title: Adherence to reduced-polluting biomass fuel stoves improves respiratory and sleep symptoms in children.
abstract: BACKGROUND
  Symptoms of sleep apnea are markedly increased in children exposed to smoke from biomass fuels and are reduced by kitchen stoves that improve indoor biomass pollution. However, the impact of adherence to the use of improved stoves has not been critically examined.
  
  
  METHODS
  Sleep-related symptom questionnaires were obtained from children <15 years of age in 56 families residing in the communities of Lliupapuquio, Andahuaylas province in Peru before and 2 years after installation of less-polluting Inkawasi cooking stoves.
  
  
  RESULTS
  82 children with lifetime exposures to indoor fuel pollution were included. When compared to those alternating between both types of stoves or those using traditional stoves only, those children who exclusively used Inkawasi cooking stoves showed significant improvements in sleep and respiratory related symptoms, but some minor albeit significant improvements occurred when both stoves were concomitantly used.
  
  
  CONCLUSIONS
  Improvements in respiratory and sleep-related symptoms associated with elevated indoor biomass pollution occur only following implementation and exclusive utilization of improved kitchen stoves.
authors.affiliation: Laboratorio de Respiración del Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Perú. roberto.accinelli@upch.pe.
authors.forename: Roberto A
authors.initials: RA
authors.lastname: Accinelli
authors.forename: Oscar
authors.initials: O
authors.lastname: Llanos
authors.forename: Lidia M
authors.initials: LM
authors.lastname: López
authors.forename: María I
authors.initials: MI
authors.lastname: Pino
authors.forename: Yeny A
authors.initials: YA
authors.lastname: Bravo
authors.forename: Verónica
authors.initials: V
authors.lastname: Salinas
authors.forename: María
authors.initials: M
authors.lastname: Lazo
authors.forename: Julio R
authors.initials: JR
authors.lastname: Noda
authors.forename: Marita
authors.initials: M
authors.lastname: Sánchez-Sierra
authors.forename: Lacey
authors.initials: L
authors.lastname: Zárate
authors.forename: Joao
authors.initials: J
authors.lastname: da Silva
authors.forename: Fabiola
authors.initials: F
authors.lastname: Gianella
authors.forename: Leila
authors.initials: L
authors.lastname: Kheirandish-Gozal
authors.forename: David
authors.initials: D
authors.lastname: Gozal
mesh_terms: D000293:Adolescent; D016902:Air Pollution, Indoor / Q000009:adverse effects* / Q000517:prevention & control*; D018533:Biomass; D002648:Child; D002675:Child, Preschool; D003297:Cooking and Eating Utensils; D004736:Energy-Generating Resources; D005260:Female; D006801:Humans; D008297:Male; D010568:Peru; D011446:Prospective Studies; D012891:Sleep Apnea Syndromes / Q000209:etiology* / Q000517:prevention & control*; D011795:Surveys and Questionnaires