wood smoke lower birth rate
1: Environ Health Perspect 2002 Jan;110(1):109-14
Birth weight and exposure to kitchen wood
smoke during pregnancy in rural Guatemala.
Boy E, Bruce N, Delgado H.
The Micronutrient Initiative, Ottawa, Ontario,
Canada.
In this study, we aimed to establish whether
domestic use of wood fuel is
associated with reduced birth weight, independent of key maternal,
social, and
economic confounding factors. We studied 1,717 women and newborn
children in
rural and urban communities in rural Guatemala. We identified
subjects through
home births reported by traditional birth attendants in six rural
districts
((italic)n(/italic) = 572) and all public hospital births in Quetzaltenango
city
during the study period ((italic)n(/italic) = 1,145). All were
seen within 72 hr
of delivery, and data were collected on the type of household
fuel used, fire
type, and socioeconomic and other confounding factors. Smoking
among women in
the study community was negligible. Children born to mothers habitually
cooking
on open fires ((italic)n(/italic) = 861) had the lowest mean birth
weight of
2,819 g [95% confidence interval (CI), 2,790-2,848]; those using
a chimney stove
((italic)n(/italic) = 490) had an intermediate mean of 2,863 g
(95% CI,
2,824-2,902); and those using the cleanest fuels (electricity
or gas,
(italic)n(/italic) = 365) had the highest mean of 2,948 g (95%
CI, 2,898-2,998)
((italic)p (/italic)< 0.0001). The percentage of low birth
weights (< 500 g) in
these three groups was 19.9% (open fire), 16.8% (chimney stove),
and 16.0%
(electricity/gas), (trend (italic)p(/italic) = 0.08). Confounding
factors were
strongly associated with fuel type, but after adjustment wood
users still had a
birth weight 63 g lower ((italic)p(/italic) = 0.05; 95% CI, 0.4-126).
This is
the first report of an association between biofuel use and reduced
birth weight
in a human population. Although there is potential for residual
confounding
despite adjustment, the better-documented evidence on passive
smoking and a
feasible mechanism through carbon monoxide exposure suggest this
association may
be real. Because two-thirds of households in developing countries
still rely on
biofuels and women of childbearing age perform most cooking tasks,
the
attributable risk arising from this association, if confirmed,
could be
substantial.
PMID: 11781172 [PubMed - in process]
1: Environ Health Perspect 2001 Jun;109 Suppl
3:405-9
Air pollution and blood markers of cardiovascular
risk.
Schwartz J.
Environmental Epidemiology Program, Department
of Environmental Health, Harvard
School of Public Health, 665 Huntington Ave., Boston, MA 02115,
USA.
jschwrtz@hsph.harvard.edu
Recent studies have linked air pollution
to tens of thousands of premature
cardiovascular deaths per year. The mechanisms of such associations
remain
unclear. In this study we examine the association between blood
markers of
cardiovascular risk and air pollution in a national sample of
the U.S.
population. Air pollution concentrations were merged to subjects
in the Third
National Health and Nutrition Examination Survey (NHANES III)
in the United
States, and the association with fibrinogen levels and counts
of platelets and
white blood cells were examined. The subjects in NHANES III are
a representative
sample of the U.S. population. Regressions controlled for age,
race, sex, body
mass index, current smoking, and number of cigarettes per day.
The complex
survey design was dealt with using mixed models with a random
sampling site
effect. In single-pollutant models, PM(10) (particulate matter
with a mass
median aerodynamic diameter less than 10 microm) was associated
with all three
outcomes (p< 0.05): Sulfur dioxide (SO(2)) was significantly
associated only
with white cell counts, nitrogen dioxide (NO(2)) with platelet
counts and
fibrinogen, and ozone with none of the outcomes. In two-pollutant
models, PM(10)
remained a significant predictor of white cell counts controlling
for SO(2) but
not vice versa. PM(10) was marginally significant in a model for
platelet counts
with NO(2), and the sign of the NO(2) coefficient was reversed.
These results
were stable with control for indoor exposures (wood stoves, environmental
tobacco smoke, gas stoves, fireplaces), dietary risk factors (saturated
fat,
alcohol, caffeine intake, n-3 fatty acids), and serum cholesterol.
