title: Impact of the improved patsari biomass stove on urinary polycyclic aromatic hydrocarbon biomarkers and carbon monoxide exposures in rural Mexican women.
abstract: BACKGROUND
  Cooking with biomass fuels on open fires results in exposure to health-damaging pollutants such as carbon monoxide (CO), polycyclic aromatic hydrocarbons (PAHs), and particulate matter.
  
  
  OBJECTIVE
  We compared CO exposures and urinary PAH biomarkers pre- and postintervention with an improved biomass stove, the Patsari stove.
  
  
  METHODS
  In a subsample of 63 women participating in a randomized controlled trial in central Mexico, we measured personal CO exposure for 8 hr during the day using continuous monitors and passive samplers. In addition, first-morning urine samples obtained the next day were analyzed for monohydroxylated PAH metabolites by gas chromatography/isotope dilution/high-resolution mass spectrometry. Exposure data were collected during the use of an open fire (preintervention) and after installation of the improved stove (postintervention) for 47 women, enabling paired comparisons.
  
  
  RESULTS
  Median pre- and postintervention values were 4 and 1 ppm for continuous personal CO and 3 and 1 ppm for passive sampler CO, respectively. Postintervention measurements indicated an average reduction of 42% for hydroxylated metabolites of naphthalene, fluorene, phenanthrene, and pyrene on a whole-weight concentration basis (micrograms per liter of urine), and a 34% reduction on a creatinine-adjusted basis (micrograms per gram of creatinine). Pre- and postintervention geometric mean values for 1-hydroxypyrene were 3.2 and 2.0 μg/g creatinine, respectively.
  
  
  CONCLUSIONS
  Use of the Patsari stove significantly reduced CO and PAH exposures in women. However, levels of many PAH biomarkers remained higher than those reported among smokers.
authors.affiliation: Environmental Health Department, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Horacio
authors.initials: H
authors.lastname: Riojas-Rodriguez
authors.forename: Astrid
authors.initials: A
authors.lastname: Schilmann
authors.forename: Adriana Teresa
authors.initials: AT
authors.lastname: Marron-Mares
authors.forename: Omar
authors.initials: O
authors.lastname: Masera
authors.forename: Zheng
authors.initials: Z
authors.lastname: Li
authors.forename: Lovisa
authors.initials: L
authors.lastname: Romanoff
authors.forename: Andreas
authors.initials: A
authors.lastname: Sjödin
authors.forename: Leonora
authors.initials: L
authors.lastname: Rojas-Bracho
authors.forename: Larry L
authors.initials: LL
authors.lastname: Needham
authors.forename: Isabelle
authors.initials: I
authors.lastname: Romieu
mesh_terms: D000328:Adult; D016902:Air Pollution, Indoor / Q000032:analysis* / Q000517:prevention & control; D015415:Biomarkers / Q000032:analysis / Q000652:urine; D018533:Biomass; D002248:Carbon Monoxide / Q000032:analysis*; D003296:Cooking / Q000295:instrumentation / Q000379:methods*; D004784:Environmental Monitoring / Q000379:methods*; D005260:Female; D006801:Humans; D008800:Mexico; D052638:Particulate Matter / Q000032:analysis*; D011084:Polycyclic Aromatic Hydrocarbons / Q000652:urine*; D012423:Rural Health; D055815:Young Adult
chemical_list: D015415:Biomarkers; D052638:Particulate Matter; D011084:Polycyclic Aromatic Hydrocarbons; D002248:Carbon Monoxide