RESUMEN
OBJECTIVE: Household air pollution (HAP) is a widespread environmental exposure worldwide. While several cleaner fuel interventions have been implemented to reduce personal exposures to HAP, it is unclear if cooking with cleaner fuels also affects the choice of meals and dietary intake. DESIGN: Individually randomised, open-label controlled trial of a HAP intervention. We aimed to determine the effect of a HAP intervention on dietary and Na intake. Intervention participants received a liquefied petroleum gas (LPG) stove, continuous fuel delivery and behavioural messaging during 1 year whereas control participants continued with usual cooking practices that involved the use of biomass-burning stoves. Dietary outcomes included energy, energy-adjusted macronutrients and Na intake at baseline, 6 months and 12 months post-randomisation using 24-h dietary recalls and 24-h urine. We used t-tests to estimate differences between arms in the post-randomisation period. SETTING: Rural settings in Puno, Peru. PARTICIPANTS: One hundred women aged 25-64 years. RESULTS: At baseline, control and intervention participants were similar in age (47·4 v. 49·5 years) and had similar daily energy (8894·3 kJ v. 8295·5 kJ), carbohydrate (370·8 g v. 373·3 g) and Na intake (4·9 g v. 4·8 g). One year after randomisation, we did not find differences in average energy intake (9292·4 kJ v. 8788·3 kJ; P = 0·22) or Na intake (4·5 g v. 4·6 g; P = 0·79) between control and intervention participants. CONCLUSIONS: Our HAP intervention consisting of an LPG stove, continuous fuel distribution and behavioural messaging did not affect dietary and Na intake in rural Peru.
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Contaminación del Aire Interior , Contaminación del Aire , Petróleo , Sodio en la Dieta , Adulto , Femenino , Humanos , Contaminación del Aire Interior/prevención & control , Contaminación del Aire Interior/análisis , Perú , Culinaria , Población RuralRESUMEN
Due to the current COVID-19 pandemic, guaranteeing thermal comfort and low CO2 levels in classrooms through efficient ventilation has become vitally important. This study presents three-dimensional simulations based on computational fluid dynamics of airflow inside an air-conditioned classroom located in Veracruz, Mexico. The analysis included various positions of an air extractor, Reynolds numbers up to 3.5 × 104, four different concentrations of pollutant sources, and three different times of the day. The simulations produced velocity, air temperature, and CO2 concentrations fields, and we calculated average air temperatures, average CO2 concentrations, and overall ventilation effectiveness. Our results revealed an optimal extractor position and Reynolds number conducive to thermal comfort and low CO2 levels due to an adequate ventilation configuration. At high pollutant concentrations, it is necessary to reduce the number of students in the classroom to achieve safe CO2 levels.
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Contaminación del Aire Interior , COVID-19 , Contaminación del Aire Interior/análisis , Contaminación del Aire Interior/prevención & control , COVID-19/epidemiología , Dióxido de Carbono/análisis , Humanos , Pandemias , SARS-CoV-2RESUMEN
This evidence map was developed to identify, summarize, and communicate to key stakeholders the findings of evidence on interventions to reduce exposure to household air pollution (HAP). The map synthesizes evidence from 48 literature reviews published on technological and sociocultural interventions and others (potentialities of public policies like incentives) to address health, environmental and economic impacts associated to HAP. Furthermore, this map seeks to inform decision-making processes on strategic interventions and most effective policies. Main results: Most of the existing HAP interventions to address indoor air quality have been focused on evaluating improved stove interventions that still use solid fuels (n = 39). It has been identified that Interventions with clean fuels (LPG, electricity, and others) are the most effective in impacting the health outcomes and reducing household air pollutants. Only six reviews analyzed or reported outcomes of sociocultural interventions (health education) aimed at reducing air pollution in homes; some showed positive impacts on health. Three reviews reported the effects of changes in people's behaviors when cooking food, which have improved indoor air quality. All authors agree on the importance of changing behavior and community practices as an essential element for the sustainability of improved kitchen interventions. Four reviews evaluated at the synergy between policies to reduce household air pollution and outdoor pollution, as well as other environmental health concerns. These reviews allow the conclusion that synergies between policies are much more effective at reducing air pollution and its impacts on the health of communities.
