Reductions in urinary metabolites of exposure to household air pollution in pregnant, rural Guatemalan women provided liquefied petroleum gas stoves

John R Weinstein, Anaité Diaz-Artiga, Neal Benowitz, Lisa M Thompson, John R Weinstein, Anaité Diaz-Artiga, Neal Benowitz, Lisa M Thompson

Abstract

Background: Household air pollution from solid fuels is a leading risk factor for morbidity and mortality worldwide. Pregnant women's exposure to polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs), two components of solid-fuel smoke, is associated with adverse birth outcomes. Even with improved solid-fuel stoves, exposure to PAHs and VOCs remains high. Therefore, cleaner cooking fuels need to be prioritized.

Objective: We aimed to quantify exposure reduction to PAHs and VOCs among pregnant women in rural Guatemala with a liquefied petroleum gas (LPG) stove intervention.

Materials and methods: Urine from pregnant women (N = 50) was collected twice: at <20 weeks gestation, when women cooked exclusively with wood, and 6-8 weeks after receiving an LPG stove. Metabolites of four PAHs and eight VOCs were analyzed. Concurrent with urine collection, personal 48-h PM2.5 exposure was measured.

Results: Women cooking exclusively with wood were exposed to high levels of particulate matter (PM2.5), which was reduced by 57% with the LPG stove. Urinary concentrations of total PAH metabolites (-37%), PMA (benzene metabolite; -49%), and CNEMA (acrylonitrile metabolite; -51%) were reduced. However, recent use of a wood-fired sauna bath led to large increases in excretion of urinary toxicant metabolites (+66-135%).

Conclusions: This is the first study to report PAH and VOC reductions from an LPG stove intervention introduced during pregnancy. However, other sources of air pollution minimized the gains seen from using an LPG stove. Thus, all sources of air pollution must be addressed in concert to reduce exposures to levels that protect health.

Trial registration: ClinicalTrials.gov NCT02812914.

Keywords: Household air pollution; LPG stoves; Polycyclic aromatic hydrocarbons; Solid fuel use; Urinary biomarkers; Volatile organic compounds.

Conflict of interest statement

Competing interests: We declare that we have no financial or non-financial competing interests related to the study.

Figures

Figure 1.
Figure 1.
Median and inter-quartile range of total PAH urinary metabolite concentration by fuel type, at baseline with wood stove (n=50) and at follow-up with exclusive LPG use (n=11) or mixed wood and LPG stove use (n=37). * Indicates significant difference between median concentrations at follow-up period between those with exclusive LPG use and mixed wood and LPG stove use at follow-up by Wilcoxon rank sum test (*

Figure 2.

Spearman correlation coefficients of urinary…

Figure 2.

Spearman correlation coefficients of urinary concentrations of PAH and VOC metabolites at baseline…

Figure 2.
Spearman correlation coefficients of urinary concentrations of PAH and VOC metabolites at baseline and follow-up.
Figure 2.
Figure 2.
Spearman correlation coefficients of urinary concentrations of PAH and VOC metabolites at baseline and follow-up.

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