Effect of a clean stove intervention on inflammatory biomarkers in pregnant women in Ibadan, Nigeria: A randomized controlled study

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Abstract

Background Exposure to household air pollution (HAP) has been linked to systemic inflammation. We determined the impact of transition from traditional firewood/kerosene stove to bioethanol-burning stove on inflammatory biomarkers in pregnant Nigerian women. Methods Women (n = 324), cooking with kerosene/firewood, were recruited during their first trimester of pregnancy from June 2013–October 2015 and were randomly allocated to either control (n = 162) or intervention (n = 162) group using web-based randomization. Controls continued to use their own firewood/kerosene stove, while intervention participants received bioethanol CleanCook stoves. Serum concentrations of retinol-binding protein (RBP), malondialdehyde (MDA), tumor necrosis factor alpha (TNF)-α, interleukin (IL)-6, and IL-8 were measured by ELISA. Results After excluding 53 women (loss of follow-up, untimely biomarker assessments, incorrect dates of enrollment), data from 271 women were included in analysis. Mean (SD) change in RBP, MDA, TNF-α, IL-6, and IL-8 between baseline and third trimester was − 2.16 (4.47), − 19.6 (46.4), 3.72 (37.2), 0.51 (14.4), and 13.2 (197), respectively, in intervention and − 2.25 (4.30), − 24.6 (43.6), 7.17 (32.6), − 1.79, (11.4), and 31.3 (296) in control groups. None of these changes differed significantly between the two treatment arms. However, changes from baseline in TNF-α levels were significantly different between intervention and control groups in subset of women (n = 99) using firewood before trial (− 7.03 [32.9] vs. + 12.4 [33.6]; 95% CI for group difference: − 35.4 to − 3.4, p = 0.018). Conclusions Decrease in TNF-α concentration from baseline to third trimesters in intervention group women could indicate reduced cardiovascular stress and prothrombotic effects from decreased HAP. Our findings suggest that ethanol-burning stoves may mitigate cardiovascular health risks.

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Olopade, C. O., Frank, E., Bartlett, E., Alexander, D., Dutta, A., Ibigbami, T., … Ojengbede, O. (2017). Effect of a clean stove intervention on inflammatory biomarkers in pregnant women in Ibadan, Nigeria: A randomized controlled study. Environment International, 98, 181–190. https://doi.org/10.1016/j.envint.2016.11.004

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