi P.O. Box AX 296, Ghana
| | - Michael K. Miyittah
- Africa Centre of Excellence in Coastal Resilience (ACECoR)-Centre for Coastal Management, University of Cape Coast, Cape Coast, Ghana
- Department of Environmental Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Hong Kong
| | - John Elvis Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Bielefeld University, Bielefeld, Germany
| | - Mohammed Hafiz Musah
- Department of Health Information Management, Tamale Teaching Hospital, Tamale, Ghana
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Balakrishnan K, Steenland K, Clasen T, Chang H, Johnson M, Pillarisetti A, Ye W, Naeher LP, Diaz-Artiga A, McCracken JP, Thompson LM, Rosa G, Kirby MA, Thangavel G, Sambandam S, Mukhopadhyay K, Puttaswamy N, Aravindalochanan V, Garg S, Ndagijimana F, Hartinger S, Underhill LJ, Kearns KA, Campbell D, Kremer J, Waller L, Jabbarzadeh S, Wang J, Chen Y, Rosenthal J, Quinn A, Papageorghiou AT, Ramakrishnan U, Howards PP, Checkley W, Peel JL. Exposure-response relationships for personal exposure to fine particulate matter (PM 2·5), carbon monoxide, and black carbon and birthweight: an observational analysis of the multicountry Household Air Pollution Intervention Network (HAPIN) trial. Lancet Planet Health 2023; 7:e387-e396. [PMID: 37164515 PMCID: PMC10186177 DOI: 10.1016/s2542-5196(23)00052-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 02/19/2023] [Accepted: 03/02/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Household air pollution (HAP) from solid fuel use is associated with adverse birth outcomes, but data for exposure-response relationships are scarce. We examined associations between HAP exposures and birthweight in rural Guatemala, India, Peru, and Rwanda during the Household Air Pollution Intervention Network (HAPIN) trial. METHODS The HAPIN trial recruited pregnant women (9-<20 weeks of gestation) in rural Guatemala, India, Peru, and Rwanda and randomly allocated them to receive a liquefied petroleum gas stove or not (ie, and continue to use biomass fuel). The primary outcomes were birthweight, length-for-age, severe pneumonia, and maternal systolic blood pressure. In this exposure-response subanalysis, we measured 24-h personal exposures to PM2·5, carbon monoxide, and black carbon once pre-intervention (baseline) and twice post-intervention (at 24-28 weeks and 32-36 weeks of gestation), as well as birthweight within 24 h of birth. We examined the relationship between the average prenatal exposure and birthweight or weight-for-gestational age Z scores using multivariate-regression models, controlling for the mother's age, nulliparity, diet diversity, food insecurity, BMI, the mother's education, neonate sex, haemoglobin, second-hand smoke, and geographical indicator for randomisation strata. FINDINGS Between March, 2018, and February, 2020, 3200 pregnant women were recruited. An interquartile increase in the average prenatal exposure to PM2·5 (74·5 μg/m3) was associated with a reduction in birthweight and gestational age Z scores (birthweight: -14·8 g [95% CI -28·7 to -0·8]; gestational age Z scores: -0·03 [-0·06 to 0·00]), as was an interquartile increase in black carbon (7·3 μg/m3; -21·9 g [-37·7 to -6·1]; -0·05 [-0·08 to -0·01]). Carbon monoxide exposure was not associated with these outcomes (1·7; -3·1 [-12·1 to 5·8]; -0·003 [-0·023 to 0·017]). INTERPRETATION Continuing efforts are needed to reduce HAP exposure alongside other drivers of low birthweight in low-income and middle-income countries. FUNDING US National Institutes of Health (1UM1HL134590) and the Bill & Melinda Gates Foundation (OPP1131279).
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Affiliation(s)
- Kalpana Balakrishnan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India.
| | - Kyle Steenland
- Gangarosa Department of Environmental Health, Emory University, Atlanta, GA, USA
| | - Thomas Clasen
- Gangarosa Department of Environmental Health, Emory University, Atlanta, GA, USA
| | - Howard Chang
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | | | - Ajay Pillarisetti
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Wenlu Ye
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Luke P Naeher
- Department of Environmental Health Sciences, University of Georgia, Athens, GA, USA
| | - Anaite Diaz-Artiga
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - John P McCracken
- Department of Environmental Health Sciences, University of Georgia, Athens, GA, USA
| | - Lisa M Thompson
- Rollins School of Public Health and Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Ghislaine Rosa
- Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Miles A Kirby
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Gurusamy Thangavel
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Sankar Sambandam
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Krishnendu Mukhopadhyay
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Naveen Puttaswamy
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Vigneswari Aravindalochanan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Sarada Garg
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | | | - Stella Hartinger
- Division of Pulmonary and Critical Care, School of Medicine and Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
| | - Lindsay J Underhill
- Cardiovascular Division, Washington University School of Medicine, St Louis, MO, USA
| | - Katherine A Kearns
- Department of Environmental Health Sciences, University of Georgia, Athens, GA, USA
| | - Devan Campbell
- Department of Environmental Health Sciences, University of Georgia, Athens, GA, USA
| | - Jacob Kremer
- Department of Environmental Health Sciences, University of Georgia, Athens, GA, USA
| | - Lance Waller
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Shirin Jabbarzadeh
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Jiantong Wang
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Yunyun Chen
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Joshua Rosenthal
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | | | - Aris T Papageorghiou
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA
| | | | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine and Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA
| | - Jennifer L Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
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Saleh S, Sambakunsi H, Makina D, Chinouya M, Kumwenda M, Chirombo J, Semple S, Mortimer K, Rylance J. Personal exposures to fine particulate matter and carbon monoxide in relation to cooking activities in rural Malawi. Wellcome Open Res 2023; 7:251. [PMID: 36874568 PMCID: PMC9975423 DOI: 10.12688/wellcomeopenres.18050.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 02/23/2023] Open
Abstract
Background: Air pollution is a major environmental risk factor for cardiorespiratory disease. Exposures to household air pollution from cooking and other activities, are particularly high in Southern Africa. Following an extended period of participant observation in a village in Malawi, we aimed to assess individuals' exposures to fine particulate matter (PM 2.5) and carbon monoxide (CO) and to investigate the different sources of exposure, including different cooking methods. Methods: Adult residents of a village in Malawi wore personal PM 2.5 and CO monitors for 24-48 hours, sampling every 1 (CO) or 2 minutes (PM 2.5). Subsequent in-person interviews recorded potential exposure details over the time periods. We present means and interquartile ranges for overall exposures and summaries stratified by time and activity (exposure). We employed multivariate regression to further explore these characteristics, and Spearman rank correlation to examine the relationship between paired PM 2.5 and CO exposures. Results : Twenty participants (17 female; median age 40 years, IQR: 37-56) provided 831 hours of paired PM 2.5 and CO data. Concentrations of PM 2.5 during combustion activity, usually cooking, far exceeded background levels (no combustion activity): 97.9μg/m 3 (IQR: 22.9-482.0), vs 7.6μg/m 3, IQR: 2.5-20.6 respectively. Background PM 2.5 concentrations were higher during daytime hours (11.7μg/m 3 [IQR: 5.2-30.0] vs 3.3μg/m 3 at night [IQR: 0.7-8.2]). Highest exposures were influenced by cooking location but associated with charcoal use (for CO) and firewood on a three-stone fire (for PM 2.5). Cooking-related exposures were higher in more ventilated places, such as outside the household or on a walled veranda, than during indoor cooking. Conclusions : The study demonstrates the value of combining personal PM 2.5 exposure data with detailed contextual information for providing deeper insights into pollution sources and influences. The finding of similar/lower exposures during cooking in seemingly less-ventilated places should prompt a re-evaluation of proposed clean air interventions in these settings.
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Affiliation(s)
- Sepeedeh Saleh
- Liverpool School of Tropical Medicine, LIVERPOOL, L3 5QA, UK
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, P.O. Box 30096, Malawi
| | - Henry Sambakunsi
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, P.O. Box 30096, Malawi
| | - Debora Makina
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, P.O. Box 30096, Malawi
| | - Martha Chinouya
- Liverpool School of Tropical Medicine, LIVERPOOL, L3 5QA, UK
| | - Moses Kumwenda
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, P.O. Box 30096, Malawi
| | - James Chirombo
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, P.O. Box 30096, Malawi
| | - Sean Semple
- University of Stirling, Stirling, FK9 4LA, UK
| | - Kevin Mortimer
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Jamie Rylance
- Liverpool School of Tropical Medicine, LIVERPOOL, L3 5QA, UK
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, P.O. Box 30096, Malawi
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Zhu K, Kawyn MN, Kordas K, Mu L, Yoo EH, Seibert R, Smith LE. Assessing exposure to household air pollution in children under five: A scoping review. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 311:119917. [PMID: 35963391 DOI: 10.1016/j.envpol.2022.119917] [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: 04/08/2022] [Revised: 07/17/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Understanding the differences in the approaches used to assess household air pollution (HAP) is crucial for evaluating HAP-related health effects and interpreting the effectiveness of stove-fuel interventions. Our review aims to understand how exposure to HAP from solid fuels was measured in epidemiological studies in children under five. We conducted a search of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Global Health Library, Web of Science, and CINAHL to identify English-language research articles published between January 1, 2000 and April 30, 2022. Two researchers applied the inclusion and exclusion criteria independently. Study region, type of measurement, study design, health outcomes, and other key characteristics were extracted from each article and analyzed descriptively. Our search strategy yielded 2229 records, of which 185 articles were included. A large proportion was published between 2018 and 2022 (42.1%), applied a cross-sectional study design (47.6%), and took place in low- or lower middle-income countries. Most studies (130/185, 70.3%) assessed HAP using questionnaires/interviews, most frequently posing questions on cooking fuel type, followed by household ventilation and cooking location. Cooking frequency/duration and children's location while cooking was less commonly considered. About 28.6% (53/185) used monitors, but the application of personal portable samplers was limited (particulate matter [PM]: 12/40, 30.0%; carbon monoxide [CO]: 13/34, 38.2%). Few studies used biomarkers or modeling approaches to estimate HAP exposure among children under five. More studies that report household and behavioral characteristics and children's location while cooking, apply personal exposure samplers, and perform biomarker analysis are needed to advance our understandings of HAP exposure among infants and young children, who are particularly susceptible to HAP-related health effects.
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Affiliation(s)
- Kexin Zhu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA.
| | - Marissa N Kawyn
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Eun-Hye Yoo
- Department of Geography, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Rachel Seibert
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Laura E Smith
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY, USA
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7
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Saleh S, Sambakunsi H, Makina D, Chinouya M, Kumwenda M, Chirombo J, Semple S, Mortimer K, Rylance J. Personal exposures to fine particulate matter and carbon monoxide in relation to cooking activities in rural Malawi. Wellcome Open Res 2022; 7:251. [PMID: 36874568 PMCID: PMC9975423 DOI: 10.12688/wellcomeopenres.18050.1] [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] [Accepted: 08/04/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Air pollution is a major environmental risk factor for cardiorespiratory disease. Exposures to household air pollution from cooking and other activities, are particularly high in Southern Africa. Following an extended period of participant observation in a village in Malawi, we aimed to assess individuals' exposures to fine particulate matter (PM 2.5) and carbon monoxide (CO) and to investigate the different sources of exposure, including different cooking methods. Methods: Adult residents of a village in Malawi wore personal PM 2.5 and CO monitors for 24-48 hours, sampling every 1 (CO) or 2 minutes (PM 2.5). Subsequent in-person interviews recorded potential exposure details over the time periods. We present means and interquartile ranges for overall exposures and summaries stratified by time and activity (exposure). We employed multivariate regression to further explore these characteristics, and Spearman rank correlation to examine the relationship between paired PM 2.5 and CO exposures. Results : Twenty participants (17 female; median age 40 years, IQR: 37-56) provided 831 hours of paired PM 2.5 and CO data. Concentrations of PM 2.5 during combustion activity, usually cooking, far exceeded background levels (no combustion activity): 97.9μg/m 3 (IQR: 22.9-482.0), vs 7.6μg/m 3, IQR: 2.5-20.6 respectively. Background PM 2.5 concentrations were higher during daytime hours (11.7μg/m 3 [IQR: 5.2-30.0] vs 3.3μg/m 3 at night [IQR: 0.7-8.2]). Highest exposures were influenced by cooking location but associated with charcoal use (for CO) and firewood on a three-stone fire (for PM 2.5). Cooking-related exposures were higher in more ventilated places, such as outside the household or on a walled veranda, than during indoor cooking. Conclusions : The study demonstrates the value of combining personal PM 2.5 exposure data with detailed contextual information for providing deeper insights into pollution sources and influences. The finding of similar/lower exposures during cooking in seemingly less-ventilated places should prompt a re-evaluation of proposed clean air interventions in these settings.
