Short-term differences in cardiac function following controlled exposure to cookstove air pollution: The subclinical tests on volunteers exposed to smoke (STOVES) study

Tom Cole-Hunter; Radhika Dhingra; Kristen M. Fedak; Nicholas Good; Christian L'Orange; Gary Luckasen; John Mehaffy; Ethan Walker; Ander Wilson; John Balmes; Robert D. Brook; Maggie L. Clark; Robert B. Devlin; John Volckens; Jennifer L. Peel

Environment International (Jan 2021)

Short-term differences in cardiac function following controlled exposure to cookstove air pollution: The subclinical tests on volunteers exposed to smoke (STOVES) study

Tom Cole-Hunter,
Radhika Dhingra,
Kristen M. Fedak,
Nicholas Good,
Christian L'Orange,
Gary Luckasen,
John Mehaffy,
Ethan Walker,
Ander Wilson,
John Balmes,
Robert D. Brook,
Maggie L. Clark,
Robert B. Devlin,
John Volckens,
Jennifer L. Peel

Affiliations

Tom Cole-Hunter: Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Centre for Air Pollution, Energy, and Health Research, University of New South Wales, Sydney, NSW, Australia; International Laboratory for Air Quality and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, QLD, Australia; Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
Radhika Dhingra: Department of Environmental Sciences and Engineering, University of North Carolina, NC, USA; Environmental Public Health Division, United States Environmental Protection Agency, Chapel Hill, NC, USA
Kristen M. Fedak: Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
Nicholas Good: Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
Christian L'Orange: Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
Gary Luckasen: Heart Center of the Rockies, Fort Collins, CO, USA
John Mehaffy: Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
Ethan Walker: Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
Ander Wilson: Department of Statistics, Colorado State University, Fort Collins, CO, USA
John Balmes: Department of Medicine, University of California, San Francisco, CA, USA
Robert D. Brook: Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
Maggie L. Clark: Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
Robert B. Devlin: Environmental Public Health Division, United States Environmental Protection Agency, Chapel Hill, NC, USA
John Volckens: Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
Jennifer L. Peel: Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Corresponding author at: Post: 1681 Campus Delivery, Fort Collins, CO 80523-1681, USA.

Journal volume & issue: Vol. 146
p. 106254

Abstract

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Background: Exposure to household air pollution from solid fuel combustion for cooking and heating is an important risk factor for premature death and disability worldwide. Current evidence supports an association of ambient air pollution with cardiovascular disease but is limited for household air pollution and for cardiac function. Controlled exposure studies can complement evidence provided by field studies. Objectives: To investigate effects of short-term, controlled exposures to emissions from five cookstoves on measures of cardiac function. Methods: Forty-eight healthy adults (46% female; 20–36 years) participated in six, 2-h exposures (‘treatments’), including emissions from five cookstoves and a filtered-air control. Target fine particulate matter (PM2.5) exposure-concentrations per treatment were: control, 0 µg/m3; liquefied petroleum gas, 10 µg/m3; gasifier, 35 µg/m3; fan rocket, 100 µg/m3; rocket elbow, 250 µg/m3; and three stone fire, 500 µg/m3. Participants were treated in a set (pre-randomized) sequence as groups of 4 to minimize order bias and time-varying confounders. Heart rate variability (HRV) and cardiac repolarization metrics were calculated as 5-min means immediately and at 3 h following treatment, for analysis in linear mixed-effects models comparing cookstove to control. Results: Short-term differences in SDNN (standard deviation of duration of all NN intervals) and VLF (very-low frequency power) existed for several cookstoves compared to control. While all cookstoves compared to control followed a similar trend for SDNN, the greatest effect was seen immediately following three stone fire (β = −0.13 ms {%}; 95% confidence interval = −0.22, −0.03%), which reversed in direction at 3 h (0.03%; −0.06, 0.13%). VLF results were similar in direction and timing to SDNN; however, other HRV or cardiac repolarization results were not similar to those for SDNN. Discussion: We observed some evidence of short-term, effects on HRV immediately following cookstove treatments compared to control. Our results suggest that cookstoves with lower PM2.5 emissions are potentially capable of affecting cardiac function, similar to stoves emitting higher PM2.5 emissions.

Published in Environment International

ISSN: 0160-4120 (Print)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Geography. Anthropology. Recreation: Environmental sciences
Website: https://www.journals.elsevier.com/environment-international

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