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,
In this study, we aimed to establish whether
domestic use of wood fuel is
associated with reduced birth weight, independent of key maternal,
economic confounding factors. We studied 1,717 women and newborn
rural and urban communities in rural Guatemala. We identified
home births reported by traditional birth attendants in six rural
((italic)n(/italic) = 572) and all public hospital births in Quetzaltenango
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
on open fires ((italic)n(/italic) = 861) had the lowest mean birth
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
2,824-2,902); and those using the cleanest fuels (electricity
(italic)n(/italic) = 365) had the highest mean of 2,948 g (95%
((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),
(electricity/gas), (trend (italic)p(/italic) = 0.08). Confounding
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).
the first report of an association between biofuel use and reduced
in a human population. Although there is potential for residual
despite adjustment, the better-documented evidence on passive
smoking and a
feasible mechanism through carbon monoxide exposure suggest this
be real. Because two-thirds of households in developing countries
still rely on
biofuels and women of childbearing age perform most cooking tasks,
attributable risk arising from this association, if confirmed,
PMID: 11781172 [PubMed - in process]
1: Environ Health Perspect 2001 Jun;109 Suppl
Air pollution and blood markers of cardiovascular
Environmental Epidemiology Program, Department
of Environmental Health, Harvard
School of Public Health, 665 Huntington Ave., Boston, MA 02115,
Recent studies have linked air pollution
to tens of thousands of premature
cardiovascular deaths per year. The mechanisms of such associations
unclear. In this study we examine the association between blood
cardiovascular risk and air pollution in a national sample of
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
sample of the U.S. population. Regressions controlled for age,
race, sex, body
mass index, current smoking, and number of cigarettes per day.
survey design was dealt with using mixed models with a random
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
with white cell counts, nitrogen dioxide (NO(2)) with platelet
fibrinogen, and ozone with none of the outcomes. In two-pollutant
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
with NO(2), and the sign of the NO(2) coefficient was reversed.
were stable with control for indoor exposures (wood stoves, environmental
tobacco smoke, gas stoves, fireplaces), dietary risk factors (saturated
alcohol, caffeine intake, n-3 fatty acids), and serum cholesterol.
of the effects are modest [e.g., 13 microg/dL fibrinogen for an
range (IQR) change in PM(subscript)10(/subscript), 95% confidence
4.6-22.1 mg/dL]. However, the odds ratio of being in the top 10%
for the same IQR change was 1.77 (95% CI 1.26-2.49). These effects
considerable biologic plausibility to the mortality studies. PM(10),
gaseous air pollutants, is associated with blood markers of cardiovascular
and this may explain epidemiologic associations with early deaths.
PMID: 11427390 [PubMed - indexed for
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
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
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
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
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
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
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
Environ Health Perspect. 1991 Nov;95:135-43. Review.
PMID: 1821367 [PubMed - indexed for MEDLINE]
13: Dales RE, Burnett R, Zwanenburg
Adverse health effects among adults exposed to home dampness and
Am Rev Respir Dis. 1991 Mar;143(3):505-9.
PMID: 2001058 [PubMed - indexed for MEDLINE]
14: Festy B, Petit-Coviaux F, Le Moullec
[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
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
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
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,
Wood smoke is a significant source
of air pollution in many parts of the United
States, and epidemiological data suggest a causal relationship
wood smoke levels and health effects. The present study was designed
information on the potential respiratory health responses to subchronic
smoke exposures in a Native American community in New Mexico.
study used the same type of wood under similar burning conditions
and wood smoke
particle concentrations to mimic the conditions observed in this
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
edulis. The wood smoke consisted of fine particles (< 1 &mgr;m)
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.
material was primarily composed of carbon, and the majority of
organic compounds consisted of sugar and lignin derivatives. Pulmonary
specifically carbon monoxide-diffusing capacity and pulmonary
somewhat affected in the high-exposure group. Mild chronic inflammation
squamous metaplasia were observed in the larynx of the exposed
severity of alveolar macrophage hyperplasia and pigmentation increased
smoke concentration and length of exposure, and the alveolar septae
slightly thickened. The content of mucous cells lining the airways
Periodic Acid Schiff- to Alcian Blue-positive material in the
after 90 days. Together, these observations suggest that exposure
to wood smoke
caused minor but significant changes in Brown Norway rats. Further
needed to establish whether exposure to wood smoke exacerbates
symptoms that resemble those described for children living in
homes using wood
stoves for heating and cooking.
PMID: 11752691 [PubMed - as supplied
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. firstname.lastname@example.org
A limitation of most air pollution
health effects studies is that they rely on
monitoring data averaged over one or more ambient monitors to
air pollution exposures for individuals. Such data analyses therefore
require the assumption of a homogeneous spatial distribution for
matter (PM). This assumption may be suspected in the Pacific Northwest
of its hilly topography and local variations in wood burning.
