Current respiratory symptoms and risk factors in pregnant women cooking with biomass fuels in rural Ghana. (March 2019)

• Record Type: Journal Article
• Authors: Van Vliet, Eleanne D.S.; Kinney, Patrick L.; Owusu-Agyei, Seth; Schluger, Neil W.; Ae-Ngibise, Kenneth A.; Whyatt, Robin M.; Jack, Darby W.; Agyei, Oscar; Chillrud, Steven N.; Boamah, Ellen Abrafi; Mujtaba, Mohammed; Asante, Kwaku Poku
• Is Part Of: Environment international. Volume 124(2019)
• Page Start: 533
• Page End: 540
• Publication Date: 2019-03
• Subjects: Household air pollution -- Carbon monoxide -- Pregnant women -- Personal exposure -- Biomass -- Ghana; Environmental protection -- Periodicals; Environmental health -- Periodicals; Environmental monitoring -- Periodicals; Environmental Monitoring -- Periodicals; Environnement -- Protection -- Périodiques; Hygiène du milieu -- Périodiques; Environnement -- Surveillance -- Périodiques; Environmental health; Environmental monitoring; Environmental protection; Periodicals; 333.705
• DOI: 10.1016/j.envint.2019.01.046
• Languages: English
• ISSNs: 0160-4120

Abstract

Abstract: Background: More than 75% of the population in Ghana relies on biomass fuels for cooking and heating. Household air pollution (HAP) emitted from the incomplete combustion of these fuels has been associated with adverse health effects including respiratory effects in women that can lead to chronic obstructive pulmonary disease (COPD), a major contributor to global HAP-related mortality. HAP is a modifiable risk factor in the global burden of disease, exposure to which can be reduced. Objective: This study assessed the prevalence of respiratory symptoms, as well as associations between respiratory symptoms and HAP exposure, as measured using continuous personal carbon monoxide (CO), in nonsmoking pregnant women in rural Ghana. Methods: We analyzed current respiratory health symptoms and CO exposures upon enrollment in a subset (n = 840) of the population of pregnant women cooking with biomass fuels and enrolled in the GRAPHS randomized clinical control trial. Personal CO was measured using Lascar continuous monitors. Associations between CO concentrations as well as other sources of pollution exposures and respiratory health symptoms were estimated using logistic regression models. Conclusion: There was a positive association between CO exposure per 1 ppm increase and a composite respiratory symptom score of current cough (lasting >5 days), wheeze and/or dyspnea (OR: 1.2, p = 0.03). CO was also positively associated with wheeze (OR: 1.3, p = 0.05), phlegm (OR: 1.2, p = 0.08) and reported clinic visit for respiratory infection in past 4 weeks (OR: 1.2, p = 0.09). Multivariate models showed significant associations between second-hand tobacco smoke and a composite outcome (OR: 2.1, p < 0.01) as well as individual outcomes of cough >5 days (OR: 3.1, p = 0.01), wheeze (OR: 2.7, p < 0.01) and dyspnea (OR: 2.2, p = 0.01). Other covariates found to be significantly associated with respiratory outcomes include involvement in charcoal production business and dyspnea, and involvement in burning grass/field and wheeze. Results suggest that exposure to HAP increases the risk of adverse respiratory symptoms among pregnant women using biomass fuels for cooking in rural Ghana. Highlights: Quantitative exposure measurements are lacking in household air pollution studies. We measured continuous personal CO exposure in pregnant women cooking with biomass fuels. Household air pollution exposure is associated with respiratory symptoms. Approximately 20% of pregnant women in rural Ghana are exposed to secondhand smoke.