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IMPACT OF AN INDOOR COOK STOVE INTERVENTION ON MEASURES OF SYSTEMIC INFLAMMATION
Citation:
Clark, M. L., A. Bachand, J. M. Heiderscheidt, D. DIAZ-SANCHEZ, L. Bevin, J. Volckens, S. J. Reynolds, L. M. NEAS, AND J. L. Peel. IMPACT OF AN INDOOR COOK STOVE INTERVENTION ON MEASURES OF SYSTEMIC INFLAMMATION. Presented at International Society for Environmental Epidemiology (ISEE), Barcelona, SPAIN, September 13 - 16, 2011.
Impact/Purpose:
This project demonstrated the feasibility of a novel finger-stick dried blood spot method for measuring markers of systemic inflammation in developing countries with limited facilities or other constraints regarding blood draws.
Description:
Background and Aims: Approximately three billion people use inefficient and poorly-vented indoor cook stoves, which can result in high indoor air pollution concentrations. Few studies have evaluated the cardiovascular effects of indoor biomass burning. Methods: In this pilot study we conducted a cook stove intervention in 123 Nicaraguan households. Forty women provided finger-stick dried blood spot samples at baseline and approximately one year following the improved cook stove introduction. We measured several markers of inflammation in the blood spot samples; systemic inflammation is part of the hypothesized biologic pathway linking inhaled pollution and cardiovascular disease. Additionally, we measured 48-hour indoor particulate matter (PM2.s) in a subgroup before and after improved stove introduction (n=34). Results: Approximately half of the population reported continued use of the traditional open fire (solely or in conjunction with the improved stove) during the follow-up year. A 68% reduction in PM2.s was observed, with a larger reduction (78%) observed among those not reporting any open fire use in the follow-up year (n=16). In preliminary results, we observed a 36% mean reduction (95% confidence interval: 1%, 71%) in C-reactive protein from baseline to follow-up only among those participants adopting the improved stove; however, less consistent associations by stove use were observed for other inflammatory markers. We observed larger reductions among obese participants for several of the inflammatory markers. Conclusions: This project demonstrated the feasibility of a novel finger-stick dried blood spot method for measuring markers of systemic inflammation in developing countries with limited facilities or other constraints regarding blood draws. Mixed use of traditional and improved stoves may have limited our ability to detect consistent reductions in inflammatory markers. Given the ubiquity of traditional cook stove use combined with increasing cardiovascular disease and obesity in developing countries, cook stove research should evaluate a broader range of health effects. This work was supported by NIEHSR03 ES019696-01. This is abstract does not necessarily reflect the policies of the U.S. Environmental Protection Agency.