Occupational and Environmental Lung Diseases |

Randomized Controlled Study of Bioethanol Stove Intervention on Blood Pressure Changes During Pregnancy in Nigerian Women FREE TO VIEW

Donee Alexander, PhD; Amanda Northcross, PhD; Rishi Pandya; Damilola Adu, MPH; Temitope Ibigbami, MS; John Olajumilo, MPH; Theodore Karrison, PhD; Oladosu Ojengbede, MBBS; C Olopade, MD
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University of Chicago, Chicago, IL

Chest. 2015;148(4_MeetingAbstracts):763A. doi:10.1378/chest.2271078
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SESSION TITLE: Occupational and Environmental Lung Diseases Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: More than 40% of the world’s population use solid fuels for cooking and energy needs, producing household air pollution (HAP) with elevated levels of particulate matter (PM) and other pollutants. Kerosene, a popular alternative to solid fuels also produces PM levels that exceed WHO standards. HAP is associated with elevated blood pressure (BP), a known risk factor for cardiovascular disease worldwide. Previous studies have examined improved cookstoves as a means to reduce HAP and improve BP. Ours is the first to evaluate the effects of HAP on BP through a randomized controlled intervention (RCT) comparing an ethanol cookstove with solid fuel and kerosene stoves

METHODS: As part of a larger study evaluating the associations between pregnancy outcomes and HAP, we recruited 300 pregnant women from selected clinics in Ibadan, Nigeria. Participants were < 18 weeks gestational age and use firewood or kerosene as their primary fuel, did not smoke or have HTN. Those eligible were randomized to the control arm (continued use of firewood or kerosene) or the intervention arm for which they received an ethanol cookstove. The control group participated in an education program, while the ethanol group was encouraged to use it exclusively for cooking. All subjects had six BP measurements during antenatal visits and 6 weeks post-delivery

RESULTS: We randomized 294 women with similar mean baseline systolic BP (SBP) and diastolic BP (DBP) between ethanol users and controls. Among women who have already delivered (n = 154), mean SBP in the intervention group at last measurement before delivery was 110.7 mm Hg, significantly lower than control group’s mean SBP of 115.1 mm Hg (p = .02). Mean DBP was significantly lower in the intervention group at this time (69.5 vs. 74.5 mm Hg, p = .001). The number of participants with a post-pregnancy BP measurement is small (n = 90), and the difference in mean SBP and DBP between the 2 groups is not significant. Comparing the last BP measurement before delivery between the intervention group (n = 83) and kerosene users alone (n = 54), mean SBP in the ethanol group was significantly lower (110.7 vs 116.2 mm Hg, p = .007). Difference in mean DBP among these groups was again significant (69.5 vs. 75.7 mm Hg, p = .0002)

CONCLUSIONS: Our study has found a significant reduction in SBP and DBP with a RCT ethanol cookstove intervention study during pregnancy.

CLINICAL IMPLICATIONS: Preliminary results suggest that adoption of ethanol cookstoves has the potential to reduce BP during pregnancy.

DISCLOSURE: The following authors have nothing to disclose: Donee Alexander, Amanda Northcross, Rishi Pandya, Damilola Adu, Temitope Ibigbami, John Olajumilo, Theodore Karrison, Oladosu Ojengbede, C Olopade

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