Regional and seasonal variations in household and personal exposures to air pollution in one urban and two rural Chinese communities: A pilot study to collect time-resolved data using static and wearable devices

BACKGROUND: Previous studies of the health impact of ambient and household air pollution (AAP/HAP) have chiefly relied on self-reported and/or address-based exposure modelling data. We assessed the feasibility of collecting and integrating detailed personal exposure data in different settings and seasons. METHODS/DESIGN: We recruited 477 participants (mean age 58 years, 72% women) from three (two rural [Gansu/Henan] and one urban [Suzhou]) study areas in the China Kadoorie Biobank, based on their previously reported fuel use patterns. A time-resolved monitor (PATS+CO) was used to measure continuously for 120-hour the concentration of fine particulate matter (PM(2.5)) at personal and household (kitchen and living room) levels in warm (May-September 2017) and cool (November 2017–January 2018) seasons, along with questionnaires on participants’ characteristics (e.g. socio-demographic, and fuel use) and time-activity (48-hour). Parallel local ambient monitoring of particulate matter (PM(1), PM(2.5) and PM(10)) and gaseous pollutants (CO, ozone, nitrogen oxides) was conducted using regularly-calibrated devices. The air pollution exposure data were compared by study sites and seasons. FINDINGS: Overall 76% reported cooking at least weekly (regular-cooks), and 48% (urban 1%, rural 65%) used solid fuels (wood/coal) for cooking. Winter heating was more common in rural sites than in urban site (74–91% vs 17% daily), and mainly involved solid fuels. Mixed use of clean and solid fuels was common for cooking in rural areas (38%) but not for heating (0%). Overall, the measured mean PM(2.5) levels were 2–3 fold higher in the cool than warm season, and in rural (e.g. kitchen: Gansu(warm_season) = 142.3 µg/m(3); Gansu(cool_season) = 508.1 µg/m(3); Henan(warm_season) = 77.5 µg/m(3); Henan(cool_season) = 222.3 µg/m(3)) than urban sites (Suzhou(warm_season) = 41.6 µg/m(3); Suzhou(cool_season) = 81.6 µg/m(3)). The levels recorded tended to be the highest in kitchens, followed by personal, living room and outdoor. Time-resolved data show prominent peaks consistently recorded in the kitchen at typical cooking times, and sustained elevated PM(2.5) levels (> 100 µg/m(3)) were observed in rural areas where use of solid fuels for heating was common. DISCUSSION: Personal air pollution exposure can be readily assessed using a low-cost time-resolved monitor in different settings, which, in combination with other personal and health outcome data, will enable reliable assessment of the long-term health effects of HAP/AAP exposures in general populations.