Cooking with liquefied petroleum gas or biomass and fetal growth outcomes: a multi-country randomised controlled trial.

BACKGROUND: Household air pollution might lead to fetal growth restriction during pregnancy. We aimed to investigate whether a liquefied petroleum gas (LPG) intervention to reduce personal exposures to household air pollution during pregnancy would alter fetal growth. METHODS: The Household Air Pollution Intervention Network (HAPIN) trial was an open-label randomised controlled trial conducted in ten resource-limited settings across Guatemala, India, Peru, and Rwanda. Pregnant women aged 18-34 years (9-19 weeks of gestation) were randomly assigned in a 1:1 ratio to receive an LPG stove, continuous fuel delivery, and behavioural messaging or to continue usual cooking with biomass for 18 months. We conducted ultrasound assessments at baseline, 24-28 weeks of gestation (the first pregnancy visit), and 32-36 weeks of gestation (the second pregnancy visit), to measure fetal size; we monitored 24 h personal exposures to household air pollutants during these visits; and we weighed children at birth. We conducted intention-to-treat analyses to estimate differences in fetal size between the intervention and control group, and exposure-response analyses to identify associations between household air pollutants and fetal size. This trial is registered with ClinicalTrials.gov (NCT02944682). FINDINGS: Between May 7, 2018, and Feb 29, 2020, we randomly assigned 3200 pregnant women (1593 to the intervention group and 1607 to the control group). The mean gestational age was 14·5 (SD 3·0) weeks and mean maternal age was 25·6 (4·5) years. We obtained ultrasound assessments in 3147 (98·3%) women at baseline, 3052 (95·4%) women at the first pregnancy visit, and 2962 (92·6%) at the second pregnancy visit, through to Aug 25, 2020. Intervention adherence was high (the median proportion of days with biomass stove use was 0·0%, IQR 0·0-1·6) and pregnant women in the intervention group had lower mean exposures to particulate matter with a diameter less than 2·5 µm (PM2·5; 35·0 [SD 37·2] µg/m3vs 103·3 [97·9] µg/m3) than did women in the control group. We did not find differences in averaged post-randomisation Z scores for head circumference (0·30 vs 0·39; p=0·04), abdominal circumference (0·38 vs 0·39; p=0·99), femur length (0·44 vs 0·45; p=0·73), and estimated fetal weight or birthweight (-0·13 vs -0·12; p=0·70) between the intervention and control groups. Personal exposures to household air pollutants were not associated with fetal size. INTERPRETATION: Although an LPG cooking intervention successfully reduced personal exposure to air pollution during pregnancy, it did not affect fetal size. Our findings do not support the use of unvented liquefied petroleum gas stoves as a strategy to increase fetal growth in settings were biomass fuels are used predominantly for cooking. FUNDING: US National Institutes of Health and Bill & Melinda Gates Foundation. TRANSLATIONS: For the Kinyarwanda, Spanish and Tamil translations of the abstract see Supplementary Materials section.

Association between socioeconomic status and hypertension among adults in Fujian province and the mediating effect of BMI and cooking salt intake: a cross-sectional study.

OBJECTIVES: This study aimed to investigate the association between socioeconomic status (SES) and the prevalence of hypertension in Fujian province, China, and to evaluate the mediating effect of body mass index (BMI) and cooking salt intake between SES and hypertension. DESIGN: Community-based cross-sectional survey was conducted between June 2018 and December 2019. SETTING: Fujian province, China. PARTICIPANTS: A total of 26 500 participants aged >18 years completed the survey. OUTCOME MEASURES: The primary outcome was the prevalence of hypertension. Education, income and occupation were used as SES indicators. Meanwhile, certain health behaviours and metabolic risk factors were used as secondary indicators of SES. RESULTS: The prevalence of hypertension was relatively high among participants who finished primary education (34.8%), had the lowest annual income (46.0%), were unemployed or retired (34.7%). Education and income levels were negatively associated with the prevalence of hypertension (p<0.05). Regular smoking, alcohol consumption, BMI and high cooking salt intake were also significantly associated with the prevalence of hypertension (p<0.05). Cooking salt intake was identified as a partial mediator between income and hypertension, mediating 3.45% of the association. Both BMI and cooking salt intake were partial mediators between education and hypertension, mediating 5.23% and 1.93% of the association, respectively. CONCLUSIONS: SES was associated with the prevalence of hypertension among adults in Fujian province, China. BMI and cooking salt intake were partial mediators of the association between SES and hypertension.

