Short-term differences in cardiac function following controlled exposure to cookstove air pollution: The subclinical tests on volunteers exposed to smoke (STOVES) study,Environment International

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Short-term differences in cardiac function following controlled exposure to cookstove air pollution: The subclinical tests on volunteers exposed to smoke (STOVES) study
Environment International ( IF 10.3 ) Pub Date : 2020-11-19 , DOI: 10.1016/j.envint.2020.106254
Tom Cole-Hunter ₁ , Radhika Dhingra ₂ , Kristen M Fedak ₃ , Nicholas Good ₃ , Christian L'Orange ₄ , Gary Luckasen ₅ , John Mehaffy ₄ , Ethan Walker ₃ , Ander Wilson ₆ , John Balmes ₇ , Robert D Brook ₈ , Maggie L Clark ₃ , Robert B Devlin ₉ , John Volckens ₁₀ , Jennifer L Peel ₃

Affiliation

Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Centre for Air Pollution, Energy, and Health Research, University of New South Wales, Sydney, NSW, Australia; International Laboratory for Air Quality and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, QLD, Australia; Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Department of Environmental Sciences and Engineering, University of North Carolina, NC, USA; Environmental Public Health Division, United States Environmental Protection Agency, Chapel Hill, NC, USA.
Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.
Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA.
Heart Center of the Rockies, Fort Collins, CO, USA.
Department of Statistics, Colorado State University, Fort Collins, CO, USA.
Department of Medicine, University of California, San Francisco, CA, USA.
Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Environmental Public Health Division, United States Environmental Protection Agency, Chapel Hill, NC, USA.
Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA.

Background

Exposure to household air pollution from solid fuel combustion for cooking and heating is an important risk factor for premature death and disability worldwide. Current evidence supports an association of ambient air pollution with cardiovascular disease but is limited for household air pollution and for cardiac function. Controlled exposure studies can complement evidence provided by field studies.

Objectives

To investigate effects of short-term, controlled exposures to emissions from five cookstoves on measures of cardiac function.

Methods

Forty-eight healthy adults (46% female; 20–36 years) participated in six, 2-h exposures (‘treatments’), including emissions from five cookstoves and a filtered-air control. Target fine particulate matter (PM_2.5) exposure-concentrations per treatment were: control, 0 µg/m³; liquefied petroleum gas, 10 µg/m³; gasifier, 35 µg/m³; fan rocket, 100 µg/m³; rocket elbow, 250 µg/m³; and three stone fire, 500 µg/m³. Participants were treated in a set (pre-randomized) sequence as groups of 4 to minimize order bias and time-varying confounders. Heart rate variability (HRV) and cardiac repolarization metrics were calculated as 5-min means immediately and at 3 h following treatment, for analysis in linear mixed-effects models comparing cookstove to control.

Results

Short-term differences in SDNN (standard deviation of duration of all NN intervals) and VLF (very-low frequency power) existed for several cookstoves compared to control. While all cookstoves compared to control followed a similar trend for SDNN, the greatest effect was seen immediately following three stone fire (β = −0.13 ms {%}; 95% confidence interval = −0.22, −0.03%), which reversed in direction at 3 h (0.03%; −0.06, 0.13%). VLF results were similar in direction and timing to SDNN; however, other HRV or cardiac repolarization results were not similar to those for SDNN.

Discussion

We observed some evidence of short-term, effects on HRV immediately following cookstove treatments compared to control. Our results suggest that cookstoves with lower PM_2.5 emissions are potentially capable of affecting cardiac function, similar to stoves emitting higher PM_2.5 emissions.

中文翻译：

受控暴露于炉灶空气污染后心脏功能的短期差异：对暴露于烟雾的志愿者的亚临床测试（STOVES）研究

背景

因烹饪和取暖而燃烧固体燃料而造成的家庭空气污染是全世界过早死亡和残疾的一个重要风险因素。目前的证据支持环境空气污染与心血管疾病之间的关联，但仅限于家庭空气污染和心脏功能。受控暴露研究可以补充现场研究提供的证据。

目标

旨在研究短期、受控接触五个炉灶排放物对心脏功能测量的影响。

方法

48 名健康成年人（46% 为女性；20-36 岁）参与了六次为期 2 小时的暴露（“治疗”），其中包括来自五个炉灶和过滤空气控制的排放物。每次处理的目标细颗粒物 (PM _2.5 ) 暴露浓度为：对照，0 µg/m ³ ；对照，0 µg/m 3 ；液化石油气，10 µg/m ³ ；气化炉，35 µg/m ³ ；风扇火箭，100 µg/m ³ ；火箭弯头，250 µg/m ³ ；三石火，500 µg/m ³ 。参与者按照 4 人一组的设定（预先随机化）顺序进行治疗，以尽量减少顺序偏差和随时间变化的混杂因素。心率变异性 (HRV) 和心脏复极指标按治疗后立即和 3 小时的 5 分钟平均值计算，用于比较炉灶与对照的线性混合效应模型中的分析。

结果

与对照相比，多个炉灶的 SDNN（所有 NN 间隔持续时间的标准差）和 VLF（极低频功率）存在短期差异。虽然与对照相比，所有炉灶的 SDNN 都遵循类似的趋势，但在三块石火之后立即出现最大效果（β = -0.13 ms {%}；95% 置信区间 = -0.22，-0.03%），其方向发生了逆转3 小时（0.03%；-0.06，0.13%）。 VLF 结果在方向和时间上与 SDNN 相似；然而，其他 HRV 或心脏复极结果与 SDNN 的结果并不相似。