The use of bluetooth low energy Beacon systems to estimate indirect personal exposure to household air pollution

• Type of Material: Article
• Authors: Jiawen Liao, Emory University; John P. McCracken, Universidad del Valle de Guatemala; Ricardo Piedrahita, Berkeley Air Monitoring Group; Lisa Thompson, Emory University; Erick Mollinedo, Universidad del Valle de Guatemala; Eduardo Canuz, Universidad del Valle de Guatemala; Oscar De Leon, Universidad del Valle de Guatemala; Anaite Diaz-Artiga, Universidad del Valle de Guatemala; Michael Johnson, Berkeley Air Monitoring Group; Maggie Clark, Colorado State University; Ajay Pillarisetti, Emory University; Katherine Kearns, University of Georgia; Luke Naeher, University of Georgia; Nelson Steenland, Emory University; William Checkley, Johns Hopkins University; Jennifer Peel, Colorado State University; Thomas Clasen, Emory University; Dana Barr, Emory University; Howard Chang, Emory University; Lisa Elon, Emory University; Penelope Howards, Emory University; Azhar Nizam, Emory University; Usha Ramakrishnan, Emory University; P Barry Ryan, Emory University; Jeremy Sarnat, Emory University; Sheela Sinharoy, Emory University; Lance Waller, Emory University
• Language: English
• Date: 2020-11-01
• Publisher: SPRINGERNATURE
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019, The Author(s)
• Final Published Version (URL): http://dx.doi.org/10.1038/s41370-019-0172-z
• Title of Journal or Parent Work: JOURNAL OF EXPOSURE SCIENCE AND ENVIRONMENTAL EPIDEMIOLOGY
• Volume: 30
• Issue: 6
• Start Page: 990
• End Page: 1000
• Grant/Funding Information: This study was supported through the National Heart, Lung, and Blood Institute/National Institutes of Health [1UM1HL134590-01] and Bill & Melinda Gates Foundation [OPP1131279]. A multidisciplinary, independent Data and Safety Monitoring Board (DSMB) appointed by the National Heart, Lung, and Blood Institute (NHLBI) monitors the quality of the data and protects the safety of patients enrolled in the HAPIN trial. NHLBI DSMB: Nancy R. Cook, Sc.D.; Stephen Hecht, Ph.D.; Catherine Karr, M.D., Ph.D.; Katie H. Kavounis, M.P.H.; Dong-Yun Kim, Ph.D.; Joseph Millum, Ph.D.; Lora A. Reineck, M.D., M.S.; Nalini Sathiakumar, M.D., Dr.P.H.; Paul K. Whelton, M.D.; Gail G. Weinmann, M.D. Program Coordination: Gail Rodgers, M.D., Bill & Melinda Gates Foundation; Claudia L. Thompson, Ph.D. National Institute of Environmental Health Science (NIEHS); Mark J. Parascandola, Ph.D., M.P.H., National Cancer Institute (NCI); Danuta M. Krotoski, Ph.D., Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); Joshua P. Rosenthal, Ph.D. Fogarty International Center (FIC), Conception R. Nierras, Ph.D. NIH Office of Strategic Coordination Common Fund; Antonello Punturieri, M.D., Ph.D. and Barry S. Schmetter, National Heart, Lung, and Blood Institute (NHLBI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or Bill & Melinda Gates Foundation.
• Keywords: Toxicology; LPG Intervention; Environmental Sciences & Ecology; Fine particulate matters (PM2.5); SOLID-FUEL USE; PARTICULATE MATTER; COOKING; COHORT; Microenvironment; Public, Environmental & Occupational Health; BIRTH-WEIGHT; COMBUSTION; CHILDREN; PNEUMONIA; Environmental Sciences; URBAN; Indirect exposure; Life Sciences & Biomedicine; Science & Technology; BIOMASS FUELS; Household air pollution

Abstract

Household air pollution (HAP) generated from solid fuel combustion is a major health risk. Direct measurement of exposure to HAP is burdensome and challenging, particularly for children. In a pilot study of the Household Air Pollution Intervention Network (HAPIN) trial in rural Guatemala, we evaluated an indirect exposure assessment method that employs fixed continuous PM2.5 monitors, Bluetooth signal receivers in multiple microenvironments (kitchen, sleeping area and outdoor patio), and a wearable signal emitter to track an individual’s time within those microenvironments. Over a four-month period, we measured microenvironmental locations and reconstructed indirect PM2.5 exposures for women and children during two 24-h periods before and two periods after a liquefied petroleum gas (LPG) stove and fuel intervention delivered to 20 households cooking with woodstoves. Women wore personal PM2.5 monitors to compare direct with indirect exposure measurements. Indirect exposure measurements had high correlation with direct measurements (n = 62, Spearman ρ = 0.83, PM2.5 concentration range: 5–528 µg/m3). Indirect exposure had better agreement with direct exposure measurements (bias: −17 µg/m3) than did kitchen area measurements (bias: −89 µg/m3). Our findings demonstrate that indirect exposure reconstruction is a feasible approach to estimate personal exposure when direct assessment is not possible.