Acute changes in C-reactive protein and lipoproteins following controlled exposures to cookstove air pollution in the Subclinical Tests of Volunteers Exposed to Smoke (SToVES) Study

Abstract

TPS 722: Low and middle income countries: indoor air pollutants, Exhibition Hall, Ground floor, August 28, 2019, 3:00 PM - 4:30 PM Background/Aim. Household air pollution from solid-fuel cookstoves is an important risk factor for morbidity and mortality worldwide. Improved cookstoves have been designed to reduce exposure to household air pollution, but whether such stoves meaningfully improve health remains unclear. We assessed the effect of pollution emitted from multiple cookstoves on acute changes in C-reactive protein (CRP) and lipoproteins (total cholesterol, high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides) using a controlled-, crossover-exposure design. Methods. Young, healthy participants (n=48) were assigned to sequences of six, 2-hour controlled exposures of pollution from five cookstoves and a filtered-air control. Each controlled exposure, spaced at least two weeks apart, had a fine particulate matter target concentration (µg/m3): control (0); liquefied petroleum gas (10); semi-gasifier (35); fan rocket (100); rocket elbow (250); open fire (500). CRP and lipoproteins were measured before and three timepoints after exposures (0, 3, 24 hours). Linear mixed models were used to assess differences in outcomes for cookstove exposures versus control. Results. CRP was lower 3 hours after and higher 24 hours after cookstove exposures versus control. Triglycerides were higher 24 hours after cookstove exposures versus control. LDL was lower 24 hours after cookstove exposures versus control. For example, CRP was 0.07 ln-mg/L higher (95% confidence interval [CI]: -0.07, 0.21), triglycerides were 0.11 ln-mg/dL higher (95% CI: 0.00, 0.23), and LDL was 2.7 mg/dL lower (95% CI: -7.5, 2.2) 24 hours after the open fire exposure versus control. Results were similar across cookstove types at the 24-hour post-exposure timepoint. Results from other timepoints (0, 3 hours) and outcomes (total cholesterol, HDL) were consistent with null associations. Conclusions. Short-term controlled exposures to air pollution from improved and traditional cookstoves acutely impact CRP and lipoproteins. These findings may provide insight into benefits of new and current cookstove technologies. This abstract does not represent EPA policy.