Dataset Information

Exposure to Household Air Pollution from Biomass Cookstoves and Levels of Fractional Exhaled Nitric Oxide (FeNO) among Honduran Women.

ABSTRACT: Household air pollution is estimated to be responsible for nearly three million premature deaths annually. Measuring fractional exhaled nitric oxide (FeNO) may improve the limited understanding of the association of household air pollution and airway inflammation. We evaluated the cross-sectional association of FeNO with exposure to household air pollution (24-h average kitchen and personal fine particulate matter and black carbon; stove type) among 139 women in rural Honduras using traditional stoves or cleaner-burning Justa stoves. We additionally evaluated interaction by age. Results were generally consistent with a null association; we did not observe a consistent pattern for interaction by age. Evidence from ambient and household air pollution regarding FeNO is inconsistent, and may be attributable to differing study populations, exposures, and FeNO measurement procedures (e.g., the flow rate used to measure FeNO).

SUBMITTER: Benka-Coker ML

PROVIDER: S-EPMC6267103 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Exposure to Household Air Pollution from Biomass Cookstoves and Levels of Fractional Exhaled Nitric Oxide (FeNO) among Honduran Women.

Benka-Coker Megan L ML Clark Maggie L ML Rajkumar Sarah S Young Bonnie N BN Bachand Annette M AM Balmes John R JR Brook Robert R Nelson Tracy L TL Volckens John J Reynolds Steve J SJ Wilson Ander A L'Orange Christian C Good Nicholas N Quinn Casey C Koehler Kirsten K Africano Sebastian S Osorto Pinel Anibal A Peel Jennifer L JL

International journal of environmental research and public health 20181113 11

Household air pollution is estimated to be responsible for nearly three million premature deaths annually. Measuring fractional exhaled nitric oxide (FeNO) may improve the limited understanding of the association of household air pollution and airway inflammation. We evaluated the cross-sectional association of FeNO with exposure to household air pollution (24-h average kitchen and personal fine particulate matter and black carbon; stove type) among 139 women in rural Honduras using traditional ...[more]

PMID: 30428575

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Project description:BackgroundHousehold air pollution from cooking with solid fuels affects nearly 3 billion people worldwide and is responsible for an estimated 2.5 million premature deaths and 77 million disability-adjusted life years annually. Investigating the effect of household air pollution on indicators of cardiometabolic disease, such as metabolic syndrome, can help clarify the pathways between this widespread exposure and cardiovascular diseases, which are increasing in low- and middle-income countries.MethodsOur cross-sectional study of 150 women in rural Honduras (76 with traditional stoves and 74 with cleaner-burning Justa stoves) explored the effect of household air pollution exposure on cardiovascular disease risk factors. Household air pollution was measured by stove type and 24-h average kitchen and personal fine particulate matter [PM2.5] mass and black carbon concentrations. Health endpoints included non-fasting total cholesterol, high-density lipoprotein, calculated low-density lipoprotein, triglycerides, waist circumference to indicate abdominal obesity, and presence of metabolic syndrome (defined by current modified international guidelines: waist circumference ≥ 80 cm plus any two of the following: triglycerides > 200 mg/dL, HDL < 50 mg/dL, systolic blood pressure ≥ 130 mmHg, diastolic blood pressure ≥ 85 mmHg, or glycated hemoglobin > 5.6%).ResultsForty percent of women met the criteria for metabolic syndrome. The prevalence ratio [PR] for metabolic syndrome (versus normal) per interquartile range increase in kitchen PM2.5 and kitchen black carbon was 1.16 (95% confidence interval [CI]: 1.01-1.34) per 312 μg/m3 increase in PM2.5, and 1.07 (95% CI: 1.03-1.12) per 73 μg/m3 increase in black carbon. There is suggestive evidence of a stronger effect in women ≥ 40 years of age compared to women < 40 (p-value for interaction = 0.12 for personal PM2.5). There was no evidence of associations between all other exposure metrics and health endpoints.ConclusionsThe prevalence of metabolic syndrome among our study population was high compared to global estimates. We observed a suggestive effect between metabolic syndrome and exposure to household air pollution. These results for metabolic syndrome may be driven by specific syndrome components, such as blood pressure. Longitudinal research with repeated health and exposure measures is needed to better understand the link between household air pollution and indicators of cardiometabolic disease risk.

