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洪都拉斯妇女接触生物质燃烧炉灶产生的家庭空气污染与糖化血红蛋白及糖尿病状况的关系

Exposure to household air pollution from biomass-burning cookstoves and HbA1c and diabetic status among Honduran women.

作者信息

Rajkumar S, Clark M L, Young B N, Benka-Coker M L, Bachand A M, Brook R D, Nelson T L, Volckens J, Reynolds S J, L'Orange C, Good N, Koehler K, Africano S, Osorto Pinel A B, Peel J L

机构信息

Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.

Division of Cardiovascular Medicine, University of Michigan Medical School, Domino's Farms, Ann Arbor, MI, USA.

出版信息

Indoor Air. 2018 Jun 13. doi: 10.1111/ina.12484.

Abstract

Household air pollution from biomass cookstoves is estimated to be responsible for more than two and a half million premature deaths annually, primarily in low and middle-income countries where cardiometabolic disorders, such as Type II Diabetes, are increasing. Growing evidence supports a link between ambient air pollution and diabetes, but evidence for household air pollution is limited. This cross-sectional study of 142 women (72 with traditional stoves and 70 with cleaner-burning Justa stoves) in rural Honduras evaluated the association of exposure to household air pollution (stove type, 24-hour average kitchen and personal fine particulate matter [PM ] mass and black carbon) with glycated hemoglobin (HbA1c) levels and diabetic status based on HbA1c levels. The prevalence ratio (PR) per interquartile range increase in pollution concentration indicated higher prevalence of prediabetes/diabetes (vs normal HbA1c) for all pollutant measures (eg, PR per 84 μg/m increase in personal PM , 1.49; 95% confidence interval [CI], 1.11-2.01). Results for HbA1c as a continuous variable were generally in the hypothesized direction. These results provide some evidence linking household air pollution with the prevalence of prediabetes/diabetes, and, if confirmed, suggest that the global public health impact of household air pollution may be broader than currently estimated.

摘要

据估计,生物质炉灶造成的家庭空气污染每年导致超过250万人过早死亡,主要发生在中低收入国家,在这些国家,心血管代谢疾病(如II型糖尿病)的发病率正在上升。越来越多的证据支持环境空气污染与糖尿病之间存在联系,但关于家庭空气污染的证据有限。这项横断面研究对洪都拉斯农村地区的142名妇女(72名使用传统炉灶,70名使用燃烧更清洁的Justa炉灶)进行了评估,根据糖化血红蛋白(HbA1c)水平,研究了家庭空气污染暴露(炉灶类型、24小时平均厨房和个人细颗粒物[PM]质量以及黑碳)与糖化血红蛋白(HbA1c)水平和糖尿病状态之间的关联。污染浓度每增加一个四分位数间距的患病率比(PR)表明,所有污染物指标(例如,个人PM每增加84μg/m,PR为1.49;95%置信区间[CI],1.11-2.01),糖尿病前期/糖尿病的患病率(与正常HbA1c相比)更高。糖化血红蛋白作为连续变量的结果总体上与假设方向一致。这些结果提供了一些证据,将家庭空气污染与糖尿病前期/糖尿病的患病率联系起来,如果得到证实,则表明家庭空气污染对全球公共卫生的影响可能比目前估计的更为广泛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98d6/6292747/1357d94d6fba/nihms975496f1.jpg

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