The magnitude
of the effects are modest [e.g., 13 microg/dL fibrinogen for an
interquartile
range (IQR) change in PM(subscript)10(/subscript), 95% confidence
interval (CI)
4.6-22.1 mg/dL]. However, the odds ratio of being in the top 10%
of fibrinogen
for the same IQR change was 1.77 (95% CI 1.26-2.49). These effects
provide
considerable biologic plausibility to the mortality studies. PM(10),
but not
gaseous air pollutants, is associated with blood markers of cardiovascular
risk,
and this may explain epidemiologic associations with early deaths.
PMID: 11427390 [PubMed - indexed for
MEDLINE]
1: Tesfaigzi Y, Singh SP, Foster JE,
Kubatko J, Barr EB, Fine PM, McDonald JD,
Hahn FF, Mauderly JL.
Health Effects of Subchronic Exposure to Low Levels of Wood Smoke
in Rats.
Toxicol Sci. 2002 Jan;65(1):115-125.
PMID: 11752691 [PubMed - as supplied by publisher]
2: Schwartz J.
Air pollution and blood markers of cardiovascular risk.
Environ Health Perspect. 2001 Jun;109 Suppl 3:405-9.
PMID: 11427390 [PubMed - indexed for MEDLINE]
3: Sheppard L, Levy D, Checkoway H.
Correcting for the effects of location and atmospheric conditions
on air
pollution exposures in a case-crossover study.
J Expo Anal Environ Epidemiol. 2001 Mar-Apr;11(2):86-96.
PMID: 11409009 [PubMed - indexed for MEDLINE]
4: Kinney PL, Lippmann M.
Respiratory effects of seasonal exposures to ozone and particles.
Arch Environ Health. 2000 May-Jun;55(3):210-6.
PMID: 10908105 [PubMed - indexed for MEDLINE]
5: Mishra VK, Retherford RD, Smith
KR.
Biomass cooking fuels and prevalence of tuberculosis in India.
Int J Infect Dis. 1999 Spring;3(3):119-29.
PMID: 10460922 [PubMed - indexed for MEDLINE]
6: Xu X, Niu T, Christiani DC, Weiss
ST, Chen C, Zhou Y, Fang Z, Jiang Z, Liang
W, Zhang F.
Occupational and Environmental Risk Factors for Asthma in Rural
Communities in
China.
Int J Occup Environ Health. 1996 Jul;2(3):172-176.
PMID: 9933871 [PubMed - as supplied by publisher]
7: Betchley C, Koenig JQ, van Belle
G, Checkoway H, Reinhardt T.
Pulmonary function and respiratory symptoms in forest firefighters.
Am J Ind Med. 1997 May;31(5):503-9.
PMID: 9099351 [PubMed - indexed for MEDLINE]
8: Ellegard A.
Cooking fuel smoke and respiratory symptoms among women in low-income
areas in
Maputo.
Environ Health Perspect. 1996 Sep;104(9):980-5.
PMID: 8899378 [PubMed - indexed for MEDLINE]
9: Gharaibeh NS.
Effects of indoor air pollution on lung function of primary school
children in
Jordan.
Ann Trop Paediatr. 1996 Jun;16(2):97-102.
PMID: 8790672 [PubMed - indexed for MEDLINE]
10: Larson TV, Koenig JQ.
Wood smoke: emissions and noncancer respiratory effects.
Annu Rev Public Health. 1994;15:133-56. Review.
PMID: 8054078 [PubMed - indexed for MEDLINE]
11: Gold DR.
Indoor air pollution.
Clin Chest Med. 1992 Jun;13(2):215-29. Review.
PMID: 1511550 [PubMed - indexed for MEDLINE]
12: Henry CJ, Fishbein L, Meggs WJ,
Ashford NA, Schulte PA, Anderson H, Osborne
JS, Sepkovic DW.
Approaches for assessing health risks from complex mixtures in
indoor air: a
panel overview.
Environ Health Perspect. 1991 Nov;95:135-43. Review.
PMID: 1821367 [PubMed - indexed for MEDLINE]
13: Dales RE, Burnett R, Zwanenburg
H.
Adverse health effects among adults exposed to home dampness and
molds.
Am Rev Respir Dis. 1991 Mar;143(3):505-9.
PMID: 2001058 [PubMed - indexed for MEDLINE]
14: Festy B, Petit-Coviaux F, Le Moullec
Y.
[Current data on atmospheric pollutions]
Ann Pharm Fr. 1991;49(1):1-17. French.
