title: Effectiveness of Six Improved Cookstoves in Reducing Household Air Pollution and Their Acceptability in Rural Western Kenya.
abstract: BACKGROUND
  Household air pollution (HAP) from biomass fuel burning is linked to poor health outcomes. Improved biomass cookstoves (ICS) have the potential to improve HAP.
  
  
  OBJECTIVE
  A pre-/post- intervention study assessed the impact of six ICS on indoor air quality and acceptability of ICS to local users in rural Western Kenya.
  
  
  METHODS
  We measured mean personal and kitchen level concentrations of particulate matter <2.5μm in diameter (PM2.5, μg/m3) and carbon monoxide (CO, ppm) during the 48-hour period of each ICS use in 45 households. We compared these levels to those observed with traditional 3-stone fire (TSF) use. We assessed ICS acceptability through interviews and focus groups. We evaluated association of stove type, fuel use, and factors related to cooking practices with mean kitchen PM2.5 and CO using multivariable regression.
  
  
  RESULTS
  Stove type, exclusive ICS use (vs. concurrent TSF use), and the amount of fuel used were independently associated with kitchen PM2.5 and CO levels. Reductions (95%CI) in mean PM2.5 compared to TSF, ranged by ICS from 11.9% (-2.8-24.5) to 42.3% (32.3-50.8). Reductions in kitchen CO compared to TSF, ranged by ICS from -5.8% (-21.9-8.2) to 34.5% (23.2-44.1). Mean kitchen PM2.5 ranged from 319μg/m3 to 518μg/m3 by ICS. Women thought ICS were easy to use, more efficient, produced less smoke, and cooked faster, compared to TSF. Women also reported limitations for each ICS.
  
  
  CONCLUSIONS
  We documented reductions in HAP from ICS compared to TSF. The PM2.5 levels with ICS use were still considerably higher than WHO indoor air quality guidelines. Achieving maximal potential of ICS requires adherence to more exclusive use and addressing user reported ICS limitations.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Tamara
authors.initials: T
authors.lastname: Pilishvili
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Loo
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Schrag
authors.affiliation: Department of Public Health and Policy, University of Liverpool, Liverpool, L69 3GB, United Kingdom.
authors.forename: Debbi
authors.initials: D
authors.lastname: Stanistreet
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Bryan
authors.initials: B
authors.lastname: Christensen
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Fuyuen
authors.initials: F
authors.lastname: Yip
authors.affiliation: Safe Water and AIDS Project, Kisumu, Kenya.
authors.forename: Ronald
authors.initials: R
authors.lastname: Nyagol
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Robert
authors.initials: R
authors.lastname: Quick
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Mike
authors.initials: M
authors.lastname: Sage
authors.affiliation: Department of Public Health and Policy, University of Liverpool, Liverpool, L69 3GB, United Kingdom.
authors.forename: Nigel
authors.initials: N
authors.lastname: Bruce
mesh_terms: D000293:Adolescent; D000328:Adult; D016902:Air Pollution, Indoor / Q000032:analysis*; D003296:Cooking; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007630:Kenya; D008875:Middle Aged; D052638:Particulate Matter / Q000032:analysis; D012424:Rural Population; D055815:Young Adult
chemical_list: D052638:Particulate Matter