Adoption of a semi-gasifier cookstove intervention and its impact on air pollution and cardiovascular health in southwestern China
Notice bibliographique
Résumé
Almost half of the world's households burn biomass and coal fuel as their primary energy source for cooking, heating, and other household needs. Household air pollution from inefficient biomass burning is a leading contributor to the global burden of cardiovascular disease, particularly in China. Replacing traditional biomass stoves with lower-polluting biomass stoves and fuels can potentially reduce air pollution exposures and the resulting health burden, though the evidence is limited, particularly for high-performing gasifier stove interventions. I evaluated the adoption and use of a semi-gasifier cooking and water-heating stove and pelletized biomass fuel intervention and its impact on exposures to air pollution and cardiovascular health among 205 rural Chinese women. Over a three year pre- and post-intervention study (n=125 intervention, n=80 control women), we measured women's brachial and central systolic and diastolic blood pressure (bSBP, cSBP, bDBP, cDBP), carotid-femoral pulse wave velocity (cfPWV), and central pulse pressure (cPP), women's personal exposures to air pollution, and a range of other risk factors for cardiovascular disease. I assessed the effect of the intervention on cardiovascular markers over time and between intervention groups with mixed-effects multivariable linear regression models using Bayesian inference procedures. I also collected information on stove use patterns by placing temperature sensors (stove use monitors, "SUM") on stoves for short- (48-h) and long-term (5 or 13 months) periods and administered a survey at 5-8 months after intervention. Multivariable probit and hurdle regression models were built to estimate the associations between intervention uptake (yes/no), 48-h stove use (yes/no), and 48-h duration of use (minutes). Pre- to post-intervention, blood pressure and cPP decreased on average for the intervention and control group, though reductions were slightly greater for the controls resulting in positive non-significant intervention effects for bSBP (mean posterior effect 1.44 mmHg [95% posterior credible interval (CIe) -2.5, 5.2]), cSBP (0.55 mmHg [95% CIe-3.0, 4.1]), bDBP (1.73 mmHg [95% CIe -0.2, 3.5]), cDBP (1.19 mmHg [95% CIe -0.8, 3.1]), cPP (0.23 mmHg [95% CIe -1.8, 1.1]), and no difference for pulse wave velocity (0.03 log-m/s [95% CIe -0.03, 0.08]). The lack of an observed intervention effect on cardiovascular markers was likely due to the fact that air pollution exposures decreased for both intervention and control women on average (range: -19% to -59%) and the intervention was only used a modest amount of the time (mean 40% [95% CI 34, 47] of days per month, 1-5 months post-intervention). Household intervention use was positively associated with reported cooking needs, and negatively associated with age of the main cook, household socioeconomic status, and ownership of other non-biomass stoves. As China and other countries create policies and promote interventions to reduce the burden of cardiovascular disease caused by household air pollution, my thesis provides useful and timely information on the lack of an impact that a high-performing gasifier stove intervention had on reducing air pollution and improving cardiovascular makers in a rural Chinese setting.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».