Josiah L Kephart1,2, Magdalena Fandiño-Del-Rio1,2, Kendra N Williams2,3, Gary Malpartida4,5, Kyle Steenland6, Luke P Naeher7, Gustavo F Gonzales8,9, Marilú Chiang5, William Checkley2,3,10, Kirsten Koehler1. 1. Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. 2. Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore, MD, USA. 3. Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. 4. Molecular Biology and Immunology Laboratory, Research Laboratory of Infectious Diseases, Department of Cell and Molecular Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Perú. 5. Biomedical Research Unit, Asociación Benéfica PRISMA, Lima, Perú. 6. Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 7. Environmental Health Science Department, College of Public Health, University of Georgia, Athens, GA, USA. 8. Laboratories of Investigation and Development, Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Perú. 9. High Altitude Research Institute, Universidad Peruana Cayetano Heredia, Lima, Perú. 10. Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Abstract
BACKGROUND: Household air pollution from biomass cookstoves is a major contributor to global morbidity and mortality, yet little is known about exposures to nitrogen dioxide (NO2 ). OBJECTIVE: To characterize NO2 kitchen area concentrations and personal exposures among women with biomass cookstoves in the Peruvian Andes. METHODS: We measured kitchen area NO2 concentrations at high-temporal resolution in 100 homes in the Peruvian Andes. We assessed personal exposure to NO2 in a subsample of 22 women using passive samplers. RESULTS: Among 97 participants, the geometric mean (GM) highest hourly average NO2 concentration was 723 ppb (geometric standard deviation (GSD) 2.6) and the GM 24-hour average concentration was 96 ppb (GSD 2.6), 4.4 and 2.9 times greater than WHO indoor hourly (163 ppb) and annual (33 ppb) guidelines, respectively. Compared to the direct-reading instruments, we found similar kitchen area concentrations with 48-hour passive sampler measurements (GM 108 ppb, GSD 3.8). Twenty-seven percent of women had 48-hour mean personal exposures above WHO annual guidelines (GM 18 ppb, GSD 2.3). In univariate analyses, we found that roof, wall, and floor type, as well as higher SES, was associated with lower 24-hour kitchen area NO2 concentrations. PRACTICAL IMPLICATIONS: Kitchen area concentrations and personal exposures to NO2 from biomass cookstoves in the Peruvian Andes far exceed WHO guidelines. More research is warranted to understand the role of this understudied household air pollutant on morbidity and mortality and to inform cleaner-cooking interventions for public health.
BACKGROUND: Household air pollution from biomass cookstoves is a major contributor to global morbidity and mortality, yet little is known about exposures to nitrogen dioxide (NO2 ). OBJECTIVE: To characterize NO2 kitchen area concentrations and personal exposures among women with biomass cookstoves in the Peruvian Andes. METHODS: We measured kitchen area NO2 concentrations at high-temporal resolution in 100 homes in the Peruvian Andes. We assessed personal exposure to NO2 in a subsample of 22 women using passive samplers. RESULTS: Among 97 participants, the geometric mean (GM) highest hourly average NO2 concentration was 723 ppb (geometric standard deviation (GSD) 2.6) and the GM 24-hour average concentration was 96 ppb (GSD 2.6), 4.4 and 2.9 times greater than WHO indoor hourly (163 ppb) and annual (33 ppb) guidelines, respectively. Compared to the direct-reading instruments, we found similar kitchen area concentrations with 48-hour passive sampler measurements (GM 108 ppb, GSD 3.8). Twenty-seven percent of women had 48-hour mean personal exposures above WHO annual guidelines (GM 18 ppb, GSD 2.3). In univariate analyses, we found that roof, wall, and floor type, as well as higher SES, was associated with lower 24-hour kitchen area NO2 concentrations. PRACTICAL IMPLICATIONS: Kitchen area concentrations and personal exposures to NO2 from biomass cookstoves in the Peruvian Andes far exceed WHO guidelines. More research is warranted to understand the role of this understudied household air pollutant on morbidity and mortality and to inform cleaner-cooking interventions for public health.
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