Woodsmoke exposure and novel health indicators: a feasibility field study

木烟暴露和新型健康指标：可行性实地研究

• 批准号: 8501114
• 负责人: Jennifer L Peel
• 金额: $ 21.33万
• 依托单位: COLORADO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-10 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8501114
• 关键词: Accounting; Acute; Air Pollution; Animals; Biomass; Blood Pressure; Blood Vessels; Burn injury; Carbon; Carbon Monoxide; Cardiopulmonary; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Cerebrovascular Disorders; Cessation of life; Chronic; Chronic Disease; Clinical; Coal; Country; Cross-Sectional Studies; Data; Developing Countries; Development; Diabetes Mellitus; Disease; Endotoxins; Enrollment; Environment; Evaluation; Event; Exhalation; Fire - disasters; Future; Glycosylated Hemoglobin; Goals; Health; Health Status; Healthcare; Heart Rate; Honduras; Household; Human; Impact evaluation; Indoor Air Pollution; Inflammation; Intervention; Length; Literature; Low Birth Weight Infant; Measurement; Measures; Metabolic; Metabolic syndrome; Methods; Myocardial Ischemia; Nitric Oxide; Obesity; Particulate Matter; Pollution; Population; Prediabetes syndrome; Prevalence; Randomized; Reactive Oxygen Species; Research; Research Infrastructure; Respiratory Tract Infections; Role; Rural; Smoke; Solid; Solutions; Vent; Wood material; Work; base; blood lipid; burden of illness; design; diabetic; disorder risk; experience; field study; improved; indexing; innovation; intervention program; meetings; mortality; novel; premature; public health relevance; randomized trial; respiratory; rural area; telomere; ultrafine particle

DESCRIPTION (provided by applicant): Nearly three billion people worldwide rely on solid fuel combustion to meet basic domestic energy needs. Most of this combustion, typically found among the poorest populations, takes place using inefficient and poorly vented indoor cookstoves burning biomass (wood, animal dung, crop residues) and coal, resulting in extremely high indoor air pollution concentrations. Improved, more fuel efficient and cleaner-burning, stove designs have the potential to substantially reduce indoor air pollution exposures. However, quantitative assessments of improved stove exposure and health impacts are limited. Indoor air pollution from biomass and coal combustion accounts for an estimated 1.6 million premature deaths per year worldwide, representing about 3% of the global disease burden. These estimates are based primarily on respiratory effects. In order to capture the full burden of disease (and potential benefit), cookstove research will need to incorporate a broader range of health endpoints utilizing methods that are feasible in a rural field setting and in countries with often limited healthcare infrastructure. Furthermore, previous studies, if they have incorporated quantitative pollution measurements at all - have primarily measured fine particulate matter (PM2.5) and carbon monoxide (CO); more detailed quantitative exposure assessment is necessary to inform stove design and priorities. Here we propose a cross-sectional study incorporating innovative methods to measure subclinical markers of cardiopulmonary and metabolic health as well as intensive exposure assessment. Our central hypothesis is that users of improved, cleaner burning stoves will experience better health status compared to users of traditional open-fire cookstoves. We propose the following specific aims: 1) Conduct novel exposure and health measurements in a population consisting of current traditional, open fire users and cleaner-burning stove users and 2) Evaluate the cross-sectional association between stove use (traditional vs. cleaner-burning stoves) and measured indoor and personal pollution with indicators of cardiovascular and metabolic health. Global dissemination of efficient, cleaner-burning stoves has the potential to dramatically improve the health of humans and the environment. This might appear to be a straightforward solution. However, a critical gap remains in that comprehensive evaluations of exposures and health impacts are still necessary to encourage and justify large-scale stove intervention programs. This project, incorporating novel health and exposure measures and establishing the feasibility of these measures in field settings, will contribute to our knowledge f the impacts of biomass combustion and provide preliminary evidence to support the development of larger- scale randomized trials, thereby enabling us to leverage its impact for future studies. Given the ubiquity of indoor biomass smoke exposures around the world and the increasing prevalence of these chronic diseases in developing countries, further evaluation of the impact of improved stoves is needed in order to fully assess the burden of this exposure.

描述（由申请人提供）： 全球近三十亿人依靠固体燃料燃烧来满足国内基本能源需求。大多数燃烧通常发生在最贫穷的人群中，使用低效且通风不良的室内炉灶燃烧生物质（木材、动物粪便、农作物残留物）和煤炭，导致室内空气污染浓度极高。经过改进、燃油效率更高、燃烧更清洁的炉灶设计有可能大幅减少室内空气污染。然而，对改善炉灶暴露和健康影响的定量评估是有限的。据估计，生物质和煤炭燃烧造成的室内空气污染每年导致全球 160 万人过早死亡，约占全球疾病负担的 3%。这些估计主要基于呼吸系统的影响。为了全面了解疾病负担（和潜在益处），炉灶研究需要纳入更广泛的健康终点，利用在农村地区和医疗基础设施往往有限的国家可行的方法。此外，之前的研究，如果纳入了定量污染测量的话，主要是测量细颗粒物 (PM2.5) 和一氧化碳 (CO)；需要进行更详细的定量暴露评估，以便为炉灶设计和优先事项提供信息。在这里，我们提出一项横断面研究，结合创新方法来测量心肺和代谢健康的亚临床标志物以及强化暴露评估。我们的中心假设是，与传统明火炉灶的用户相比，改进、更清洁的燃烧炉灶的用户将体验到更好的健康状况。 我们提出以下具体目标：1）在由当前传统明火使用者和清洁燃烧炉灶使用者组成的人群中进行新颖的暴露和健康测量，2）评估炉灶使用（传统与清洁燃烧炉灶）之间的横截面关联性以及通过心血管和代谢健康指标测量的室内和个人污染。在全球范围内推广高效、清洁燃烧的炉灶有可能显着改善人类和环境的健康。这似乎是一个简单的解决方案。然而，仍然存在一个关键差距，即仍然需要对暴露和健康影响进行全面评估，以鼓励和证明大规模炉灶干预计划的合理性。该项目纳入了新颖的健康和暴露措施，并确定了这些措施在实地环境中的可行性，将有助于我们了解生物质燃烧的影响，并提供初步证据来支持更大规模的随机试验的发展，从而使我们能够利用其影响进行未来的研究。鉴于室内生物质烟雾暴露在世界各地普遍存在，并且这些慢性疾病在发展中国家日益流行，需要进一步评估改进炉灶的影响，以充分评估这种暴露的负担。