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Humanos , Contaminación del Aire Interior/prevención & control , Enfermedades Respiratorias , Contaminación del Aire Interior/efectos adversosRESUMEN
Ultrasound Core Laboratories (UCL) are used in multicenter trials to assess imaging biomarkers to define robust phenotypes, to reduce imaging variability and to allow blinded independent review with the purpose of optimizing endpoint measurement precision. The Household Air Pollution Intervention Network, a multicountry randomized controlled trial (Guatemala, Peru, India and Rwanda), evaluates the effects of reducing household air pollution on health outcomes. Field studies using portable ultrasound evaluate fetal, lung and vascular imaging endpoints. The objective of this report is to describe administrative methods and training of a centralized clinical research UCL. A comprehensive administrative protocol and training curriculum included standard operating procedures, didactics, practical scanning and written/practical assessments of general ultrasound principles and specific imaging protocols. After initial online training, 18 sonographers (three or four per country and five from the UCL) participated in a 2 wk on-site training program. Written and practical testing evaluated ultrasound topic knowledge and scanning skills, and surveys evaluated the overall course. The UCL developed comprehensive standard operating procedures for image acquisition with a portable ultrasound system, digital image upload to cloud-based storage, off-line analysis and quality control. Pre- and post-training tests showed significant improvements (fetal ultrasound: 71% ± 13% vs. 93% ± 7%, p < 0.0001; vascular lung ultrasound: 60% ± 8% vs. 84% ± 10%, p < 0.0001). Qualitative and quantitative feedback showed high satisfaction with training (mean, 4.9 ± 0.1; scale: 1â¯=â¯worst, 5â¯=â¯best). The UCL oversees all stages: training, standardization, performance monitoring, image quality control and consistency of measurements. Sonographers who failed to meet minimum allowable performance were identified for retraining. In conclusion, a UCL was established to ensure accurate and reproducible ultrasound measurements in clinical research. Standardized operating procedures and training are aimed at reducing variability and enhancing measurement precision from study sites, representing a model for use of portable digital ultrasound for multicenter field studies.
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Contaminación del Aire Interior/prevención & control , Vasos Sanguíneos/diagnóstico por imagen , Computadoras de Mano , Feto/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Femenino , Guatemala , Humanos , India , Perú , Rwanda , Ultrasonido/educación , Ultrasonografía/instrumentaciónRESUMEN
ANTECEDENTES Y OBJETIVO A raíz de la pandemia por COVID-19 y con la llegada de temperaturas ambientales más bajas en la región, el Gobierno de Chile ha considerado conveniente reforzar la necesidad de ventilar espacios cerrados. A través de la ventilación, es decir, introducir aire limpio en un espacio al tiempo que se elimina el aire viciado, se podría disminuir el riesgo de propagación del virus. En este sentido, el Ministerio de Salud solicita un reporte breve de evidencia con el objetivo de conocer el efecto que la ventilación de espacios cerrados ya sea natural o a través de sistemas mecanizados, podría tener en la prevención de la transmisión de COVID-19. METODOLOGÍA Se recuperaron documentos que respondieran a la pregunta de investigación en 2 bases de datos. Se incluyen revisiones sistemáticas que tuvieran como objetivo medir el efecto en salud de la ventilación de los espacios cerrados, especialmente en la prevención de transmisión de coronavirus. Se excluye cualquier tipo de artículo diferente a una revisión sistemática. Revisiones sistemáticas que evaluaron la transmisión de enfermedades infecciosas no virales y transmisión en sistemas de transporte público. RESULTADOS Los diseños de estudio de los artículos seleccionados son observacionales. Dado lo anterior, es probable que las conclusiones de los estudios varíen en función de las características propias del espacio donde se aplicará y de los sistemas de ventilación utilizados. -No se encontraron revisiones sistemáticas evaluando específicamente el impacto de la ventilación natural en el riesgo de transmisión de SARS-CoV-2. -Si bien el uso de sistemas de ventilación mecanizados pueden ser claves en la disminución de la carga viral de SARS-CoV-2 en el aire, algunas revisiones sistemáticas reportaron que no se puede descartar que éstos puedan tener un rol en la propagación del virus, principalmente en contextos hospitalarios. -El tipo de tecnología, tipo de filtro, flujo de aire que pasa a través del filtro y su dirección, ubicación del sistema, mantenimiento del dispositivo y posición relativa entre la persona infectada y el receptor podrían ser factores claves en el nivel de eficiencia de sistemas de ventilación mecanizados en la disminución de la propagación del virus.
