Disease burden and health risk to rural communities of northeastern India from indoor cooking-related exposure to parent, oxygenated and alkylated PAHs.

Exposure to a total of 51 targeted and non-targeted polycyclic aromatic hydrocarbons (PAHs) and their oxygenated and alkylated derivatives associated with size-segregated aerosol was investigated in rural kitchens using liquefied petroleum gas (LPG), mixed biomass (MB) and firewood (FW) fuels in northeastern India. The averaged PM-associated parent-, alkylated-, and oxygenated-PAHs concentrations increased notably from LPG (257, 54, and 116 ng m) to MB (838, 119, and 272 ng m) to FW-using kitchens (2762, 225, and 554 ng m), respectively. PAHs were preferentially associated with the PM fraction with contributions increasing from 80 % in LPG to 86 % in MB and 90 % in FW-using kitchens, which in turn was dominated by <0.25 μm particles (54-75 % of the total). A clear profile of enrichment of low-molecular weight PAHs in cleaner fuels (LPG) and a contrasting enrichment of high-molecular weight PAHs in biomass-based fuels was noted. The averaged internal dose of Benzo[a]pyrene equivalent was the lowest in the case of LPG (19 ng m), followed by MB (161 ng m) and the highest in FW users (782 ng m). Estimation of incremental lifetime cancer risk (ILCR) from PAH exposure revealed extremely high cancer risk in biomass users (factors of 8-40) compared to LPG. The potential years of life lost (PYLL) and PYLL rate averaged across kitchen categories was higher for lung cancer (PYLL: 10.55 ± 1.04 years; PYLL rate: 204 ± 426) compared to upper respiratory tract cancer (PYLL: 10.02 ± 0.05 years; PYLL rate: 4 ± 7), and the PYLL rates for biomass users were higher by factors of 9-56 as compared to LPG users. These findings stress the need for accelerated governmental intervention to ensure a quick transition from traditional biomass-based fuels to cleaner alternatives for the rural population of northeastern India.