Exposure to household air pollution from biomass cookstoves and blood pressure among women in rural Honduras: A cross-sectional study

Abstract

Growing evidence links household air pollution exposure from biomass cookstoves with elevated blood pressure. We assessed cross-sectional associations of 24-hour mean concentrations of personal and kitchen fine particulate matter (PM_2.5 ), black carbon (BC), and stove type with blood pressure, adjusting for confounders, among 147 women using traditional or cleaner-burning Justa stoves in Honduras. We investigated effect modification by age and body mass index. Traditional stove users had mean (standard deviation) personal and kitchen 24-hour PM_2.5 concentrations of 126 μg/m³ (77) and 360 μg/m³ (374), while Justa stove users' exposures were 66 μg/m³ (38) and 137 μg/m³ (194), respectively. BC concentrations were similarly lower among Justa stove users. Adjusted mean systolic blood pressure was 2.5 mm Hg higher (95% CI, 0.7-4.3) per unit increase in natural log-transformed kitchen PM_2.5 concentration; results were stronger among women of 40 years or older (5.2 mm Hg increase, 95% CI, 2.3-8.1). Adjusted odds of borderline high and high blood pressure (categorized) were also elevated (odds ratio = 1.5, 95% CI, 1.0-2.3). Some results included null values and are suggestive. Results suggest that reduced household air pollution, even when concentrations exceed air quality guidelines, may help lower cardiovascular disease risk, particularly among older subgroups.

Keywords: Latin America; biomass; blood pressure; cookstoves; global health; household air pollution.

Figure 1.

Examples of traditional (A, B) and cleaner-burning Justa biomass cookstoves (C) among the study population, February – April 2015, Department of Intibucá, Honduras.

Figure 2.

Distributions of 24-hour mean personal and kitchen PM_2.5 and black carbon concentrations (μg/m³) by stove type. The black line inside the box shows the median concentration, the box shows the interquartile range, the whiskers show 1.58 times the interquartile range divided by the square root of the sample size, and black circles show values outside this range.