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Contaminación del Aire Interior/prevención & control , COVID-19 , ChileRESUMEN
Strategies to return to dental practice in pandemic times is a new challenge due to the generation and spread of potentially contaminated dispersion particles (PCDP) that may contain the SARS-CoV-2, the etiological factor of the COVID-19 disease. Due to the significant dispersion of PCDP in the dental environment, the use of equipment such as ultrasonic tips have been inadvisable during the pandemic. Several clinical procedures, however, benefit from the use of such equipment. Thus, using a microbial dispersion model of PCDP, the aim of this study was to compare the dispersion caused by the dental drill (DD) an ultrasonic tip (UT) alone and the UT coupled with a Spray control (SC) device. The DD, UT (with or without the SC) were activated for one minute having had the water from the reservoir replaced with a suspension of Lactobacillus casei Shirota (1.5 x 108 CFU/mL). Petri dishes containing MRS agar were positioned at 50cm, 100cm and 150cm from the headrest of the dental chair at different angles (0 degree and 90 degrees). At 50 cm, the mean CFU (standard deviation) of L. casei Shirota was 13554.60 (4071.03) for the DD, 286.67 (73.99) for the US (97.89% reduction), and 4.5 (0.58) CFU for the UT-SC (p < 0.0001), establishing a further 98.43% reduction between UT and UT with SC. The UT with SC model proved effective in reducing dispersion from the UT, endorsing its use as an additional strategy to reduce PCDP in the dental environment in times of pandemic.
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Contaminación del Aire Interior/prevención & control , COVID-19/prevención & control , Raspado Dental/instrumentación , COVID-19/transmisión , COVID-19/virología , Contención de Riesgos Biológicos/instrumentación , Humanos , Lacticaseibacillus casei , UltrasonidoRESUMEN
Rationale: Approximately 40% of people worldwide are exposed to household air pollution (HAP) from the burning of biomass fuels. Previous efforts to document health benefits of HAP mitigation have been stymied by an inability to lower emissions to target levels. Objectives: We sought to determine if a household air pollution intervention with liquefied petroleum gas (LPG) improved cardiopulmonary health outcomes in adult women living in a resource-poor setting in Peru. Methods: We conducted a randomized controlled field trial in 180 women aged 25-64 years living in rural Puno, Peru. Intervention women received an LPG stove, continuous fuel delivery for 1 year, education, and behavioral messaging, whereas control women were asked to continue their usual cooking practices. We assessed for stove use adherence using temperature loggers installed in both LPG and biomass stoves of intervention households. Measurements and Main Results: We measured blood pressure, peak expiratory flow (PEF), and respiratory symptoms using the St. George's Respiratory Questionnaire at baseline and at 3-4 visits after randomization. Intervention women used their LPG stove exclusively for 98% of days. We did not find differences in average postrandomization systolic blood pressure (intervention - control 0.7 mm Hg; 95% confidence interval, -2.1 to 3.4), diastolic blood pressure (0.3 mm Hg; -1.5 to 2.0), prebronchodilator peak expiratory flow/height2 (0.14 L/s/m2; -0.02 to 0.29), postbronchodilator peak expiratory flow/height2 (0.11 L/s/m2; -0.05 to 0.27), or St. George's Respiratory Questionnaire total score (-1.4; -3.9 to 1.2) over 1 year in intention-to-treat analysis. There were no reported harms related to the intervention. Conclusions: We did not find evidence of a difference in blood pressure, lung function, or respiratory symptoms during the year-long intervention with LPG. Clinical trial registered with www.clinicaltrials.gov (NCT02994680).