Project description:BackgroundThe use of fractional exhaled nitric oxide (FeNO) has been proposed for identifying and monitoring eosinophilic airway inflammation in chronic obstructive pulmonary disease (COPD). To explore the clinical utility of FeNO in COPD, we aimed to assess its short-term variability in a clinically stable COPD cohort.MethodsConsecutive COPD patients, formerly smokers, underwent FeNO assessment at the baseline and six time-points through serial sampling spaced 3 days apart.ResultsA total of 41 patients (mean age 72.9, 87.8% males) showed a median baseline value of FeNO of 11.7 (8.0-16.8) ppb. A weak linear relationship was documented between baseline FeNO values and both eosinophil counts (r = 0.341, p = 0.029) and the percentage of eosinophils (r = 0.331, p = 0.034), confirmed in multiple linear regressions after adjusting for steroid use. The overall individual variability of FeNO between time-points was 3.90 (2.53-7.29) ppb, with no significant difference in the distribution of FeNO values measured at different time-points (p = 0.204). A total of 28 (68.3%) patients exhibited FeNO always below the 25 ppb cut-off at all determinations, while the remining 13 (31.7%) had at least one value above the established limit. Interestingly, none of these 13 participants had FeNO stably above 25 ppb, all showing at least one normal value during serial sampling. Compared to these patients with more fluctuating values, the 28 with stably normal FeNO only exhibited a significantly higher body weight (80.0 ± 18.2 kg vs. 69.0 ± 8.8 kg, p = 0.013) and body mass index (29.7 ± 6.5 kg/m2 vs. 25.9 ± 3.7 kg/m2, p = 0.026), confirmed in multiple logistic regressions after adjusting for major potential confounders.ConclusionsA certain degree of FeNO variability, apparently unrelated to eosinophil counts but somehow influenced by body weight, must be considered in COPD patients. Further studies are needed to clarify whether this biomarker may be effectively used to plan more personalized pharmacological and rehabilitation strategies in this clinical setting.

Project description:INTRODUCTION:During the last decade, many articles have been published, including reviews on fractional exhaled nitric oxide (FeNO) use and utility in clinical practice and for monitoring and identifying eosinophilic airway inflammation, especially in asthma, and evaluating corticosteroid responsiveness. However, the exact role of FeNO in patients with chronic obstructive pulmonary disease (COPD) and its ability to distinguish patients with COPD and those having concomitant asthma, that is, asthma-COPD overlap (ACO) is still unclear and needs to be defined. Due to the broad topics of FeNO in chronic airway disease, we undertook a scoping review. The present article describes the protocol of a scoping review of peer-reviewed published literature specific to FeNO in COPD/ACO over the last decade. METHODS AND ANALYSIS:We used Joanna Briggs Institute Reviewers' Manual scoping review methodology as well as Levac et al's and Arksey et al's framework as guides. We searched a variety of databases, including Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Web of Science, and BioSciences Information Service (BIOSIS) on 29 June 2016. Additional studies will be recognised by exploring the reference list of identified eligible studies. Screening of eligible studies will be independently performed by two reviewers and any disagreement will be solved by the third reviewer. We will analyse the gathered data from article bibliographies and abstracts. ETHICS AND DISSEMINATION:To investigate the body of published studies regarding the role of FeNO in patients with COPD and its usefulness in the clinical setting, a scoping review can be used as a modern and pioneer model, which does not need ethics approval. By this review, new insights for conducting new research specific to FeNO in COPD/ACO population will emerge. The results of this study will be reported in the scientific meetings and conferences, which aim to provide information to the clinicians, primary care providers and basic science researchers.

Dataset Information

Exposure to Household Air Pollution from Biomass Cookstoves and Levels of Fractional Exhaled Nitric Oxide (FeNO) among Honduran Women.

Publications

Exposure to Household Air Pollution from Biomass Cookstoves and Levels of Fractional Exhaled Nitric Oxide (FeNO) among Honduran Women.

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