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Affiliation(s)
- Sepeedeh Saleh
- Liverpool School of Tropical Medicine, LIVERPOOL, L3 5QA, UK
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, P.O. Box 30096, Malawi
| | - Henry Sambakunsi
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, P.O. Box 30096, Malawi
| | - Debora Makina
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, P.O. Box 30096, Malawi
| | - Martha Chinouya
- Liverpool School of Tropical Medicine, LIVERPOOL, L3 5QA, UK
| | - Moses Kumwenda
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, P.O. Box 30096, Malawi
| | - James Chirombo
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, P.O. Box 30096, Malawi
| | - Sean Semple
- University of Stirling, Stirling, FK9 4LA, UK
| | - Kevin Mortimer
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Jamie Rylance
- Liverpool School of Tropical Medicine, LIVERPOOL, L3 5QA, UK
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, P.O. Box 30096, Malawi
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8
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Wagner DN, Odhiambo SR, Ayikukwei RM, Boor BE. High time-resolution measurements of ultrafine and fine woodsmoke aerosol number and surface area concentrations in biomass burning kitchens: A case study in Western Kenya. INDOOR AIR 2022; 32:e13132. [PMID: 36305061 PMCID: PMC9828051 DOI: 10.1111/ina.13132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/05/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Indoor air pollution associated with biomass combustion for cooking remains a significant environmental health challenge in rural regions of sub-Saharan Africa; however, routine monitoring of woodsmoke aerosol concentrations continues to remain sparse. There is a paucity of field data on concentrations of combustion-generated ultrafine particles, which efficiently deposit in the human respiratory system, in such environments. Field measurements of ultrafine and fine woodsmoke aerosol (diameter range: 10-2500 nm) with field-portable diffusion chargers were conducted across nine wood-burning kitchens in Nandi County, Kenya. High time-resolution measurements (1 Hz) revealed that indoor particle number (PN) and particle surface area (PSA) concentrations of ultrafine and fine woodsmoke aerosol are strongly temporally variant, reach exceedingly high levels (PN > 106 /cm3 ; PSA > 104 μm2 /cm3 ) that are seldom observed in non-biomass burning environments, are influenced by kitchen architectural features, and are moderately to poorly correlated with carbon monoxide concentrations. In five kitchens, PN concentrations remained above 105 /cm3 for more than half of the day due to frequent cooking episodes. Indoor/outdoor ratios of PN and PSA concentrations were greater than 10 in most kitchens and exceeded 100 in several kitchens. Notably, the use of metal chimneys significantly reduced indoor PN and PSA concentrations.
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Affiliation(s)
- Danielle N. Wagner
- Lyles School of Civil Engineering, Purdue UniversityWest LafayetteIndianaUSA
- Ray W. Herrick Laboratories, Center for High Performance BuildingsPurdue UniversityWest LafayetteIndianaUSA
| | | | | | - Brandon E. Boor
- Lyles School of Civil Engineering, Purdue UniversityWest LafayetteIndianaUSA
- Ray W. Herrick Laboratories, Center for High Performance BuildingsPurdue UniversityWest LafayetteIndianaUSA
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9
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Johnson M, Pillarisetti A, Piedrahita R, Balakrishnan K, Peel JL, Steenland K, Underhill LJ, Rosa G, Kirby MA, Díaz-Artiga A, McCracken J, Clark ML, Waller L, Chang HH, Wang J, Dusabimana E, Ndagijimana F, Sambandam S, Mukhopadhyay K, Kearns KA, Campbell D, Kremer J, Rosenthal JP, Checkley W, Clasen T, Naeher L. Exposure Contrasts of Pregnant Women during the Household Air Pollution Intervention Network Randomized Controlled Trial. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:97005. [PMID: 36112539 PMCID: PMC9480977 DOI: 10.1289/ehp10295] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 07/12/2022] [Accepted: 08/19/2022] [Indexed: 05/26/2023]
Abstract
BACKGROUND Exposure to PM 2.5 arising from solid fuel combustion is estimated to result in ∼ 2.3 million premature deaths and 91 million lost disability-adjusted life years annually. Interventions attempting to mitigate this burden have had limited success in reducing exposures to levels thought to provide substantive health benefits. OBJECTIVES This paper reports exposure reductions achieved by a liquified petroleum gas (LPG) stove and fuel intervention for pregnant mothers in the Household Air Pollution Intervention Network (HAPIN) randomized controlled trial. METHODS The HAPIN trial included 3,195 households primarily using biomass for cooking in Guatemala, India, Peru, and Rwanda. Twenty-four-hour exposures to PM 2.5 , carbon monoxide (CO), and black carbon (BC) were measured for pregnant women once before randomization into control (n = 1,605 ) and LPG (n = 1,590 ) arms and twice thereafter (aligned with trimester). Changes in exposure were estimated by directly comparing exposures between intervention and control arms and by using linear mixed-effect models to estimate the impact of the intervention on exposure levels. RESULTS Median postrandomization exposures of particulate matter (PM) with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ) in the intervention arm were lower by 66% at the first (71.5 vs. 24.1 μ g / m 3 ), and second follow-up visits (69.5 vs. 23.7 μ g / m 3 ) compared to controls. BC exposures were lower in the intervention arm by 72% (9.7 vs. 2.7 μ g / m 3 ) and 70% (9.6 vs. 2.8 μ g / m 3 ) at the first and second follow-up visits, respectively, and carbon monoxide exposure was 82% lower at both visits (1.1 vs. 0.2 ppm ) in comparison with controls. Exposure reductions were consistent over time and were similar across research locations. DISCUSSION Postintervention PM 2.5 exposures in the intervention arm were at the lower end of what has been reported for LPG and other clean fuel interventions, with 69% of PM 2.5 samples falling below the World Health Organization Annual Interim Target 1 of 35 μ g / m 3 . This study indicates that an LPG intervention can reduce PM 2.5 exposures to levels at or below WHO targets. https://doi.org/10.1289/EHP10295.
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Affiliation(s)
| | - Ajay Pillarisetti
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California, USA
| | | | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Jennifer L. Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Kyle Steenland
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Lindsay J. Underhill
- Cardiovascular Division, School of Medicine, Washington University, St. Louis, Missouri, USA
| | - Ghislaine Rosa
- Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Miles A. Kirby
- Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | - John McCracken
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Maggie L. Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Lance Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Howard H. Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Jiantong Wang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | | | - Sankar Sambandam
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Krishnendu Mukhopadhyay
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Katherine A. Kearns
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Devan Campbell
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Jacob Kremer
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Joshua P. Rosenthal
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Thomas Clasen
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Luke Naeher
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - and the Household Air Pollution Intervention Network (HAPIN) Trial Investigators
- Berkeley Air Monitoring Group, Berkeley, California, USA
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California, USA
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Cardiovascular Division, School of Medicine, Washington University, St. Louis, Missouri, USA
- Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Universidad del Valle de Guatemala, Guatemala City, Guatemala
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia, USA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Eagle Research Center, Kigali, Rwanda
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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10
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Lim S, Bassey E, Bos B, Makacha L, Varaden D, Arku RE, Baumgartner J, Brauer M, Ezzati M, Kelly FJ, Barratt B. Comparing human exposure to fine particulate matter in low and high-income countries: A systematic review of studies measuring personal PM 2.5 exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 833:155207. [PMID: 35421472 PMCID: PMC7615091 DOI: 10.1016/j.scitotenv.2022.155207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 04/02/2022] [Accepted: 04/08/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Due to the adverse health effects of air pollution, researchers have advocated for personal exposure measurements whereby individuals carry portable monitors in order to better characterise and understand the sources of people's pollution exposure. OBJECTIVES The aim of this systematic review is to assess the differences in the magnitude and sources of personal PM2.5 exposures experienced between countries at contrasting levels of income. METHODS This review summarised studies that measured participants personal exposure by carrying a PM2.5 monitor throughout their typical day. Personal PM2.5 exposures were summarised to indicate the distribution of exposures measured within each country income category (based on low (LIC), lower-middle (LMIC), upper-middle (UMIC), and high (HIC) income countries) and between different groups (i.e. gender, age, urban or rural residents). RESULTS From the 2259 search results, there were 140 studies that met our criteria. Overall, personal PM2.5 exposures in HICs were lower compared to other countries, with UMICs exposures being slightly lower than exposures measured in LMICs or LICs. 34% of measured groups in HICs reported below the ambient World Health Organisation 24-h PM2.5 guideline of 15 μg/m3, compared to only 1% of UMICs and 0% of LMICs and LICs. There was no difference between rural and urban participant exposures in HICs, but there were noticeably higher exposures recorded in rural areas compared to urban areas in non-HICs, due to significant household sources of PM2.5 in rural locations. In HICs, studies reported that secondhand smoke, ambient pollution infiltrating indoors, and traffic emissions were the dominant contributors to personal exposures. While, in non-HICs, household cooking and heating with biomass and coal were reported as the most important sources. CONCLUSION This review revealed a growing literature of personal PM2.5 exposure studies, which highlighted a large variability in exposures recorded and severe inequalities in geographical and social population subgroups.
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Affiliation(s)
- Shanon Lim
- MRC Centre for Environment and Health, Imperial College London, UK.
| | - Eridiong Bassey
- MRC Centre for Environment and Health, Imperial College London, UK
| | - Brendan Bos
- MRC Centre for Environment and Health, Imperial College London, UK
| | - Liberty Makacha
- MRC Centre for Environment and Health, Imperial College London, UK; Place Alert Labs, Department of Surveying and Geomatics, Faculty of Science and Technology, Midlands State University, Zimbabwe; Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, UK
| | - Diana Varaden
- MRC Centre for Environment and Health, Imperial College London, UK; NIHR-HPRU Environmental Exposures and Health, School of Public Health, Imperial College London, UK
| | - Raphael E Arku
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, USA
| | - Jill Baumgartner
- Institute for Health and Social Policy, and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Michael Brauer
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada; Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Majid Ezzati
- MRC Centre for Environment and Health, Imperial College London, UK; Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, UK; Regional Institute for Population Studies, University of Ghana, Legon, Ghana
| | - Frank J Kelly
- MRC Centre for Environment and Health, Imperial College London, UK; NIHR-HPRU Environmental Exposures and Health, School of Public Health, Imperial College London, UK
| | - Benjamin Barratt
- MRC Centre for Environment and Health, Imperial College London, UK; NIHR-HPRU Environmental Exposures and Health, School of Public Health, Imperial College London, UK
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11
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Islam MM, Wathore R, Zerriffi H, Marshall JD, Bailis R, Grieshop AP. Assessing the Effects of Stove Use Patterns and Kitchen Chimneys on Indoor Air Quality during a Multiyear Cookstove Randomized Control Trial in Rural India. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:8326-8337. [PMID: 35561333 DOI: 10.1021/acs.est.1c07571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
We conducted indoor air quality (IAQ) measurements during a multiyear cookstove randomized control trial in two rural areas in northern and southern India. A total of 1205 days of kitchen PM2.5 were measured in control and intervention households during six ∼3 month long measurement periods across two study locations. Stoves used included traditional solid fuel (TSF), improved biomass, and liquefied petroleum gas (LPG) models. Intent-to-treat analysis indicates that the intervention reduced average 24 h PM2.5 and black carbon in only one of the two follow-up measurement periods in both areas, suggesting mixed effectiveness. Average PM2.5 levels were ∼50% lower in households with LPG (for exclusive LPG use: >75% lower) than in those without LPG. PM2.5 was 66% lower in households making exclusive use of an improved chimney stove versus a traditional chimney stove and TSF-exclusive kitchens with a built-in chimney had ∼60% lower PM2.5 than those without a chimney, indicating that kitchen ventilation can be as important as the stove technology in improving IAQ. Diurnal trends in real-time PM2.5 indicate that kitchen chimneys were especially effective at reducing peak concentrations, which leads to decreases in daily PM2.5 in these households. Our data demonstrate a clear hierarchy of IAQ improvement in real world, "stove-stacking" households, driven by different stove technologies and kitchen characteristics.
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Affiliation(s)
- Mohammad Maksimul Islam
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, North Carolina 27695-7908, United States
| | - Roshan Wathore
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, North Carolina 27695-7908, United States
| | - Hisham Zerriffi
- Department of Forest Resources Management, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - Julian D Marshall
- Civil & Environmental Engineering, University of Washington, Seattle, Washington 98195-2700, United States
| | - Rob Bailis
- Stockholm Environmental Institute─US Centre, Somerville, Massachusetts 02144-1224, United States
| | - Andrew P Grieshop
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, North Carolina 27695-7908, United States
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12
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Johnson M, Piedrahita R, Pillarisetti A, Shupler M, Menya D, Rossanese M, Delapeña S, Penumetcha N, Chartier R, Puzzolo E, Pope D. Modeling approaches and performance for estimating personal exposure to household air pollution: A case study in Kenya. INDOOR AIR 2021; 31:1441-1457. [PMID: 33655590 DOI: 10.1111/ina.12790] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 06/12/2023]
Abstract
This study assessed the performance of modeling approaches to estimate personal exposure in Kenyan homes where cooking fuel combustion contributes substantially to household air pollution (HAP). We measured emissions (PM2.5 , black carbon, CO); household air pollution (PM2.5 , CO); personal exposure (PM2.5 , CO); stove use; and behavioral, socioeconomic, and household environmental characteristics (eg, ventilation and kitchen volume). We then applied various modeling approaches: a single-zone model; indirect exposure models, which combine person-location and area-level measurements; and predictive statistical models, including standard linear regression and ensemble machine learning approaches based on a set of predictors such as fuel type, room volume, and others. The single-zone model was reasonably well-correlated with measured kitchen concentrations of PM2.5 (R2 = 0.45) and CO (R2 = 0.45), but lacked precision. The best performing regression model used a combination of survey-based data and physical measurements (R2 = 0.76) and a root mean-squared error of 85 µg/m3 , and the survey-only-based regression model was able to predict PM2.5 exposures with an R2 of 0.51. Of the machine learning algorithms evaluated, extreme gradient boosting performed best, with an R2 of 0.57 and RMSE of 98 µg/m3 .