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Contaminación del Aire Interior/prevención & control , Biomasa , Culinaria/métodos , Petróleo , Salud Rural/estadística & datos numéricos , Adulto , Femenino , Humanos , Persona de Mediana Edad , PerúRESUMEN
Household air pollution (HAP) due to solid fuel use during pregnancy is associated with adverse birth outcomes. The real-life effectiveness of clean cooking interventions has been disappointing overall yet variable, but the sociodemographic determinants are not well described. We measured personal 24-h PM2.5 (particulate matter <2.5 µm in aerodynamic diameter) thrice in pregnant women (n = 218) gravimetrically with Teflon filter, impactor, and personal pump setups. To estimate the effectiveness of owning chimney and liquefied petroleum gas (LPG) stoves (i.e., proportion of PM2.5 exposure that would be prevented) and to predict subject-specific typical exposures, we used linear mixed-effects models with log (PM2.5) as dependent variable and random intercept for subject. Median (IQR) personal PM2.5 in µg/m3 was 148 (90-249) for open fire, 78 (51-125) for chimney stove, and 55 (34-79) for LPG stoves. Adjusted effectiveness of LPG stoves was greater in women with ≥6 years of education (49% (95% CI: 34, 60)) versus <6 years (26% (95% CI: 5, 42)). In contrast, chimney stove adjusted effectiveness was greater in women with <6 years of education (50% (95% CI: 38, 60)), rural residence (46% (95% CI: 34, 55)) and lowest SES (socio-economic status) quartile (59% (95% CI: 45, 70)) than ≥6 years education (16% (95% CI: 22, 43)), urban (23% (95% CI: -164, 42)) and highest SES quartile (-44% (95% CI: -183, 27)), respectively. A minority of LPG stove owners (12%) and no chimney owner had typical exposure below World Health Organization Air Quality guidelines (35 µg/m3). Although having a cleaner stove alone typically does not lower exposure enough to protect health, understanding sociodemographic determinants of effectiveness may lead to better targeting, implementation, and adoption of interventions.
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Contaminación del Aire Interior , Contaminación del Aire , Culinaria , Exposición a Riesgos Ambientales , Contaminación del Aire/prevención & control , Contaminación del Aire Interior/prevención & control , Biomasa , Culinaria/instrumentación , Exposición a Riesgos Ambientales/prevención & control , Femenino , Guatemala , Humanos , Material Particulado/análisis , Material Particulado/toxicidad , EmbarazoRESUMEN
In southern Chile, epidemiological studies have linked high levels of air pollution produced by the use of wood-burning stoves with the incidence of numerous diseases. Using a quasi-experimental design, this study explores the potential of participatory sensing strategies to transform experiences, perceptions, attitudes, and daily routine activities in 15 households equipped with wood-burning stoves in the city of Temuco, Chile. The results suggest that the experience of using a low-cost sensor improves household members' awareness levels of air pollution. However, the information provided by the sensors does not seem to improve the participants' self-efficacy to control air quality and protect themselves from pollution. The high degree of involvement with the participatory sensing experience indicates that the distribution of low-cost sensors could be a key element in the risk communication policies.
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Contaminantes Atmosféricos/análisis , Contaminación del Aire Interior/análisis , Monitoreo del Ambiente/métodos , Material Particulado/análisis , Contaminación del Aire Interior/prevención & control , Chile , Ciudades , Participación de la Comunidad , Monitoreo del Ambiente/instrumentación , Humanos , Madera/químicaRESUMEN
BACKGROUND: Growing evidence links household air pollution exposure from biomass-burning cookstoves to cardiometabolic disease risk. Few randomized controlled interventions of cookstoves (biomass or otherwise) have quantitatively characterized changes in exposure and indicators of cardiometabolic health, a growing and understudied burden in low- and middle-income countries (LMICs). Ideally, the solution is to transition households to clean cooking, such as with electric or liquefied petroleum gas stoves; however, those unable to afford or to access these options will continue to burn biomass for the foreseeable future. Wood-burning cookstove designs such as the Justa (incorporating an engineered combustion zone and chimney) have the potential to substantially reduce air pollution exposures. Previous cookstove intervention studies have been limited by stove types that did not substantially reduce exposures and/or by low cookstove adoption and sustained use, and few studies have incorporated community-engaged approaches to enhance the intervention. METHODS/DESIGN: We conducted an individual-level, stepped-wedge randomized controlled trial with the Justa cookstove intervention in rural Honduras. We enrolled 230 female primary cooks who were not pregnant, non-smoking, aged 24-59 years old, and used traditional wood-burning cookstoves at baseline. A community advisory board guided survey development and communication with participants, including recruitment and retention strategies. Over a 3-year study period, participants completed 6 study visits approximately 6 months apart. Half of the women received the Justa after visit 2 and half after visit 4. At each visit, we measured 24-h gravimetric personal and kitchen fine particulate matter (PM2.5) concentrations, qualitative and quantitative cookstove use and adoption metrics, and indicators of cardiometabolic health. The primary health endpoints were blood pressure, C-reactive protein, and glycated hemoglobin. Overall study goals are to explore barriers and enablers of new cookstove adoption and sustained use, compare health endpoints by assigned cookstove type, and explore the exposure-response associations between PM2.5 and indicators of cardiometabolic health. DISCUSSION: This trial, utilizing an economically feasible, community-vetted cookstove and evaluating endpoints relevant for the major causes of morbidity and mortality in LMICs, will provide critical information for household air pollution stakeholders globally. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT02658383 , posted January 18, 2016, field work completed May 2018. Official title, "Community-Based Participatory Research: A Tool to Advance Cookstove Interventions." Principal Investigator Maggie L. Clark, Ph.D. Last update posted July 12, 2018.