Human exposure to elements through consumption of raw and cooked fish in an urban region of the central Brazilian Amazon biome: Health risks.

Fish is an important source of animal protein for local communities in the Amazon basin, whose food safety must be assured. However, certain potential toxicants elements, can bioaccumulate in fish species, which inhabit anthropogenically polluted waters, ultimately posing a risk to human health. In the present study, the concentrations of nine elements (Al, As, Cd, Cr, Cu, Hg, Ni, Pb and Zn) were determined in raw and cooked samples of eight fish species consumed in Santarém (northern Brazil, Amazon biome). The potential for non- carcinogenic human health risks linked to the consumption of cooked fish were evaluated for adults and children in two different scenarios. Four carnivores, three omnivores and one detritivore, all of them regularly marketed and consumed by the Santarém population, were the target species. The safety reference values set by national and international guidelines for humans, in both raw and cooked preparations, were used. In most cases, the cooking process showed a trend to increase elements concentrations compared to raw samples, however the differences were not significant. Moreover, the risk assessment showed danger for children in relation to Hg from the consumption of fish, in both scenarios evaluated. For adults, in one of the scenarios, there was a health risk associated to Hg as a result of carnivorous fish consumption. In a context of combined exposure to all elements, children were at risk when consuming fish, especially carnivorous and omnivorous species. For adults, the mixture of elements posed a risk to health human only for carnivorous fish consumption. The results reveal an environmental scenario of Hg contamination, which requires monitoring actions to preserve the aquatic biodiversity and human health in the Brazilian Amazon biome.

Rapid quantitative evaluation of total polar materials (TPM) in frying oil based on an "off-on" fluorescence viscosity response probe.

The content of total polar material (TPM) is considered as a comprehensive indicator to evaluate the quality of edible oils which should be discarded and no longer be used when TPM content exceeding 27 %. Nevertheless, there is currently a lack of a convenient and efficient TPM detection method, which is a meaningful challenge. With the increase of TPM content, the viscosity of frying oil grows, and the two maintain a satisfactory positive correlation. Consequently, an "off-on" fluorescence probe TCF-PR method based on viscosity-response has been developed. There exists a good linear relationship between the fluorescence intensity of the probe and the TPM content of soybean oil ((R2 = 0.9936) and salad oil (R2 = 0.9878), accompanying with the advantage of fast response (3 s), which means the rapid detection of TPM can be realized to determine the quality of frying oil in the field of food safety.

Intelligence detection of oil absorption in French fries by surface profiles.

Surface profiles are important evaluation indices for oil absorption behavior of fried foods. This research established two intelligent models of partial least-squares regression (PLSR) and back propagation artificial neural network (BP-ANN) for monitoring the oil absorption behavior of French fries based on the surface characteristics. Surface morphology and texture of French fries by rapeseed oil (RO) and high-oleic peanut oil (HOPO) at different temperatures were investigated. Results showed that oil content of samples increased with frying temperature, accounting for 37.7% and 41.4% of samples fried by RO and HOPO respectively. The increase of crust ratio, roughness and texture parameters (Fm, Nwr, fwr, Wc) and the decrease of uniformity were observed with the frying temperature. Coefficients of prediction set of PLSR and BP-ANN models were more than 0.93, which indicated that surface features combined with chemometrics were rapid and precise methods for determining the oil content of French fries.

Study by means of 1H nuclear magnetic resonance of the oxidation process in high oleic sunflower oil and palm oil during deep-frying of fish cakes.