PMID: 1867457 [PubMed - indexed for MEDLINE]
15: Pierson WE, Koenig JQ, Bardana
EJ Jr.
Potential adverse health effects of wood smoke.
West J Med. 1989 Sep;151(3):339-42. Review.
PMID: 2686171 [PubMed - indexed for MEDLINE]
16: Boleij JS, Brunekreef B.
Domestic pollution as a factor causing respiratory health effects.
Chest. 1989 Sep;96(3 Suppl):368S-372S. Review. No abstract available.
PMID: 2670478 [PubMed - indexed for MEDLINE]
17: Englert N.
[Indoor air pollutants and their effects on human health]
Offentl Gesundheitswes. 1989 Aug-Sep;51(8-9):409-13. Review. German.
PMID: 2531320 [PubMed - indexed for MEDLINE]
18: Koenig JQ.
Indoor and outdoor pollutants and the upper respiratory tract.
J Allergy Clin Immunol. 1988 May;81(5 Pt 2):1055-9. Review.
PMID: 3286732 [PubMed - indexed for MEDLINE]
19: Samet JM, Marbury MC, Spengler
JD.
Health effects and sources of indoor air pollution. Part I.
Am Rev Respir Dis. 1987 Dec;136(6):1486-508. Review.
PMID: 3318602 [PubMed - indexed for MEDLINE]
20: Samet JM, Marbury MC, Spengler
JD.
Respiratory effects of indoor air pollution.
J Allergy Clin Immunol. 1987 May;79(5):685-700.
PMID: 3571762 [PubMed - indexed for MEDLINE]
1: Toxicol Sci 2002 Jan;65(1):115-125
Health Effects of Subchronic Exposure
to Low Levels of Wood Smoke in Rats.
Tesfaigzi Y, Singh SP, Foster JE,
Kubatko J, Barr EB, Fine PM, McDonald JD, Hahn
FF, Mauderly JL.
Lovelace Respiratory Research Institute,
2425 Ridgecrest Drive SE, Albuquerque,
New Mexico 87108 and California Institute of Technology, Pasadena,
California
91125.
Wood smoke is a significant source
of air pollution in many parts of the United
States, and epidemiological data suggest a causal relationship
between elevated
wood smoke levels and health effects. The present study was designed
to provide
information on the potential respiratory health responses to subchronic
wood
smoke exposures in a Native American community in New Mexico.
Therefore, this
study used the same type of wood under similar burning conditions
and wood smoke
particle concentrations to mimic the conditions observed in this
community.
Brown Norway rats were exposed 3 h/day, 5 days/week for 4 or 12
weeks to air as
control, or to 1 or 10 mg/m(3) concentrations of wood smoke particles
from pinus
edulis. The wood smoke consisted of fine particles (< 1 &mgr;m)
that formed
larger chains and aggregates having a size distribution of 63-74%
in the <
1-&mgr;m fraction and 26-37% in the > 1-&mgr;m fraction.
The particle-bound
material was primarily composed of carbon, and the majority of
identified
organic compounds consisted of sugar and lignin derivatives. Pulmonary
function,
specifically carbon monoxide-diffusing capacity and pulmonary
resistance, was
somewhat affected in the high-exposure group. Mild chronic inflammation
and
squamous metaplasia were observed in the larynx of the exposed
groups. The
severity of alveolar macrophage hyperplasia and pigmentation increased
with
smoke concentration and length of exposure, and the alveolar septae
were
slightly thickened. The content of mucous cells lining the airways
changed from
Periodic Acid Schiff- to Alcian Blue-positive material in the
low-exposure group
after 90 days. Together, these observations suggest that exposure
to wood smoke
caused minor but significant changes in Brown Norway rats. Further
studies are
needed to establish whether exposure to wood smoke exacerbates
asthmalike
symptoms that resemble those described for children living in
homes using wood
stoves for heating and cooking.
PMID: 11752691 [PubMed - as supplied
by publisher]
1: J Expo Anal Environ Epidemiol 2001 Mar-Apr;11(2):86-96
Correcting for the effects of location
and atmospheric conditions on air
pollution exposures in a case-crossover study.
Sheppard L, Levy D, Checkoway H.
Department of Biostatistics and Environmental
Health, University of Washington,
Seattle, Washington 98195-7232, USA. sheppard@biostat.washington.edu
A limitation of most air pollution
health effects studies is that they rely on
monitoring data averaged over one or more ambient monitors to
represent daily
air pollution exposures for individuals. Such data analyses therefore
implicitly
require the assumption of a homogeneous spatial distribution for
particulate
matter (PM). This assumption may be suspected in the Pacific Northwest
because
of its hilly topography and local variations in wood burning.
