Low birth weight contributes to as many as 60% of all neonatal deaths; exposure during pregnancy to household air pollution has been implicated as a risk factor. Between 2011 and 2013, we measured personal exposures to carbon monoxide (CO) and fine particulate matter (PM2.5) in 239 pregnant women in Dar es Salaam, Tanzania. CO and PM2.5 exposures during pregnancy were moderately high (geometric means 2.0 ppm and 40.5 μg/m3); 87% of PM2.5 measurements exceeded WHO air quality guidelines Median and high (75th centile) CO exposures were increased for those cooking with charcoal and kerosene versus kerosene alone in quantile regression. High PM2.5 exposures were increased with charcoal use. Outdoor cooking reduced median PM2.5 exposures. For PM2.5, we observed a 0.15 kilogram reduction in birth weight per interquartile increase in exposure (23.0 μg/m3) in multivariable linear regression; this finding was of borderline statistical significance (95% confidence interval −0.30, 0.00 kilograms; p=0.05). PM2.5 was not significantly associated with birth length or head circumference nor were CO exposures associated with newborn anthropometrics. Our findings contribute to the evidence that exposure to household air pollution, and specifically fine particulate matter, may adversely affect birth weight.

Background:Smoke from the burning of biomass fuels has been linked with adverse pregnancy outcomes such as low birth weight, stillbirth, and prematurity.Objective:To identify potential underlying mechanisms of adverse perinatal outcomes, we explored the association of placental pathology with household air pollution in pregnant women from urban/periurban Tanzania who cook predominantly with charcoal.Methods:Between 2011 and 2013, we measured personal exposures to fine particulate matter (PM2.5) and carbon monoxide (CO) over 72 hr among a cohort of Tanzanian pregnant women. Placentas were collected after delivery for examination. Placental pathologies of inflammatory, hypoxic, ischemic/hypertensive, infectious and thrombotic etiologies were diagnosed, blinded to exposure levels. Using multiple logistic regression, we explored the association of PM2.5 and CO exposure with placental pathology.Results:One hundred sixteen women had personal air exposure measurements and placental histopathology available for analysis. PM2.5 and CO exposures were moderate [geometric means (GSD) were 40.5 μg/m3 (17.3) and 2.21 ppm (1.47) respectively]; 88.6% of PM2.5 measurements exceeded World Health Organization air quality guidelines. We observed an increase in the odds (per 1-unit increase in exposure on the ln-scale) of fetal thrombotic vasculopathy (FTV) both with increasing PM2.5 [adjusted odds ratio (aOR) = 5.5; 95% CI: 1.1, 26.8] and CO measurements (aOR = 2.5; 95% CI: 1.0, 6.4) in adjusted models only. FTV also was more common among pregnancies complicated by stillbirth or low birth weight.Conclusions:Fetal thrombosis may contribute to the adverse outcomes associated with household air pollution from cook stoves during pregnancy. Larger studies are necessary for confirmation.Citation:Wylie BJ, Matechi E, Kishashu Y, Fawzi W, Premji Z, Coull BA, Hauser R, Ezzati M, Roberts D. 2017. Placental pathology associated with household air pollution in a cohort of pregnant women from Dar es Salaam, Tanzania. Environ Health Perspect 125:134–140; http://dx.doi.org/10.1289/EHP256

BackgroundWork-related injuries affect people in their most productive years. Globally more than 5500 workers are killed by injuries and illnesses every day, and more than 270 million workers are injured at work each year (ILO, 2009).Severe work-related injuries and the resulting adverse socioeconomic impacts, represent a special burden to developing countries. This study, which was conducted in Tanzania, sought to describe patterns of severe traumatic work-related injuries; identify their causes and risk factors; evaluate the quality of reporting work-related injuries and; identify strategies for their prevention and control in Tanzania and other developing countries.MethodsData was collected through structured interviews with 1385 injury cases admitted in the largest trauma hospital in Tanzania from March 2007 to March 2008. Detailed information was collected after work-relatedness of a case was established. Information from interviews was linked with hospital records, workers compensation and police data.FindingsA total of 638 (46%) injury cases were classified as work-related injuries, and majority were male-workers (93%). Linkage identified 138 (10%) cases that were initially not identified as work-related. Peak age-group for both sexes was 2635 years. Road traffic injury was the most common reason for admission (62%) followed by falls (15%). Road was the leading place of injury (64%) followed by work premises (27%).ConclusionsThe study revealed new patterns of work-related injuries in Tanzania. Road traffic safety becomes an important component of workers safety in Tanzania and other developing countries.

BackgroundInjury is one of the leading causes of death and disability in developing countries (Krug, 1999). Data on the impact of injuries on society have been non-existent in most developing countries, a situation likely to account for slow recognition of injuries as a public health problem by decision and policy-makers (Mock, 1995). This study, which was conducted in Tanzania, sought to describe patterns of severe traumatic work-related injuries; identify their causes and risk factors; evaluate the quality of reporting and recording work-related injuries and; identify strategies for their prevention and control in Tanzania and other developing countries.MethodsData were collected through structured interviews with 1385 injury cases admitted in the largest trauma hospital in Tanzania from March 2007 to March 2008. Detailed information was collected after work-relatedness of a case was established. Information from interviews was linked with hospital records, workers compensation and police data.FindingsA total of 638 (46%) injury cases were classified as work-related injuries, and majority were male-workers (93%). Linkage identified 138 (10%) cases that were initially not identified as work-related. Based on minimum injury dataset, workers compensation data source had the most comprehensive injury dataset followed by hospital data source.ConclusionsSystems in place for collecting and recording injury data, lack nationally agreed guidelines for defining, reporting and recording injury information among the injury data sources in Tanzania. Injury surveillance systems in low-income countries such as Tanzania could be developed using data linkages.

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