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Improved Biomass Stove Intervention in Rural Mexico

Impact on the Respiratory Health of Women

¹ Environmental Health Department, National Institute of Public Health (INSP), Cuernavaca, Morelos; ² National Institute of Respiratory Diseases (INER), Distrito Federal; ³ Center for Ecosystem Research, National Autonomous University of Mexico (UNAM) and Interdisciplinary Group for Appropriate Rural Technology (GIRA), Morelia, Michoacán, México

Correspondence and requests for reprints should be addressed to Horacio Riojas-Rodríguez, M.D., Instituto Nacional de Salud Pública, 655 Av. Universidad, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos, 62508 México. E-mail: hriojas{at}correo.insp.mx

Rationale: Exposure to biomass smoke has been related to adverse health effects. In Mexico, one household in four still cooks with biomass fuel, but there has been no evaluation of the health impact of reducing indoor air pollution.

Objectives: To evaluate the health impact of the introduction of an improved biomass stove (Patsari; Interdisciplinary Group for Appropriate Rural Technology [GIRA], Patzcuaro, Mexico) in Mexican women.

Methods: A randomized controlled trial was conducted in the Central Mexican state of Michoacán. Households were randomized to receive the Patsari stove or keep their traditional open fire. A total of 552 women were followed with monthly visits over 10 months to assess stove use, inquire about respiratory and other symptoms, and obtain lung function measurements. Statistical analysis was conducted using longitudinal models.

Measurements and Main Results: Adherence to the intervention was low (50%). Women who reported using the Patsari stove most of the time compared with those using the open fire had significantly lower risk of respiratory symptoms (relative risk [RR], 0.77; 95% confidence interval [CI], 0.62–0.95 for cough and RR, 0.29; 95% CI, 0.11–0.77 for wheezing) adjusted for confounders. Similar results were found for other respiratory symptoms as well as for eye discomfort, headache, and back pain. Actual use of the Patsari stove was associated with a lower FEV₁ decline (31 ml) compared with the open fire use (62 ml) over 1 year of follow-up (P = 0.012) for women 20 years of age and older, adjusting for confounders.

Conclusions: The use of the Patsari stove was significantly associated with a reduction of symptoms and of lung function decline comparable to smoking cessation.

Key Words: biomass fuels • respiratory symptoms • lung function tests • longitudinal models

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject Cooking and heating with biomass fuels on open fires or traditional stoves results in high levels of health-damaging pollutants and has been associated with numerous respiratory problems, thus contributing to global mortality and burden of disease. One approach to reduce the health burden related to biomass fuel has been the provision of improved wood-burning stoves in rural areas of developing countries. What This Study Adds to the Field The use of the Patsari stove was significantly associated with a reduction in symptoms and lung function decline when compared with the use of an open fire.

 

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Biomass-fueled Intervention Stoves in the Developing World: Potential and Challenges

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AJRCCM 2009 180: 586-587. [Full Text]  

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				L. P. Naeher Biomass-fueled Intervention Stoves in the Developing World: Potential and Challenges Am. J. Respir. Crit. Care Med., October 1, 2009; 180(7): 586 - 587. [Full Text] [PDF]