Household air pollution (HAP) from biomass stoves is a leading risk factor for cardiopulmonary outcomes; however, its toxicity pathways and relationship with inflammation markers are poorly understood. Among 180 adult women in rural Peru, we examined the cross-sectional exposure-response relationship between biomass HAP and markers of inflammation in blood using baseline measurements from a randomized trial. We measured markers of inflammation (CRP, IL-6, IL-10, IL-1β, and TNF-α) with dried blood spots, 48-h kitchen area concentrations and personal exposures to fine particulate matter (PM2.5 ), black carbon (BC), and carbon monoxide (CO), and 48-h kitchen concentrations of nitrogen dioxide (NO2 ) in a subset of 97 participants. We conducted an exposure-response analysis between quintiles of HAP levels and markers of inflammation. Markers of inflammation were more strongly associated with kitchen area concentrations of BC than PM2.5 . As expected, kitchen area BC concentrations were positively associated with TNF-α (pro-inflammatory) concentrations and negatively associated with IL-10, an anti-inflammatory marker, controlling for confounders in single- and multi-pollutant models. However, contrary to expectations, kitchen area BC and NO2 concentrations were negatively associated with IL-1β, a pro-inflammatory marker. No associations were identified for IL-6 or CRP, or for any marker in relation to personal exposures.

Three billion people (>40% of the world\'s population) lack access to clean cooking solutions, including 2.5 billion people that still rely on the traditional use of biomass for cooking. In urban contexts, the rate of access to clean cooking solutions is normally higher than in rural contexts due to greater availability of these solutions. The relevance of providing access to clean cooking solutions (SDG 7) is linked to several associated co-benefits that contribute to a wide range of Sustainable Development Goals (SDGs). Therefore, this paper shows a comprehensive analysis of multiple co-benefits of a clean cooking solution intervention. Health (SDG 3), gender (SDG 5) and climate change (SDG 13) co-benefits were analysed and compared through a cost-benefit analysis using a comprehensive approach in a case study in the Casamance Natural Subregion, located in Western Africa. The most important co-benefits were related to gender (SDG 5), representing 60-97% of the total economic benefits. Climate change co-benefits (SDG 13) were also relevant, representing 3-40% of the total economic benefits. Health co-benefits (SDG 3) were very limited for this case study, representing <1% of the total economic benefits. Considering these results, implications for urban settings were discussed in the light of the \"making the available clean\" or \"making the clean available\" strategies.

High levels of PM2.5 exposure and associated health risks are of great concern in rural China. For this study, we used portable PM2.5 monitors for monitoring concentrations online, recorded personal time-activity patterns, and analyzed the contribution from different microenvironments in rural areas of the Yangtze River Delta, China. The daily exposure levels of rural participants were 66 μg/m3 (SD 40) in winter and 65 μg/m3 (SD 16) in summer. Indoor exposure levels were usually higher than outdoor levels. The exposure levels during cooking in rural kitchens were 140 μg/m3 (SD 116) in winter and 121 μg/m3 (SD 70) in summer, the highest in all microenvironments. Winter and summer values were 252 μg/m3 (SD 103) and 204 μg/m3 (SD 105), respectively, for rural people using biomass for fuel, much higher than those for rural people using LPG and electricity. By combining PM2.5 concentrations and time spent in different microenvironments, we found that 92% (winter) and 85% (summer) of personal exposure to PM2.5 in rural areas was attributable to indoor microenvironments, of which kitchens accounted for 24% and 27%, respectively. Consequently, more effective policies and measures are needed to replace biomass fuel with LPG or electricity, which would benefit the health of the rural population in China.