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Affiliation(s)
| | | | - Ajay Pillarisetti
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Matthew Shupler
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Diana Menya
- Department of Epidemiology and Medical Statistics, School of Public Health, College of Health Sciences, Moi University, Eldoret, Kenya
| | | | | | | | - Ryan Chartier
- RTI International, Research Triangle Park, North Carolina, USA
| | - Elisa Puzzolo
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
- Global LPG Partnership, London, UK
| | - Daniel Pope
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
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13
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Suliman AK, Saleh MM, Sznajder K, King TS, Warren WS. Prospective Cohort Study on the Effect of an Intervention to Reduce Household Air Pollution Among Sudanese Women and Children. J Health Pollut 2021; 11:210905. [PMID: 34434597 PMCID: PMC8383785 DOI: 10.5696/2156-9614-11.31.210905] [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: 03/08/2021] [Accepted: 04/24/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Exposure to household air pollution through the burning of biomass fuels is a global health concern and can lead to negative health outcomes such as asthma and lung disease. OBJECTIVES The goal of this four-year study was to determine whether an intervention to reduce household air pollution (HAP) which included health education and a new well-ventilated cooking location would reduce exposure to HAP, lower carbon monoxide (CO) levels and improve the health of women and children in Port Sudan, Sudan. METHODS In 2016, 115 women of low socioeconomic status and their children were invited to participate in the study at two women's centers. One hundred and eleven women consented to participate and were divided into study and control groups on the basis of home ownership. Women who owned their homes learned about the adverse effects of HAP and a well-ventilated outside cooking location (rakoobah) was provided. Control women did not receive HAP education or a rakoobah. Questionnaires were used to assess the effect of education and a new well-ventilated cooking location for a group of Sudanese women who cook with biomass fuels. CO-oximetry was performed. Each year from 2017-2019, the questionnaires and CO-oximetry were repeated. RESULTS Sixty-five women and 33 children were assigned to the study group and 46 women and 19 children were assigned to the control group in 2016. Women were enrolled in 2016 with CO levels of 17.8% and 17.4%, respectively. One year later some of the study group women had lower CO levels and others higher, while the CO levels of the controls were stable. An intensive HAP education program was started for the study group women. By 2019, the last study year, the CO levels of both the study and control group women had dropped to normal levels of 2.9% and 3.1%, respectively. Control group women may have benefited from the HAP education and modeled behavior of those in the study group. CONCLUSIONS The health impact of the change in cooking location was unclear, yet both groups reported fewer health care visits in 2019. Education and an outside cooking location resulted in lower CO levels of Sudanese women and children. PARTICIPANT CONSENT Obtained. ETHICS APPROVAL The study was approved by the Penn State Milton S. Hershey Medical Center Institutional Review Board and the Ethics Committee of the Red Sea University Faculty of Medicine located in Port Sudan, Sudan. COMPETING INTERESTS The authors declare no competing financial interests.
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Affiliation(s)
- Alawia K Suliman
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania
| | | | - Kristin Sznajder
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Tonya S. King
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - W. Stuart Warren
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania
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14
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Elgamal Z, Singh P, Geraghty P. The Upper Airway Microbiota, Environmental Exposures, Inflammation, and Disease. ACTA ACUST UNITED AC 2021; 57:medicina57080823. [PMID: 34441029 PMCID: PMC8402057 DOI: 10.3390/medicina57080823] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 02/07/2023]
Abstract
Along with playing vital roles in pathogen exclusion and immune system priming, the upper airways (UAs) and their microbiota are essential for myriad physiological functions such as conditioning and transferring inhaled air. Dysbiosis, a microbial imbalance, is linked with various diseases and significantly impedes the quality of one’s life. Daily inhaled exposures and/or underlying conditions contribute to adverse changes to the UA microbiota. Such variations in the microbial community exacerbate UA and pulmonary disorders via modulating inflammatory and immune pathways. Hence, exploring the UA microbiota’s role in maintaining homeostasis is imperative. The microbial composition and subsequent relationship with airborne exposures, inflammation, and disease are crucial for strategizing innovating UA diagnostics and therapeutics. The development of a healthy UA microbiota early in life contributes to normal respiratory development and function in the succeeding years. Although different UA cavities present a unique microbial profile, geriatrics have similar microbes across their UAs. This lost community segregation may contribute to inflammation and disease, as it stimulates disadvantageous microbial–microbial and microbial–host interactions. Varying inflammatory profiles are associated with specific microbial compositions, while the same is true for many disease conditions and environmental exposures. A shift in the microbial composition is also detected upon the administration of numerous therapeutics, highlighting other beneficial and adverse side effects. This review examines the role of the UA microbiota in achieving homeostasis, and the impact on the UAs of environmental airborne pollutants, inflammation, and disease.
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Affiliation(s)
- Ziyad Elgamal
- Department of Biomedical Science, University of Guelph, Guelph, ON N1G 2W1, Canada;
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, State University of New York Downstate Medical Centre, Brooklyn, NY 11203, USA
| | - Pratyush Singh
- Department of Biology, University of Western Ontario, London, ON N6A 5B7, Canada;
| | - Patrick Geraghty
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, State University of New York Downstate Medical Centre, Brooklyn, NY 11203, USA
- Correspondence: ; Tel.: +1-718-270-3141
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15
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Chillrud SN, Ae-Ngibise KA, Gould CF, Owusu-Agyei S, Mujtaba M, Manu G, Burkart K, Kinney PL, Quinn A, Jack DW, Asante KP. The effect of clean cooking interventions on mother and child personal exposure to air pollution: results from the Ghana Randomized Air Pollution and Health Study (GRAPHS). JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:683-698. [PMID: 33654272 DOI: 10.1038/s41370021-00309-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Clean cooking interventions to reduce air pollution exposure from burning biomass for daily cooking and heating needs have the potential to reduce a large burden of disease globally. OBJECTIVE The objective of this study is to evaluate the air pollution exposure impacts of a fan-assisted efficient biomass-burning cookstove and a liquefied petroleum gas (LPG) stove intervention in rural Ghana. METHODS We randomized 1414 households in rural Ghana with pregnant mothers into a control arm (N = 526) or one of two clean cooking intervention arms: a fan-assisted efficient biomass-burning cookstove (N = 527) or an LPG stove and cylinder refills as needed (N = 361). We monitored personal maternal carbon monoxide (CO) at baseline and six times after intervention and fine particulate matter (PM2.5) exposure twice after intervention. Children received three CO exposure monitoring sessions. RESULTS We obtained 5655 48-h maternal CO exposure estimates and 1903 for children, as well as 1379 maternal PM2.5 exposure estimates. Median baseline CO exposures in the control, improved biomass, and LPG arms were 1.17, 1.17, and 1.30 ppm, respectively. Based on a differences-in-differences approach, the LPG arm showed a 47% reduction (95% confidence interval: 34-57%) in mean 48-h CO exposure compared to the control arm. Mean maternal PM2.5 exposure in the LPG arm was 32% lower than the control arm during the post-intervention period (52 ± 29 vs. 77 ± 44 μg/m3). The biomass stove did not meaningfully reduce CO or PM2.5 exposure. CONCLUSIONS We show that LPG interventions lowered air pollution exposure significantly compared to three-stone fires. However, post-intervention exposures still exceeded health-relevant targets. SIGNIFICANCE In a large controlled trial of cleaner cooking interventions, an LPG stove and fuel intervention reduced air pollution exposure in a vulnerable population in a low-resource setting.
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Affiliation(s)
- Steven N Chillrud
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | | | - Carlos F Gould
- Department of Environmental Health Science, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Mohammed Mujtaba
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Grace Manu
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Katrin Burkart
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Ashlinn Quinn
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Darby W Jack
- Department of Environmental Health Science, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
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Chillrud SN, Ae-Ngibise KA, Gould CF, Owusu-Agyei S, Mujtaba M, Manu G, Burkart K, Kinney PL, Quinn A, Jack DW, Asante KP. The effect of clean cooking interventions on mother and child personal exposure to air pollution: results from the Ghana Randomized Air Pollution and Health Study (GRAPHS). JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:683-698. [PMID: 33654272 PMCID: PMC8273075 DOI: 10.1038/s41370-021-00309-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND Clean cooking interventions to reduce air pollution exposure from burning biomass for daily cooking and heating needs have the potential to reduce a large burden of disease globally. OBJECTIVE The objective of this study is to evaluate the air pollution exposure impacts of a fan-assisted efficient biomass-burning cookstove and a liquefied petroleum gas (LPG) stove intervention in rural Ghana. METHODS We randomized 1414 households in rural Ghana with pregnant mothers into a control arm (N = 526) or one of two clean cooking intervention arms: a fan-assisted efficient biomass-burning cookstove (N = 527) or an LPG stove and cylinder refills as needed (N = 361). We monitored personal maternal carbon monoxide (CO) at baseline and six times after intervention and fine particulate matter (PM2.5) exposure twice after intervention. Children received three CO exposure monitoring sessions. RESULTS We obtained 5655 48-h maternal CO exposure estimates and 1903 for children, as well as 1379 maternal PM2.5 exposure estimates. Median baseline CO exposures in the control, improved biomass, and LPG arms were 1.17, 1.17, and 1.30 ppm, respectively. Based on a differences-in-differences approach, the LPG arm showed a 47% reduction (95% confidence interval: 34-57%) in mean 48-h CO exposure compared to the control arm. Mean maternal PM2.5 exposure in the LPG arm was 32% lower than the control arm during the post-intervention period (52 ± 29 vs. 77 ± 44 μg/m3). The biomass stove did not meaningfully reduce CO or PM2.5 exposure. CONCLUSIONS We show that LPG interventions lowered air pollution exposure significantly compared to three-stone fires. However, post-intervention exposures still exceeded health-relevant targets. SIGNIFICANCE In a large controlled trial of cleaner cooking interventions, an LPG stove and fuel intervention reduced air pollution exposure in a vulnerable population in a low-resource setting.
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Affiliation(s)
- Steven N Chillrud
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | | | - Carlos F Gould
- Department of Environmental Health Science, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Mohammed Mujtaba
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Grace Manu
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Katrin Burkart
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Ashlinn Quinn
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Darby W Jack
- Department of Environmental Health Science, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
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17
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Liu X, Shen G, Chen L, Qian Z, Zhang N, Chen Y, Chen Y, Cao J, Cheng H, Du W, Li B, Li G, Li Y, Liang X, Liu M, Lu H, Luo Z, Ren Y, Zhang Y, Zhu D, Tao S. Spatially Resolved Emission Factors to Reduce Uncertainties in Air Pollutant Emission Estimates from the Residential Sector. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:4483-4493. [PMID: 33715364 DOI: 10.1021/acs.est.0c08568] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The residential sector is a major source of air pollutant emission inventory uncertainties. A nationwide field emission measurement campaign was conducted in rural China to evaluate the variabilities of realistic emission factors (EFs) from indoor solid fuel combustion. For a total of 1313 burning events, the overall average EFs (±standard deviation) of PM2.5 were 8.93 ± 6.95 and 7.33 ± 9.01 g/kg for biomass and coals, respectively, and 89.3 ± 51.2 and 114 ± 87 g/kg for CO. Higher EFs were found from burning of uncompressed straws, while lower EFs were found from processed biomass pellets, coal briquettes, and relatively clean anthracite coals. Modified combustion efficiency was found to be the most significant factor associated with variations in CO EFs, whereas for PM2.5, fuel and stove differences determined its variations. Weak correlations between PM2.5 and CO indicated high uncertainties in using CO as a surrogate for PM2.5. EFs accurately fit log-normal distributions, and obvious spatial heterogeneity was observed attributed to different fuel-stove combinations across the country. Emission estimation variabilities, which are determined by the interquartile ranges divided by the median values, were notably reduced when spatially resolved EFs were adopted in the inventory.
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Affiliation(s)
- Xinlei Liu
- Laboratory for Earth Surface Process, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Guofeng Shen
- Laboratory for Earth Surface Process, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Laiguo Chen
- State Environmental Protection Key Laboratory of Urban Ecological Environment Simulation and Protetion, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Zhe Qian
- College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China
| | - Ningning Zhang
- Key Lab of Aerosol Chemistry & Physics, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an 710049, China
| | - Yuanchen Chen
- College of Environment, Zhejiang University of Technology, Hangzhou 310014, China
| | - Yingjun Chen
- Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention, Department of Environmental Science and Engineering, Fudan University, Shanghai 200438, China
| | - Junji Cao
- Key Lab of Aerosol Chemistry & Physics, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an 710049, China
| | - Hefa Cheng
- Laboratory for Earth Surface Process, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Wei Du
- Laboratory of Geographic Information Science, School of Geographic Sciences, East China Normal University, Shanghai 200241, China
| | - Bengang Li
- Laboratory for Earth Surface Process, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Gang Li
- School of Materials Science and Mechanical Engineering, Beijing Technology and Business University, Beijing 100048, China
| | - Yaojie Li
- Laboratory for Earth Surface Process, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Xiaoming Liang
- State Environmental Protection Key Laboratory of Urban Ecological Environment Simulation and Protetion, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Ming Liu
- State Environmental Protection Key Laboratory of Urban Ecological Environment Simulation and Protetion, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Haitao Lu
- State Environmental Protection Key Laboratory of Urban Ecological Environment Simulation and Protetion, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Zhihan Luo
- Laboratory for Earth Surface Process, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Yuxuan Ren
- Laboratory for Earth Surface Process, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Yong Zhang
- Key Lab of Aerosol Chemistry & Physics, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an 710049, China
| | - Dongqiang Zhu
- Laboratory for Earth Surface Process, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Shu Tao
- Laboratory for Earth Surface Process, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
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18
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Islam MM, Wathore R, Zerriffi H, Marshall JD, Bailis R, Grieshop AP. In-use emissions from biomass and LPG stoves measured during a large, multi-year cookstove intervention study in rural India. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 758:143698. [PMID: 33321364 DOI: 10.1016/j.scitotenv.2020.143698] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 06/12/2023]
Abstract
We conducted an emission measurement campaign as a part of a multiyear cookstove intervention trial in two rural locations in northern and southern India. 253 uncontrolled cooking tests measured emissions in control and intervention households during three ~3-month-long measurement periods in each location. We measured pollutants including fine particulate matter (PM2.5), organic and elemental carbon (OC, EC), black carbon (BC) and carbon monoxide (CO) from stoves ranging from traditional solid fuel (TSF) to improved biomass stoves (rocket, gasifier) to liquefied petroleum gas (LPG) models. TSF stoves showed substantial variability in pollutant emission factors (EFs; g kg-1 wood) and optical properties across measurement periods. Multilinear regression modeling found that measurement period, fuel properties, relative humidity, and cooking duration are significant predictors of TSF EFs. A rocket stove showed moderate reductions relative to TSF. LPG stoves had the lowest pollutant EFs, with mean PM2.5 and CO EFs (g MJdelivered-1) >90% lower than biomass stoves. However, in-home EFs of LPG were substantially higher than lab EFs, likely influenced by non-ideal combustion performance, emissions from food and possible influence from other combustion sources. In-home emission measurements may depict the actual exposure benefits associated with dissemination of LPG stoves in real world interventions.