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Contaminación del Aire Interior/prevención & control , Enfermedades Cardiovasculares/prevención & control , Culinaria/métodos , Exposición a Riesgos Ambientales/prevención & control , Artículos Domésticos , Adulto , Contaminación del Aire Interior/efectos adversos , Biomasa , Enfermedades Cardiovasculares/etiología , Exposición a Riesgos Ambientales/efectos adversos , Composición Familiar , Femenino , Honduras , Humanos , Persona de Mediana Edad , Material Particulado/análisis , Embarazo , Ensayos Clínicos Controlados Aleatorios como Asunto , Población Rural , Adulto JovenRESUMEN
Household air pollution is the sixth leading risk factor for premature mortality in Guatemala. Households in Guatemala are gradually adopting liquefied petroleum gas (LPG) stoves, but a strong tradition of woodstove use persists. We conducted a mixed-methods study of LPG stove use in peri-urban Guatemala. We used knowledge, attitudes and practices surveys with 187 LPG stove owners who also used woodstoves to identify perceptions of stove and cooking practices. Barriers to sustained use of LPG stoves were evaluated through focus groups, participant observations with stove users, and key informant interviews with community leaders. Seven themes emerged that explain household decisions to use LPG stoves: (1) The "new technology" should be framed in terms of what the "old technology" lacks, (2) income is not a predictor of gas stove acquisition but may predict sustained use, (3) men are key decision-makers but messages about LPG do not target them, (4) when stoves are viewed as "prize possessions" they may not be used, (5) collective fear about gas stoves is not based on personal experience, but on "stories we hear," (6) sustained LPG use is hampered by two major factors, seasonally available wood and LPG retailers who are perceived as dishonest, and (7) wood fuel collection is a time to enjoy the company of friends and family and is not "drudgery." National policies should promote the use of clean cookstove technologies in peri-urban and rapidly urbanizing areas in Guatemala where LPG stoves are in use, but used intermittently, instead of the current plan to install 100,000 "improved" woodstoves by 2032. This could be done by improving dependable cylinder distribution services, targeting gas safety and promoting positive health messages that appeal to men, as well as women.
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Contaminación del Aire Interior/prevención & control , Culinaria , Composición Familiar , Petróleo , Adulto , Contaminación del Aire Interior/efectos adversos , Estudios Transversales , Femenino , Guatemala , Conocimientos, Actitudes y Práctica en Salud , Humanos , Entrevistas como Asunto , Masculino , Petróleo/provisión & distribución , Investigación Cualitativa , Encuestas y CuestionariosRESUMEN
Burning solid fuels to fulfill daily household energy needs results in chronic exposure to household air pollution (HAP), which is among the world's greatest health risks. This paper presents the results of a cross-sectional study of cookstove usage, fuel consumption, and indoor PM2.5 concentrations in rural and urban Honduran homes cooking with the Envirofit HM-5000 metal plancha stove (n = 32) as compared to control households using baseline cooking technologies (n = 33). Temperature-based stove usage measurements showed high HM-5000 acceptance, with significant displacement of the traditional cookstoves at both the urban (99%, P < .05) and rural study sites (75%, P < .05). However, longer-term usage data collected in peri-urban households showed that participants cooked on the HM-5000 more frequently during the 3-day monitoring period than during the following 3 weeks. Average indoor PM2.5 was 66% lower in HM-5000 households as compared to control households (P < .05). Lower indoor PM2.5 concentrations observed in participant homes as compared to control households, supported by high usage and traditional stove displacement, suggest the potential for the HM-5000 to yield health improvements in adopting Honduran households.