To examine the
bias from substituting regional PM (i.e., the average of three
ambient monitor
measurements) for individual PM exposure, we conducted an exposure
substudy to
identify the influence of location factors, specifically urban
versus suburban
classification and topographic features ("upstream"
versus "downstream"), on
local ambient measurements. Using nephelometer measurements collected
over 1
year in four locations, we developed regression models to predict
local PM as a
function of regional PM, atmospheric stagnation, temperature,
and location. We
found a significant interaction between atmospheric stagnation
and topography,
with the most upstream site having reduced PM levels on high stagnation
days
after controlling for regional PM. We also found a significant
interaction with
temperature at one downstream site thought to be heavily exposed
to wood smoke
in the winter. These results are consistent with the physics of
surface
radiation inversions. The interactions reordered the index versus
referent
exposures in a case-crossover analysis of out-of-hospital primary
cardiac arrest
for subjects living in specific locations, but did not meaningfully
change the
associations with PM from the analysis using regional PM as the
exposure. The
lack of change in these results may be due to limitations in the
data used to
correct the exposure estimates or to the absence of a PM effect
among persons
without prior heart disease who experienced a primary cardiac
arrest.
PMID: 11409009 [PubMed - indexed for
MEDLINE]
1: Arch Environ Health 2000 May-Jun;55(3):210-6
Respiratory effects of seasonal exposures
to ozone and particles.
Kinney PL, Lippmann M.
Division of Environmental Health Sciences,
Columbia School of Public Health, New
York, New York 10032-4206, USA.
Whereas human respiratory effects
of brief ozone exposures are well documented,
much less is known about the human health effects of mid- to long-term
exposures. The authors' objective in this study was to determine
whether lung
function or respiratory symptom changes would occur over the course
of a summer
season among healthy young adults working outdoors in the presence
of ozone. The
authors studied 72 sophomore cadets from the U.S. Military Academy
at West
Point, New York, 21 of whom attended special summer training in
Fort Dix, New
Jersey, an area characterized by elevated ozone levels; the remaining
cadets
attended training in areas with moderate ozone levels (i.e., Fort
Benning,
Georgia; Fort Leonard Wood, Missouri; and Fort Sill, Oklahoma).
The authors
hypothesized that adverse respiratory outcomes, if any, would
be more pronounced
in the group exposed to higher ozone levels. Spirometry was performed
and
respiratory symptoms were assessed-both before and after the summer-in
a clinic
at West Point. Time spent outdoors during summer training averaged
11 hr/d. Both
mean and peak ozone levels were higher at Fort Dix than at the
three remaining
sites. Regional levels of sulfur dioxide and particulate matter
less than 10
microm in aerodynamic diameter were relatively low during the
study. However,
all cadets reported frequent exposure to dust, exhaust, and smoke
in the course
of their training. Averaged across all subjects, there was a statistically
significant drop in forced expiratory volume in 1 sec of 44 ml
(p = .035) over
the summer. There were also significant increases in reports of
cough, chest
tightness, and sore throat at the follow-up clinic visit. A larger
mean forced
expiratory volume in 1 sec decline was observed at Fort Dix, where
ozone
exposures were the highest. The results of this study demonstrated
a seasonal
decline in respiratory function among healthy young adults working
outdoors in
the presence of ozone and particulate matter.
PMID: 10908105 [PubMed - indexed for
MEDLINE]
1: Int J Infect Dis 1999 Spring;3(3):119-29
Biomass cooking fuels and prevalence
of tuberculosis in India.
Mishra VK, Retherford RD, Smith KR.
Population and Health Studies, East-West
Center, Honolulu, Hawaii 96848-1601,
USA. mishra@hawaii.edu
OBJECTIVES: To examine the relation
between use of biomass cooking fuels (wood
or dung) and prevalence of active tuberculosis in India. METHODS:
The analysis
is based on 260,162 persons age 20 and over in India's 1992-93
National Family
Health Survey. Logistic regression is used to estimate the effects
of biomass
fuel use on prevalence of active tuberculosis, as reported by
household heads,
after controlling for a number of potentially confounding variables.