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Affiliation(s)
- Mohammad Maksimul Islam
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, NC, USA
| | - Roshan Wathore
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, NC, USA
| | - Hisham Zerriffi
- Department of Forest Resources Management, University of British Columbia, Vancouver, British Columbia, Canada
| | - Julian D Marshall
- Civil & Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Rob Bailis
- Stockholm Environmental Institute - US Centre, Somerville, MA, USA
| | - Andrew P Grieshop
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, NC, USA.
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Lee M, Carter E, Yan L, Chan Q, Elliott P, Ezzati M, Kelly F, Schauer JJ, Wu Y, Yang X, Zhao L, Baumgartner J. Determinants of personal exposure to PM 2.5 and black carbon in Chinese adults: A repeated-measures study in villages using solid fuel energy. ENVIRONMENT INTERNATIONAL 2021; 146:106297. [PMID: 33395942 PMCID: PMC7762838 DOI: 10.1016/j.envint.2020.106297] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/23/2020] [Accepted: 11/22/2020] [Indexed: 05/03/2023]
Abstract
Exposure to air pollution is a leading health risk factor. The variance components and contributions of indoor versus outdoor source determinants of personal exposure to air pollution are poorly understood, especially in settings of household solid fuel use. We conducted a panel study with up to 4 days of repeated measures of integrated gravimetric personal exposure to PM2.5 and black carbon in 787 men and women (ages 40-79) living in peri-urban villages in northern (Beijing and Shanxi) and southern (Guangxi) China. We simultaneously measured outdoor PM2.5 and collected questionnaire data on sociodemographic characteristics and indoor pollution sources including tobacco smoking and solid fuel stove use. We obtained over 2000 days of personal exposure monitoring which showed higher exposures in the heating season (geometric mean (GM): 108 versus 65 μg/m3 in the non-heating season for PM2.5) and among northern participants (GM: 90 versus 59 μg/m3 in southern China in the non-heating season for PM2.5). We used mixed-effects models to estimate within- and between-participant variance components and to assess the determinants of exposures. Within-participant variance in exposure dominated the total variability (68-95%). Outdoor PM2.5 was the dominant variable for explaining within-participant variance in exposure to PM2.5 (16%). Household fuel use (PM2.5: 8%; black carbon: 10%) and smoking status (PM2.5: 27%; black carbon: 5%) explained the most between-participant variance. Indoor sources (solid fuel stoves, tobacco smoking) were associated with 13-30% higher exposures to air pollution and each 10 μg/m3 increase in outdoor PM2.5 was associated with 6-8% higher exposure. Our findings indicate that repeated measurements of daily exposure are likely needed to capture longer-term exposures in settings of household solid fuel use, even within a single season, and that reducing air pollution from both outdoor and indoor sources is likely needed to achieve measurable reductions in exposures to air pollution.
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Affiliation(s)
- Martha Lee
- Department of Epidemology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Ellison Carter
- Institute on the Environment, University of Minnesota, Saint Paul, MN, USA; Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, CO, USA
| | - Li Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; Department of Analytical, Environmental & Forensic Sciences, School of Population Health and Environmental Sciences, Kings College London, London, UK
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; NIHR Imperial College London Biomedical Research Centre, London, UK
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Frank Kelly
- Department of Analytical, Environmental & Forensic Sciences, School of Population Health and Environmental Sciences, Kings College London, London, UK
| | - James J Schauer
- Department of Civil and Environmental Engineering, University of Wisconsin, Madison, USA; Environmental Chemistry & Technology Program, University of Wisconsin, Madison, USA
| | - Yangfeng Wu
- Peking University Clinical Research Institute, Beijing, China
| | - Xudong Yang
- Department of Building Science, School of Architecture, Tsinghua University, Beijing, China
| | - Liancheng Zhao
- National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Jill Baumgartner
- Department of Epidemology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Institute for Health and Social Policy, McGill University, Montreal, Canada.
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20
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Qiu G, Yu K, Yu C, Li W, Lv J, Guo Y, Bian Z, Yang L, Chen Y, Chen Z, Hu FB, Li L, Wu T. Association of exhaled carbon monoxide with risk of cardio-cerebral-vascular disease in the China Kadoorie Biobank cohort study. Sci Rep 2020; 10:19507. [PMID: 33177548 PMCID: PMC7659340 DOI: 10.1038/s41598-020-76353-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 10/22/2020] [Indexed: 11/09/2022] Open
Abstract
Exhaled carbon monoxide (COex) level has been proposed as a noninvasive and easily-obtainable cardiovascular risk marker, however, with limited prospective evidence, and its association with stroke risk has been rarely explored. Measurements of COex were performed during 2004-2008 baseline examinations in the China Kadoorie Biobank study among 512,891 adults aged 30-79 years from 10 diverse study areas. After excluding participants with baseline cardiopulmonary diseases, stroke and cancer, 178,485 men and 267,202 women remained. Cox regression yielded hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of cardio-cerebral-vascular disease (CCVD) associated with COex levels, with sequential addition of adjustment for proxy variables for CO exposure, including study area indexing ambient CO variations at large, and smoking and solid fuel use, apart from adjusting for traditional cardiovascular risk factors. During 7-year follow-up, we documented 1744 and 1430 major coronary events (myocardial infarction plus fatal ischemic heart disease), 8849 and 10,922 ischemic strokes, and 2492 and 2363 hemorrhagic strokes among men and women, respectively. The HRs with 95% CIs comparing the highest with lowest COex quintile were 2.15 [1.72, 2.69] for major coronary events, 1.65 [1.50, 1.80] for ischemic stroke, and 1.35 [1.13, 1.61] for hemorrhagic stroke among men, while among women higher associated risk was only observed for major coronary events (1.64 [1.35, 2.00]) and ischemic stroke (1.87 [1.73, 2.01]). The elevated risks were consistent when COex level was over 3 ppm. However, these associations were all attenuated until null by sequential addition of stratification by study areas, and adjustments of smoking and solid fuel use. Nevertheless, the association with ischemic stroke was maintained among the subgroup of male smokers even with adjustment for the depth and amount of cigarette smoking (HR [95% CI]: 1.37 [1.06, 1.77]), while a negative association with hemorrhagic stroke also appeared within this subgroup. Higher COex level (over 3 ppm) was associated with elevated risk of ischemic CCVD, but not independently of CO exposure. Our finding suggests that, though not an independent risk factor, COex could potentially provide a cost-effective biomarker for ischemic cardio-cerebral-vascular risk, given that CO exposure is ubiquitous.
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Affiliation(s)
- Gaokun Qiu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, People's Republic of China.
| | - Kuai Yu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, People's Republic of China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, People's Republic of China
| | - Wending Li
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, People's Republic of China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, People's Republic of China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Ling Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Frank B Hu
- Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, People's Republic of China.
- Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
| | - Tangchun Wu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, People's Republic of China.
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21
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Xue Y, Chu J, Li Y, Kong X. The influence of air pollution on respiratory microbiome: A link to respiratory disease. Toxicol Lett 2020; 334:14-20. [DOI: 10.1016/j.toxlet.2020.09.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/10/2020] [Accepted: 09/12/2020] [Indexed: 01/08/2023]
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22
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Liao J, McCracken JP, Piedrahita R, Thompson L, Mollinedo E, Canuz E, De Léon O, Díaz-Artiga A, Johnson M, Clark M, Pillarisetti A, Kearns K, Naeher L, Steenland K, Checkley W, Peel J, Clasen TF. The use of bluetooth low energy Beacon systems to estimate indirect personal exposure to household air pollution. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2020; 30:990-1000. [PMID: 31558836 PMCID: PMC7325654 DOI: 10.1038/s41370-019-0172-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/09/2019] [Accepted: 07/25/2019] [Indexed: 05/05/2023]
Abstract
Household air pollution (HAP) generated from solid fuel combustion is a major health risk. Direct measurement of exposure to HAP is burdensome and challenging, particularly for children. In a pilot study of the Household Air Pollution Intervention Network (HAPIN) trial in rural Guatemala, we evaluated an indirect exposure assessment method that employs fixed continuous PM2.5 monitors, Bluetooth signal receivers in multiple microenvironments (kitchen, sleeping area and outdoor patio), and a wearable signal emitter to track an individual's time within those microenvironments. Over a four-month period, we measured microenvironmental locations and reconstructed indirect PM2.5 exposures for women and children during two 24-h periods before and two periods after a liquefied petroleum gas (LPG) stove and fuel intervention delivered to 20 households cooking with woodstoves. Women wore personal PM2.5 monitors to compare direct with indirect exposure measurements. Indirect exposure measurements had high correlation with direct measurements (n = 62, Spearman ρ = 0.83, PM2.5 concentration range: 5-528 µg/m3). Indirect exposure had better agreement with direct exposure measurements (bias: -17 µg/m3) than did kitchen area measurements (bias: -89 µg/m3). Our findings demonstrate that indirect exposure reconstruction is a feasible approach to estimate personal exposure when direct assessment is not possible.
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Affiliation(s)
- Jiawen Liao
- Department of Environmental Health, Emory University, Atlanta, GA, USA.
| | - John P McCracken
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | | | - Lisa Thompson
- Department of Environmental Health, Emory University, Atlanta, GA, USA
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Erick Mollinedo
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Eduardo Canuz
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Oscar De Léon
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Anaité Díaz-Artiga
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | | | - Maggie Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Ajay Pillarisetti
- Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Katherine Kearns
- College of Public Health, University of Georgia, Athens, GA, USA
| | - Luke Naeher
- College of Public Health, University of Georgia, Athens, GA, USA
| | - Kyle Steenland
- Department of Environmental Health, Emory University, Atlanta, GA, USA
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Center for Global Non-Communicable Diseases, Johns Hopkins University, Baltimore, MD, USA
| | - Jennifer Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Thomas F Clasen
- Department of Environmental Health, Emory University, Atlanta, GA, USA
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23
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Champion WM, Warren SH, Kooter IM, Preston W, Krantz QT, DeMarini DM, Jetter JJ. Mutagenicity- and pollutant-emission factors of pellet-fueled gasifier cookstoves: Comparison with other combustion sources. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 739:139488. [PMID: 32526531 PMCID: PMC7676151 DOI: 10.1016/j.scitotenv.2020.139488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/01/2020] [Accepted: 05/15/2020] [Indexed: 05/13/2023]
Abstract
Emissions from solid-fuel burning cookstoves are associated with 3 to 4 million premature deaths annually and contribute significantly to impacts on climate. Pellet-fueled gasifier stoves have some emission factors (EFs) approaching those of gas-fuel (liquid petroleum gas) stoves; however, their emissions have not been evaluated for biological effects. Here we used a new International Organization for Standardization (ISO) testing protocol to determine pollutant- and mutagenicity-EFs for a stove designed for pellet fuel, the Mimi Moto, and for two other forced-draft stoves, Xunda and Philips HD4012, burning pellets of hardwood or peanut hulls. The Salmonella assay-based mutagenicity-EFs (revertants/megajouledelivered) spanned three orders of magnitude and correlated highly (r = 0.99; n = 5) with EFs of the sum of 32 particle-phase polycyclic aromatic hydrocarbons (PAHs). The Mimi Moto/hardwood pellet combination had total-PAH- and mutagenicity-EFs 99.2 and 96.6% lower, respectively, compared to data published previously for the Philips stove burning non-pelletized hardwood, and 100 and 99.8% lower, respectively, compared to those of a wood-fueled three-stone fire. The Xunda burning peanut hull pellets had the highest fuel energy-based mutagenicity-EF (revertants/megajoulethermal) of the pellet stove/fuel combinations tested, which was between that of diesel exhaust, a known human carcinogen, and a natural-draft wood stove. Although the Mimi Moto burning hardwood pellets had the lowest fuel energy-based mutagenicity-EF, this value was between that of utility coal and utility wood boilers. This advanced stove/fuel combination has the potential to greatly reduce emissions in contrast to a traditional stove, but adequate ventilation is required to approach acceptable levels of indoor air quality.
