Fine Particulate Matter Exposure from Wood-Burning Cookstoves in Relation to Augmentation Index and Blood Pressure among Honduran Women

摘要

Limited, but growing epidemiologic evidence exists for associations between household air pollution (HAP) from biomass cookstoves and risk factors for cardiovascular diseases (CVDs). We evaluated the cross-sectional association of fine particulate matter (PM2.5) exposure with augmentation index, a measure of arterial stiffness, and blood pressure among women using wood-burning cookstoves in rural Honduras. Data were collected at two baseline visits (dry and rainy season) during a randomized controlled cookstove trial among 224 female primary cooks, aged 25-55 years. Personal and kitchen 24-hour PM2.5 were measured gravimetrically using AirChek XR5000 pumps and Triplex Cyclones; central augmentation index and brachial blood pressure were collected via the Sphygmocor XCEL. We evaluated the associations between PM2.5 and augmentation index (both log-transformed) and blood pressure in separate mixed effects regression models adjusted for age, years of school completed, waist-hip ratio, dietary diversity score, physical activity (log-transformed), and mean kitchen temperature. Median 24-hour PM2.5 concentrations were 83 (25th percentile: 51; 75th percentile: 141) μg/m3 and 197 (25th percentile: 81; 75th percentile: 473) μg/m3 for personal and kitchen measurements, respectively. The adjusted difference in augmentation index per 10% increase in kitchen and personal PM2.5 was -0.01% (95% CI, -0.13, 0.10) and -0.05% (95% CI, -0.21, 0.10), respectively. Results for systolic and diastolic blood pressure were also consistent with a null association. We did not observe any seasonal effects on the results. These results are not consistent with existing literature supporting an association between HAP and blood pressure. Given the elevated PM2.5 concentrations at baseline in this study, the results may be consistent with the hypothesized supralinear exposure-response curve between HAP and CVD that suggests weaker or no association at higher concentrations.