2016 Theses Doctoral

Household Air Pollution Exposures and Respiratory Health Among Women in Rural Ghana

Van Vliet, Eleanne D.S.

Approximately 3 billion people in developing countries rely on solid fuels for their cooking, heating and lighting needs (Smith 2000). Household air pollution (HAP) from the incomplete combustion of these fuels constitutes the fourth leading risk factor for death and morbidity worldwide, and the number one risk factor for disease burden in some developing nations, including Ghana (Lim et al. 2013; Institute for Health Metrics and Evaluation 2016). While research shows biomass fuel combustion presents a significant global health and environmental burden, no regional, national or global policies have been enacted to reduce fine particulate matter (PM2.5) and black carbon (BC) emissions from cooking with biomass fuels. More data on personal exposures to particulate matter and BC from cooking with biomass are needed across geographic areas to assess whether exposure is mediated by (cultural) cooking customs, practices and behaviors. These data are critical in informing improved cookstove design as well as policies aimed at reducing harmful emissions and exposures from biomass smoke. The overall objective of this proposal is to examine personal exposures to cooking and non-cooking sources of HAP, characterize the elemental composition of the fine particulate matter across two common biomass fuels (charcoal and wood), and assess acute respiratory symptoms in pregnant women cooking with biomass fuels in rural Ghana. Through aerosol monitoring of PM2.5, our goal is to identify and apportion sources of personal exposures borne by cooks in rural Ghana, in order to inform mitigation policies and intervention design to alleviate health burden associated with cooking with biomass fuels. Specifically, in Aim 1 we propose to measure personal exposures and kitchen air concentrations of PM2.5 and BC across cooking locations, (i.e. enclosed, semi-enclosed, outdoor) and assess cooking characteristics (e.g. fuel, kitchen type, ethnicity) as possible determinants of exposure. In Aim 2, we will characterize the elemental composition of personal and kitchen air samples across fuel and kitchen types. These two aims will allow us to assess cooking and non-cooking sources of personal HAP exposure based on air monitoring data, composition of the filters, and survey-based cooking characteristics/demographics. In Aim 3, we propose to characterize the prevalence of adult respiratory symptoms in 1183 pregnant women in the region, and assess associations between personal exposure, measured by personal carbon monoxide (CO), and other cooking and non-cooking determinants of personal exposure, including fuel type, years cooked, kerosene lamp, mosquito coils, and charcoal production.