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Affiliation(s)
- Wyatt M Champion
- Oak Ridge Institute for Science and Education (ORISE), U.S. Environmental Protection Agency, Office of Research and Development, Research Triangle Park, NC, United States.
| | - Sarah H Warren
- Biomolecular and Computational Toxicology Division, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
| | - Ingeborg M Kooter
- Department of Environmental Modelling, Sensing and Analyses, Netherlands Organisation for Applied Scientific Research (TNO), Utrecht, the Netherlands
| | | | - Q Todd Krantz
- Biomolecular and Computational Toxicology Division, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
| | - David M DeMarini
- Biomolecular and Computational Toxicology Division, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
| | - James J Jetter
- Air Methods and Characterization Division, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States
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24
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Kephart JL, Fandiño-Del-Rio M, Koehler K, Bernabe-Ortiz A, Miranda JJ, Gilman RH, Checkley W. Indoor air pollution concentrations and cardiometabolic health across four diverse settings in Peru: a cross-sectional study. Environ Health 2020; 19:59. [PMID: 32493322 PMCID: PMC7268316 DOI: 10.1186/s12940-020-00612-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/21/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND Indoor air pollution is an important risk factor for health in low- and middle-income countries. METHODS We measured indoor fine particulate matter (PM2.5) and carbon monoxide (CO) concentrations in 617 houses across four settings with varying urbanisation, altitude, and biomass cookstove use in Peru, between 2010 and 2016. We assessed the associations between indoor pollutant concentrations and blood pressure (BP), exhaled carbon monoxide (eCO), C-reactive protein (CRP), and haemoglobin A1c (HbA1c) using multivariable linear regression among all participants and stratifying by use of biomass cookstoves. RESULTS We found high concentrations of indoor PM2.5 across all four settings (geometric mean ± geometric standard deviation of PM2.5 daily average in μg/m3): Lima 41.1 ± 1.3, Tumbes 35.8 ± 1.4, urban Puno 14.1 ± 1.7, and rural Puno 58.8 ± 3.1. High indoor CO concentrations were common in rural households (geometric mean ± geometric standard deviation of CO daily average in ppm): rural Puno 4.9 ± 4.3. Higher indoor PM2.5 was associated with having a higher systolic BP (1.51 mmHg per interquartile range (IQR) increase, 95% CI 0.16 to 2.86), a higher diastolic BP (1.39 mmHg higher DBP per IQR increase, 95% CI 0.52 to 2.25), and a higher eCO (2.05 ppm higher per IQR increase, 95% CI 0.52 to 3.57). When stratifying by biomass cookstove use, our results were consistent with effect measure modification in the association between PM2.5 and eCO: among biomass users eCO was 0.20 ppm higher per IQR increase in PM2.5 (95% CI - 2.05 to 2.46), and among non-biomass users eCO was 5.00 ppm higher per IQR increase in PM2.5 (95% CI 1.58 to 8.41). We did not find associations between indoor air concentrations and CRP or HbA1c outcomes. CONCLUSIONS Excessive indoor concentrations of PM2.5 are widespread in homes across varying levels of urbanisation, altitude, and biomass cookstove use in Peru and are associated with worse BP and higher eCO.
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Affiliation(s)
- Josiah L. Kephart
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD USA
- Present Address: Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Magdalena Fandiño-Del-Rio
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD USA
| | - Kirsten Koehler
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - J. Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert H. Gilman
- Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
| | - William Checkley
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD USA
- Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1830 E. Monument St Room 555, Baltimore, MD 21287 USA
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Johnson MA, Steenland K, Piedrahita R, Clark ML, Pillarisetti A, Balakrishnan K, Peel JL, Naeher LP, Liao J, Wilson D, Sarnat J, Underhill LJ, Burrowes V, McCracken JP, Rosa G, Rosenthal J, Sambandam S, de Leon O, Kirby MA, Kearns K, Checkley W, Clasen T. Air Pollutant Exposure and Stove Use Assessment Methods for the Household Air Pollution Intervention Network (HAPIN) Trial. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:47009. [PMID: 32347764 PMCID: PMC7228125 DOI: 10.1289/ehp6422] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/27/2020] [Accepted: 04/01/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND High quality personal exposure data is fundamental to understanding the health implications of household energy interventions, interpreting analyses across assigned study arms, and characterizing exposure-response relationships for household air pollution. This paper describes the exposure data collection for the Household Air Pollution Intervention Network (HAPIN), a multicountry randomized controlled trial of liquefied petroleum gas stoves and fuel among 3,200 households in India, Rwanda, Guatemala, and Peru. OBJECTIVES The primary objectives of the exposure assessment are to estimate the exposure contrast achieved following a clean fuel intervention and to provide data for analyses of exposure-response relationships across a range of personal exposures. METHODS Exposure measurements are being conducted over the 3-y time frame of the field study. We are measuring fine particulate matter [PM < 2.5 μ m in aerodynamic diameter (PM 2.5 )] with the Enhanced Children's MicroPEM™ (RTI International), carbon monoxide (CO) with the USB-EL-CO (Lascar Electronics), and black carbon with the OT21 transmissometer (Magee Scientific) in pregnant women, adult women, and children < 1 year of age, primarily via multiple 24-h personal assessments (three, six, and three measurements, respectively) over the course of the 18-month follow-up period using lightweight monitors. For children we are using an indirect measurement approach, combining data from area monitors and locator devices worn by the child. For a subsample (up to 10%) of the study population, we are doubling the frequency of measurements in order to estimate the accuracy of subject-specific typical exposure estimates. In addition, we are conducting ambient air monitoring to help characterize potential contributions of PM 2.5 exposure from background concentration. Stove use monitors (Geocene) are being used to assess compliance with the intervention, given that stove stacking (use of traditional stoves in addition to the intervention gas stove) may occur. CONCLUSIONS The tools and approaches being used for HAPIN to estimate personal exposures build on previous efforts and take advantage of new technologies. In addition to providing key personal exposure data for this study, we hope the application and learnings from our exposure assessment will help inform future efforts to characterize exposure to household air pollution and for other contexts. https://doi.org/10.1289/EHP6422.
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Affiliation(s)
| | - Kyle Steenland
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | - Maggie L Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Ajay Pillarisetti
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Jennifer L Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Luke P Naeher
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Jiawen Liao
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | - Jeremy Sarnat
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Lindsay J Underhill
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Vanessa Burrowes
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - John P McCracken
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Ghislaine Rosa
- Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Joshua Rosenthal
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Sankar Sambandam
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Oscar de Leon
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Miles A Kirby
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Katherine Kearns
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Thomas Clasen
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Walker ES, Clark ML, Young BN, Rajkumar S, Benka-Coker ML, Bachand AM, Brook RD, Nelson TL, Volckens J, Reynolds SJ, L’Orange C, Africano S, Pinel ABO, Good N, Koehler K, Peel JL. Exposure to household air pollution from biomass cookstoves and self-reported symptoms among women in rural Honduras. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2020; 30:160-173. [PMID: 30760020 PMCID: PMC6692243 DOI: 10.1080/09603123.2019.1579304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/31/2018] [Indexed: 06/09/2023]
Abstract
Household air pollution from combustion of solid fuels is an important risk factor for morbidity and mortality, causing an estimated 2.6 million premature deaths globally in 2016. Self-reported health symptoms are a meaningful measure of quality of life, however, few studies have evaluated symptoms and quantitative measures of exposure to household air pollution. We assessed the cross-sectional association of self-reported symptoms and exposures to household air pollution among women in rural Honduras using stove type (traditional [n = 76]; cleaner-burning Justa [n = 74]) and 24-hour average personal and kitchen fine particulate matter (PM2.5) concentrations. The odds of prevalent symptoms were higher among women using traditional stoves vs Justa stoves (e.g. headache: odds ratio = 2.23; 95% confidence interval = 1.13-4.39). Associations between symptoms and measured PM2.5 were generally consistent with the null. These results add to the evidence suggesting reduced exposures and better health-related quality of life among women using cleaner-burning biomass stoves.
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Affiliation(s)
- Ethan S. Walker
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Maggie L. Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Bonnie N. Young
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sarah Rajkumar
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Megan L. Benka-Coker
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Annette M. Bachand
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Robert D. Brook
- Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Tracy L. Nelson
- Department of Health and Exercise Science and Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA
| | - John Volckens
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Stephen J. Reynolds
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
- Mountain and Plains ERC, Denver, CO, USA
| | - Christian L’Orange
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | | | | | - Nicholas Good
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Kirsten Koehler
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jennifer L. Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
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Tadevosyan A, Mikulski MA, Baber Wallis A, Rubenstein L, Abrahamyan S, Arestakesyan L, Hovsepyan M, Reynolds SJ, Fuortes LJ. Open fire ovens and effects of in-home lavash bread baking on carbon monoxide exposure and carboxyhemoglobin levels among women in rural Armenia. INDOOR AIR 2020; 30:361-369. [PMID: 31724228 PMCID: PMC9514389 DOI: 10.1111/ina.12623] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/28/2019] [Accepted: 11/11/2019] [Indexed: 05/16/2023]
Abstract
Lavash is a traditional flatbread commonly baked at home by women in Armenia and other Middle Eastern and Caucasus countries. The baking process follows centuries' old recipes and is done primarily in open fire ovens. Data are limited regarding the impact of baking on indoor air quality and health outcomes. This study aimed at assessing the effects of lavash baking on household air pollution and cardiovascular outcomes among women who bake lavash in rural Armenia. A convenience sample of 98 bakers, all women, never-smokers, representing 36 households were enrolled. Carbon monoxide (CO) concentrations and carboxyhemoglobin (COHb) levels were monitored before, during, and/or after baking. As expected, exposure to concentrations of CO peaking at/or above 35-ppm during baking was more likely to occur in homes with fully enclosed and poorly ventilated baking rooms, compared to those with three or fewer walls and/or one or more windows. Bakers in homes where CO concentrations peaked at/or above 35-ppm were more likely to have an increase in post-baking COHb levels compared to those in homes with lower CO concentrations.
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Affiliation(s)
- Artashes Tadevosyan
- Department of Public Health and Healthcare Organization, Yerevan State Medical University, Yerevan, Armenia
| | - Marek A Mikulski
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Anne Baber Wallis
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | - Linda Rubenstein
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Satenik Abrahamyan
- Department of Public Health and Healthcare Organization, Yerevan State Medical University, Yerevan, Armenia
| | - Lusine Arestakesyan
- Department of Public Health and Healthcare Organization, Yerevan State Medical University, Yerevan, Armenia
| | - Marina Hovsepyan
- Arabkir Joint Medical Center- Institute of Child and Adolescent Health, Yerevan, Armenia
| | - Steve J Reynolds
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Laurence J Fuortes
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA, USA
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28
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Baumgartner J, Brauer M, Ezzati M. The role of cities in reducing the cardiovascular impacts of environmental pollution in low- and middle-income countries. BMC Med 2020; 18:39. [PMID: 32089131 PMCID: PMC7038592 DOI: 10.1186/s12916-020-1499-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/21/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND As low- and middle-income countries urbanize and industrialize, they must also cope with pollution emitted from diverse sources. MAIN TEXT Strong and consistent evidence associates exposure to air pollution and lead with increased risk of cardiovascular disease occurrence and death. Further, increasing evidence, mostly from high-income countries, indicates that exposure to noise and to both high and low temperatures may also increase cardiovascular risk. There is considerably less research on the cardiovascular impacts of environmental conditions in low- and middle-income countries (LMICs), where the levels of pollution are often higher and the types and sources of pollution markedly different from those in higher-income settings. However, as such evidence gathers, actions to reduce exposures to pollution in low- and middle-income countries are warranted, not least because such exposures are very high. Cities, where pollution, populations, and other cardiovascular risk factors are most concentrated, may be best suited to reduce the cardiovascular burden in LMICs by applying environmental standards and policies to mitigate pollution and by implementing interventions that target the most vulnerable. The physical environment of cities can be improved though municipal processes, including infrastructure development, energy and transportation planning, and public health actions. Local regulations can incentivize or inhibit the polluting behaviors of industries and individuals. Environmental monitoring can be combined with public health warning systems and publicly available exposure maps to inform residents of environmental hazards and encourage the adoption of pollution-avoiding behaviors. Targeted individual or neighborhood interventions that identify and treat high-risk populations (e.g., lead mitigation, portable air cleaners, and preventative medications) can also be leveraged in the very near term. Research will play a key role in evaluating whether these approaches achieve their intended benefits, and whether these benefits reach the most vulnerable. CONCLUSION Cities in LMICs can play a defining role in global health and cardiovascular disease prevention in the next several decades, as they are well poised to develop innovative, multisectoral approaches to pollution mitigation, while also protecting the most vulnerable.
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Affiliation(s)
- Jill Baumgartner
- Institute for Health and Social Policy, McGill University, Montreal, QC, Canada.
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1110 Pine Avenue West, Montreal, QC, H3A 1A3, Canada.
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
| | - Michael Brauer
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Center for Environment and Health, Imperial College London, London, UK
- WHO Collaborating Centre for NCD Surveillance and Epidemiology, Imperial College London, London, UK
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29
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Levels and Determinants of Fine Particulate Matter and Carbon Monoxide in Kitchens Using Biomass and Non-Biomass Fuel for Cooking. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041287. [PMID: 32079287 PMCID: PMC7068500 DOI: 10.3390/ijerph17041287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 02/06/2020] [Accepted: 02/11/2020] [Indexed: 01/20/2023]
Abstract
To assist interpretation of a study in rural Pakistan on the use of biomass for cooking and the risk of coronary heart disease, we continuously monitored airborne concentrations of fine particulate matter (PM2.5) and carbon monoxide (CO) for up to 48 h in the kitchens of households randomly selected from the parent study. Satisfactory data on PM2.5 and CO respectively were obtained for 16 and 17 households using biomass, and 19 and 17 using natural gas. Linear regression analysis indicated that in comparison with kitchens using natural gas, daily average PM2.5 concentrations were substantially higher in kitchens that used biomass in either a chimney stove (mean difference 611, 95% CI: 359, 863 µg/m3) or traditional three-stone stove (mean difference 389, 95% CI: 231, 548 µg/m3). Daily average concentrations of CO were significantly increased when biomass was used in a traditional stove (mean difference from natural gas 3.7, 95% CI: 0.8, 6.7 ppm), but not when it was used in a chimney stove (mean difference −0.8, 95% CI: −4.8, 3.2 ppm). Any impact of smoking by household members was smaller than that of using biomass, and not clearly discernible. In the population studied, cooking with biomass as compared with natural gas should serve as a good proxy for higher personal exposure to PM2.5.
