title: Eye discomfort, headache and back pain among Mayan Guatemalan women taking part in a randomised stove intervention trial.
abstract: BACKGROUND
  Indoor air pollution (IAP) from combustion of biomass fuels represents a global health problem, estimated to cause 1.6 million premature deaths annually.
  
  
  OBJECTIVE
  RESPIRE (Randomised Exposure Study of Pollution Indoors and Respiratory Effects) Guatemala is the first randomised controlled trial ever performed on health effects from solid fuel use. Its goal is to assess the effect of improved stoves (planchas) on exposure and health outcomes in a rural population reliant on wood fuel.
  
  
  METHODS
  Questions about symptoms were asked at baseline and periodically after the intervention, to an initial group of 504 women (259 randomly assigned to planchas (mean (standard deviation) age 27.4 (7.2) years) and 245 using traditional open fires (28.1 (7.1) years)). Levels of carbon monoxide (CO) in exhaled breath, a biomarker of recent exposure to air pollution from biomass combustion, were measured at each visit. In addition to reducing IAP levels, the plancha may also have a positive health effect by changing the working posture to an upright position.
  
  
  RESULTS
  A high prevalence of eye discomfort, headache and backache was found. The odds of having sore eyes and headache were substantially reduced in the plancha group relative to the group using open fires for the follow-up period (odds ratio (OR) 0.18, 95% confidence interval (CI) 0.11 to 0.29 and (OR) 0.63, 95% CI 0.42 to 0.94, respectively). Median CO in breath among women in the intervention trial was significantly lower than controls.
  
  
  CONCLUSIONS
  In addition to reducing discomfort for women, tangible improvements in symptoms experienced by a substantial proportion of women may help to gain acceptance and wider use of planchas.
authors.affiliation: Section for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, N-5018 Bergen, Norway. esperanza.diaz@isf.uib.no
authors.forename: Esperanza
authors.initials: E
authors.lastname: Díaz
authors.forename: Tone
authors.initials: T
authors.lastname: Smith-Sivertsen
authors.forename: Dan
authors.initials: D
authors.lastname: Pope
authors.forename: Rolv T
authors.initials: RT
authors.lastname: Lie
authors.forename: Anaite
authors.initials: A
authors.lastname: Díaz
authors.forename: John
authors.initials: J
authors.lastname: McCracken
authors.forename: Byron
authors.initials: B
authors.lastname: Arana
authors.forename: Kirk R
authors.initials: KR
authors.lastname: Smith
authors.forename: Nigel
authors.initials: N
authors.lastname: Bruce
mesh_terms: D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects / Q000032:analysis*; D001416:Back Pain / Q000139:chemically induced / Q000453:epidemiology*; D001944:Breath Tests; D002248:Carbon Monoxide / Q000009:adverse effects / Q000032:analysis*; D003296:Cooking / Q000295:instrumentation; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis*; D005128:Eye Diseases / Q000139:chemically induced / Q000453:epidemiology*; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D006261:Headache / Q000139:chemically induced / Q000453:epidemiology*; D006794:Household Articles / Q000295:instrumentation; D006801:Humans; D012423:Rural Health; D014691:Ventilation; D014934:Wood / Q000009:adverse effects
chemical_list: D002248:Carbon Monoxide