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. 2020 Feb:89:105909.
doi: 10.1016/j.cct.2019.105909. Epub 2019 Dec 12.

Wood stove interventions and child respiratory infections in rural communities: KidsAir rationale and methods

Curtis W Noonan  1 , Erin O Semmens  2 , Desirae Ware  2 , Paul Smith  2 , Bert B Boyer  3 , Esther Erdei  4 , Scarlett E Hopkins  3 , Johnnye Lewis  4 , Tony J Ward  2
Affiliations

Wood stove interventions and child respiratory infections in rural communities: KidsAir rationale and methods

Curtis W Noonan et al. Contemp Clin Trials. 2020 Feb.

Abstract

Background: Acute lower respiratory tract infections (LRTIs) account for >27% of all hospitalizations among US children under five years of age. Residential burning of biomass for heat leads to elevated indoor levels of fine particulate matter (PM2.5) that often exceed current health based air quality standards. This is concerning as PM2.5 exposure is associated with many adverse health outcomes, including a greater than three-fold increased risk of LRTIs. Evidence-based efforts are warranted in rural and American Indian/Alaska Native (AI/AN) communities in the US that suffer from elevated rates of childhood LRTI and commonly use wood for residential heating.

Design: In three rural and underserved settings, we conducted a three-arm randomized controlled, post-only intervention trial in wood stove homes with children less than five years old. Education and household training on best-burn practices were introduced as one intervention arm (Tx1). This intervention was evaluated against an indoor air filtration unit arm (Tx2), as well as a control arm (Tx3). The primary outcome was LRTI incidence among children under five years of age.

Discussion: To date, exposure reduction strategies in wood stove homes have been either inconsistently effective or include factors that limit widespread dissemination and continued compliance in rural and economically disadvantaged populations. As part of the "KidsAIR" study described herein, the overall hypothesis was that a low-cost, educational intervention targeting indoor wood smoke PM2.5 exposures would be a sustainable approach for reducing children's risk of LRTI in rural and AI/AN communities.

Keywords: Biomass combustion; Filter; Home intervention; Pediatric; Respiratory infection; Wood stove.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no competing interests.

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