D26-07 Effects of Cooking With Liquefied Petroleum Gas or Biomass on Lung Function by Oscillometry Among Pre-school Aged Children in Peru

Rationale Billions of people worldwide are exposed to household air pollution from the use of solid fuels, placing them at increased risk of lung function impairment and chronic respiratory disease. Understanding the significance of household air pollution on early life lung function is essential to understanding potential windows of opportunity for interventions that may reduce the burden of respiratory illnesses. Methods We conducted pre- and post-bronchodilator respiratory oscillometry lung function measurements in a follow-up study of 3-5-year-olds whose mothers had participated in a randomized trial of a liquefied petroleum gas (LPG) cooking intervention versus usual solid fuel use during pregnancy and infancy. Among well children we assessed oscillometry resistance during tidal breathing at 7 Hertz (Hz) (R7), reactance at 7 Hz (X7), difference in resistance at 7 and 19 Hz (R7-19), resonance frequency (fres) and area above the reactance curve (AX7). For R7, X7, fres, and AX7 we computed z-scores using available pediatric reference equations based on height. All data underwent automatic and manual quality control to ensure only valid measurements were retained for analysis. We also conducted exposure-response analyses to examine the association between R7 or AX7 z-scores and PM2.5 or CO exposures during pregnancy and first year of life. Results We tested 101 children (mean age 4.4 ± 0.6 years, 51.5% (n = 52) male, 50.5% (n = 51) from the intervention arm). Mean R7, X7, fres and AX7 z-scores among intervention compared to control children were -0.1±1.0 vs -0.2±1.2 (p = 0.52), -0.8±1.0 vs -1.0±1.1 (p = 0.53), 0.9±1.1 vs 0.4±1.1 (p = 0.07), and 1.2±1.0 vs 1.3±1.1.3 (p = 0.79), respectively. In adjusted intention-to-treat analysis, mean differences in R7, X7, fres and AX7 z-scores were -0.01 (95% CI -0.44 to 0.41), 0.11 (-0.32 to 0.54), 0.33 (-0.13 to 0.79), and -0.08 (-0.51 to 0.35), respectively, between intervention and control children. Postnatal CO exposure was associated with higher R7 and AX7, with mean increases in R7 and AX7 z-scores of 0.39 (0.02 to 0.76) and 0.42 (0.04 to 0.79), respectively, for a 10 ppm increase in CO. We found no association between prenatal or postnatal PM2.5 and oscillometry before or after bronchodilation. Conclusions Children whose mothers cooked with LPG during pregnancy and through infancy did not have better oscillometric lung function compared to those whose mothers cooked with biomass. Higher postnatal CO exposure was associated with worse oscillometric lung function. This abstract is funded by: NIH Fogarty International Center (D43 TW009340; D43 TW011502), Johns Hopkins University Division of Pulmonary and Critical Care (INSPIRE award), NIH (UM 1HL134590), Bill & Melinda Gates Foundation (OPP1131279).