Biomonitoring Human Exposure to Household Air Pollution and Association with Self-reported Health Symptoms – A Stove Intervention Study in Peru

Abstract

Background Household air pollution (HAP) from indoor biomass stoves contains harmful pollutants, such as polycyclic aromatic hydrocarbons (PAHs), and is a leading risk factor for global disease burden. We used biomonitoring to assess HAP exposure and association with self-reported symptoms in 334 non-smoking Peruvian women to evaluate the efficacy of a stove intervention program. Methods We conducted a cross-sectional study within the framework of a community randomized control trial. Using urinary PAH metabolites (OH-PAHs) as the exposure biomarkers, we investigated whether the intervention group (n = 155, with new chimney-equipped stoves) were less exposed to HAP compared to the control group (n = 179, with mostly open-fire stoves). We also estimated associations between the exposure biomarkers, risk factors, and self-reported health symptoms, such as recent eye conditions, respiratory conditions, and headache. Results We observed reduced headache and ocular symptoms in the intervention group than the control group. Urinary 2-naphthol, a suggested biomarker for inhalation PAH exposure, was significantly lower in the intervention group (GM with 95% CI: 13.4 [12.3, 14.6] μg/g creatinine) compared to control group (16.5 [15.0, 18.0] μg/g creatinine). Stove type and/or 2-naphthol was associated with a number of self-reported symptoms, such as red eye (adjusted OR with 95% CI: 3.80 [1.32, 10.9]) in the past 48 h. Conclusions Even with the improved stoves, the biomarker concentrations in this study far exceeded those of the general populations and were higher than a no-observed-genotoxic-effect-level, indicating high exposure and a potential for increased cancer risk in the population.

Individual and cumulative impacts of fire emissions and tobacco consumption on wildland firefighters’ total exposure to polycyclic aromatic hydrocarbons

“…They are formed during incomplete combustion of organic matter and originate from both natural and anthropogenic sources [22,23]. Human exposure to PAHs occurs by all routes of exposure, namely inhalation, ingestion, and skin contact [8,[24][25][26][27][28]. Once absorbed into blood stream, PAHs are biotransformed and distributed within human body, being mostly eliminated through urine as glucuronide and/or sulfate conjugates [22,29,30].…”

Reductions in urinary metabolites of exposure to household air pollution in pregnant, rural Guatemalan women provided liquefied petroleum gas stoves

“…There are no other published studies on reductions of VOC urinary metabolite concentrations from a stove intervention (either LPG or an improved solidfuel stove) in the context of household air pollution. However, there have been previous studies investigating the effect of improved solid-fuel stoves on urinary PAH metabolites in other Latin American countries that can serve as a benchmark for reducing exposure with new stove technologies [24][25][26][27]. Absolute reductions of smoke Fig.…”

“…Clean cookstove interventions have led to reductions in exposure to HAP. Compared to women cooking over open fires in their homes, vented chimney wood stoves have been shown to reduce exposure to particulate matter by over 50% and to PAHs by a lesser degree (6% increase to 48% reduction) in multiple studies in Latin America [24][25][26][27]. However, these interventions did not reduce exposure to particulate matter to levels required to protect health, as outlined by the WHO [28].…”

How to prevent skin damage from air pollution. Part 1: Exposure assessment

“…In situ techniques use the spectroscopic properties of substances, Several investigators have attempted to demonstrate the role of skin absorption as a route of AP exposure including blood cobalt levels in hard metal-production workers (Klasson et al, 2017), urinary PAH metabolites as exposure biomarkers (Li et al, 2016) and plasma levels of phthalates (Weschler et al, 2015).…”