title: Using exhaled carbon monoxide and carboxyhemoglobin to evaluate the effectiveness of a chimney stove model in Peru.
abstract: BACKGROUND
  Measurement of biological indicators of physiological change may be useful in evaluating the effectiveness of stove models, which are intended to reduce indoor smoke exposure and potential health effects.
  
  
  OBJECTIVE
  We examined changes in exhaled carbon monoxide (CO), percentage carboxy-hemoglobin, and total hemoglobin in response to the installation of a chimney stove model by the Juntos National Program in Huayatan, Peru in 2008.
  
  
  METHODS
  Biomarkers were measured in a convenience sample comprising 35 women who met requirements for participation, and were measured before and three weeks after installation of a chimney stove. The relationships between exposure to indoor smoke and biomarker measurements were also analyzed using simple linear regression models.
  
  
  RESULTS
  Exhaled CO reduced from 6.71 ppm (95% CI 5.84-7.71) to 3.14 ppm (95% CI 2.77-3.66) three weeks after stove installation (P < 0.001) while % COHb reduced from 1.76% (95% CI 1.62-1.91) to 1.18% (95% CI 1.12-1.25; P < 0.001). Changes in exhaled CO and % COHb from pre- to post-chimney stove installation were not correlated with corresponding changes in exposure to CO and PM2.5 even though the exposures also reduced after stove installation.
  
  
  CONCLUSIONS
  Exhaled CO and % COHb both showed improvement with reduction in concentration after the installation of the chimney cook stoves, indicating a positive physiological response subsequent to the intervention.
authors.affiliation: The University of Georgia, College of Public Health, Department of Environmental Health Science, Athens, Georgia, USA.
authors.forename: Adam R
authors.initials: AR
authors.lastname: Eppler
authors.affiliation: The University of Georgia, College of Public Health, Department of Environmental Health Science, Athens, Georgia, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Fitzgerald
authors.affiliation: The University of Georgia, College of Public Health, Department of Environmental Health Science, Athens, Georgia, USA.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Dorner
authors.affiliation: Asociación del Aire Ambiental, Lima, Peru.
authors.forename: Manuel
authors.initials: M
authors.lastname: Aguilar-Villalobos
authors.affiliation: The University of Georgia, College of Public Health, Department of Epidemiology and Biostatistics, Athens, Georgia, USA.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Rathbun
authors.affiliation: The University of Georgia, College of Public Health, Department of Environmental Health Science, Athens, Georgia, USA.
authors.forename: Olorunfemi
authors.initials: O
authors.lastname: Adetona
authors.affiliation: The University of Georgia, College of Public Health, Department of Environmental Health Science, Athens, Georgia, USA.
authors.forename: Luke P
authors.initials: LP
authors.lastname: Naeher
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000032:analysis; D016902:Air Pollution, Indoor / Q000032:analysis; D015415:Biomarkers; D002248:Carbon Monoxide / Q000032:analysis*; D002263:Carboxyhemoglobin / Q000032:analysis*; D003296:Cooking / Q000379:methods*; D004781:Environmental Exposure / Q000032:analysis; D045853:Exhalation; D005260:Female; D006801:Humans; D008875:Middle Aged; D052638:Particulate Matter / Q000032:analysis; D010568:Peru / Q000453:epidemiology; D014934:Wood
chemical_list: D000393:Air Pollutants; D015415:Biomarkers; D052638:Particulate Matter; D002248:Carbon Monoxide; D002263:Carboxyhemoglobin