Household Air Pollution and Glycated Hemoglobin among Women in Honduras: Baseline Data from Two Seasons

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OBJECTIVE: Growing evidence suggests a link between air pollution and cardiometabolic diseases, such as diabetes, yet most data come from ambient air pollution studies. We evaluated the exposure-response associations between household air pollution from traditional, wood-burning cookstoves and glycated hemoglobin (HbA1c), an estimate of average blood glucose concentration over the past 3 months, among women in rural Honduras. METHODS: We assessed two time points at baseline (rainy and dry seasons) from an ongoing randomized trial among 231 women, for a total of 462 observations. Exposure to household air pollution included 24-hour gravimetric personal and kitchen fine particulate matter (PM2.5) concentrations. HbA1c was measured with the A1cNow+ kit. We used mixed-effects regression models adjusting for known risk factors, including age, household material wealth, physical activity, body mass index, and daily consumption of cereals (corn, grains, rice, and chip products), as well as season. RESULTS: Median 24-hour PM2.5 concentrations were 83 (25th percentile: 51; 75th percentile: 141) µg/m3 and 197 (25th percentile: 81; 75th percentile: 473) µg/m3 for personal and kitchen measurements, respectively. Mean HbA1c estimates were the same for both seasons at 5.5% (Phase 1 standard deviation: 0.6, Phase 2 standard deviation: 0.7). After adjusting for relevant confounders, results were consistent with a null association. Season did not impact the effect estimates. CONCLUSIONS: While exposure to household air pollution has known detrimental health effects, our baseline cross-sectional results did not suggest an association with HbA1c; these results are inconsistent with limited evidence from ambient air pollution. The ongoing trial will evaluate household air pollution and cardiometabolic disease following a cleaner-burning cookstove intervention among the study population.