Abstract
BACKGROUND: Occupational biomass pollutant exposure as observed in charcoal workers may have significant cardiovascular effects. This study aims to ascertain the prevalence and risk factors of hypertension and high pulse pressure (HPP), a marker of arterial stiffness, in charcoal workers compared with a control group of agricultural workers from the Democratic Republic of Congo. METHODS AND RESULTS: The charcoal worker and agricultural worker groups (n=485; median age, 35-40 years) were composed of male charcoal producers (n=229), charcoal saleswomen (n=72), male farmers (n=118), and vegetable saleswomen (n=66). We assessed workplace air pollution, sociodemographic parameters, self-reported physical activity, body composition, exhaled air carbon monoxide, and blood pressure. Hypertension and HPP prevalences were determined. Logistic regression, adjusted for confounding variables was used to identify the risk factors. Charcoal workplaces were more polluted than agricultural workplaces (P<0.01). Charcoal producers performed higher levels of physical activity (P=0.018) and demonstrated higher levels of exhaled air carbon monoxide (P<0.0001) and pulse pressure (P=0.006), and higher prevalence of grade 1 hypertension (P=0.007), isolated systolic hypertension (P=0.04), and HPP (P=0.02) than farmers. Overall, hypertension (adjusted odds ratio [aOR], 11.76 [95% CI, 6.26-22.13]), level of particulate matter <10 μm pollutants (aOR, 1.001 [95% CI, 1.0002-1.0017]), smoking (aOR, 2.21 [95% CI, 1.15-4.24]) and low education (aOR, 2.14 [95% CI, 1.10-4.17]) were independently associated with HPP. The level of particulate matter <1.0 μm pollutants (aOR, 1.0009 [95% CI, 1.0002-1.0015]), male sex (aOR, 2.09 [95% CI, 1.21-3.64]), and job seniority (aOR, 1.022 [95% CI, 1.004-1.044]) were independently associated with isolated systolic hypertension. CONCLUSIONS: Charcoal producers appear to develop isolated systolic hypertension and HPP more, both indices of cardiovascular events in which occupational biomass particles seem to play an early significant role.