Acute Changes in Blood Pressure Following Controlled Exposures to Cookstove Air Pollution in the Subclinical Tests of Volunteers Exposed to Smoke (STOVES) Study

摘要

Exposure to household air pollution from cookstoves is a top risk factor for disease globally; cardiovascular diseases make up about half of the burden. However, the association between household air pollution and cardiovascular effects is not well characterized; health assessments often rely on data from other sources (e.g. cigarette smoking, ambient fine particulate matter [PM2.5]). Evidence specifically for the cardiovascular impacts of wood smoke continues to be mixed. We conducted a controlled human exposure study to investigate acute responses in blood pressure following cookstove-generated pollution exposure. Forty-eight young, healthy subjects were assigned to six, two-hour exposures: five cookstove treatments at target PM2.5 concentrations representative of the stove's emissions (liquid petroleum gas [LPG], 10ug/m3; semi-gasifier, 35ug/m3; fan rocket, 100ug/m3; rocket elbow, 250ug/m3; open fire, 500ug/m3) and a filtered air control (0ug/m3). Mixed models were used to estimate associations between treatments and blood pressure. At 24 hours post-exposure, systolic pressure was on average 2-3 mmHg higher for all treatments compared to the control, except the rocket elbow stove, which was not different than control. For example, the estimated difference for the LPG stove compared to control was 3.1 mmHg (95% CI, 1.0-5.3). No clear or consistent differences were observed for systolic pressure immediately post-exposure or three hours post-exposure, or for diastolic pressure at any time point or treatment. These results, combined with evidence from other research, suggest that short-term exposure to cookstove-generated air pollution may adversely impact blood pressure in healthy young adults, even at low PM2.5 concentrations and for stove technologies considered to be some of the cleanest available in many locations worldwide. Further analyses will consider exposure-response and additional pollutants. [This abstract does not represent EPA policy.]