Household Air Pollution (PM2.5) and Blood Pressure in Non-Hypertensive Adult Women Living in the Highlands of Peru Open Access

Abstract

Purpose: To characterize blood pressure (BP) in non-hypertensive women age 25-65 years who use biomass fuel for cooking in the highlands of Peru. Also, to describe the association between personal exposure to PM2.5 from household air pollution and BP in this non-smoking, non-pregnant population in Puno, Peru.

Methods: Conducted a literature review, then analyzed personal PM2.5 exposure and BP data. Personal PM2.5 exposure was measured using 48-hour direct-reading and gravimetric samples. Corrected PM2.5 measurements were used for analysis. Systolic blood pressure (SBP), diastolic blood pressure (DBP), height, weight, date of birth was also measured. The preliminary data used for this thesis included 100 women. SAS 9.4 was used to run two sets of multivariate linear regression models, one with SBP and one with DBP. All independent variables (PM2.5, BMI, age, and Time BP was measured) were categorized.

Results: The mean BMI was 26.6 kg/m2, the mean age was 48 years old, and a large majority of participants had SBP and DBP which were within the normal blood pressure range (since the study excluded hypertensive women). Average personal exposure to PM2.5 was 128.83 μg/m3.

Overall, there was a negative or no correlation between PM2.5 and BP. The model indicated an inverse relationship between PM2.5 and both SBP and DBP after controlling for age, BMI, and time of day BP was taken (although not statistically significant for DBP). The largest inverse relationship was noted for PM2.5 between 57.49 - 92.63 μg/m3 when compared to PM2.5 less than 34 μg/m3 (SBP: -11.91mmHg, p-value: 0.0033, DBP: -5.34 mmHg, p-value: 0.0914).

Conclusions: This study is the first study we identified looking at the association between personal exposure to PM2.5 from biomass fuel and BP in the highlands of Peru. The only significant results in our data indicate that personal PM2.5 has an inverse association with SBP, after controlling for age, BMI, and time of day BP was taken. Our findings go against a priori knowledge, perhaps due to the cross-sectional study design and restrictions in our study population. As the literature is very sparse on this topic, more research is needed.

Table of Contents

Background: ..................................................................................................................................... 1

Methods ........................................................................................................................................... 8

Study Objectives .......................................................................................................................... 8

Project Design and Methodology .............................................................................................. 11

Methods of Analysis ................................................................................................................... 14

Results ............................................................................................................................................ 17

Descriptive Statistics .................................................................................................................. 17

Analytic statistics: ...................................................................................................................... 21

Discussion ...................................................................................................................................... 25

Conclusions and Recommendations .............................................................................................. 28

References ..................................................................................................................................... 30

Tables & Figures ............................................................................................................................. 34

Appendices ..................................................................................................................................... 41

About this Master's Thesis

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School	Rollins School of Public Health
Department	Environmental Health
Degree	M.S.P.H.
Submission	Master's Thesis
Language	English
Research Field	Biology, Anatomy Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	BP Peru Puno Blood Pressure particulate matter Household Air Pollution PM2.5 Hypertension HAP Highlands Women
Committee Chair / Thesis Advisor	Steenland, Kyle , Emory University
Committee Members	Tolbert, Paige, Emory University Kephart, Josiah , Johns Hopkins University
Partnering Agencies	University, college or education institution (other than Emory)

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