Work

Effects of a cleaner-burning biomass cookstove intervention on augmentation index and central pulse pressure during a randomized controlled trial in rural Honduras

Year: 2019

Type: article

Abstract: GREEN, AIR, LMIC: PECHAKUCHA COMES TO ISEE! Johan Friso Foyer, Floor 1, August 27, 2019, 10:30 AM - 12:00 PM Background/Aim. Household air pollution from combustion of solid fuels for cooking and heating is an important risk factor for global morbidity and mortality. Cleaner-burning biomass cookstoves have been developed to reduce exposure to air pollution, but the health impacts of these cookstoves are unclear. We assessed a cleaner-burning biomass cookstove intervention on measures of central hemodynamics (augmentation index [AIx], central pulse pressure [CPP]) in a randomized controlled trial among women in rural Honduras. Methods. Participants (n=230 women) used only traditional biomass cookstoves at baseline. Data collection occurred during six household visits approximately every six months over three years. Women were randomly assigned to one of two study arms (n=115 per arm) to receive a cleaner-burning biomass Justa cookstove (with chimney and improved combustion chamber) after the second visit or after the fourth visit. AIx and CPP were measured during each visit using the SphygmoCor XCEL. Linear mixed models were used in an intent-to-treat analysis to assess the intervention. Separate models evaluated age and body mass index (BMI) as potential effect modifiers. Results. Participants had the following characteristics at baseline (mean, standard deviation): age (38 years, 9); BMI (26 kg/m2, 4); AIx (22%, 15); CPP (34 mmHg, 8). Results (n = 1162 observations) suggest the intervention had little impact on AIx and CPP: AIx was 0.3 percentage points higher for Justa vs traditional cookstove users (95% confidence interval: -0.8, 1.5); CPP was 0.3 mmHg higher for Justa vs traditional cookstove users (95% confidence interval: -0.3, 0.9). We did not observe evidence that age or BMI modified the relationships. During the final visit, 53% of participants self-reported using a traditional biomass cookstove in addition to the intervention cookstove. Conclusion. We did not observe meaningful changes in AIx or CPP following a cleaner-burning biomass cookstove intervention in rural Honduras using an intent-to-treat analysis.

Source: Environmental Epidemiology

DOI: 10.1097/01.ee9.0000611168.87602.7a