This study aimed to compare the frying performance of palm oil (PO) and high oleic sunflower oil (HOSO) during frying aquatic products. The quality change and frying performance of HOSO and PO during frying of fish cakes were investigated. The oxidation and hydrolysis products of both oils were explored by the nuclear magnetic resonance technique. The results showed that the color deepening rate of PO was higher than that of HOSO. After 18 h of frying, the total polar compound content of PO and HOSO reached 25.67% and 27.50%, respectively. HOSO had lower degree of oxidation than PO after 24 h of continuous frying. The polyunsaturated fatty acid content in HOSO and PO significantly decreased. The oleic acid content in HOSO remained above 80% during the frying process. The major aldehydes in both oils were (E, E)-2,4-alkadienals and n-alkanals and glycerol diesters (DAGs) were abundant in PO. Furthermore, the addition of fish cakes had slight effect on the quality of the frying oil. Therefore, HOSO is an appropriate candidate for frying owing to its excellent frying stability and nutritional value.

Multiresponsive luminescent metal-organic framework for cooking oil adulteration detection and gallium(III) sensing.

A new 3D metal-organic framework {[Cd16(tr2btd)10(dcdps)16(H2O)3(EtOH)]∙15DMF}n (MOF 1, tr2btd = 4,7-di(1,2,4-triazol-1-yl)benzo-2,1,3-thiadiazole, H2dcdps = 4,4'-sulfonyldibenzoic acid) was obtained and its luminescent properties were studied. MOF 1 exhibited bright blue-green luminescence with a high quantum yield of 74 % and luminescence quenching response to a toxic natural polyphenol gossypol and luminescence enhancement response to some trivalent metal cations (Fe3+, Cr3+, Al3+ and Ga3+). The limit of gossypol detection was 0.20 µM and the determination was not interfered by the components of the cottonseed oil. The limit of detection of gallium(III) was 1.1 µM. It was demonstrated that MOF 1 may be used for distinguishing between the genuine sunflower oil and oil adulterated by crude cottonseed oil through qualitative luminescent and quantitative visual gossypol determination.

The relationship between cooking fuel use and sex hormone levels: A cross-sectional study and Mendelian randomization study.

PURPOSE: The aim of this study was to investigate the effect of solid fuel use on serum sex hormone levels. Furthermore, the effects of improved kitchen ventilation and duration of cooking time on the relationship between solid fuel use and serum sex hormone levels will be further explored. METHODS: In this cross-sectional study, 5386 individuals were recruited. Gender and menopausal status modified associations between solid fuel type and serum sex hormone levels was investigated through generalized linear models and further analyzed by improving kitchen ventilation and length of cooking time on the relationship between solid fuel use and serum sex hormone levels. To identify the causal association, mendelian randomization of two-sample was performed. RESULTS: In observational analyses, for ln-17-hydroxyprogesterone, ln-testosterone, and ln-androstenedione among premenopausal women, the estimated ß and 95 % CI of sex hormone levels for the effect of solid fuel users was -0.337 (-0.657, -0.017), -0.233 (-0.47, 0.005), and - 0.240 (-0.452, -0.028) respectively, and - 0.150 (-0.296, -0.004) in ln-progesterone among postmenopausal women. It was found that combining solid fuels with long cooking periods or no ventilation more effectively reduced testosterone and androstenedione in premenopausal women. We further found the adverse effects of using solid fuel on progesterone, testosterone, and androstenedione levels were enhanced with the increases of PM1, PM2.5, PM10, and NO2. Corresponding genetic, the causal risk effect of solid fuel were - 0.056 (-0.513, 0.4) and 0.026 (-3.495, 3.547) for testosterone levels and sex hormone binding globulin, respectively. CONCLUSION: Using gas or solid fuel was negatively related to sex hormone levels. A combination of using solid fuels, cooking for a long time, or cooking without ventilation had a stronger effect on sex hormone levels. However, genetic evidence did not support causality for the associations. WHAT IS ALREADY KNOWN ON THIS TOPIC?: The mechanisms underlying these associations household air pollution (HAP) from incomplete combustion of such fuels and occurrence of chronic diseases remained obscure. Recent years, extensive evidences from animal as well as human researches have suggested that progestogen and androgen hormones are involved in the development of diabetes, hypertension, and cardiovascular disease, which indicated that changes in serum progestogen and androgen hormones levels might play a role in these pathological mechanisms. However, limited evidence exists examining the effect of HAP from solid fuel use on serum sex hormone levels.

Natural antioxidants (rosemary and parsley) in microwaved ground meat patties: effects of in vitro digestion.

