4 research outputs found

    HOUSEHOLD AIR POLLUTION FROM BIOMASS COOKSTOVES AND A LIQUEFIED PETROLEUM GAS INTERVENTION IN RURAL PERU

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    Problem Statement: Approximately 3 billion people worldwide, mostly from low and middle-income countries, use biomass fuels such as wood and dung for cooking. Household air pollution (HAP) from biomass cookstoves is recognized as one of the largest environmental risk factors for preventable disease. Previous interventions to reduce HAP from biomass cookstoves have shown limited health improvements. As a result, recent efforts are focusing on cleaner fuels such as liquefied petroleum gas (LPG). This dissertation aimed to 1) characterize HAP concentrations from biomass cookstoves, 2) examine the exposure-response relationships between HAP and markers of inflammation, and 3) evaluate the longitudinal impact of an LPG stove intervention on HAP. Methods: We conducted a randomized, controlled field trial with 180 female participants that use biomass cookstoves in rural Peru, randomizing half of them to receive free LPG stoves and free fuel delivery for one year. We collected kitchen area concentrations and personal exposures to carbon monoxide (CO), fine particulate matter (PM2.5) and black carbon (BC), as well as dried blood samples. In the first manuscript, we determined the associations between household characteristics and HAP at baseline. In the second manuscript, we developed exposure-response models between HAP and markers of inflammation at baseline. In the third manuscript, we assessed the longitudinal impact of the LPG stove intervention on HAP concentrations at baseline and 3-, 6- and 12-months post-intervention. Results: In our first study, we observed that roof type has an important impact in kitchen ventilation of households in rural Peru. In our second study, we found statistically significant associations between kitchen area BC concentrations and inflammatory markers that were robust to adjustment for PM2.5 concentrations. In our third study, we found that our LPG stove intervention significantly reduced PM2.5, BC, and CO concentrations by at least 62%, to levels comparable with health-based guidelines. Conclusions: HAP concentrations from biomass cookstoves in rural Peru were well above recommended guidelines. The kitchen area concentrations were associated with inflammation markers. The success of an LPG stove intervention in reducing HAP is encouraging for future LPG programs to potentially improve health in resource-limited settings such as Peru

    Effects of a Household Air Pollution Intervention with Liquefied Petroleum Gas on Cardiopulmonary Outcomes in Peru A Randomized Controlled Trial

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    Rationale: Approximately 40% of people worldwide are exposed to household air pollution (HAP) from the burning of biomass fuels. Previous efforts to document health benefits of HAP mitigation have been stymied by an inability to lower emissions to target levels. Objectives: We sought to determine if a household air pollution intervention with liquefied petroleum gas (LPG) improved cardiopulmonary health outcomes in adult women living in a resource-poor setting in Peru. Methods: We conducted a randomized controlled field trial in 180 women aged 25-64 years living in rural Puno, Peru. Intervention women received an LPG stove, continuous fuel delivery for 1 year, education, and behavioral messaging, whereas control women were asked to continue their usual cooking practices. We assessed for stove use adherence using temperature loggers installed in both LPG and biomass stoves of intervention households. Measurements and Main Results: We measured blood pressure, peak expiratory flow (PEF), and respiratory symptoms using the St. George's Respiratory Questionnaire at baseline and at 3-4 visits after randomization. Intervention women used their LPG stove exclusively for 98% of days. We did not find differences in average postrandomization systolic blood pressure (intervention - control 0.7 mm Hg; 95% confidence interval, -2.1 to 3.4), diastolic blood pressure (0.3 mm Hg; -1.5 to 2.0), prebronchodilator peak expiratory flow/height(2) (0.14 L/s/m(2); -0.02 to 0.29), postbronchodilator peak expiratory flow/height(2) (0.11 L/s/m(2); -0.05 to 0.27), or St. George's Respiratory Questionnaire total score (-1.4; -3.9 to 1.2) over 1 year in intention-to-treat analysis. There were no reported harms related to the intervention. Conclusions: We did not find evidence of a difference in blood pressure, lung function, or respiratory symptoms during the year-long intervention with LPG
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