Predictors of Personal Exposure to Fine Particulate Matter, Black Carbon, and Carbon Monoxide among Pregnant Women in Rwanda: Baseline Data from the HAPIN Trial.

BACKGROUND

Exposure to household air pollution from the combustion of solid fuels is a leading risk factor for death and disease in low- and middle-income countries, where cleaner cooking and lighting options are often unavailable. Few studies have measured personal exposure during pregnancy, a sensitive period of development, particularly in Africa.

OBJECTIVE

We aimed to characterize exposure during early to midpregnancy among women in Rwanda and to assess predictors of personal exposure, including stove and fuel type, cooking behaviors, housing conditions, sociodemographic characteristics, and other potential sources of exposure.

METHODS

We assessed 24-h baseline personal exposure data among 798 pregnant women in the Household Air Pollution Intervention Network (HAPIN) trial in Rwanda, including 717 with fine particulate matter ( ), 569 with black carbon (BC), and 716 with carbon monoxide (CO) samples. Best subsets regression identified key predictors of personal , BC, and CO exposure, defined by maximizing adjusted values and minimizing prediction errors (Mallow's C and the Bayesian information criterion).

RESULTS

The 24-h median concentrations at baseline were [ ], ( 7.6), and ( 1.9) for BC, and CO, respectively. Households using kerosene as a primary lighting source had higher levels ( , 107) than those using electricity ( , 69). Women in households with modified biomass stoves with a chimney had lower median values ( , 52) for , compared with those in households using open fires ( , 74) and other traditional stove types ( , 43) that yielded the highest values. Consensus models from the best subsets' regression explained 26% of the variation in , 36% in BC, and 31% in CO concentrations.

CONCLUSIONS

Based on a unique and large dataset describing personal exposure among pregnant women in rural Rwanda, lighting and cooking practices described some variability in household concentrations, but overall, substantial unexplained variability remained. https://doi.org/10.1289/JHP1049.