Acute changes in lung function following controlled exposure to cookstove air pollution in the subclinical tests of volunteers exposed to smoke (STOVES) study

Abstract

Background: Exposure to household air pollution generated as a result of cooking and heating is a leading contributor to global disease. The effects of cookstove-generated air pollution on adult lung function, however, remain uncertain.

Objectives: We investigated acute responses in lung function following controlled exposures to cookstove-generated air pollution.

Methods: We recruited 48 healthy adult volunteers to undergo six two-hour treatments: a filtered-air control and emissions from five different stoves with fine particulate matter (PM_2.5) targets from 10 to 500 µg/m³. Spirometry was conducted prior to exposure and immediately, and three and 24 h post-exposure. Mixed-effect models were used to estimate differences in post-exposure lung function for stove treatments versus control.

Results: Immediately post-exposure, lung function was lower compared to the control for the three highest PM_2.5-level stoves. The largest differences were for the fan rocket stove (target 250 µg/m³; forced vital capacity (FVC): −60 mL, 95% confidence interval (95% CI) -135, 15; forced expiratory volume (FEV₁): −51 mL, 95% CI -117, 16; mid-expiratory flow (FEF_25–75): −116 mL/s, 95% CI -239, 8). At 3 h post-exposure, lung function was lower compared to the control for all stove treatments; effects were of similar magnitude for all stoves. At 24 h post-exposure, results were consistent with a null association for FVC and FEV₁; FEF_25–75 was lower relative to the control for the gasifier, fan rocket, and three stone fire.

Conclusions: Patterns suggesting short-term decreases in lung function follow from exposure to cookstove air pollution even for stove exposures with low PM_2.5 levels.

Keywords:

• Air pollution
• cookstoves
• spirometry
• FEV1
• FVC
• controlled exposure

Acknowledgements

The authors are grateful to the volunteer participants of this study, the nurses and doctors from Heart Center of the Rockies who supported the project, and student technicians who operated our controlled exposure facility.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Institute of Environmental Health Sciences under Grant R01ES023688.