TY - JOUR

T1 - Acute Effects on Blood Pressure Following Controlled Exposure to Cookstove Air Pollution in the STOVES Study

AU - Fedak, Kristen M.

AU - Good, Nicholas

AU - Walker, Ethan S.

AU - Balmes, John

AU - Brook, Robert D.

AU - Clark, Maggie L.

AU - Cole-Hunter, Tom

AU - Devlin, Robert

AU - L'Orange, Christian

AU - Luckasen, Gary

AU - Mehaffy, John

AU - Shelton, Rhiannon

AU - Wilson, Ander

AU - Volckens, John

AU - Peel, Jennifer L.

N1 - Funding Information: This research was funded by the US National Institute of Environmental Health Sciences grant ES023688. Publisher Copyright: © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

PY - 2019

Y1 - 2019

N2 - Background: Exposure to air pollution from solid fuel used in residential cookstoves is considered a leading environmental risk factor for disease globally, but evidence for this relationship is largely extrapolated from literature on smoking, secondhand smoke, and ambient fine particulate matter (PM2.5). Methods and Results: We conducted a controlled human-exposure study (STOVES [the Subclinical Tests on Volunteers Exposed to Smoke] Study) to investigate acute responses in blood pressure following exposure to air pollution emissions from cookstove technologies. Forty-eight healthy adults received 2-hour exposures to 5 cookstove treatments (three stone fire, rocket elbow, fan rocket elbow, gasifier, and liquefied petroleum gas), spanning PM2.5 concentrations from 10 to 500 μg/m3, and a filtered air control (0 μg/m3). Thirty minutes after exposure, systolic pressure was lower for the three stone fire treatment (500 μg/m3 PM2.5) compared with the control (−2.3 mm Hg; 95% CI, −4.5 to −0.1) and suggestively lower for the gasifier (35 μg/m3 PM2.5; −1.8 mm Hg; 95% CI, −4.0 to 0.4). No differences were observed at 3 hours after exposure; however, at 24 hours after exposure, mean systolic pressure was 2 to 3 mm Hg higher for all treatments compared with control except for the rocket elbow stove. No differences were observed in diastolic pressure for any time point or treatment. Conclusions: Short-term exposure to air pollution from cookstoves can elicit an increase in systolic pressure within 24 hours. This response occurred across a range of stove types and PM2.5 concentrations, raising concern that even low-level exposures to cookstove air pollution may pose adverse cardiovascular effects.

AB - Background: Exposure to air pollution from solid fuel used in residential cookstoves is considered a leading environmental risk factor for disease globally, but evidence for this relationship is largely extrapolated from literature on smoking, secondhand smoke, and ambient fine particulate matter (PM2.5). Methods and Results: We conducted a controlled human-exposure study (STOVES [the Subclinical Tests on Volunteers Exposed to Smoke] Study) to investigate acute responses in blood pressure following exposure to air pollution emissions from cookstove technologies. Forty-eight healthy adults received 2-hour exposures to 5 cookstove treatments (three stone fire, rocket elbow, fan rocket elbow, gasifier, and liquefied petroleum gas), spanning PM2.5 concentrations from 10 to 500 μg/m3, and a filtered air control (0 μg/m3). Thirty minutes after exposure, systolic pressure was lower for the three stone fire treatment (500 μg/m3 PM2.5) compared with the control (−2.3 mm Hg; 95% CI, −4.5 to −0.1) and suggestively lower for the gasifier (35 μg/m3 PM2.5; −1.8 mm Hg; 95% CI, −4.0 to 0.4). No differences were observed at 3 hours after exposure; however, at 24 hours after exposure, mean systolic pressure was 2 to 3 mm Hg higher for all treatments compared with control except for the rocket elbow stove. No differences were observed in diastolic pressure for any time point or treatment. Conclusions: Short-term exposure to air pollution from cookstoves can elicit an increase in systolic pressure within 24 hours. This response occurred across a range of stove types and PM2.5 concentrations, raising concern that even low-level exposures to cookstove air pollution may pose adverse cardiovascular effects.

KW - air pollution

KW - blood pressure

KW - cardiovascular disease risk factors

U2 - 10.1161/JAHA.119.012246

DO - 10.1161/JAHA.119.012246

M3 - Journal article

C2 - 31286826

AN - SCOPUS:85069302902

VL - 8

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 14

M1 - e012246

ER -