BACKGROUND: Minimizing food oxidation remains a challenge in several environments. The addition of rosemary extract (150 mg kg-1) and lyophilized parsley (7.1 g kg-1) at equivalent antioxidant activity (5550 µg Trolox equivalents kg-1) to meat patties was assessed in terms of their effect during microwave cooking and after being subjected to an in vitro digestion process. RESULTS: Regardless of the use of antioxidants, cooking caused a decrease of the fat content as compared to raw samples, without noticing statistical differences in the fatty acid distribution between raw and cooked samples [44%, 47% and 6.8%, of saturated fatty acid (SFA), monounsaturated fatty acid (MUFA) and polyunsaturated fatty acid (PUFA), respectively]. However, the bioaccessible lipid fraction obtained after digestion was less saturated (around 34% SFA) and more unsaturated (35% MUFA +30% PUFA). Cooking caused, in all types of samples, an increased lipid [thiobarbituric acid reactive substances (TBARS)] and protein (carbonyls) oxidation values. The increase of TBARS during in vitro digestion was around 7 mg malondialdehyde (MDA) kg-1 for control and samples with parsley and 4.8 mg MDA kg-1 with rosemary. The addition of parsley, and particularly of rosemary, significantly increased the antioxidant activity (DPPH) of cooked and digested microwaved meat patties. CONCLUSION: Whereas rosemary was effective in minimizing protein oxidation during cooking and digestion as compared to control samples, parsley could only limit it during digestion. Lipid oxidation was only limited by rosemary during in vitro digestion. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Effect of pre-drying and post-frying holding treatments on the oil absorption and quality of fried batter-coated peanuts.

In this study, the effect of pre-drying and post-frying holding treatments on the oil absorption and the quality of the fried batter-coated peanuts were explored. The results showed that hot air drying and microwave drying induced the gelatinization of starch in the batter before frying. The thermodynamic properties of starch in the batter after frying indicated that pre-drying could protect the orderliness of the starch. CLSM images showed that the pre-drying treatment reduced the number of large oil spots on the surface of batter of fried batter-coated peanuts. SEM observation revealed that the structure of the batter treated with pre-drying was denser and the number of large pores was reduced after frying. The post-frying holding treatment improved the color and texture of the batter-coated peanuts. In conclusion, the pre-drying and post-frying holding treatment can reduce the oil content and improve the fracturability of the fried batter-coated peanuts.

Incorporating edible oil during cooking tailors the microstructure and quality features of brown rice following heat moisture treatment.

While brown rice (BR) has numerous nutritional properties, the consumption potential of which is seriously restricted since the poor cooking quality and undesirable flavor. Here, edible oils (pork lard and corn oil, 1-5 wt%) were incorporated during the cooking of BR following heat moisture treatment. Incorporating corn oil rather than lard significantly ameliorated the texture properties (e.g. hardness, cohesiveness, and chewiness) and sensory properties of cooked BR. Both lard- and corn oil-incorporated cooked BR showed obvious structural changes accompanied by the formation of amylose-lipid complexes during cooking. It was confirmed that the incorporation of lard and corn oil allowed a higher degree of short-range molecular order, more V-type starch crystallites, and elevated nano-structural arrangements. Additionally, a decreased hardness (from 559.04 g to 424.18 g and 385.91 g, respectively) and enriched resistant starch (RS) were also observed, the highest RS content (15.95 % and 16.32 %, respectively) was observed when 1 wt% of lard and corn oil were incorporated.

Cooking methods determine chemical composition and functional properties of squash blossoms: A study of microstructural and bioaccessibility changes.

This research aimed to evaluate the effect of different cooking methods (boiling, stir-frying, and steaming) on the microstructure, moisture, fat, protein, and glucose-derived carbohydrate contents, and the bioactive compounds (total carotenoids: CAR, total chlorophyll: CHLO, and total phenolic compounds: TPC) and antioxidant capacity (AC) of squash blossoms. Furthermore, we characterized polyphenolic compounds using HPLC and evaluated their bioaccessibility via in vitro digestions. Our results show that steaming and boiling do not affect moisture content. Only stir-frying decreased (p < 0.05) this parameter by 8 %. Additionally, the cooking methods increased (p < 0.05) protein and glucose-derived carbohydrate contents. All cooking methods changed the microstructure of the blossoms, probably due to the thermal and mechanical variations that result in moisture loss and degradation of cell wall components. As for the functional properties, boiling caused a greater loss of TPC (up to 96 %) and AC (up to 91 %). Stir-frying caused the greatest loss of CAR (up to 81 %) and CHLO (up to 84 %). The in vitro digestion assays showed changes in the bioaccessibility of CAR, CHLO, TPC, and AC in the cooked flowers compared to the fresh ones. Finally, kaempferol and gallic acid were the most resistant polyphenols to the cooking methods and in vitro digestion.

