The effect of clean cooking interventions on mother and child personal exposure to air pollution: results from the Ghana Randomized Air Pollution and Health Study (GRAPHS).

ABSTRACT:

Background

Clean cooking interventions to reduce air pollution exposure from burning biomass for daily cooking and heating needs have the potential to reduce a large burden of disease globally.

Objective

The objective of this study is to evaluate the air pollution exposure impacts of a fan-assisted efficient biomass-burning cookstove and a liquefied petroleum gas (LPG) stove intervention in rural Ghana.

Methods

We randomized 1414 households in rural Ghana with pregnant mothers into a control arm (N = 526) or one of two clean cooking intervention arms: a fan-assisted efficient biomass-burning cookstove (N = 527) or an LPG stove and cylinder refills as needed (N = 361). We monitored personal maternal carbon monoxide (CO) at baseline and six times after intervention and fine particulate matter (PM_2.5) exposure twice after intervention. Children received three CO exposure monitoring sessions.

Results

We obtained 5655 48-h maternal CO exposure estimates and 1903 for children, as well as 1379 maternal PM_2.5 exposure estimates. Median baseline CO exposures in the control, improved biomass, and LPG arms were 1.17, 1.17, and 1.30 ppm, respectively. Based on a differences-in-differences approach, the LPG arm showed a 47% reduction (95% confidence interval: 34-57%) in mean 48-h CO exposure compared to the control arm. Mean maternal PM_2.5 exposure in the LPG arm was 32% lower than the control arm during the post-intervention period (52 ± 29 vs. 77 ± 44 μg/m³). The biomass stove did not meaningfully reduce CO or PM_2.5 exposure.

Conclusions

We show that LPG interventions lowered air pollution exposure significantly compared to three-stone fires. However, post-intervention exposures still exceeded health-relevant targets.

Significance

In a large controlled trial of cleaner cooking interventions, an LPG stove and fuel intervention reduced air pollution exposure in a vulnerable population in a low-resource setting.

SUBMITTER: Chillrud SN 

PROVIDER: S-EPMC8273075 | biostudies-literature |

REPOSITORIES: biostudies-literature