RESULTS:
Persons living in households that primarily use biomass for cooking
fuel have
substantially higher prevalence of active tuberculosis than persons
living in
households that use cleaner fuels (odds ratio [OR] = 3.56; 95%
confidence
interval [CI] = 2.82-4. 50). This effect is reduced somewhat when
availability
of a separate kitchen, house type, indoor crowding, age, gender,
urban or rural
residence, education, religion, caste or tribe, and geographic
region are
statistically controlled (OR = 2.58; 95% CI = 1.98-3.37). Fuel
type also has a
large effect when the analysis is done separately for men (OR
= 2.46; 95% CI =
1.79-3.39) and women (OR = 2. 74; 95% CI = 1.86-4.05) and separately
for urban
areas (OR = 2.29; 95% CI = 1.61-3.23) and rural areas (OR = 2.65;
95% CI =
1.74-4.03). The analysis also indicates that, among persons age
20 years and
over, 51% of the prevalence of active tuberculosis is attributable
to cooking
smoke. CONCLUSIONS: Results strongly suggest that use of biomass
fuels for
cooking substantially increases the risk of tuberculosis in India.
PMID: 10460922 [PubMed - indexed for
MEDLINE]
1: Am J Ind Med 1997 May;31(5):503-9
Pulmonary function and respiratory
symptoms in forest firefighters.
Betchley C, Koenig JQ, van Belle G,
Checkoway H, Reinhardt T.
Department of Environmental Health,
University of Washington, Seattle
98195-7234, USA.
This study evaluated effects on respiratory
health of forest firefighters
exposed to high concentrations of smoke during their work shift.
This is the
first study of cross-shift respiratory effects in forest firefighters
conducted
on the job. Spirometric measurements and self-administered questionnaire
data
were collected before and after the 1992 firefighting season.
Seventy-six (76)
subjects were studied for cross-shift and 53 for cross-season
analysis. On
average, the cross-season data were collected 77.7 days after
the last
occupational smoke exposure. The cross-shift analysis identified
significant
mean individual declines in FVC. FEV1, and FEF25 75. The preshift
to midshift
decreases were 0.089 L, 0.190 L, and 0.439 I/sec. respectively,
with preshift to
postshift declines of 0.065 L, 0.150 L, and 0.496 L/sec. Mean
individual
declines for FVC, FEV1 and FEF25 75 of 0.033 L, 0.104 L, and 0.275
I/sec.
respectively, also were noted in the cross-season analysis. The
FEV1 changed
significantly (p < 0.05). The use of wood for indoor heat also
was associated
with the declines in FEV1. Although annual lung function changes
for a small
subset (n = 10) indicated reversibility of effect, this study
suggests a concern
for potential adverse respiratory effects in forest firefighters.
PMID: 9099351 [PubMed - indexed for
MEDLINE]
<pre>
1: Environ Health Perspect 1996 Sep;104(9):980-5
Cooking fuel smoke and respiratory
symptoms among women in low-income areas in
Maputo.
Ellegard A.
University of Goteborg, Department
for Human Ectology, Goteborg, Sweden.
The association between exposure to air pollution
from cooking fuels and health
aspects was studied in Maputo. Mozambique. Almost 1200 randomly
selected women
residing in the suburbs of Maputo were interviewed and 218 were
monitored for
air pollution. The fuels most commonly used were wood, charcoal,
electricity,
and liquified petroleum gas (LPG). Wood users were exposed to
significantly
higher levels of particulate pollution during cooking time (1200
micrograms/m3)
than charcoal users (540 micrograms/m3) and users of modern fuels
(LPG and
electricity) (200-380 micrograms/m3). Wood users were found to
have
significantly more cough symptoms than other groups. This association
remained
significant when controlling for a large number of environmental
variables.
There was no difference in cough symptoms between charcoal users
and users of
modern fuels. Other respiratory symptoms such as dyspnea, wheezing,
and
inhalation and exhalation difficulties were not associated with
wood use.
Reducing wood use would likely improve acute respiratory health
effects in wood
users and possibly improve the ambient air pollution conditions
in Maputo. To
reduce the health impact of wood smoke exposure, it appears that
the least
costly and quickest method would be to encourage charcoal use
to a greater
extent, although high carbon monoxide levels would have to be
addressed. Turning
to modern fuels is beyond the means of most these households in
the short term
and could not be shown to be more effective.
PMID: 8899378 [PubMed - indexed for
MEDLINE]
</pre>
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