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. 2022 Apr:241:113949.
doi: 10.1016/j.ijheh.2022.113949. Epub 2022 Mar 5.

Household air pollution from wood-burning cookstoves and C-reactive protein among women in rural Honduras

Megan L Benka-Coker  1 , Maggie L Clark  2 , Sarah Rajkumar  2 , Bonnie N Young  2 , Annette M Bachand  2 , Robert D Brook  3 , Tracy L Nelson  4 , John Volckens  5 , Stephen J Reynolds  2 , Ander Wilson  6 , Christian L'Orange  7 , Nicholas Good  7 , Casey Quinn  7 , Kirsten Koehler  8 , Sebastian Africano  9 , Anibal B Osorto Pinel  10 , David Diaz-Sanchez  11 , Lucas Neas  11 , Jennifer L Peel  12
Affiliations

Household air pollution from wood-burning cookstoves and C-reactive protein among women in rural Honduras

Megan L Benka-Coker et al. Int J Hyg Environ Health. 2022 Apr.

Abstract

Household air pollution from solid fuel combustion was estimated to cause 2.31 million deaths worldwide in 2019; cardiovascular disease is a substantial contributor to the global burden. We evaluated the cross-sectional association between household air pollution (24-h gravimetric kitchen and personal particulate matter (PM2.5) and black carbon (BC)) and C-reactive protein (CRP) measured in dried blood spots among 107 women in rural Honduras using wood-burning traditional or Justa (an engineered combustion chamber) stoves. A suite of 6 additional markers of systemic injury and inflammation were considered in secondary analyses. We adjusted for potential confounders and assessed effect modification of several cardiovascular-disease risk factors. The median (25th, 75th percentiles) 24-h-average personal PM2.5 concentration was 115 μg/m3 (65,154 μg/m3) for traditional stove users and 52 μg/m3 (39, 81 μg/m3) for Justa stove users; kitchen PM2.5 and BC had similar patterns. Higher concentrations of PM2.5 and BC were associated with higher levels of CRP (e.g., a 25% increase in personal PM2.5 was associated with a 10.5% increase in CRP [95% CI: 1.2-20.6]). In secondary analyses, results were generally consistent with a null association. Evidence for effect modification between pollutant measures and four different cardiovascular risk factors (e.g., high blood pressure) was inconsistent. These results support the growing evidence linking household air pollution and cardiovascular disease.

Keywords: Biomass; Black carbon; C-Reactive protein; Cookstoves; Household air pollution; Particulate matter.

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Figures

Figure 1:
Figure 1:. Protein saver card and dried blood spot
Photo Credit: Joanna B Pinneo Photography, https://www.joannabpinneophoto.com/index
Figure 2:
Figure 2:. Venn diagram of risk factors for cardiovascular disease (N = 110)
†18 participants did not have any risk factor BMI = body mass index, HbA1c = glycated hemoglobin
Figure 3.
Figure 3.. Associations between 24-hour average pollutant concentrations and levels of C-reactive protein (CRP)
Models were adjusted for age, body mass index (BMI), number of assets (<2 or ≥2), electricity (yes/no), years of education (<6 or ≥6) A: Model for age; Low age = <40 years old (N =47 kitchen PM, N= 48 for personal PM, kitchen BC and personal BC); high age = ≥40 years old (N = 27 for kitchen PM and kitchen BC, N=25 for personal PM and personal BC) B: Model for BMI; Low BMI = BMI <25.1 kg/m3 (N = 31 for kitchen PM and kitchen BC, N=30 for personal PM and personal BC); high BMI = ≥ 25.1 kg/m ( N =44 kitchen BC, N= 43 for personal PM, kitchen BC and personal BC) C: Model for blood pressure; Normal blood pressure= normal blood pressure (systolic <120 mmHg and diastolic <80 mmHg) (N = 53 for kitchen PM, personal PM, and personal BC, N= 54 for kitchen BC); Elevated BP = elevated blood pressure (systolic ≥120 mmHg and/or diastolic ≥80 mmHg) (N=19 for kitchen PM and kitchen BC, N=18 for personal PM and personal BC) D: Model for HbA1c: Normal HbA1c = HbA1c <5.7% (N = 61 for kitchen PM and kitchen BC, N=60 for personal PM and personal BC); Elevated HbA1c = HbA1c ≥5.7 *Statistically significant at the 0.05 level
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