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Contaminación del Aire Interior/análisis , Culinaria/instrumentación , Monitoreo del Ambiente/estadística & datos numéricos , Artículos Domésticos/instrumentación , Material Particulado/análisis , Contaminación del Aire Interior/prevención & control , Estudios Transversales , Diseño de Equipo , Composición Familiar , Honduras , Vivienda , Humanos , Población Rural , Temperatura , Factores de Tiempo , Población UrbanaRESUMEN
BACKGROUND: Three billion people use solid cooking fuels, and 4 million people die from household air pollution annually. Shifting households to clean fuels, like liquefied petroleum gas (LPG), may protect health only if stoves are consistently used. Few studies have used an implementation science framework to systematically assess "de-implementation" of traditional stoves, and none have done so with pregnant women who are more likely to adopt new behaviors. We evaluated an introduced LPG stove coupled with a phased behavioral intervention to encourage exclusive gas stove use among pregnant women in rural Guatemala. METHODS: We enrolled 50 women at < 20 weeks gestation in this prospective cohort study. All women received a free 3-burner LPG stove and ten tank refills. We conducted formative research using COM-B Model and Theoretical Domains Framework (TDF). This included thematic analysis of focus group findings and classes delivered to 25 pregnant women (Phase 1). In Phase 2, we complemented classes with a home-based tailored behavioral intervention with a different group of 25 pregnant women. We mapped 35 TDF constructs onto survey questions. To evaluate stove use, we placed temperature sensors on wood and gas stoves and estimated fraction of stove use three times during pregnancy and twice during the first month after infant birth. RESULTS: Class attendance rates were above 92%. We discussed feasible ways to reduce HAP exposure, proper stove use, maintenance and safety. We addressed food preferences, ease of cooking and time savings through cooking demonstrations. In Phase 2, the COM-B framework revealed that other household members needed to be involved if the gas stove was to be consistently used. Social identity and empowerment were key in decisions about stove repairs and LPG tank refills. The seven intervention functions included training, education, persuasion, incentivization, modelling, enablement and environmental restructuring. Wood stove use dropped upon introduction of the gas stove from 6.4 h to 1.9 h. CONCLUSIONS: This is the first study using the COM-B Model to develop a behavioral intervention that promotes household-level sustained use of LPG stoves. This study lays the groundwork for a future LPG stove intervention trial coupled with a behavioral change intervention. TRIAL REGISTRATION: NCT02812914, registered 3 June 2016, retrospectively registered.
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Culinaria/instrumentación , Promoción de la Salud/métodos , Petróleo/estadística & datos numéricos , Mujeres Embarazadas/psicología , Población Rural , Adulto , Contaminación del Aire Interior/prevención & control , Femenino , Gases , Guatemala , Humanos , Modelos Psicológicos , Embarazo , Estudios Prospectivos , Teoría Psicológica , Población Rural/estadística & datos numéricos , Adulto JovenRESUMEN
A biotrickling filter was evaluated to treat the air of the interior of a bioprocess research laboratory. Initially, various solid-phase microextraction (SPME) fibers were used to identify and quantify the volatile organic pollutants and hexane, methyl isobutyl ketone, benzene, toluene, and xylene were further selected as indicators due to their prevalence and relative abundance. The system treated organic loading rates between 0.16 mgcarbon m-3 h-1 and close to 30 mgcarbon m-3 h-1 achieving removal efficiencies (RE) over 85% during 136 operational days. Respirometry experiments demonstrated that moderate acidification (below 5.0), due to microbial activity, adversely affected biofilter performance and consequently pH control was necessary to maintain performance.
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Filtros de Aire , Contaminantes Atmosféricos/análisis , Contaminación del Aire Interior , Monitoreo del Ambiente/métodos , Compuestos Orgánicos Volátiles/análisis , Filtros de Aire/microbiología , Contaminación del Aire Interior/análisis , Contaminación del Aire Interior/prevención & control , Biodegradación Ambiental , Monitoreo del Ambiente/instrumentación , Filtración , Microextracción en Fase SólidaRESUMEN
BACKGROUND: The World Health Organization (WHO) estimates that 25% of global morbidity and one-third of childhood morbidity may be attributable to environment. Low and high-income countries displayed different environmental risks. Mexico demonstrates the necessity for creating a national environmental health program. In southeastern Mexico, Tixméhuac, is a Mayan community with a high marginalization degree and social backwardness. The main childhood morbidities are acute and chronic diseases. OBJECTIVE: The aim of the study was to recognize environmental risks for children's health in Tixméhauc, Yucatan State. METHODS: A total of one hundred children under five years old participated. To identify the environmental risks at home, items from the Green Sheet Guidance (WHO), Salamanca General Survey and Environmental Clinical History were used. To know the prevalence of respiratory diseases and asthma, the International Study of Asthma and Allergies in Children (ISAAC) survey was used. Potentially hazardous sites were identified partially using the Methodology for Identification and Evaluation of Health Hazards in Contaminated Sites from the Pan American Health Organization (PAHO). FINDINGS: The low stature of, malnutrition, presence of wheezing and asthma symptoms in children were higher than expected. The suspected cases of parasitosis and vector-borne disease occurred in 50% of the children. Indoor air quality perception was associated with respiratory pathology history; housing quality was related to suspected cases of vector-borne diseases; drinking water quality was linked to suspected cases of parasitosis. Risk areas in the community include agricultural activity, which has led to deposits of empty containers of agrochemicals and electronic waste among solid waste dump. CONCLUSION: This study presents observed environmental risks to children in a low development country and in developing countries. The community has a low perception of the environmental risk. The need for public health programs reducing risks to children's environmental health is imperative.
