Associations between fine particulate matter and lung function during late childhood and adolescence: the Sustainable Household Energy Adoption in Rwanda (SHEAR) Study

In low-resource areas, biomass burning for cooking leads to high levels of household air pollution. Lung function can be compromised by long-term pollution exposure, yet little is known about health risks during childhood. In the Sustainable Household Energy Adoption in Rwanda (SHEAR) study, we examined baseline lung function in 8-17 year-olds before implementing a household energy intervention. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC ratio were measured in 283 boys and 295 girls in rural Rwanda using the EasyOne spirometer. Ultrasonic Personal Aerosol Samplers measured 48-hour fine particulate matter (PM2.5) exposure. Cross-sectional associations between age- and height-standardized lung function (z-scores) and PM2.5 levels were examined in separate models for boys and girls, adjusted for an asset index. For sensitivity analyses, we stratified models by pre-pubertal age estimates (11 for girls, 13 for boys). 96.4% FEV1 and 96.9% FVC were expert graded as high-quality. We did not observe associations between PM2.5 and lung function in primary analyses (e.g., FEV1 among girls: 0.02 per log-µg/m3 increase in PM2.5, 95% confidence interval [CI]: −0.10, 0.15). We observed suggestive associations between PM2.5 and the FEV1/FVC ratio among younger boys and older girls (e.g., among younger boys: −0.17 per log-µg/m3 increase in PM2.5, 95% CI: −0.35, 0.01). Despite the lack of clear associations, we collected robust measures in an understudied population. Our findings suggest that pubescence may be important in understanding how household air pollution affects lung function.