Assessing the Respiratory Effects of Air Pollution from Biomass Cookstoves on Pregnant Women in Rural India

Raj Parikh, Sowmya R. Rao, Rakesh Kukde, George T. O'Connor, Archana Patel and Patricia L. Hibberd
Additional contact information
Raj Parikh: Division of Pulmonary and Critical Care Medicine, Boston University School of Medicine, Boston University Medical Center 72 East Concord Street, R304, Boston, MA 02118, USA
Sowmya R. Rao: Department of Global Health, Boston University School of Public Health, Boston, MA 02118, USA
Rakesh Kukde: Lata Medical Research Foundation, Nagpur 440002, India
George T. O'Connor: Division of Pulmonary and Critical Care Medicine, Boston University School of Medicine, Boston University Medical Center 72 East Concord Street, R304, Boston, MA 02118, USA
Archana Patel: Lata Medical Research Foundation, Nagpur 440002, India
Patricia L. Hibberd: Department of Global Health, Boston University School of Public Health, Boston, MA 02118, USA

IJERPH, 2020, vol. 18, issue 1, 1-11

Abstract: Background: In India, biomass fuel is burned in many homes under inefficient conditions, leading to a complex milieu of particulate matter and environmental toxins known as household air pollution (HAP). Pregnant women are particularly vulnerable as they and their fetus may suffer from adverse consequences of HAP. Fractional exhaled nitric oxide (FeNO) is a noninvasive, underutilized tool that can serve as a surrogate for airway inflammation. We evaluated the prevalence of respiratory illness, using pulmonary questionnaires and FeNO measurements, among pregnant women in rural India who utilize biomass fuel as a source of energy within their home. Methods: We prospectively studied 60 pregnant women in their 1st and 2nd trimester residing in villages near Nagpur, Central India. We measured FeNO levels in parts per billion (ppb), St. George’s Respiratory Questionnaire (SGRQ-C) scores, and the Modified Medical Research Council (mMRC) Dyspnea Scale. We evaluated the difference in the outcome distributions between women using biomass fuels and those using liquefied petroleum gas (LPG) using two-tailed t-tests. Results: Sixty-five subjects (32 in Biomass households; 28 in LPG households; 5 unable to complete) were enrolled in the study. Age, education level, and second-hand smoke exposure were comparable between both groups. FeNO levels were higher in the Biomass vs. LPG group (25.4 ppb vs. 8.6 ppb; p -value = 0.001). There was a difference in mean composite SGRQ-C score (27.1 Biomass vs. 10.8 LPG; p -value < 0.001) including three subtotal scores for Symptoms (47.0 Biomass vs. 20.2 LPG; p -value< 0.001), Activity (36.4 Biomass vs. 16.5 LPG; p -value < 0.001) and Impact (15.9 Biomass vs. 5.2 LPG; p -value < 0.001). The mMRC Dyspnea Scale was higher in the Biomass vs. LPG group as well (2.9 vs. 0.5; p < 0.001). Conclusion: Increased FeNO levels and higher dyspnea scores in biomass-fuel-exposed subjects confirm the adverse respiratory effects of this exposure during pregnancy. More so, FeNO may be a useful, noninvasive biomarker of inflammation that can help better understand the physiologic effects of biomass smoke on pregnant women. In the future, larger studies are needed to characterize the utility of FeNO in a population exposed to HAP.

Keywords: household air pollution; biomass fuel; fractional exhaled nitric oxide; Central India; indoor air pollution (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/18/1/183/pdf (application/pdf)
https://www.mdpi.com/1660-4601/18/1/183/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2020:i:1:p:183-:d:469873

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().