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Contaminación del Aire Interior , Salud Infantil/estadística & datos numéricos , Exposición a Riesgos Ambientales , Salud Ambiental , Enfermedades Parasitarias/epidemiología , Enfermedades Respiratorias/epidemiología , Agroquímicos/efectos adversos , Agroquímicos/análisis , Contaminación del Aire Interior/efectos adversos , Contaminación del Aire Interior/análisis , Contaminación del Aire Interior/prevención & control , Preescolar , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/prevención & control , Exposición a Riesgos Ambientales/estadística & datos numéricos , Salud Ambiental/métodos , Salud Ambiental/organización & administración , Femenino , Vivienda , Humanos , Residuos Industriales/efectos adversos , Residuos Industriales/análisis , Residuos Industriales/prevención & control , Masculino , México/epidemiología , Morbilidad , Evaluación de Necesidades , Medición de Riesgo/métodos , Factores de RiesgoRESUMEN
BACKGROUND: Biomass fuel smoke is a leading risk factor for the burden of disease worldwide. International campaigns are promoting the widespread adoption of liquefied petroleum gas (LPG) in resource-limited settings. However, it is unclear if the introduction and use of LPG stoves, in settings where biomass fuels are used daily, reduces pollution concentration exposure, improves health outcomes, or how cultural and social barriers influence the exclusive adoption of LPG stoves. METHODS: We will conduct a randomized controlled, field intervention trial of LPG stoves and fuel distribution in rural Puno, Peru, in which we will enroll 180 female participants aged 25-64 years and follow them for 2 years. After enrollment, we will collect information on sociodemographic characteristics, household characteristics, and cooking practices. During the first year of the study, LPG stoves and fuel tanks will be delivered to the homes of 90 intervention participants. During the second year, participants in the intervention arm will keep their LPG stoves, but the gas supply will stop. Control participants will receive LPG stoves and vouchers to obtain free fuel from distributors at the beginning of the second year, but gas will not be delivered. Starting at baseline, we will collect longitudinal measurements of respiratory symptoms, pulmonary function, blood pressure, endothelial function, carotid artery intima-media thickness, 24-h dietary recalls, exhaled carbon monoxide, quality-of-life indicators, and stove-use behaviors. Environmental exposure assessments will occur six times over the 2-year follow-up period, consisting of 48-h personal exposure and kitchen concentration measurements of fine particulate matter and carbon monoxide, and 48-h kitchen concentrations of nitrogen dioxide for a subset of 100 participants. DISCUSSION: Findings from this study will allow us to better understand behavioral patterns, environmental exposures, and cardiovascular and pulmonary outcomes resulting from the adoption of LPG stoves. If this trial indicates that LPG stoves are a feasible and effective way to reduce household air pollution and improve health, it will provide important information to support widespread adoption of LPG fuel as a strategy to reduce the global burden of disease. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02994680 , Cardiopulmonary Outcomes and Household Air Pollution (CHAP) Trial. Registered on 28 November 2016.
