Reductions in urinary metabolites of exposure to household air pollution in pregnant, rural Guatemalan women provided liquefied petroleum gas stoves

• Type of Material: Article
• Authors: John R. Weinstein, University of California San Francisco; Anaite Diaz-Artiga, Universidad del Valle de Guatemala; Neal Benowitz, University of California San Francisco; Lisa Thompson, Emory University
• Language: English
• Date: 2020-03-01
• Publisher: NATURE PUBLISHING GROUP
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019, The Author(s), under exclusive licence to Springer Nature America, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1038/s41370-019-0163-0
• Title of Journal or Parent Work: JOURNAL OF EXPOSURE SCIENCE AND ENVIRONMENTAL EPIDEMIOLOGY
• Volume: 30
• Issue: 2
• Start Page: 362
• End Page: 373
• Grant/Funding Information: This work was supported by the National Institutes of Health (No. 1R21ES025032-01A1, S10 RR026437 and P30 DA012393).
• Keywords: RISK; Public, Environmental & Occupational Health; LPG stoves; Life Sciences & Biomedicine; Toxicology; Science & Technology; PRENATAL EXPOSURE; POLYCYCLIC AROMATIC-HYDROCARBONS; POLLUTANTS; Urinary biomarkers; Solid fuel use; VOLATILE ORGANIC-COMPOUNDS; MATERNAL OCCUPATIONAL-EXPOSURE; Household air pollution; INDOOR; BIRTH OUTCOMES; CARBON-MONOXIDE; Volatile organic compounds; Environmental Sciences & Ecology; FETAL-GROWTH; Polycyclic aromatic hydrocarbons; Environmental Sciences
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Toxicology; Environmental Sciences; Health Sciences, Public Health

Abstract

Background: Household air pollution from solid fuels is a leading risk factor for morbidity and mortality worldwide. Pregnant women’s exposure to polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs), two components of solid-fuel smoke, is associated with adverse birth outcomes. Even with improved solid-fuel stoves, exposure to PAHs and VOCs remains high. Therefore, cleaner cooking fuels need to be prioritized. Objective: We aimed to quantify exposure reduction to PAHs and VOCs among pregnant women in rural Guatemala with a liquefied petroleum gas (LPG) stove intervention. Materials and methods: Urine from pregnant women (N = 50) was collected twice: at <20 weeks gestation, when women cooked exclusively with wood, and 6–8 weeks after receiving an LPG stove. Metabolites of four PAHs and eight VOCs were analyzed. Concurrent with urine collection, personal 48-h PM2.5 exposure was measured. Results: Women cooking exclusively with wood were exposed to high levels of particulate matter (PM2.5), which was reduced by 57% with the LPG stove. Urinary concentrations of total PAH metabolites (−37%), PMA (benzene metabolite; −49%), and CNEMA (acrylonitrile metabolite; −51%) were reduced. However, recent use of a wood-fired sauna bath led to large increases in excretion of urinary toxicant metabolites (+66–135%). Conclusions: This is the first study to report PAH and VOC reductions from an LPG stove intervention introduced during pregnancy. However, other sources of air pollution minimized the gains seen from using an LPG stove. Thus, all sources of air pollution must be addressed in concert to reduce exposures to levels that protect health.