Respiratory health in children exposed to air pollution from biomass combustion at home or during maternal professional activities in Abidjan, Ivory Coast.

Context

The APIMAMA Kids study is a sub-study of the participatory and interdisciplinary APIMAMA study (Air Pollution Mitigation Actions for Megacities in Africa, 2022-2024), conducted in Abidjan by teams from Félix Houphouët Boigny University and Paul Sabatier University of Toulouse. Its aim is to contribute to reducing health risks associated with air pollution from all sources of combustion in African cities by assessing the impact of implementing strategies to mitigate pollutant emissions and changing practices, urban space organization, and public action. It studies exposure to indoor and outdoor pollution among three groups of women exposed to biomass combustion for both professional and personal reasons: women involved in fish smoking, women producing charcoal, and women using charcoal for cooking. The study includes measuring pollutant levels, examining the socio-economic determinants of air pollution, assessing the respiratory health of women, measuring risk culture indices related to air pollution, setting up and providing improved stoves and cookstoves, and evaluating the impact of these mitigation strategies on women’s health, the environment, and socio-economic outcomes after one year

Hypothesis

Children living in an environment with high PM2.5 concentrations have more respiratory symptoms than children living in an environment less polluted with fine particles. Children know little about the various sources of exposure to air pollution, and the consequences for their health and the environment. The implementation of interventions to reduce children’s exposure to air pollution would lead to savings in family healthcare costs and fuel purchases.

Objectives

To document the issues, determinants and impacts on respiratory health of family, occupational and environmental exposure to indoor and outdoor air pollution in urban African children

Methods

APIMAMA Kids is a repeated cross-sectional observational study combined with a longitudinal cohort to track children with respiratory functional disorders or asthma. Its main objective is to assess the frequency and determinants of respiratory disorders and symptoms in children and grandchildren under the age of 16 from women included in the APIMAMA study, who use charcoal (biomass combustion) for cooking, engage in fish smoking, and a control group of women using gas for cooking. Additionally, we study the effect of introducing improved combustion technologies in mothers’ practices on the children’s health.
APIMAMA Kids combines the expertise of various disciplines: public health, pediatric pulmonology, atmospheric physics, and sociology. It will provide evidence-based data on the respiratory health of children, their exposure to pollution and its determinants, as well as their perceptions and knowledge of air pollution

Progress

. 210 children and 86 women were enrolled. All pre-intervention measurements and assessments (prior to the implementation of spaces and distribution of ovens and cookstoves) were completed in the three study groups.

. Two meetings of the scientific advisory board, chaired by Pr. Michaël Fayon, were held in May 2023 and September 2024. These meetings provided an opportunity to discuss the progress of the project, the publication plan, and the results of the initial data collected. They also allowed for project adjustments in response to methodological and scientific questions raised.

. The ceremony for the distribution of improved cookstoves for fish smoking took place on Friday, November 29, 2024. This was the final implementation of the mitigation strategies planned for this project, led by the APIMAMA mothers project. At this stage of the study, the only remaining task is to conduct the post-intervention data collection campaigns in order to compare health and pollution data before and after the implementation of the mitigation strategies.