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Contaminación del Aire Interior/efectos adversos , Culinaria/instrumentación , Cardiopatías/etiología , Artículos Domésticos , Exposición por Inhalación/efectos adversos , Enfermedades Pulmonares/etiología , Petróleo/efectos adversos , Adulto , Contaminación del Aire Interior/prevención & control , Sistema Cardiovascular/fisiopatología , Monitoreo del Ambiente/métodos , Diseño de Equipo , Femenino , Gases , Cardiopatías/diagnóstico , Cardiopatías/fisiopatología , Cardiopatías/prevención & control , Vivienda , Humanos , Exposición por Inhalación/prevención & control , Pulmón/fisiopatología , Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/fisiopatología , Enfermedades Pulmonares/prevención & control , Persona de Mediana Edad , Perú , Proyectos de Investigación , Factores de Riesgo , Salud Rural , Factores de TiempoRESUMEN
This study examined measures of clean cookstove adoption after improved solid fuel stove programmes in three geographically and culturally diverse rural Andean settings and explored factors associated with these measures. A questionnaire was administered to 1200 households on stove use and cooking behaviours including previously defined factors associated with clean cookstove adoption. Logistic multivariable regressions with 16 pre-specified explanatory variables were performed for three outcomes; (1) daily improved solid fuel stove use, (2) use of liquefied petroleum gas stove and (3) traditional stove displacement. Eighty-seven percent of households reported daily improved solid fuel stove use, 51% liquefied petroleum gas stove use and 66% no longer used the traditional cookstove. Variables associated with one or more of the three outcomes are: education, age and civil status of the reporting female, household wealth and size, region, encounters of problems with the improved solid fuel stove, knowledge of somebody able to build an improved solid fuel stove, whether stove parts are obtainable in the community, and subsidy schemes. We conclude that to be successful, improved solid fuel stove programmes need to consider (1) existing household characteristics, (2) the household's need for ready access to maintenance and repair, and (3) improved knowledge at the community level.
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Contaminación del Aire Interior/prevención & control , Culinaria , Artículos Domésticos , Adulto , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Perú , Petróleo , Evaluación de Programas y Proyectos de Salud , Población Rural , Encuestas y CuestionariosRESUMEN
Polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs) are important indoor contaminants. Their hydrophobic nature hinders the possibility of biological abatement using biofiltration. Our aim was to establish whether the use of a consortium of Fusarium solani and Rhodococcus erythropolis shows an improved performance (in terms of mineralization rate and extent) towards the degradation of formaldehyde, as a slightly polar VOC; toluene, as hydrophobic VOC; and benzo[α]pyrene (BaP) as PAH at low concentrations compared to a single-species biofilm in serum bottles with vermiculite as solid support to mimic a biofilter and to relate the possible improvements with the surface hydrophobicity and partition coefficient of the biomass at three different temperatures. Results showed that the hydrophobicity of the surface of the biofilms was affected by the hydrophobicity of the carbon source in F. solani but it did not change in R. erythropolis. Similarly, the partition coefficients of toluene and BaP in F. solani biomass (both as pure culture and consortium) show a reduction of up to 38 times compared to its value in water, whereas this reduction was only 1.5 times in presence of R. erythropolis. Despite that increments in the accumulated CO2 and its production rate were found when F. solani or the consortium was used, the mineralization extent of toluene was below 25%. Regarding BaP degradation, the higher CO2 production rates and percent yields were obtained when a consortium of F. solani and R. erythropolis was used, despite a pure culture of R. erythropolis exhibits poor mineralization of BaP.
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Benzo(a)pireno/metabolismo , Biodegradación Ambiental , Formaldehído/metabolismo , Fusarium/metabolismo , Rhodococcus/metabolismo , Tolueno/metabolismo , Contaminación del Aire Interior/prevención & control , Biomasa , Filtración/instrumentación , Consorcios Microbianos/fisiología , Hidrocarburos Policíclicos Aromáticos/metabolismo , Compuestos Orgánicos Volátiles/metabolismoRESUMEN
Many households in low- and middle-income countries cook with inefficient biomass-burning stoves, which cause high levels of household air pollution and threaten long-term health. Although clean stoves and fuels are available, uptake and consistent use has been low. Using observations and in-depth interviews, we assessed the attitudes, preferences, and beliefs about traditional versus liquefied petroleum gas (LPG) stoves in rural Puno, Peru. A total of 31 in-depth interviews were conducted with primary cooks and their families, health workers, community leaders, and improved stove contractors. Six in-home observations of meal preparation were also conducted. Six major barriers to consistent use of clean stoves were identified: (1) perceived differences in food taste and nutrition by stove type; (2) cooking niches filled by different stoves; (3) social norms related to cooking practices; (4) safety concerns; (5) comparative costs of using different stoves; and (6) lack of awareness and concern about long-term health risks. These findings suggest that to successfully reduce household air pollution, clean cooking programs and policies must consider the many factors influencing adoption beyond health, such as cost, taste, fears, and cultural traditions. These factors could be incorporated into community-based and national efforts to scale-up sustained and exclusive adoption of clean cooking.