Association of household air pollution exposure and anemia among pregnant women: Analysis of baseline data from ’Household Air Pollution Intervention Network (HAPIN)’ trial

Yanling Deng; Kyle Steenland; Sheela S. Sinharoy; Jennifer L. Peel; Wenlu Ye; Ajay Pillarisetti; Stephanie M. Eick; Howard H. Chang; Jiantong Wang; Yunyun Chen; Bonnie N. Young; Maggie L. Clark; Dana Boyd Barr; Thomas F. Clasen, on behalf of the HAPIN Investigators

Environment International (Aug 2024)

Association of household air pollution exposure and anemia among pregnant women: Analysis of baseline data from ’Household Air Pollution Intervention Network (HAPIN)’ trial

Yanling Deng,
Kyle Steenland,
Sheela S. Sinharoy,
Jennifer L. Peel,
Wenlu Ye,
Ajay Pillarisetti,
Stephanie M. Eick,
Howard H. Chang,
Jiantong Wang,
Yunyun Chen,
Bonnie N. Young,
Maggie L. Clark,
Dana Boyd Barr,
Thomas F. Clasen, on behalf of the HAPIN Investigators

Affiliations

Yanling Deng: Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Corresponding author.
Kyle Steenland: Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
Sheela S. Sinharoy: Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Jennifer L. Peel: Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
Wenlu Ye: Division of Environmental Health Sciences, University of California at Berkeley, Berkeley, CA, USA
Ajay Pillarisetti: Division of Environmental Health Sciences, University of California at Berkeley, Berkeley, CA, USA
Stephanie M. Eick: Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
Howard H. Chang: Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
Jiantong Wang: Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
Yunyun Chen: Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
Bonnie N. Young: Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
Maggie L. Clark: Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
Dana Boyd Barr: Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
Thomas F. Clasen, on behalf of the HAPIN Investigators: Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA

Journal volume & issue: Vol. 190
p. 108815

Abstract

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Background: Anemia is common in low- and middle-income countries (LMICs), causing significant health issues and social burdens. Exposure to household air pollution from using biomass fuels for cooking and heating has been associated with anemia, but the exposure–response association has not been studied. Objectives: We evaluated the associations between personal exposure to air pollution and both hemoglobin levels and anemia prevalence among pregnant women in a multi-country randomized controlled trial. Methods: We studied 3,163 pregnant women aged 18–35 years with 9–20 weeks of gestation, recruited as part of the Household Air Pollution Intervention Network (HAPIN) randomized controlled trial in Guatemala, India, Peru, and Rwanda. We assessed 24-hour personal exposures to fine particulate matter (PM2.5), black carbon (BC), and carbon monoxide (CO), and measured hemoglobin levels at baseline (15 ± 3 weeks gestation). Linear and logistic regression models were used to examine the associations of measured pollutants with hemoglobin levels and anemia prevalence, adjusting for confounding. Results: Single-pollutant models showed associations of CO with higher hemoglobin levels and lower anemia prevalence. Bipollutant models involving CO and PM2.5 also revealed that an interquartile range (IQR) increase in CO concentrations (2.26 ppm) was associated with higher hemoglobin levels [β = 0.04; 95 % confidence interval (CI): 0.01, 0.07], and a lower odds of anemia prevalence [odds ratios (OR) = 0.90; 95 % CI: 0.83, 0.98]. PM2.5 was inversely related to hemoglobin and positively associated with anemia, but results were not statistically significant at the 0.05 alpha level. County-specific results showed that 3 of 4 countries showed a similar association between CO and hemoglobin. We found no association of BC levels with hemoglobin levels or with anemia prevalence. Conclusion: Our findings suggest that exposure to CO is associated with higher hemoglobin and lower anemia prevalence among pregnant women, whereas PM2.5 showed the opposite associations.

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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