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30
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Carrión D, Kaali S, Kinney PL, Owusu-Agyei S, Chillrud S, Yawson AK, Quinn A, Wylie B, Ae-Ngibise K, Lee AG, Tokarz R, Iddrisu L, Jack DW, Asante KP. Examining the relationship between household air pollution and infant microbial nasal carriage in a Ghanaian cohort. ENVIRONMENT INTERNATIONAL 2019; 133:105150. [PMID: 31518936 PMCID: PMC6868532 DOI: 10.1016/j.envint.2019.105150] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/19/2019] [Accepted: 09/02/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND Pneumonia, a leading cause of childhood mortality, is associated with household air pollution (HAP) exposure. Mechanisms between HAP and pneumonia are poorly understood, but studies suggest that HAP may increase the likelihood of bacterial, instead of viral, pneumonia. We assessed the relationship between HAP and infant microbial nasal carriage among 260 infants participating in the Ghana Randomized Air Pollution and Health Study (GRAPHS). METHODS Data are from GRAPHS, a cluster-randomized controlled trial of cookstove interventions (improved biomass or LPG) versus the 3-stone (baseline) cookstove. Infants were surveyed for pneumonia during the first year of life and had routine personal exposure assessments. Nasopharyngeal swabs collected from pneumonia cases (n = 130) and healthy controls (n = 130) were analyzed for presence of 22 common respiratory microbes by MassTag polymerase chain reaction. Data analyses included intention-to-treat (ITT) comparisons of microbial species presence by study arm, and exposure-response relationships. RESULTS In ITT analyses, 3-stone arm participants had a higher mean number of microbial species than the LPG (LPG: 2.71, 3-stone: 3.34, p < 0.0001, n = 260). This difference was driven by increased bacterial (p < 0.0001) rather than viral species presence (non-significant). Results were pronounced in pneumonia cases and attenuated in healthy controls. Higher prevalence bacterial species were Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. Exposure-response relationships did not yield significant associations between measured CO and nasal microbial carriage. CONCLUSIONS Our intention-to-treat findings are consistent with a link between HAP and bacterial nasal carriage. No relationships were found for viral carriage. Given the null results in exposure-response analysis, it is likely that a pollutant besides CO is driving these differences.
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Affiliation(s)
| | - Seyram Kaali
- Kintampo Health Research Centre, Kintampo, Ghana
| | - Patrick L Kinney
- Department of Environmental Health, Boston University, Boston, USA
| | | | - Steven Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, New York, USA
| | | | - Ashlinn Quinn
- Fogarty International Center, National Institutes of Health, Bethesda, USA
| | - Blair Wylie
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, USA
| | | | - Alison G Lee
- Icahn School of Medicine at Mount Sinai, New York, USA
| | - Rafal Tokarz
- Center for Infection and Immunity, Columbia University, New York, USA
| | | | - Darby W Jack
- Department of Environmental Health Sciences, Columbia University, New York, USA.
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31
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Carter E, Yan L, Fu Y, Robinson B, Kelly F, Elliott P, Wu Y, Zhao L, Ezzati M, Yang X, Chan Q, Baumgartner J. Household Transitions to Clean Energy in a Multi-Provincial Cohort Study in China. NATURE SUSTAINABILITY 2019; 3:42-50. [PMID: 37767329 PMCID: PMC7615133 DOI: 10.1038/s41893-019-0432-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 10/18/2019] [Indexed: 09/29/2023]
Abstract
Household solid fuel (biomass, coal) burning contributes to climate change and is a leading health risk factor. How and why households stop using solid fuel stoves after adopting clean fuels has not been studied. We assessed trends in the uptake, use, and suspension of household stoves and fuels in a multi-provincial cohort study of 753 Chinese adults and evaluated determinants of clean fuel uptake and solid fuel suspension. Over one-third (35%) and one-fifth (17%) of participants suspended use of solid fuel for cooking and heating, respectively, during the past 20 years. Determinants of solid fuel suspension (younger age, widowed) and of earlier suspension (younger age, higher education, and poor self-reported health status) differed from the determinants of clean fuel uptake (younger age, higher income, smaller households, and retired) and of earlier adoption (higher income). Clean fuel adoption and solid fuel suspension warrant joint consideration as indicators of household energy transition. Household energy research and planning efforts that more closely examine solid fuel suspension may accelerate household energy transitions that benefit climate and human health.
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Affiliation(s)
- Ellison Carter
- Department of Civil and Environmental Engineering, Colorado State University, 1372 Campus Delivery, Fort Collins, CO, USA 80524
- Institute on the Environment, University of Minnesota, 1954 Buford Avenue, Saint Paul, MN, USA, 55108
| | - Li Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place St. Mary's Campus, London, UK W2 1PG
- Department of Analytical, Environmental & Forensic Sciences, School of Population Health & Environmental Sciences, Kings College London, 150 Stamford Street, London, UK SE1 1UL
| | - Yu Fu
- Department of Building Science, School of Architecture, Tsinghua University, 1 QingHua Yuan Road, Beijing, China 100084
| | - Brian Robinson
- Department of Geography, McGill University, 805 Sherbrooke Street West, Montreal, Canada H3A 0B9
| | - Frank Kelly
- Department of Analytical, Environmental & Forensic Sciences, School of Population Health & Environmental Sciences, Kings College London, 150 Stamford Street, London, UK SE1 1UL
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place St. Mary's Campus, London, UK W2 1PG
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place St. Mary's Campus, London, UK W2 1PG
| | - Yangfeng Wu
- Peking University Clinical Research Institute, 38 Xueyuan Road, Beijing, China 100191
| | - Liancheng Zhao
- National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China 100006
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place St. Mary's Campus, London, UK W2 1PG
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place St. Mary's Campus, London, UK W2 1PG
| | - Xudong Yang
- Department of Building Science, School of Architecture, Tsinghua University, 1 QingHua Yuan Road, Beijing, China 100084
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place St. Mary's Campus, London, UK W2 1PG
| | - Jill Baumgartner
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1110 Pine Avenue West, Montreal, Canada H3A 1A3
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32
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North CM, MacNaughton P, Lai PS, Vallarino J, Okello S, Kakuhikire B, Tsai AC, Castro MC, Siedner MJ, Allen JG, Christiani DC. Personal carbon monoxide exposure, respiratory symptoms, and the potentially modifying roles of sex and HIV infection in rural Uganda: a cohort study. Environ Health 2019; 18:73. [PMID: 31429759 PMCID: PMC6701123 DOI: 10.1186/s12940-019-0517-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 08/12/2019] [Indexed: 05/04/2023]
Abstract
BACKGROUND Most of the global burden of pollution-related morbidity and mortality is believed to occur in resource-limited settings, where HIV serostatus and sex may influence the relationship between air pollution exposure and respiratory morbidity. The lack of air quality monitoring networks in these settings limits progress in measuring global disparities in pollution-related health. Personal carbon monoxide monitoring may identify sub-populations at heightened risk for air pollution-associated respiratory morbidity in regions of the world where the financial cost of air quality monitoring networks is prohibitive. METHODS From September 2015 through May 2017, we measured 48-h ambulatory carbon monoxide (CO) exposure in a longitudinal cohort of HIV-infected and uninfected adults in rural southwestern Uganda. We fit generalized mixed effects models to identify correlates of CO exposure exceeding international air quality thresholds, quantify the relationship between CO exposure and respiratory symptoms, and explore potential effect modification by sex and HIV serostatus. RESULTS Two hundred and sixty study participants completed 419 sampling periods. Personal CO exposure exceeded international thresholds for 50 (19%) participants. In covariate-adjusted models, living in a home where charcoal was the main cooking fuel was associated with CO exposure exceeding international thresholds (adjusted odds ratio [AOR] 11.3, 95% confidence interval [95%CI] 4.7-27.4). In sex-stratified models, higher CO exposure was associated with increased odds of respiratory symptoms among women (AOR 3.3, 95%CI 1.1-10.0) but not men (AOR 1.3, 95%CI 0.4-4.4). In HIV-stratified models, higher CO exposure was associated with increased odds of respiratory symptoms among HIV-infected (AOR 2.5, 95%CI 1.01-6.0) but not HIV-uninfected (AOR 1.4, 95%CI 0.1-14.4) participants. CONCLUSIONS In a cohort in rural Uganda, personal CO exposure frequently exceeded international thresholds, correlated with biomass exposure, and was associated with respiratory symptoms among women and people living with HIV. Our results provide support for the use of ambulatory CO monitoring as a low-cost, feasible method to identify subgroups with heightened vulnerability to pollution-related respiratory morbidity in resource-limited settings and identify subgroups that may have increased susceptibility to pollution-associated respiratory morbidity.
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Affiliation(s)
- Crystal M. North
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 55 Fruit Street, BUL-148, Boston, MA 02118 USA
- Harvard T.H. Chan School of Public Health, Boston, MA USA
- Harvard Medical School, Boston, MA USA
| | | | - Peggy S. Lai
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 55 Fruit Street, BUL-148, Boston, MA 02118 USA
- Harvard T.H. Chan School of Public Health, Boston, MA USA
- Harvard Medical School, Boston, MA USA
| | - Jose Vallarino
- Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Samson Okello
- Harvard T.H. Chan School of Public Health, Boston, MA USA
- Mbarara University of Science and Technology, Mbarara, Uganda
- University of Virginia Health System, Charlottesville, USA
| | | | - Alexander C. Tsai
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 55 Fruit Street, BUL-148, Boston, MA 02118 USA
- Harvard Medical School, Boston, MA USA
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Mark J. Siedner
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 55 Fruit Street, BUL-148, Boston, MA 02118 USA
- Harvard Medical School, Boston, MA USA
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joseph G. Allen
- Harvard T.H. Chan School of Public Health, Boston, MA USA
- Harvard Medical School, Boston, MA USA
| | - David C. Christiani
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 55 Fruit Street, BUL-148, Boston, MA 02118 USA
- Harvard T.H. Chan School of Public Health, Boston, MA USA
- Harvard Medical School, Boston, MA USA
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Agarwal A, Kirwa K, Eliot MN, Alenezi F, Menya D, Mitter SS, Velazquez EJ, Vedanthan R, Wellenius GA, Bloomfield GS. Household Air Pollution Is Associated with Altered Cardiac Function among Women in Kenya. Am J Respir Crit Care Med 2019; 197:958-961. [PMID: 28925740 DOI: 10.1164/rccm.201704-0832le] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | | | - Melissa N Eliot
- 3 Brown University School of Public Health Providence, Rhode Island
| | | | | | - Sumeet S Mitter
- 5 Icahn School of Medicine at Mount Sinai New York, New York
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Baumgartner J, Clark S, Carter E, Lai A, Zhang Y, Shan M, Schauer JJ, Yang X. Effectiveness of a Household Energy Package in Improving Indoor Air Quality and Reducing Personal Exposures in Rural China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2019; 53:9306-9316. [PMID: 31294968 DOI: 10.1021/acs.est.9b02061] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
We evaluated whether an energy package comprising a low-polluting semigasifier cookstove with chimney, water heater, and pelletized biomass fuel would improve air pollution in China. We measured the stove use, 48-h air pollution exposures (PM2.5, black carbon), and kitchen concentrations (PM2.5, black carbon, carbon monoxide, nitrogen oxides) for 205 women, along with ambient PM2.5. Over half (n = 125) were offered the energy package after baseline assessment, forming "treated" and "untreated" groups, and we repeated the measurements up to 3 occasions over 18-months. Kitchen carbon monoxide did not change, and nitrogen oxides increased in summer but decreased in winter for both groups. Summer geometric mean exposures and kitchen concentrations of PM2.5 and black carbon decreased by 24-67% in women who received the energy package, but greater reductions (48-70%) were observed in untreated homes, likely due to increased use of gas stoves. After adjusting for differences in outdoor PM2.5, receiving the energy package was associated with decreased winter exposures to PM2.5 (-46%; 95% CI: -70, -2) and black carbon (-55%; -74, -25) and the summer increases were smaller (PM2.5: 8%; -22, 51 and black carbon: 37%; -12, 113). However, PM2.5 exposures remained 1.5-3 times higher than those of health-based international air pollution targets.