Effect of lignin on the formation of polycyclic aromatic hydrocarbons in smoked and grilled meat products.

In order to explore the influence of wood types on formation of polycyclic aromatic hydrocarbons (PAHs) in traditional smoked and grilled meat products, the effect of lignin in woods on formation of PAHs was investigated in meat model systems. The results showed that PAHs formation was much dependent on the heating conditions. The addition of lignin led to significantly increased PAHs, which being connected with lignin structure. In comparison, the formation of PAHs was more facilitated by lignin with G structure than that with G/S structure. However, further study of adding lignin precursors demonstrated that lignin precursors with S structure were more favorable to the formation of PAHs than those with G structure. It was proposed that the relative content and activity of G/S structure of lignin in wood played a significant role in the formation of PAHs, which might provide theoretical reference for inhibition of PAHs fundamentally.

Effects of a liquefied petroleum gas stove intervention on stillbirth, congenital anomalies and neonatal mortality: A multi-country household air pollution intervention network trial.

Household air pollution (HAP) from cooking with solid fuels used during pregnancy has been associated with adverse pregnancy outcomes. The Household Air Pollution Intervention Network (HAPIN) trial was a randomized controlled trial that assessed the impact of a liquefied petroleum gas (LPG) stove and fuel intervention on health in Guatemala, India, Peru, and Rwanda. Here we investigated the effects of the LPG stove and fuel intervention on stillbirth, congenital anomalies and neonatal mortality and characterized exposure-response relationships between personal exposures to fine particulate matter (PM2.5), black carbon (BC) and carbon monoxide (CO) and these outcomes. Pregnant women (18 to <35 years of age; gestation confirmed by ultrasound at 9 to <20 weeks) were randomly assigned to intervention or control arms. We monitored these fetal and neonatal outcomes and personal exposure to PM2.5, BC and CO three times during pregnancy, we conducted intention-to-treat (ITT) and exposure-response (E-R) analyses to determine if the HAPIN intervention and corresponding HAP exposure was associated with the risk of fetal/neonatal outcomes. A total of 3200 women (mean age 25.4 ± 4.4 years, mean gestational age at randomization 15.4 ± 3.1 weeks) were included in this analysis. Relative risks for stillbirth, congenital anomaly and neonatal mortality were 0.99 (0.60, 1.66), 0.92 (95 % CI 0.52, 1.61), and 0.99 (0.54, 1.85), respectively, among women in the intervention arm compared to controls in an ITT analysis. Higher mean personal exposures to PM2.5, CO and BC during pregnancy were associated with a higher, but statistically non-significant, incidence of adverse outcomes. The LPG stove and fuel intervention did not reduce the risk of these outcomes nor did we find evidence supporting an association between personal exposures to HAP and stillbirth, congenital anomalies and neonatal mortality.

Harnessing the Carrier Solvent Complexity of Crop Biostimulant Liquid Formulations Using Locally Available Transesterified Waste Cooking Oil: Economic Recycling, Solvent Performance, and Bioefficacy Evaluation.

