Acute Effects on Blood Pressure Following Controlled Exposure to Cookstove Air Pollution in the STOVES Study

J Am Heart Assoc. 2019 Jul 16;8(14):e012246. doi: 10.1161/JAHA.119.012246. Epub 2019 Jul 9.


Background Exposure to air pollution from solid fuel used in residential cookstoves is considered a leading environmental risk factor for disease globally, but evidence for this relationship is largely extrapolated from literature on smoking, secondhand smoke, and ambient fine particulate matter ( PM 2.5). Methods and Results We conducted a controlled human-exposure study (STOVES [the Subclinical Tests on Volunteers Exposed to Smoke] Study) to investigate acute responses in blood pressure following exposure to air pollution emissions from cookstove technologies. Forty-eight healthy adults received 2-hour exposures to 5 cookstove treatments (three stone fire, rocket elbow, fan rocket elbow, gasifier, and liquefied petroleum gas), spanning PM 2.5 concentrations from 10 to 500 μg/m3, and a filtered air control (0 μg/m3). Thirty minutes after exposure, systolic pressure was lower for the three stone fire treatment (500 μg/m3 PM 2.5) compared with the control (-2.3 mm Hg; 95% CI, -4.5 to -0.1) and suggestively lower for the gasifier (35 μg/m3 PM 2.5; -1.8 mm Hg; 95% CI , -4.0 to 0.4). No differences were observed at 3 hours after exposure; however, at 24 hours after exposure, mean systolic pressure was 2 to 3 mm Hg higher for all treatments compared with control except for the rocket elbow stove. No differences were observed in diastolic pressure for any time point or treatment. Conclusions Short-term exposure to air pollution from cookstoves can elicit an increase in systolic pressure within 24 hours. This response occurred across a range of stove types and PM 2.5 concentrations, raising concern that even low-level exposures to cookstove air pollution may pose adverse cardiovascular effects.

Keywords: air pollution; blood pressure; cardiovascular disease risk factors.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Air Pollution, Indoor / adverse effects*
  • Blood Pressure*
  • Cooking*
  • Female
  • Healthy Volunteers
  • Household Articles*
  • Humans
  • Male
  • Particulate Matter / adverse effects*
  • Smoke / adverse effects
  • Young Adult


  • Particulate Matter
  • Smoke