Household Air Pollution Exposure And Blood Pressure Among Pregnant Women In Rural Ghana

Abstract

Introduction: In 2010 Household Air Pollution (HAP) was ranked the fourth contributing risk factor to the burden of disease worldwide, and is ranked the #1 risk factor for the country of Ghana specifically. These calculations attribute a large portion of the HAP-related burden of disease to cardiovascular disease (CVD), but research to date on the health effects of HAP has largely focused on respiratory, and not cardiovascular, outcomes. Blood Pressure (BP) is a known risk factor for CVD, and has been shown to respond to changes in air pollution. Given that household air pollution from biomass burning may be implicated in adverse cardiovascular outcomes, we sought to determine whether exposure to carbon monoxide (CO), as a proxy for smoke from cooking with wood, was associated with blood pressure (BP) among 855 pregnant women in the Ghana Randomized Air Pollution and Health Study (GRAPHS). Methods: Multivariate linear regression models were used to evaluate the association between CO exposure, determined with 72-hour personal monitoring at study enrollment, and BP, also measured at study enrollment. At the time of these assessments, women were in the first or second trimester of pregnancy. Results: A significant positive association was found between CO exposure and diastolic blood pressure (DBP) (increase of 0.71 mmHg DBP with each log-unit increase in exposure to CO). An increase in systolic blood pressure was also observed with increasing CO exposure, but the results were not statistically significant. Conclusions: This cross-sectional analysis supports the conclusion that household air pollution from wood-burning fires is associated with increased blood pressure, particularly DBP, in pregnant women at early to mid-gestation. As the observed increase is small, its clinical significance remains uncertain.