Indoor air pollution and hypertension disease burden among women using low-grade fuels

Exposures to indoor air pollution from the combustion of Low-grade Fuels (LgFs) is a leading risk factor for global disease burden. Emerging evidence suggest a potential role of PM_2.5 exposures in Blood Pressure (BP) elevation. This study assessed the effects of Indoor Air Pollution (IAP) from the use of LgFs on hypertension disease burden among women in low-income settlements. We measured the kitchen concentrations and personal exposures to PM_2.5 for users of LgFs compared with users of LPG in the city of Aba, Nigeria. The study also assessed hypertension markers for 328 adult women in the population. Association between PM_2.5 exposures and BP was modelled with hierarchical multiple regression, adjusting for major covariates. The indoor PM_2.5 concentrations for users of LgFs ranged from 47.5 to 800.0 μg/m³ while that for LPG users ranged from 33.0 to 112.5 μg/m³. The mean personal exposures were 152.3 μg/m³ and 58.3 μg/m³ for users of LgFs and LPG, respectively. The age-standardized hypertension prevalence in the population was 24.4 % and 15.6 % for users of LgFs and LPG, respectively. Exposures to PM_2.5 moderately predicted SBP among users of LgFs but not among LPG users; the increase in 1 μg/m³ of PM_2.5 exposure resulted to 0.44 mmHg increase in SBP among users LgFs. Long-term exposures to IAP from the use of low-grade fuels is associated with increased SBP and greater risks of systemic hypertension. These findings reinforce the need for public policies towards improving access to, and affordability of LPG as an alternative household fuel.