Acute Effects on Blood Pressure Following Controlled Exposure to Cookstove Air Pollution in the STOVES Study

• Published in: Journal of the American Heart Association Vol. 8; no. 14; p. e012246
• Main Authors: Fedak, Kristen M, Good, Nicholas, Walker, Ethan S, Balmes, John, Brook, Robert D, Clark, Maggie L, Cole-Hunter, Tom, Devlin, Robert, L'Orange, Christian, Luckasen, Gary, Mehaffy, John, Shelton, Rhiannon, Wilson, Ander, Volckens, John, Peel, Jennifer L
• Format: Journal Article
• Language: English
• Published: England John Wiley and Sons Inc 16.07.2019; Wiley
• Subjects: Adult; air pollution; Air Pollution, Indoor - adverse effects; Blood Pressure; cardiovascular disease risk factors; Cooking; Female; Healthy Volunteers; Household Articles; Humans; Male; Original Research; Particulate Matter - adverse effects; Smoke - adverse effects; Young Adult; blood pressure; air pollution; cardiovascular disease risk factors
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.119.012246

Background Exposure to air pollution from solid fuel used in residential cookstoves is considered a leading environmental risk factor for disease globally, but evidence for this relationship is largely extrapolated from literature on smoking, secondhand smoke, and ambient fine particulate matter ( PM ). Methods and Results We conducted a controlled human-exposure study (STOVES [the Subclinical Tests on Volunteers Exposed to Smoke] Study) to investigate acute responses in blood pressure following exposure to air pollution emissions from cookstove technologies. Forty-eight healthy adults received 2-hour exposures to 5 cookstove treatments (three stone fire, rocket elbow, fan rocket elbow, gasifier, and liquefied petroleum gas), spanning PM concentrations from 10 to 500 μg/m , and a filtered air control (0 μg/m ). Thirty minutes after exposure, systolic pressure was lower for the three stone fire treatment (500 μg/m PM ) compared with the control (-2.3 mm Hg; 95% CI, -4.5 to -0.1) and suggestively lower for the gasifier (35 μg/m PM ; -1.8 mm Hg; 95% CI , -4.0 to 0.4). No differences were observed at 3 hours after exposure; however, at 24 hours after exposure, mean systolic pressure was 2 to 3 mm Hg higher for all treatments compared with control except for the rocket elbow stove. No differences were observed in diastolic pressure for any time point or treatment. Conclusions Short-term exposure to air pollution from cookstoves can elicit an increase in systolic pressure within 24 hours. This response occurred across a range of stove types and PM concentrations, raising concern that even low-level exposures to cookstove air pollution may pose adverse cardiovascular effects.