Measuring the exposure of infants and children to indoor air pollution from biomass fuels in The Gambia

Indoor air pollution (IAP) from biomass fuels contains high concentrations of health damaging pollutants and is associated with an increased risk of childhood pneumonia. We aimed to design an exposure measurement component for a matched case-control study of IAP as a risk factor for pneumonia and severe pneumonia in infants and children in The Gambia. We conducted co-located simultaneous area measurement of carbon monoxide (CO) and particles with aerodynamic diameter <2.5 μm (PM2.5) in 13 households for 48 h each. CO was measured using a passive integrated monitor and PM2.5 using a continuous monitor. In three of the 13 households, we also measured continuous PM2.5 concentration for 2 weeks in the cooking, sleeping, and playing areas. We used gravimetric PM2.5 samples as the reference to correct the continuous PM2.5 for instrument measurement error. Forty-eight hour CO and PM2.5 concentrations in the cooking area had a correlation coefficient of 0.80. Average 48-h CO and PM2.5 concentrations in the cooking area were 3.8 ± 3.9 ppm and 361 ± 312 μg/m3, respectively. The average 48-h CO exposure was 1.5 ± 1.6 ppm for children and 2.4 ± 1.9 ppm for mothers. PM 2.5 exposure was an estimated 219 μg/m3 for children and 275 μg/m3 for their mothers. The continuous PM2.5 concentration had peaks in all households representing the morning, midday, and evening cooking periods, with the largest peak corresponding to midday. The results are used to provide specific recommendations for measuring the exposure of infants and children in an epidemiological study. © 2008 The Authors.