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Reductions in urinary metabolites of exposure to household air pollution in pregnant, rural Guatemalan women provided liquefied petroleum gas stoves



Household air pollution from solid fuels is a leading risk factor for morbidity and mortality worldwide. Pregnant women’s exposure to polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs), two components of solid-fuel smoke, is associated with adverse birth outcomes. Even with improved solid-fuel stoves, exposure to PAHs and VOCs remains high. Therefore, cleaner cooking fuels need to be prioritized.


We aimed to quantify exposure reduction to PAHs and VOCs among pregnant women in rural Guatemala with a liquefied petroleum gas (LPG) stove intervention.

Materials and methods

Urine from pregnant women (N = 50) was collected twice: at <20 weeks gestation, when women cooked exclusively with wood, and 6–8 weeks after receiving an LPG stove. Metabolites of four PAHs and eight VOCs were analyzed. Concurrent with urine collection, personal 48-h PM2.5 exposure was measured.


Women cooking exclusively with wood were exposed to high levels of particulate matter (PM2.5), which was reduced by 57% with the LPG stove. Urinary concentrations of total PAH metabolites (−37%), PMA (benzene metabolite; −49%), and CNEMA (acrylonitrile metabolite; −51%) were reduced. However, recent use of a wood-fired sauna bath led to large increases in excretion of urinary toxicant metabolites (+66–135%).


This is the first study to report PAH and VOC reductions from an LPG stove intervention introduced during pregnancy. However, other sources of air pollution minimized the gains seen from using an LPG stove. Thus, all sources of air pollution must be addressed in concert to reduce exposures to levels that protect health.

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This work was supported by the National Institutes of Health (No. 1R21ES025032-01A1, S10 RR026437 and P30 DA012393). We thank Kristina Bello and Lawrence Chan for performing the analytical chemistry. We are very grateful to Gilberto Davila, Eduardo Canuz, Maritza Barrios, Expedita Ramirez, Micaela Marroquin and study participants in Guatemala.

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Correspondence to Lisa M. Thompson.

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The authors declare that they have no conflict of interest.

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The study received ethical approval from the Committee for Human Research at UCSF and UVG and was registered on (ID: NCT02812914). Participants were informed of the study by trained field workers fluent in both Spanish and Mam.

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Weinstein, J.R., Diaz-Artiga, A., Benowitz, N. et al. Reductions in urinary metabolites of exposure to household air pollution in pregnant, rural Guatemalan women provided liquefied petroleum gas stoves. J Expo Sci Environ Epidemiol 30, 362–373 (2020).

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  • Solid fuel use
  • Household air pollution
  • LPG stoves
  • Urinary biomarkers
  • Polycyclic aromatic hydrocarbons
  • Volatile organic compounds


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