Indoor air pollution in a Mexican indigenous community: evaluation of risk reduction program using biomarkers of exposure and effect.

Indoor air pollution can be an important risk factor for human health, considering that people spend more than 60% of their time indoors. Fifty percent of the world population and approximately 90% of the rural population in developing countries are using biomass as energy source. Latin America represents 12% of the global consumption of biomass; in Mexico, 27 million people use wood as an energy source. Therefore, in this study we evaluated a 3-stage risk reduction program. The stages were: 1) removal of indoor soot adhered to roofs and internal walls; 2) paving the dirt floors; and 3) introduction of a new wood stove with a metal chimney that expels smoke outdoors. The complete intervention program was applied. In 20 healthy subject residents from an indigenous community in San Luis Potosí, Mexico, we measured blood carboxyhemoglobin (% COHb), DNA damage (comet assay) in nucleated blood cells, and urinary 1-OHP levels before and after the program. Before intervention individuals had a geometric mean COHb level of 4.93% and 53% of the population presented levels above 2.5% considered a safe level. However, in all the studied individuals the levels of COHb were reduced to below 2.5% (mean level 1.0%) one month after the intervention. Moreover, when compared, DNA damage in people exposed before the intervention was higher (5.8+/-1.3 of Tail Moment) than when the program was introduced (2.8+/-0.9 of Tail Moment) (P>0.05) and a same trend was observed with urinary 1-OHP levels; 6.71+/-3.58 micromol/mol creatinine was the concentration before intervention; whereas, 4.80+/-3.29 micromol/mol creatinine was the one after the program. The results suggest that the intervention program offers an acceptable risk reduction to those families that use biomass for food cooking.