Acute changes in heart rate variability and cardiac repolarization following controlled exposure to cookstove air pollution

Abstract

OPS 09: Cookstoves and children, Room 114, Floor 1, August 26, 2019, 1:30 PM - 3:00 PM Background: Household air pollution from solid fuel combustion for cooking and heating is an important risk factor for premature death and morbidity worldwide. Current evidence supports an association of ambient air pollution and cardiovascular disease, but limited information exists specifically for household air pollution. We investigated acute impacts of short-term, controlled exposures to emissions from several cookstoves on heart rate variability (HRV) and cardiac repolarization, risk factors for adverse cardiovascular events. Methods: Forty-eight healthy adults underwent six, 2-hour exposures, including emissions from five cookstoves and a filtered-air control. The target PM2.5 exposure concentrations for each were: control, 0 µg/m3; liquefied petroleum gas (LPG), 10 µg/m3; gasifier, 35 µg/m3; fan rocket, 100 µg/m3; rocket elbow, 250 µg/m3; three stone fire, 500 µg/m3. Five-minute means of HRV and cardiac repolarization outcomes were measured immediately and three hours following exposure. Linear mixed effects models compared the outcomes after cookstove exposure to after control. Results: Compared to control, overall HRV (SDNN: standard deviation of duration of all NN intervals) was lower immediately after exposures to gasifier (difference compared to control = -0.12 milliseconds {ms}; 95% confidence interval = -0.22, -0.03 ms) and three stone fire (-0.12 ms; -0.21, -0.02 ms); there were no differences for other cookstoves. SDNN was higher at three hours after LPG (0.13 ms; 0.04, 0.23 ms) and rocket elbow (0.15 ms; 0.06, 0.25 ms) exposures compared to control; there were no differences for other cookstoves. There were no differences in changes of cardiac repolarization (QTc: interval of time between Q and T interval) following cookstove exposures compared to control. Conclusions: Results immediately following exposure suggest small adverse impacts on HRV for some cookstoves compared to control; however results overall were inconsistent. Immediate adverse impacts (during the 2-hour controlled exposure) for these parameters may not have been captured in this design.