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Affiliation(s)
- Jill Baumgartner
- Institute for Health and Social Policy , McGill University , Montreal , Quebec H3A 1A3 , Canada
- Department of Epidemiology, Biostatistics, & Occupational Health , McGill University , Montreal , Quebec H3A 1A2 , Canada
- Institute on the Environment , University of Minnesota , Minneapolis , Minnesota 55108 , United States
| | - Sierra Clark
- Department of Epidemiology, Biostatistics, & Occupational Health , McGill University , Montreal , Quebec H3A 1A2 , Canada
| | - Ellison Carter
- Institute on the Environment , University of Minnesota , Minneapolis , Minnesota 55108 , United States
- Department of Civil & Environmental Engineering , Colorado State University , Fort Collins , Colorado 80521 , United States
| | - Alexandra Lai
- Environmental Chemistry and Technology , University of Wisconsin-Madison , Madison , Wisconsin 53706 , United States
| | - Yuanxun Zhang
- College of Resources and Environment , University of the Chinese Academy of Sciences , Beijing 100049 , P. R. China
| | - Ming Shan
- Department of Building Science , Tsinghua University , Beijing 100084 , P. R. China
| | - James J Schauer
- Environmental Chemistry and Technology , University of Wisconsin-Madison , Madison , Wisconsin 53706 , United States
| | - Xudong Yang
- Department of Building Science , Tsinghua University , Beijing 100084 , P. R. China
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Li S, Yang M, Carter E, Schauer JJ, Yang X, Ezzati M, Goldberg MS, Baumgartner J. Exposure–Response Associations of Household Air Pollution and Buccal Cell Telomere Length in Women Using Biomass Stoves. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:87004. [PMID: 31393791 PMCID: PMC6792380 DOI: 10.1289/ehp4041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Telomere shortening is associated with early mortality and chronic disease. Recent studies indicate that environmental exposures, including urban and traffic-related air pollution, may shorten telomeres. Associations between exposure to household air pollution from solid fuel stoves and telomere length have not been evaluated. METHODS Among 137 rural Chinese women using biomass stoves ([Formula: see text] of age), we measured 48-h personal exposures to fine particulate matter [PM [Formula: see text] in aerodynamic diameter ([Formula: see text])] and black carbon and collected oral DNA on up to three occasions over a period of 2.5 y. Relative telomere length (RTL) was quantified using a modified real-time polymerase chain reaction protocol. Mixed effects regression models were used to investigate the exposure–response associations between household air pollution and RTL, adjusting for key sociodemographic, behavioral, and environmental covariates. RESULTS Women's daily exposures to air pollution ranged from [Formula: see text] for [Formula: see text] ([Formula: see text]) and [Formula: see text] for black carbon ([Formula: see text]). Natural cubic spline models indicated a mostly linear association between increased exposure to air pollution and shorter RTL, except at very high concentrations where there were few observations. We thus modeled the linear associations with all observations, excluding the highest 3% and 5% of exposures. In covariate-adjusted models, an interquartile range (IQR) increase in exposure to black carbon ([Formula: see text]) was associated with shorter RTL [all observations: [Formula: see text] (95% CI: [Formula: see text], [Formula: see text]); excluding highest 5% exposures: [Formula: see text] (95% CI: [Formula: see text], [Formula: see text])]. Further adjustment for outdoor temperature brought the estimates closer to zero [all observations: [Formula: see text] (95% CI: [Formula: see text], 0.06); excluding highest 5% exposures: [Formula: see text] (95% CI: [Formula: see text], [Formula: see text])]. Models with [Formula: see text] as the exposure metric followed a similar pattern. CONCLUSION Telomere shortening, which is a biomarker of biological aging and chronic disease, may be associated with exposure to air pollution in settings where household biomass stoves are commonly used. https://doi.org/10.1289/EHP4041.
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Affiliation(s)
- Sabrina Li
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
| | - Ming Yang
- Cancer Research Center, Shandong University, Jinan, China
- Shandong Cancer Hospital and Institute, Jinan, China
| | - Ellison Carter
- Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, Colorado, USA
- Institute on the Environment, University of Minnesota, Minneapolis, Minnesota, USA
| | - James J. Schauer
- Department of Civil and Environmental Engineering, University of Wisconsin, Madison, Wisconsin, USA
| | - Xudong Yang
- Department of Building Science, Tsinghua University, Beijing, China
| | - Majid Ezzati
- School of Public Health, Imperial College London, London, United Kingdom
- Medical Research Council and Health Protection Agency (MRC-PHE) Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Mark S. Goldberg
- Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada
- Research Institute, Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jill Baumgartner
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
- Institute on the Environment, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
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Abstract
Biomass burning for home energy use is a major environmental health concern. Improved cooking technologies could generate environmental health benefits, yet prior results regarding reduced personal exposure to air pollution are mixed. In this study, two improved stove types were distributed over four study groups in Northern Ghana. Participants wore real-time carbon monoxide (CO) monitors to measure the effect of the intervention on personal exposures. Relative to the control group (those using traditional stoves), there was a 30.3% reduction in CO exposures in the group given two Philips forced draft stoves (p = 0.08), 10.5% reduction in the group given two Gyapa stoves (locally made rocket stoves) (p = 0.62), and 10.2% reduction in the group given one of each (p = 0.61). Overall, CO exposure for participants was low given the prevalence of cooking over traditional three-stone fires, with 8.2% of daily samples exceeding WHO Tier-1 standards. We present quantification methods and performance of duplicate monitors. We analyzed the relationship between personal carbonaceous particulate matter less than 2.5 microns (PM2.5) and CO exposure for the dataset that included both measurements, finding a weak relationship likely due to the diversity of identified air pollution sources in the region and behavior variability.
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Socioeconomic determinants of community knowledge and practice in relation to malaria in high- and low-transmission areas of central India. J Biosoc Sci 2019; 52:317-329. [PMID: 31296270 DOI: 10.1017/s0021932019000440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study was undertaken with an aim of exploring community knowledge and treatment practices related to malaria and their determinants in high- and low-transmission areas of central India. A community-based cross-sectional study was carried out between August 2015 and January 2016 in two high- and two low-malaria-endemic districts of central India. A total of 1470 respondents were interviewed using a pre-tested structured interview schedule. Respondents residing in high-transmission areas with higher literacy levels, and of higher socioeconomic status, were found to practise more modern preventive measures than those living in low-transmission areas with low literacy levels and who were economically poor. Level of literacy, socioeconomic status and area (district) of residence were found to be the main factors affecting people's knowledge of malaria aetiology and clinical features, and prevention and treatment practices, in this community in central India.
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Brehmer C, Lai A, Clark S, Shan M, Ni K, Ezzati M, Yang X, Baumgartner J, Schauer JJ, Carter E. The Oxidative Potential of Personal and Household PM 2.5 in a Rural Setting in Southwestern China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2019; 53:2788-2798. [PMID: 30696246 DOI: 10.1021/acs.est.8b05120] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The chemical constituents of fine particulate matter (PM2.5) vary by source and capacity to participate in redox reactions in the body, which produce cytotoxic reactive oxygen species (ROS). Knowledge of the sources and components of PM2.5 may provide insight into the adverse health effects associated with the inhalation of PM2.5 mass. We collected 48 h household and personal PM2.5 exposure measurements in the summer months among 50 women/household pairs in a rural area of southwestern China where daily household biomass burning is common. PM2.5 mass was analyzed for ions, trace metals, black carbon, and water-soluble organic matter, as well as ROS-generating capability (oxidative potential) by one cellular and one acellular assay. Crustal enrichment factors and a principal component analysis identified the major sources of PM2.5 as dust, biomass burning, and secondary sulfate. Elements associated with the secondary sulfate source (As, Mo, Zn) had the strongest correlation with increased cellular oxidative potential (Spearman r: 0.74, 0.68, and 0.64). Chemical markers of biomass burning (water-soluble potassium and water-soluble organic matter) had negligible oxidative potential, suggesting that these assays may not be useful as health-relevant exposure metrics in populations that are exposed to high levels of smoke from household biomass burning.
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Affiliation(s)
- Collin Brehmer
- Environmental Chemistry and Technology Program , University of Wisconsin-Madison , Madison , Wisconsin 53706 , United States
| | - Alexandra Lai
- Environmental Chemistry and Technology Program , University of Wisconsin-Madison , Madison , Wisconsin 53706 , United States
| | - Sierra Clark
- Institute for Health and Social Policy and Department of Epidemiology, Biostatistics, and Occupational Health , McGill University , Montreal , Quebec H3A 1A3 , Canada
| | - Ming Shan
- Department of Building Science , Tsinghua University , Beijing 100084 , China
| | - Kun Ni
- Department of Building Science , Tsinghua University , Beijing 100084 , China
| | - Majid Ezzati
- MRC-PHE Centre for Environment and Health, Department of Epidemiology, Biostatics, and Occupational Health, School of Public Health , Imperial College London , London W2 1PG , U.K
| | - Xudong Yang
- Department of Building Science , Tsinghua University , Beijing 100084 , China
| | - Jill Baumgartner
- Institute for Health and Social Policy and Department of Epidemiology, Biostatistics, and Occupational Health , McGill University , Montreal , Quebec H3A 1A3 , Canada
| | - James J Schauer
- Environmental Chemistry and Technology Program , University of Wisconsin-Madison , Madison , Wisconsin 53706 , United States
- Wisconsin State Laboratory of Hygiene , University of Wisconsin-Madison , Madison , Wisconsin 53718 , United States
| | - Ellison Carter
- Department of Civil and Environmental Engineering , Colorado State University , Fort Collins , Colorado 80523 , United States
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Tagle M, Pillarisetti A, Hernandez MT, Troncoso K, Soares A, Torres R, Galeano A, Oyola P, Balmes J, Smith KR. Monitoring and modeling of household air quality related to use of different Cookfuels in Paraguay. INDOOR AIR 2019; 29:252-262. [PMID: 30339298 PMCID: PMC6849814 DOI: 10.1111/ina.12513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 10/12/2018] [Indexed: 06/02/2023]
Abstract
In Paraguay, 49% of the population depends on biomass (wood and charcoal) for cooking. Residential biomass burning is a major source of fine particulate matter (PM2.5 ) and carbon monoxide (CO) in and around the household environment. In July 2016, cross-sectional household air pollution sampling was conducted in 80 households in rural Paraguay. Time-integrated samples (24 hours) of PM2.5 and continuous CO concentrations were measured in kitchens that used wood, charcoal, liquefied petroleum gas (LPG), or electricity to cook. Qualitative and quantitative household-level variables were captured using questionnaires. The average PM2.5 concentration (μg/m3 ) was higher in kitchens that burned wood (741.7 ± 546.4) and charcoal (107.0 ± 68.6) than in kitchens where LPG (52.3 ± 18.9) or electricity (52.0 ± 14.8) was used. Likewise, the average CO concentration (ppm) was higher in kitchens that used wood (19.4 ± 12.6) and charcoal (7.6 ± 6.5) than in those that used LPG (0.5 ± 0.6) or electricity (0.4 ± 0.6). Multivariable linear regression was conducted to generate predictive models for indoor PM2.5 and CO concentrations (predicted R2 = 0.837 and 0.822, respectively). This study provides baseline indoor air quality data for Paraguay and presents a multivariate statistical approach that could be used in future research and intervention programs.
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Affiliation(s)
- Matias Tagle
- Environmental Health SciencesSchool of Public HealthUniversity of California at BerkeleyBerkeleyCalifornia
- Centro Mario Molina ChileProvidencia, SantiagoChile
| | - Ajay Pillarisetti
- Environmental Health SciencesSchool of Public HealthUniversity of California at BerkeleyBerkeleyCalifornia
| | - Maria Teresa Hernandez
- Environmental Health SciencesSchool of Public HealthUniversity of California at BerkeleyBerkeleyCalifornia
| | - Karin Troncoso
- Pan American Health OrganizationWashingtonDistrict of Columbia
| | - Agnes Soares
- Pan American Health OrganizationWashingtonDistrict of Columbia
| | - Ricardo Torres
- Pan American Health OrganizationWashingtonDistrict of Columbia
| | - Aida Galeano
- Dirección General de Salud AmbientalSan LorenzoParaguay
| | - Pedro Oyola
- Centro Mario Molina ChileProvidencia, SantiagoChile
| | - John Balmes
- Environmental Health SciencesSchool of Public HealthUniversity of California at BerkeleyBerkeleyCalifornia
- School of MedicineUniversity of CaliforniaSan FranciscoCalifornia
| | - Kirk R. Smith
- Environmental Health SciencesSchool of Public HealthUniversity of California at BerkeleyBerkeleyCalifornia
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Van Vliet EDS, Kinney PL, Owusu-Agyei S, Schluger NW, Ae-Ngibise KA, Whyatt RM, Jack DW, Agyei O, Chillrud SN, Boamah EA, Mujtaba M, Asante KP. Current respiratory symptoms and risk factors in pregnant women cooking with biomass fuels in rural Ghana. ENVIRONMENT INTERNATIONAL 2019; 124:533-540. [PMID: 30685455 PMCID: PMC7069526 DOI: 10.1016/j.envint.2019.01.046] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 01/16/2019] [Accepted: 01/16/2019] [Indexed: 05/31/2023]
Abstract
BACKGROUND More than 75% of the population in Ghana relies on biomass fuels for cooking and heating. Household air pollution (HAP) emitted from the incomplete combustion of these fuels has been associated with adverse health effects including respiratory effects in women that can lead to chronic obstructive pulmonary disease (COPD), a major contributor to global HAP-related mortality. HAP is a modifiable risk factor in the global burden of disease, exposure to which can be reduced. OBJECTIVE This study assessed the prevalence of respiratory symptoms, as well as associations between respiratory symptoms and HAP exposure, as measured using continuous personal carbon monoxide (CO), in nonsmoking pregnant women in rural Ghana. METHODS We analyzed current respiratory health symptoms and CO exposures upon enrollment in a subset (n = 840) of the population of pregnant women cooking with biomass fuels and enrolled in the GRAPHS randomized clinical control trial. Personal CO was measured using Lascar continuous monitors. Associations between CO concentrations as well as other sources of pollution exposures and respiratory health symptoms were estimated using logistic regression models. CONCLUSION There was a positive association between CO exposure per 1 ppm increase and a composite respiratory symptom score of current cough (lasting >5 days), wheeze and/or dyspnea (OR: 1.2, p = 0.03). CO was also positively associated with wheeze (OR: 1.3, p = 0.05), phlegm (OR: 1.2, p = 0.08) and reported clinic visit for respiratory infection in past 4 weeks (OR: 1.2, p = 0.09). Multivariate models showed significant associations between second-hand tobacco smoke and a composite outcome (OR: 2.1, p < 0.01) as well as individual outcomes of cough >5 days (OR: 3.1, p = 0.01), wheeze (OR: 2.7, p < 0.01) and dyspnea (OR: 2.2, p = 0.01). Other covariates found to be significantly associated with respiratory outcomes include involvement in charcoal production business and dyspnea, and involvement in burning grass/field and wheeze. Results suggest that exposure to HAP increases the risk of adverse respiratory symptoms among pregnant women using biomass fuels for cooking in rural Ghana.
