Personal, household, and community PM2.5 exposure by cooking and heating fuel use and other key characteristics in the CKB-Air study

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BACKGROUND AND AIM: We aimed to assess the integrated and time-resolved personal, household, and community PM₂.₅ exposure patterns associated with different cooking and heating fuels and other key characteristics in rural and urban China. METHOD: The CKB-Air study involved parallel measurements of personal, household, and community PM₂.₅ in summer (MAY-SEP 2017) and winter (NOV 2017-JAN 2018) in ~380 participants from one urban and two rural communities in China, with ~61,000-81,000 person-hours of data across different locations after data cleaning. Age- and sex-adjusted geometric means of PM₂.₅ were calculated, by key participant characteristics overall and by season. Spearman correlation coefficients between PM₂.₅ levels across different locations were computed. RESULTS: Solid fuel users had ~90% higher personal and kitchen 24-hour average PM₂.₅ exposure than clean fuel users or those who did not cook or heat. They also had a more substantial increase (~75%) in personal and household PM₂.₅ in winter (versus summer) compared to other participants (~20%), whereas community levels were 2-3 times higher in winter regardless of fuel use. Overall, solid fuel users had markedly higher weighted annual average PM₂.₅ exposure (personal: 77.8 [71.1-85.2] µg/m³, ~90% higher; kitchen: 103.7 [91.5-117.6] µg/m³, ~130% higher; living room (62.0 [57.1-67.4] µg/m³, ~65% higher) than clean fuel users. There was a remarkable diurnal variability in PM₂.₅ exposure among the participants, with 5-minute moving average 700-1,200µg/m³ in typical meal times. Personal PM₂.₅ was moderately correlated with living room (Spearman r: 0.64-0.66) and kitchen (0.52-0.59) levels, but only weakly correlated with community levels, especially in summer (r_summer_range: 0.15-0.34) and among solid fuel users (r_summer_range: 0.11-0.31). CONCLUSIONS: Solid fuel use for cooking and heating was associated with estimated annual personal and household PM₂.₅ exposure levels at 15-20 times the WHO Air Quality Guideline. Household PM₂.₅ was a better proxy of personal exposure than community PM₂.₅ in this setting.

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