A clean fuel cookstove is associated with improved lung function: Effect modification by age and secondhand tobacco smoke exposure

Sarmila Mazumder,Jeanine M D’Armiento,Steven N Chillrud,Alison Lee,Divya Mehra,Nita Bhandari,Beizhan Yan,Phue Khaing,Sunita Taneja,Brinda Dube

doi:10.1038/s41598-018-37887-8

Abstract

Household air pollution (HAP) secondary to the burning of solid fuels is a major risk factor for the development of COPD. Our study seeks to examine the impact of a clean cookstove, liquid petroleum gas (LPG), on respiratory outcomes. Women (n = 200) from neighboring Indian communities, one cooking with LPG and one with biomass, were enrolled. Spirometry was performed. Relationships between primary cooking fuel and spirometry measures, as raw values, Global Lung Initiative (GLI) percent predicted (pp), and GLI z-scores, were examined using linear regression. Effect modification by age was explored. Women were young (average age 33.3 years), with low education (median 5.0 years), and the majority had multiple sources of air pollution exposures. Overall, the lung function in both groups was poor [FEV1 z-score median −2.05, IQR (−2.64, −1.41). Biomass was associated with lower FEV1/FVC (raw values −7.0, p = 0.04; GLI pp −7.62, p = 0.05, and z-score −0.86, p = 0.05) and FEF25–75 (GLI pp −25.78, p = 0.05, z-score −1.24, p = 0.05), after adjusting for confounders. Increasing impairment in lung function with age was found among biomass users (p-interaction = 0.01). In conclusion, use of a clean fuel cookstove may improve lung function. These findings have broad implications for research and public policy.

Highlights

Household air pollution (HAP) secondary to the burning of solid fuels is a major risk factor for the development of COPD
To determine the effects of chronic clean cookstove use on lung function and respiratory symptoms, we identified one Indian community that predominantly cooked with liquid petroleum gas (LPG) and one nearby village that predominantly cooked with dung biomass to examine whether women chronically exposed to household air pollution secondary to the burning of cow dung biomass had impaired pulmonary function and increased respiratory symptoms
Use of additional biomass cooking fuels to supplement the primary dung biomass or LPG fuel was more common in the Biomass group

Summary

Introduction

Household air pollution (HAP) secondary to the burning of solid fuels is a major risk factor for the development of COPD. Half of the world’s population is exposed daily to high levels of household air pollution (HAP) secondary to the burning of solid fuels, such as charcoal or biomass (e.g. wood, animal dung, crop residuals), on inefficient stoves for daily cooking and heating activities[1]. To determine the effects of chronic clean cookstove use on lung function and respiratory symptoms, we identified one Indian community that predominantly cooked with LPG and one nearby village that predominantly cooked with dung biomass to examine whether women chronically exposed to household air pollution secondary to the burning of cow dung biomass had impaired pulmonary function and increased respiratory symptoms. We performed household and ambient particulate matter (PM) sampling to determine differences in PM composition between the two communities

Methods

Results

Conclusion