Abstract
Background: Household air pollution increases the risk of non-communicable diseases, such as cardiovascular diseases and metabolic syndrome. This study hypothesised that the reduction of household air pollution through the installation of improved cookstoves is associated with the prevalence of metabolic syndrome. We compared the prevalence of metabolic syndrome between adults using open fire stoves and using improved cookstoves in high altitude provinces of Cajabamba and San Marcos in rural Peruvian Andes.Methods: This is a quasi experimental study nested within a randomised controlled trial (parent study) of 317 children randomised in four study arms. The parents study applied a 2x2 factorial design with three single intervention arms (improved cookstove (ICS), early child development (ECD) and Control) and one combined arm (ICS-ECD). This study was conducted 6-10 months after the ICS intervention was implemented and all parents of the 317 children in the parent study were eligible to participate. Ventilated improved cookstoves using biomass fuel were provided to intervention homes. All participants answered a 24-hour food recall and underwent a physical examination for metabolic syndrome diagnosis. Results: A total of 385 participants were allocated to two groups of improved cookstove users with 190 (112 women and 78 men) and open-fire stove users with 195 (123 women and 72 men). Metabolic syndrome was detected in 21% of all participants and more frequently in women than men (26% versus 13%). In women, the improved cookstove intervention was a protective factor for metabolic syndrome (Prevalence Ratio= 0.70 (0.46 to 1.08), p=0.11). In addition, PR increased with age in women. In both gender, significantly lower PR was found in participants living ≥2500 meters above sea level (PR=0.65 (0.42 to 1.00), p=0.051 in women; (PR=0.25 (0.07 to 0.71), p=0.009 in men).Conclusions: The improved cookstove intervention reducing household air pollution is associated with a lower prevalence of MetS in women users. In addition, residential altitude is an important risk factor for metabolic syndrome even in high altitude populations. Keywords: biomass fuel ventilated improved cookstove, household air pollution, metabolic syndrome, high altitude, Peru Trial registration: Trial registration number ISRCTN26548981 at www.srctn.com . Registered retrospectively, Jan. 15 2018.
High prevalence of asthma symptoms in Warao Amerindian children in Venezuela is significantly associated with open-fire cooking: a cross-sectional observational study