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dc.contributor.advisorScott, Alan L
dc.creatorFandino Del Rio, Magdalena
dc.date.accessioned2020-06-21T20:06:18Z
dc.date.created2020-05
dc.date.issued2020-03-13
dc.date.submittedMay 2020
dc.identifier.urihttp://jhir.library.jhu.edu/handle/1774.2/62518
dc.description.abstractProblem Statement: Approximately 3 billion people worldwide, mostly from low and middle-income countries, use biomass fuels such as wood and dung for cooking. Household air pollution (HAP) from biomass cookstoves is recognized as one of the largest environmental risk factors for preventable disease. Previous interventions to reduce HAP from biomass cookstoves have shown limited health improvements. As a result, recent efforts are focusing on cleaner fuels such as liquefied petroleum gas (LPG). This dissertation aimed to 1) characterize HAP concentrations from biomass cookstoves, 2) examine the exposure-response relationships between HAP and markers of inflammation, and 3) evaluate the longitudinal impact of an LPG stove intervention on HAP. Methods: We conducted a randomized, controlled field trial with 180 female participants that use biomass cookstoves in rural Peru, randomizing half of them to receive free LPG stoves and free fuel delivery for one year. We collected kitchen area concentrations and personal exposures to carbon monoxide (CO), fine particulate matter (PM2.5) and black carbon (BC), as well as dried blood samples. In the first manuscript, we determined the associations between household characteristics and HAP at baseline. In the second manuscript, we developed exposure-response models between HAP and markers of inflammation at baseline. In the third manuscript, we assessed the longitudinal impact of the LPG stove intervention on HAP concentrations at baseline and 3-, 6- and 12-months post-intervention. Results: In our first study, we observed that roof type has an important impact in kitchen ventilation of households in rural Peru. In our second study, we found statistically significant associations between kitchen area BC concentrations and inflammatory markers that were robust to adjustment for PM2.5 concentrations. In our third study, we found that our LPG stove intervention significantly reduced PM2.5, BC, and CO concentrations by at least 62%, to levels comparable with health-based guidelines. Conclusions: HAP concentrations from biomass cookstoves in rural Peru were well above recommended guidelines. The kitchen area concentrations were associated with inflammation markers. The success of an LPG stove intervention in reducing HAP is encouraging for future LPG programs to potentially improve health in resource-limited settings such as Peru.
dc.format.mimetypeapplication/pdf
dc.language.isoen_US
dc.publisherJohns Hopkins University
dc.subjectCookstoves
dc.subjectindoor air pollution
dc.subjecthousehold air pollution
dc.subjectpersonal exposure
dc.subjectbiomass fuel
dc.subjectmarkers of inflammation
dc.subjectliquefied petroleum gas
dc.subjectrural Peru
dc.titleHOUSEHOLD AIR POLLUTION FROM BIOMASS COOKSTOVES AND A LIQUEFIED PETROLEUM GAS INTERVENTION IN RURAL PERU
dc.typeThesis
thesis.degree.disciplineEnvironmental Health & Engineering
thesis.degree.grantorJohns Hopkins University
thesis.degree.grantorBloomberg School of Public Health
thesis.degree.levelDoctoral
thesis.degree.namePh.D.
dc.date.updated2020-06-21T20:06:18Z
dc.type.materialtext
thesis.degree.departmentEnvironmental Health and Engineering
local.embargo.lift2023-05-01
local.embargo.terms2023-05-01
dc.contributor.committeeMemberKoehler, Kirsten
dc.contributor.committeeMemberCheckley, William
dc.contributor.committeeMemberBuckley, Jessie P
dc.contributor.committeeMemberWinch, Peter
dc.publisher.countryUSA
dc.creator.orcid0000-0003-0601-4377


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