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Affiliation(s)
| | | | | | - Neil W Schluger
- Columbia University College of Physicians and Surgeons, New York, NY, USA; Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Robin M Whyatt
- 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
| | - Oscar Agyei
- Kintampo Health Research Centre, Kintampo, Ghana
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY, USA
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Quinn C, Miller-Lionberg DD, Klunder KJ, Kwon J, Noth EM, Mehaffy J, Leith D, Magzamen S, Hammond SK, Henry CS, Volckens J. Personal Exposure to PM 2.5 Black Carbon and Aerosol Oxidative Potential using an Automated Microenvironmental Aerosol Sampler (AMAS). ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:11267-11275. [PMID: 30200753 PMCID: PMC6203932 DOI: 10.1021/acs.est.8b02992] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Traditional methods for measuring personal exposure to fine particulate matter (PM2.5) are cumbersome and lack spatiotemporal resolution; methods that are time-resolved are limited to a single species/component of PM. To address these limitations, we developed an automated microenvironmental aerosol sampler (AMAS), capable of resolving personal exposure by microenvironment. The AMAS is a wearable device that uses a GPS sensor algorithm in conjunction with a custom valve manifold to sample PM2.5 onto distinct filter channels to evaluate home, school, and other (e.g., outdoors, in transit, etc.) exposures. Pilot testing was conducted in Fresno, CA where 25 high-school participants ( n = 37 sampling events) wore an AMAS for 48-h periods in November 2016. Data from 20 (54%) of the 48-h samples collected by participants were deemed valid and the filters were analyzed for PM2.5 black carbon (BC) using light transmissometry and aerosol oxidative potential (OP) using the dithiothreitol (DTT) assay. The amount of inhaled PM2.5 was calculated for each microenvironment to evaluate the health risks associated with exposure. On average, the estimated amount of inhaled PM2.5 BC (μg day-1) and OP [(μM min-1) day-1] was greatest at home, owing to the proportion of time spent within that microenvironment. Validation of the AMAS demonstrated good relative precision (8.7% among collocated instruments) and a mean absolute error of 22% for BC and 33% for OP when compared to a traditional personal sampling instrument. This work demonstrates the feasibility of new technology designed to quantify personal exposure to PM2.5 species within distinct microenvironments.
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Affiliation(s)
- Casey Quinn
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado 80523, United States
| | - Daniel D. Miller-Lionberg
- Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado 80523, United States
| | - Kevin J. Klunder
- Department of Chemistry, Colorado State University, Fort Collins, Colorado 80523, United States
| | - Jaymin Kwon
- Department of Public Health, California State University, Fresno, California 93740, United States
| | - Elizabeth M. Noth
- Environmental Health Sciences Division, School of Public Health, University of California, Berkeley, California 94720, United States
| | - John Mehaffy
- Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado 80523, United States
| | - David Leith
- Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado 80523, United States
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado 80523, United States
| | - S. Katharine Hammond
- Environmental Health Sciences Division, School of Public Health, University of California, Berkeley, California 94720, United States
| | - Charles S. Henry
- Department of Chemistry, Colorado State University, Fort Collins, Colorado 80523, United States
| | - John Volckens
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado 80523, United States
- Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado 80523, United States
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Havens D, Wang D, Grigg J, Gordon SB, Balmes J, Mortimer K. The Cooking and Pneumonia Study (CAPS) in Malawi: A Cross-Sectional Assessment of Carbon Monoxide Exposure and Carboxyhemoglobin Levels in Children under 5 Years Old. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091936. [PMID: 30189674 PMCID: PMC6163876 DOI: 10.3390/ijerph15091936] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/22/2018] [Accepted: 08/30/2018] [Indexed: 12/31/2022]
Abstract
Household air pollution is estimated to cause half a million deaths from pneumonia in children worldwide. The Cooking and Pneumonia Study (CAPS) was conducted to determine whether the use of cleaner-burning biomass-fueled cookstoves would reduce household air pollution and thereby the incidence of pneumonia in young children in rural Malawi. Here we report a cross-sectional assessment of carbon monoxide (CO) exposure and carboxyhemoglobin (COHgB) levels at recruitment to CAPS. Mean (SD; range) 48-h CO exposure of 1928 participating children was 0.90 (2.3; 0–49) ppm and mean (SD; range) COHgB level was 5.8% (3.3; 0–20.3). Higher mean CO and COHgB levels were associated with location (Chikhwawa versus Chilumba) (OR 3.55 (1.73–7.26)); (OR 2.77 (1.08–7.08)). Correlation between mean CO and COHgB was poor (Spearman’s ρ = 0.09, p < 0.001). The finding of high COHgB levels in young children in rural Malawi that are at levels at which adverse neurodevelopmental and cognitive effects occur is of concern. Effective approaches for reducing exposure to CO and other constituents of air pollution in rural sub-Saharan African settings are urgently needed.
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Affiliation(s)
- Deborah Havens
- Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK.
| | - Duolao Wang
- Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK.
| | - Jonathan Grigg
- Centre for Genomics and Child Health, Queen Mary University of London, London E1 2AT, UK.
| | | | - John Balmes
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA 94720-7360, USA.
- Department of Medicine, University of California, San Francisco, San Francisco, CA 94143-0844, USA.
| | - Kevin Mortimer
- Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK.
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Salmon M, Milà C, Bhogadi S, Addanki S, Madhira P, Muddepaka N, Mora A, Sanchez M, Kinra S, Sreekanth V, Doherty A, Marshall JD, Tonne C. Wearable camera-derived microenvironments in relation to personal exposure to PM 2.5. ENVIRONMENT INTERNATIONAL 2018; 117:300-307. [PMID: 29778830 PMCID: PMC6024072 DOI: 10.1016/j.envint.2018.05.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/23/2018] [Accepted: 05/08/2018] [Indexed: 05/15/2023]
Abstract
Data regarding which microenvironments drive exposure to air pollution in low and middle income countries are scarce. Our objective was to identify sources of time-resolved personal PM2.5 exposure in peri-urban India using wearable camera-derived microenvironmental information. We conducted a panel study with up to 6 repeated non-consecutive 24 h measurements on 45 participants (186 participant-days). Camera images were manually annotated to derive visual concepts indicative of microenvironments and activities. Men had slightly higher daily mean PM2.5 exposure (43 μg/m3) compared to women (39 μg/m3). Cameras helped identify that men also had higher exposures when near a biomass cooking unit (mean (sd) μg/m3: 119 (383) for men vs 83 (196) for women) and presence in the kitchen (133 (311) for men vs 48 (94) for women). Visual concepts associated in regression analysis with higher 5-minute PM2.5 for both sexes included: smoking (+93% (95% confidence interval: 63%, 129%) in men, +29% (95% CI: 2%, 63%) in women), biomass cooking unit (+57% (95% CI: 28%, 93%) in men, +69% (95% CI: 48%, 93%) in women), visible flame or smoke (+90% (95% CI: 48%, 144%) in men, +39% (95% CI: 6%, 83%) in women), and presence in the kitchen (+49% (95% CI: 27%, 75%) in men, +14% (95% CI: 7%, 20%) in women). Our results indicate wearable cameras can provide objective, high time-resolution microenvironmental data useful for identifying peak exposures and providing insights not evident using standard self-reported time-activity.
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Affiliation(s)
- Maëlle Salmon
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Carles Milà
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | | | | | | | | | | | - Margaux Sanchez
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - V Sreekanth
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Aiden Doherty
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Julian D Marshall
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Cathryn Tonne
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain..
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Baumgartner J, Carter E, Schauer JJ, Ezzati M, Daskalopoulou SS, Valois MF, Shan M, Yang X. Household air pollution and measures of blood pressure, arterial stiffness and central haemodynamics. Heart 2018; 104:1515-1521. [DOI: 10.1136/heartjnl-2017-312595] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 01/16/2018] [Accepted: 01/18/2018] [Indexed: 11/03/2022] Open
Abstract
ObjectiveWe evaluated the exposure–response associations between personal exposure to air pollution from biomass stoves and multiple vascular and haemodynamic parameters in rural Chinese women.MethodsWe analysed the baseline information from a longitudinal study in southwestern China. Women’s brachial and central blood pressure and pulse pressure, carotid-femoral pulse wave velocity and augmentation index, and their 48-hour personal exposures to fine particulate matter (PM2.5) and black carbon were measured in summer and winter. We evaluated the associations between exposure to air pollution and haemodynamic parameters using mixed-effects regression models adjusted for known cardiovascular risk factors.ResultsWomen’s (n=205, ages 27–86 years) exposures to PM2.5 and black carbon ranged from 14 µg/m3 to 1405 µg/m3 and 0.1–121.8 µg/m3, respectively. Among women aged ≥50 years, increased PM2.5 exposure was associated with higher systolic (brachial: 3.5 mm Hg (P=0.05); central: 4.4 mm Hg (P=0.005)) and diastolic blood pressure (central: 1.3 mm Hg (P=0.10)), higher pulse pressure (peripheral: 2.5 mm Hg (P=0.05); central: 2.9 mm Hg (P=0.008)) and lower peripheral–central pulse pressure amplification (−0.007 (P=0.04)). Among younger women, the associations were inconsistent in the direction of effect and not statistically significant. Increased PM2.5 exposure was associated with no difference in pulse wave velocity and modestly higher augmentation index though the CI included zero (1.1%; 95% CI −0.2% to 2.4%). Similar associations were found for black carbon exposure.ConclusionsExposure to household air pollution was associated with higher blood pressure and central haemodynamics in older Chinese women, with no associations observed with pulse wave velocity.
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Lucarelli K, Wyne K, Svenson JE. Improved cookstoves and their effect on carbon monoxide levels in San Lucas Tolimán, Guatemala. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2018; 28:64-70. [PMID: 29380623 DOI: 10.1080/09603123.2018.1429575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Installation of ventilated cookstoves has been shown to improve 24-h carbon monoxide (CO) and particulate exposure in the Guatemalan highlands. However, a survey of villagers around San Lucas Tolimán found much higher than expected CO levels. Our purpose is to evaluate the effects of improved cookstoves on CO levels in these villagers. METHODS This is cross sectional observational study in six rural communities. Blood carboxyhemoglobin (SpCO) was measured at three different times during the day. Stove type and location, as well as any respiratory, eye, or general symptoms reported were recorded. RESULTS 122 patients were included. CO levels were much higher than would be expected in a non-smoking population, with an average level of 4.6 ± 2.3 percent. There was no significant correlation in CO level and stove type or in CO level and time of day. Reported frequency of respiratory and eye symptoms (dyspnea, p = 0.03; cough, p = 0.01; burning eyes, p = 0.001; and excessive tearing, p = 0.001) did vary significantly between improved and unimproved stove groups. CONCLUSION This study found high average SpCO levels in all villagers. This suggests that some contributor other than cookstoves may be an additional driver of individual CO exposure in this area.
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Affiliation(s)
- Katherine Lucarelli
- a Department of Emergency Medicine , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - Kevin Wyne
- b Department of Family Medicine and Community Health , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
| | - James E Svenson
- a Department of Emergency Medicine , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA
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Sood A, Assad NA, Barnes PJ, Churg A, Gordon SB, Harrod KS, Irshad H, Kurmi OP, Martin WJ, Meek P, Mortimer K, Noonan CW, Perez-Padilla R, Smith KR, Tesfaigzi Y, Ward T, Balmes J. ERS/ATS workshop report on respiratory health effects of household air pollution. Eur Respir J 2018; 51:51/1/1700698. [PMID: 29301918 DOI: 10.1183/13993003.00698-2017] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/08/2017] [Indexed: 12/18/2022]
Abstract
Exposure to household air pollution (HAP) from solid fuel combustion affects almost half of the world population. Adverse respiratory outcomes such as respiratory infections, impaired lung growth and chronic obstructive pulmonary disease have been linked to HAP exposure. Solid fuel smoke is a heterogeneous mixture of various gases and particulates. Cell culture and animal studies with controlled exposure conditions and genetic homogeneity provide important insights into HAP mechanisms. Impaired bacterial phagocytosis in exposed human alveolar macrophages possibly mediates several HAP-related health effects. Lung pathological findings in HAP-exposed individuals demonstrate greater small airways fibrosis and less emphysema compared with cigarette smokers. Field studies using questionnaires, air pollution monitoring and/or biomarkers are needed to better establish human risks. Some, but not all, studies suggest that improving cookstove efficiency or venting emissions may be associated with reduced respiratory symptoms, lung function decline in women and severe pneumonia in children. Current studies focus on fuel switching, stove technology replacements or upgrades and air filter devices. Several governments have initiated major programmes to accelerate the upgrade from solid fuels to clean fuels, particularly liquid petroleum gas, which provides research opportunities for the respiratory health community.
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Affiliation(s)
- Akshay Sood
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Nour A Assad
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Peter J Barnes
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Andrew Churg
- University of British Columbia, Vancouver, BC, Canada
| | | | - Kevin S Harrod
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hammad Irshad
- Lovelace Respiratory Research Institute, Albuquerque, NM, USA
| | | | | | - Paula Meek
- University of Colorado at Denver, Denver, CO, USA
| | | | | | | | - Kirk R Smith
- University of California School of Public Health, Berkeley, CA, USA
| | | | - Tony Ward
- University of Montana, Missoula, MT, USA
| | - John Balmes
- University of California School of Public Health, Berkeley, CA, USA.,University of California, San Francisco, CA, USA
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