Raphael E Arku1, Majid Ezzati2, Jill Baumgartner3, Günther Fink4, Bin Zhou2, Perry Hystad5, Michael Brauer6. 1. School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada; Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA. Electronic address: rka281@mail.harvard.edu. 2. MRC-PHE Centre for Environment and Health and WHO Collaborating Centre on NCD Surveillance and Epidemiology, School of Public Health, Imperial College London, London, UK. 3. Institute for Health and Social Policy and Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada. 4. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland. 5. The School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA. 6. School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada.
Abstract
BACKGROUND: Approximately three billion people are exposed to household air pollution (HAP) from solid fuel cookstoves. Studies from single settings have linked HAP with elevated blood pressure (BP), but no evidence exists from multi-country analyses. OBJECTIVES: Using nationally representative and internationally comparable data, we examined the association between solid fuel use and BP in 77,605 largely premenopausal women (aged 15-49) from ten resource-poor countries. METHODS: We obtained data on systolic and diastolic BP, self-reported primary cooking fuel, health and socio-demographic characteristics from 12 Demographic and Health Surveys conducted in Albania, Armenia, Azerbaijan, Bangladesh, Benin, Ghana, Kyrgyzstan, Lesotho, Namibia, and Peru. We estimated associations between history of fuel use [solid fuel (coal or biomass) versus clean fuel (electricity or gas)] with systolic and diastolic BP and hypertension using a meta-analytical approach. RESULTS: Overall, the country-level mean systolic and diastolic BP were 117 (range: 111-127) and 74 (71-83) mmHg, respectively. The country-level mean age of the women was 30.8 years (range: 28.4-32.9). The prevalence of solid fuel use was 46.0% (range: 4.1-95.8). In adjusted, pooled analyses, primary use of solid fuel was associated with 0.58mmHg higher systolic BP (95% CI: 0.23, 0.93) as compared to primary use of clean fuel. The pooled estimates for diastolic BP and pulse pressure were also positive, but the confidence intervals contained zero. The pooled odds of hypertension was [OR = 1.07 (95% CI: 0.99, 1.16)], an effect that was driven by rural participants for whom solid fuel use was associated with a 16% greater odds of hypertension [OR = 1.16 (95% CI: 1.01, 1.35)]. CONCLUSIONS: Cooking with solid fuels was associated with small increases in BP and odds of hypertension. Use of cleaner fuels like gas or electricity may reduce cardiovascular risk in developing countries, particularly among rural residents.
BACKGROUND: Approximately three billion people are exposed to household air pollution (HAP) from solid fuel cookstoves. Studies from single settings have linked HAP with elevated blood pressure (BP), but no evidence exists from multi-country analyses. OBJECTIVES: Using nationally representative and internationally comparable data, we examined the association between solid fuel use and BP in 77,605 largely premenopausal women (aged 15-49) from ten resource-poor countries. METHODS: We obtained data on systolic and diastolic BP, self-reported primary cooking fuel, health and socio-demographic characteristics from 12 Demographic and Health Surveys conducted in Albania, Armenia, Azerbaijan, Bangladesh, Benin, Ghana, Kyrgyzstan, Lesotho, Namibia, and Peru. We estimated associations between history of fuel use [solid fuel (coal or biomass) versus clean fuel (electricity or gas)] with systolic and diastolic BP and hypertension using a meta-analytical approach. RESULTS: Overall, the country-level mean systolic and diastolic BP were 117 (range: 111-127) and 74 (71-83) mmHg, respectively. The country-level mean age of the women was 30.8 years (range: 28.4-32.9). The prevalence of solid fuel use was 46.0% (range: 4.1-95.8). In adjusted, pooled analyses, primary use of solid fuel was associated with 0.58mmHg higher systolic BP (95% CI: 0.23, 0.93) as compared to primary use of clean fuel. The pooled estimates for diastolic BP and pulse pressure were also positive, but the confidence intervals contained zero. The pooled odds of hypertension was [OR = 1.07 (95% CI: 0.99, 1.16)], an effect that was driven by rural participants for whom solid fuel use was associated with a 16% greater odds of hypertension [OR = 1.16 (95% CI: 1.01, 1.35)]. CONCLUSIONS: Cooking with solid fuels was associated with small increases in BP and odds of hypertension. Use of cleaner fuels like gas or electricity may reduce cardiovascular risk in developing countries, particularly among rural residents.
Authors: Raphael E Arku; Aaron Birch; Matthew Shupler; Salim Yusuf; Perry Hystad; Michael Brauer Journal: Environ Int Date: 2018-03-19 Impact factor: 9.621
Authors: Raphael E Arku; Michael Brauer; MyLinh Duong; Li Wei; Bo Hu; Lap Ah Tse; Prem K Mony; P V M Lakshmi; Rajamohanan K Pillai; Viswanathan Mohan; Karen Yeates; Lanthe Kruger; Sumathy Rangarajan; Teo Koon; Salim Yusuf; Perry Hystad Journal: Environ Res Date: 2020-06-27 Impact factor: 6.498
Authors: Matthew Shupler; Perry Hystad; Paul Gustafson; Sumathy Rangarajan; Maha Mushtaha; K G Jayachtria; Prem K Mony; Deepa Mohan; Parthiban Kumar; Pvm Lakshmi; Vivek Sagar; Rajeev Gupta; Indu Mohan; Sanjeev Nair; Ravi Prasad Varma; Wei Li; Bo Hu; Kai You; Tatenda Ncube; Brian Ncube; Jephat Chifamba; Nicola West; Karen Yeates; Romaina Iqbal; Rehman Khawaja; Rita Yusuf; Afreen Khan; Pamela Seron; Fernando Lanas; Patricio Lopez-Jaramillo; Paul A Camacho; Thandi Puoane; Salim Yusuf; Michael Brauer Journal: Environ Res Lett Date: 2019-07-29 Impact factor: 6.793
Authors: Jasleen Tiwana; Catherine Benziger; Laura Hooper; Karl Pope; Vijay Alurkar; Ramchandra Kafle; Tula R Sijali; John R Balmes; Joel D Kaufman; Michael N Bates Journal: Glob Heart Date: 2020-02-07