To examine the
bias from substituting regional PM (i.e., the average of three
measurements) for individual PM exposure, we conducted an exposure
identify the influence of location factors, specifically urban
classification and topographic features ("upstream"
versus "downstream"), on
local ambient measurements. Using nephelometer measurements collected
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
with the most upstream site having reduced PM levels on high stagnation
after controlling for regional PM. We also found a significant
temperature at one downstream site thought to be heavily exposed
to wood smoke
in the winter. These results are consistent with the physics of
radiation inversions. The interactions reordered the index versus
exposures in a case-crossover analysis of out-of-hospital primary
for subjects living in specific locations, but did not meaningfully
associations with PM from the analysis using regional PM as 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
without prior heart disease who experienced a primary cardiac
PMID: 11409009 [PubMed - indexed for
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
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
Point, New York, 21 of whom attended special summer training in
Fort Dix, New
Jersey, an area characterized by elevated ozone levels; the remaining
attended training in areas with moderate ozone levels (i.e., Fort
Georgia; Fort Leonard Wood, Missouri; and Fort Sill, Oklahoma).
hypothesized that adverse respiratory outcomes, if any, would
be more pronounced
in the group exposed to higher ozone levels. Spirometry was performed
respiratory symptoms were assessed-both before and after the summer-in
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
sites. Regional levels of sulfur dioxide and particulate matter
less than 10
microm in aerodynamic diameter were relatively low during the
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
tightness, and sore throat at the follow-up clinic visit. A larger
expiratory volume in 1 sec decline was observed at Fort Dix, where
exposures were the highest. The results of this study demonstrated
decline in respiratory function among healthy young adults working
the presence of ozone and particulate matter.
PMID: 10908105 [PubMed - indexed for
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,
OBJECTIVES: To examine the relation
between use of biomass cooking fuels (wood
or dung) and prevalence of active tuberculosis in India. METHODS:
is based on 260,162 persons age 20 and over in India's 1992-93
Health Survey. Logistic regression is used to estimate the effects
fuel use on prevalence of active tuberculosis, as reported by
after controlling for a number of potentially confounding variables.
Persons living in households that primarily use biomass for cooking
substantially higher prevalence of active tuberculosis than persons
households that use cleaner fuels (odds ratio [OR] = 3.56; 95%
interval [CI] = 2.82-4. 50). This effect is reduced somewhat when
of a separate kitchen, house type, indoor crowding, age, gender,
urban or rural
residence, education, religion, caste or tribe, and geographic
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
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
smoke. CONCLUSIONS: Results strongly suggest that use of biomass
cooking substantially increases the risk of tuberculosis in India.
PMID: 10460922 [PubMed - indexed for
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
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
on the job. Spirometric measurements and self-administered questionnaire
were collected before and after the 1992 firefighting season.
subjects were studied for cross-shift and 53 for cross-season
average, the cross-season data were collected 77.7 days after
occupational smoke exposure. The cross-shift analysis identified
mean individual declines in FVC. FEV1, and FEF25 75. The preshift
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
declines for FVC, FEV1 and FEF25 75 of 0.033 L, 0.104 L, and 0.275
respectively, also were noted in the cross-season analysis. The
significantly (p < 0.05). The use of wood for indoor heat also
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
1: Environ Health Perspect 1996 Sep;104(9):980-5
Cooking fuel smoke and respiratory
symptoms among women in low-income areas in
University of Goteborg, Department
for Human Ectology, Goteborg, Sweden.
The association between exposure to air pollution
from cooking fuels and health
PMID: 8899378 [PubMed - indexed for
aspects was studied in Maputo. Mozambique. Almost 1200 randomly
residing in the suburbs of Maputo were interviewed and 218 were
air pollution. The fuels most commonly used were wood, charcoal,
and liquified petroleum gas (LPG). Wood users were exposed to
higher levels of particulate pollution during cooking time (1200
than charcoal users (540 micrograms/m3) and users of modern fuels
electricity) (200-380 micrograms/m3). Wood users were found to
significantly more cough symptoms than other groups. This association
significant when controlling for a large number of environmental
There was no difference in cough symptoms between charcoal users
and users of
modern fuels. Other respiratory symptoms such as dyspnea, wheezing,
inhalation and exhalation difficulties were not associated with
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
costly and quickest method would be to encourage charcoal use
to a greater
extent, although high carbon monoxide levels would have to be
to modern fuels is beyond the means of most these households in
the short term
and could not be shown to be more effective.
Point Arena CA 95468
Email: [pm10mary at mcn dot org]
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