Locally sourced waste cooking oil (WCO) was successfully base-catalyzed and transesterified with methanol into biodiesel to produce biostimulant (nitrobenzene) formulations and replace high-risk carrier solvents. Ideal synthesis conditions were composed of 1% NaOH, MeOH/oil molar ratio (6:1), reaction temperature (65 °C), a 3 h mixing rate, and 97-98% yields. Gas chromatography-mass spectrometry (GC-MS) analysis identified five fatty acid methyl esters (FAMEs) including palmitic, linoleic, oleic, stearic, and eicosenoic acids with high solubilization and olfactory characteristics. Using anionic and nonionic emulsifiers in conjunction with recycled biodiesel, a stable emulsifiable concentrate (NB 35% EC) was created with greater storage stability, wettability, and spreading capabilities than those of organic solvent-based ones. The highest counts of fruits per plant (35.80), flowers per plant (60.00), yield per plant (3.56 kg), and yield per hectare (143.7 quintals) were recorded in treatments with 4 mL/L biodiesel-based EC in field bioassays. In addition to having superior biosafety, FAME-based EC exhibits minimal phytotoxicity and is less harmful to aquatic creatures. It was discovered that the average cost-effectiveness was 5.49 times less expensive than solvent-based EC. In order to utilize waste oils as a locally obtained, sustainable alternative solvent with a wide solubilization range, low ecotax profile, circular economy, and high renewable carbon index, this integrative technique was expanded.

Household air pollution and pneumococcal density related to nasopharyngeal inflammation in mothers and children in Ethiopia: A cross-sectional study.

BACKGROUND: Three billion people in low- and middle-income countries are exposed to household air pollution as they use biomass fuel for cooking. We investigated the associations between solid fuel use and nasopharyngeal (NP) inflammation, as well as the associations between high pneumococcal density and NP inflammation, in mothers and children in rural and urban Ethiopia. MATERIALS AND METHODS: Sixty pairs of mothers (median age, 30 years; range, 19-45 years) with a child (median age, 9 months; range, 1-24 months) were included from rural Butajira (n = 30) and urban Addis Ababa (n = 30) in Ethiopia. The cohort was randomly selected from a previous study of 545 mother/child pairs included 2016. Questionnaire-based data were collected which included fuel type used (solid: wood, charcoal, dung or crop waste; cleaner: electricity, liquefied petroleum gas). Nasopharyngeal (NP) samples were collected from all mothers and children and analyzed for the levels of 18 cytokines using a Luminex immunoassay. Pneumococcal DNA densities were measured by a real-time multiplex PCR and a high pneumococcal density was defined as a cyclic threshold (Ct) value ≤ 30. RESULTS: Mothers from rural areas had higher median CXCL8 levels in NP secretions than those from urban areas (8000 versus 1900 pg/mL; p < 0.01), while rural children had slightly higher IL-10 levels than those from the urban area (26 vs 13 pg/mL; p = 0.04). No associations between fuel type and cytokine levels were found. However, a high pneumococcal density was associated with higher levels of cytokines in both mothers (CCL4, CXCL8, IL-1ß, IL-6 and VEGF-A) and children (CCL4, CXCL8, IL-1ß, IL-6 and IL-18). CONCLUSIONS: No significant associations were found between solid fuel use and NP inflammation in Ethiopian mothers and children, but the inflammatory activity was higher in individuals living in the rural compared to the urban area. In addition, high cytokine levels were associated with high pneumococcal density in both mothers and children, indicating a significant impact of NP pathogens on inflammatory mediator levels in upper airways.

Application of waste derived magnetic acid-base bifunctional CoFe/biochar/CaO as an efficient catalyst for biodiesel production from waste cooking oil.

The loss of active components, weak acid resistance, and low recover efficiency of common Ca-based catalysts limited its further development and application. In this study, to effectively produce biodiesel from waste cooking oil (WCO), a green and recyclable magnetic acid-base bifunctional CoFe/biochar/CaO catalyst was prepared from sargassum and river snail shell waste via hydrothermal method. The catalysts' structure and properties were investigated by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), CO2/NH3 temperature programmed desorption (CO2/NH3 TPD), etc., The prepared catalyst mainly consisted of the carbon skeleton, CoFe alloy, and CaO. CoFe alloy provided catalyst's ferromagnetism for magnetic separation as well as acid sites for transesterification of WCO. Ca and other metal species with nanoscale (∼5.64 nm) were dispersively anchored on sargassum biochar surface, thereby leading to good catalytic activity (99.21% biodiesel yield) and stability (91.70% biodiesel yield after the 5th cycle). In addition, response surface methodology-Box-Behnken design (RSM-BBD) revealed the optimal operational conditions were 16:1 methanol/oil molar ratio, 3 wt% catalyst dosage, 73 °C for 157 min. The maximum biodiesel yield predicted value was 98.29% and the experimental value was 99.21%, indicating good satisfaction of the established model. Moreover, the quality of WCO biodiesel met the ASTM D6751 standards. This study benefits magnetic waste-derived acid-base bifunctional catalysts for the disposal of WCO towards sustainable biodiesel production.

