Impact of improved cookstoves on women’s and child health in low and middle income countries: a systematic review and meta-analysis

Thakur, Megha; Nuyts, Paulien A W; Boudewijns, Esther A.; Kim, Javier Flores; Faber, Timor; Babu, Giridhara R; Schayck, Onno C. P. van; Been, Jasper V

doi:10.1136/thoraxjnl-2017-210952

Cited by 63 publications

(56 citation statements)

References 73 publications

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“…HAP is associated with childhood acute lower respiratory infections [3,4] and low birth weight [5,6], both of which are the leading causes of death among children under 5 year old in LMICs [7,8]. However, HAP mitigation through cleaner cooking interventions, such as improved biomass stoves, has resulted in inconsistent results [9,10], and many interventions have failed to sufficiently reduce HAP exposures.…”

Section: Introductionmentioning

confidence: 99%

The use of bluetooth low energy Beacon systems to estimate indirect personal exposure to household air pollution

Liao

McCracken²,

Piedrahita

et al. 2019

J Expo Sci Environ Epidemiol

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Household air pollution (HAP) generated from solid fuel combustion is a major health risk. Direct measurement of exposure to HAP is burdensome and challenging, particularly for children. In a pilot study of the Household Air Pollution Intervention Network (HAPIN) trial in rural Guatemala, we evaluated an indirect exposure assessment method that employs fixed continuous PM 2.5 monitors, Bluetooth signal receivers in multiple microenvironments (kitchen, sleeping area and outdoor patio), and a wearable signal emitter to track an individual's time within those microenvironments. Over a four-month period, we measured microenvironmental locations and reconstructed indirect PM 2.5 exposures for women and children during two 24-h periods before and two periods after a liquefied petroleum gas (LPG) stove and fuel intervention delivered to 20 households cooking with woodstoves. Women wore personal PM 2.5 monitors to compare direct with indirect exposure measurements. Indirect exposure measurements had high correlation with direct measurements (n = 62, Spearman ρ = 0.83, PM 2.5 concentration range: 5-528 µg/m 3). Indirect exposure had better agreement with direct exposure measurements (bias: −17 µg/m 3) than did kitchen area measurements (bias: −89 µg/m 3). Our findings demonstrate that indirect exposure reconstruction is a feasible approach to estimate personal exposure when direct assessment is not possible.

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Section: Introductionmentioning

confidence: 99%

The use of bluetooth low energy Beacon systems to estimate indirect personal exposure to household air pollution

Liao

McCracken²,

Piedrahita

et al. 2019

J Expo Sci Environ Epidemiol

View full text Add to dashboard Cite

show abstract

“…7,10 Improved cookstovesoutside of the laboratory setting-have hardly demonstrated any consistent improvements in health outcomes (high-quality articles reported no health benefits, some health benefits, or inconclusiveness). [10][11][12][13][14] In the real world, clean cookstoves have turned out to be incredibly challenging to implement. Adoption rates frequently remain unreported, but studies that report on adoption success use descriptions as 'largely discouraging', 'a mere 10%', 'only 4%', 'rare', and 'very low'.…”

Section: The Discrepancy Between Implementation Evidence and Implemenmentioning

confidence: 99%

Let’s stop dumping cookstoves in local communities. It’s time to get implementation right

Brakema

Kleij

Vermond

et al. 2020

npj Prim. Care Respir. Med.

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“…Extensive evidence exists that tobacco smoke and biomass exposure, including dried wood, animal dung, or charcoal, are risk factors for the development of chronic bronchitis, emphysema, and lung cancers (75)(76)(77)(78). In contrast, the existing evidence suggests that chronic cannabis smoke exposure results in only a chronic bronchitis phenotype with little evidence of emphysema (25)(26)(27)(28).…”

Section: Discussionmentioning

confidence: 99%

A comparative analysis of cannabis and tobacco smoke exposure on human airway epithelial cell gene expression, immune phenotype, and response to formoterol and budesonide treatment

Aguiar

Huff

Tse

et al. 2019

Preprint

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Word Count -271Global recreational cannabis use is a potentially important public health issue that would benefit from experimental evidence to inform policy, regulations, and individual user practices. Comparative analyses between cannabis and tobacco smoke, the latter long reported to have negative impacts on respiratory health, may help provide context and provide clinically relevant evidence.To address this unmet need we performed a comparative study between cannabis and tobacco smoke exposure in the Calu-3 human airway epithelial cells using concentration-response and pharmacological intervention study designs with outcome measurements of cell viability, epithelial cell barrier function, cytokine profile, and transcriptomics.Our results demonstrate that cannabis smoke exposure reduces epithelial cell barrier function without impacting cell viability, accompanied by a cytokine profile associated with inflammation (elevated IL-6 and IL-8), barrier repair (elevated TGF-α and PDGF-AA) and suppressed antiviral immunity (decreased IP-10 and RANTES). Transcriptomic analyses revealed a cannabis smoke induced signature associated with suppressed antiviral genes and induction of oncogenic and oxidative stress pathways. Similar trends were observed for tobacco smoke exposure. A formoterol/budesonide intervention was unable to prevent cannabis smoke-induced reductions in antiviral pathways or normalize induction of oncogenic and oxidative stress responses.Our results show striking similarities between cannabis and tobacco smoke exposure on impairing barrier function, suppressing antiviral pathways, potentiating of pro-inflammatory mediators, and inducing oncogenic and oxidative stress gene expression signatures. Furthermore, we demonstrate that an intervention with formoterol and budesonide is unable to completely normalized cannabisinduced responses. Collectively our data suggest that cannabis smoke exposure is not innocuous and may possess many of the deleterious properties of tobacco smoke, warranting additional studies to support public policy, government regulations, and individual user practices.

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Impact of improved cookstoves on women’s and child health in low and middle income countries: a systematic review and meta-analysis

Abstract: PROSPERO: CRD42016033075.

Cited by 63 publications

References 73 publications

The use of bluetooth low energy Beacon systems to estimate indirect personal exposure to household air pollution

The use of bluetooth low energy Beacon systems to estimate indirect personal exposure to household air pollution

Let’s stop dumping cookstoves in local communities. It’s time to get implementation right

A comparative analysis of cannabis and tobacco smoke exposure on human airway epithelial cell gene expression, immune phenotype, and response to formoterol and budesonide treatment

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