Effect of a clean stove intervention on inflammatory biomarkers in pregnant women in Ibadan, Nigeria: A randomized controlled study.

Christopher O Olopade, Elizabeth Frank, Emily Bartlett, Donee Alexander, Anindita Dutta, Tope Ibigbami, Damilola Adu, John Olamijulo, Ganiyu Arinola, Theodore Karrison, Oladosu Ojengbede

Journal: Environment international 2018;98():181-190

PMID: 27839852

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Abstract

BACKGROUND

Exposure to household air pollution (HAP) has been linked to systemic inflammation. We determined the impact of transition from traditional firewood/kerosene stove to bioethanol-burning stove on inflammatory biomarkers in pregnant Nigerian women.

METHODS

Women (n=324), cooking with kerosene/firewood, were recruited during their first trimester of pregnancy from June 2013-October 2015 and were randomly allocated to either control (n=162) or intervention (n=162) group using web-based randomization. Controls continued to use their own firewood/kerosene stove, while intervention participants received bioethanol CleanCook stoves. Serum concentrations of retinol-binding protein (RBP), malondialdehyde (MDA), tumor necrosis factor alpha (TNF)-α, interleukin (IL)-6, and IL-8 were measured by ELISA.

RESULTS

After excluding 53 women (loss of follow-up, untimely biomarker assessments, incorrect dates of enrollment), data from 271 women were included in analysis. Mean (SD) change in RBP, MDA, TNF-α, IL-6, and IL-8 between baseline and third trimester was -2.16 (4.47), -19.6 (46.4), 3.72 (37.2), 0.51 (14.4), and 13.2 (197), respectively, in intervention and -2.25 (4.30), -24.6 (43.6), 7.17 (32.6), -1.79, (11.4), and 31.3 (296) in control groups. None of these changes differed significantly between the two treatment arms. However, changes from baseline in TNF-α levels were significantly different between intervention and control groups in subset of women (n=99) using firewood before trial (-7.03 [32.9] vs. +12.4 [33.6]; 95% CI for group difference: -35.4 to -3.4, p=0.018).

CONCLUSIONS

Decrease in TNF-α concentration from baseline to third trimesters in intervention group women could indicate reduced cardiovascular stress and prothrombotic effects from decreased HAP. Our findings suggest that ethanol-burning stoves may mitigate cardiovascular health risks.

Address: Center for Global Health, University of Chicago, 5841 S. Maryland Avenue, MC 2021, Chicago, IL 60637, USA; Department of Medicine, University of Chicago, 5841 S. Maryland Avenue, MC 6076, Chicago, IL 60637, USA. Electronic address: [email protected].; Center for Global Health, University of Chicago, 5841 S. Maryland Avenue, MC 2021, Chicago, IL 60637, USA.; Pritzker School of Medicine, University of Chicago, 924 East 57th Street, Suite 104, Chicago, IL 60637, USA.; Center for Global Health, University of Chicago, 5841 S. Maryland Avenue, MC 2021, Chicago, IL 60637, USA; Department of Medicine, University of Chicago, 5841 S. Maryland Avenue, MC 6076, Chicago, IL 60637, USA.; Healthy Life for All Foundation, House 38, University College Hospital Campus, University of Ibadan, Oyo State, Ibadan, Nigeria.; College of Medicine, University College Hospital, Ibadan, Nigeria.; Department of Public Health Sciences, University of Chicago, 5841 South Maryland Ave, MC2000, Chicago, IL 60637, USA.; Department of Obstetrics and Gynecology, University College Hospital Campus, University of Ibadan, Oyo State, Ibadan, Nigeria.

DOI: 10.1016/j.envint.2016.11.004

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Full Text Sources:

https://linkinghub.elsevier.com/retrieve/pii/S0160...

Medical:

https://medlineplus.gov/indoorairpollution.html

Other Literature Sources:

https://scite.ai/reports/27839852

MeSH Terms: Adolescent, Adult, Air Pollution, Air Pollution, Indoor, Biofuels, Biomarkers, Cooking, Ethanol, Female, Household Articles, Household Products, Humans, Inflammation, Interleukin-6, Kerosene, Nigeria, Oxidative Stress, Pregnancy, Pregnant People, Young Adult