Gas cooking indoors and respiratory symptoms in the ECRHS cohort.

BACKGROUND: Gas cooking is an important source of indoor air pollutants, and there is some limited evidence that it might adversely be associated with respiratory health. Using repeated cross-sectional data from the multi-centre international European Community Respiratory Health Survey, we assessed whether adults using gas cookers have increased risk of respiratory symptoms compared to those using electric cookers and tested whether there was effect modification by a priori selected factors. METHODS: Data on respiratory symptoms and gas cooking were collected from participants at 26-55 and 38-67 years (median time between examinations 11.4 years) from interviewer-led questionnaires. Repeated associations between gas cooking (versus electric) and respiratory symptoms were estimated using multivariable mixed-effects logistic regression models adjusted for age, sex, study arm, smoking status, education level, and included random intercepts for participants within study centres. Analyses were repeated using a 3-level variable for type of cooker and gas source. Effect modification by ventilation habits, cooking duration, sex, age atopy, asthma, and study arm were examined. RESULTS: The sample included 4337 adults (43.7% males) from 19 centres in 9 countries. Gas cooking increased the risk of "shortness of breath whilst at rest" (OR = 1.38; 95%CI: 1.06-1.79) and "wheeze with breathlessness" (1.32; 1.00-1.74). For several other symptoms, effect estimates were larger in those who used both gas hobs and ovens, had a bottled gas source and cooked for over 60 min per day. Stratifying results by sex and age found stronger associations in females and younger adults. CONCLUSION: This multi-centre international study, using repeat data, suggested using gas cookers in the home was more strongly associated than electric cookers with certain respiratory symptoms in adults. As gas cooking is common, these results may play an important role in population respiratory health.

Liquefied Petroleum Gas or Biomass Cooking and Severe Infant Pneumonia.

BACKGROUND: Exposure to household air pollution is a risk factor for severe pneumonia. The effect of replacing biomass cookstoves with liquefied petroleum gas (LPG) cookstoves on the incidence of severe infant pneumonia is uncertain. METHODS: We conducted a randomized, controlled trial involving pregnant women 18 to 34 years of age and between 9 to less than 20 weeks' gestation in India, Guatemala, Peru, and Rwanda from May 2018 through September 2021. The women were assigned to cook with unvented LPG stoves and fuel (intervention group) or to continue cooking with biomass fuel (control group). In each trial group, we monitored adherence to the use of the assigned cookstove and measured 24-hour personal exposure to fine particulate matter (particles with an aerodynamic diameter of ≤2.5 µm [PM2.5]) in the women and their offspring. The trial had four primary outcomes; the primary outcome for which data are presented in the current report was severe pneumonia in the first year of life, as identified through facility surveillance or on verbal autopsy. RESULTS: Among 3200 pregnant women who had undergone randomization, 3195 remained eligible and gave birth to 3061 infants (1536 in the intervention group and 1525 in the control group). High uptake of the intervention led to a reduction in personal exposure to PM2.5 among the children, with a median exposure of 24.2 µg per cubic meter (interquartile range, 17.8 to 36.4) in the intervention group and 66.0 µg per cubic meter (interquartile range, 35.2 to 132.0) in the control group. A total of 175 episodes of severe pneumonia were identified during the first year of life, with an incidence of 5.67 cases per 100 child-years (95% confidence interval [CI], 4.55 to 7.07) in the intervention group and 6.06 cases per 100 child-years (95% CI, 4.81 to 7.62) in the control group (incidence rate ratio, 0.96; 98.75% CI, 0.64 to 1.44; P = 0.81). No severe adverse events were reported to be associated with the intervention, as determined by the trial investigators. CONCLUSIONS: The incidence of severe pneumonia among infants did not differ significantly between those whose mothers were assigned to cook with LPG stoves and fuel and those whose mothers were assigned to continue cooking with biomass stoves. (Funded by the National Institutes of Health and the Bill and Melinda Gates Foundation; HAPIN ClinicalTrials.gov number, NCT02944682.).