Open Access Research article

Adherence to reduced-polluting biomass fuel stoves improves respiratory and sleep symptoms in children

Roberto A Accinelli123*, Oscar Llanos1, Lidia M López1, María I Pino1, Yeny A Bravo123, Verónica Salinas1, María Lazo1, Julio R Noda1, Marita Sánchez-Sierra1, Lacey Zárate1, Joao da Silva1, Fabiola Gianella1, Leila Kheirandish-Gozal45 and David Gozal45*

Author Affiliations

1 Laboratorio de Respiración del Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Perú

2 Hospital Nacional Cayetano Heredia, Lima, Perú

3 Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú

4 Section of Pediatric Sleep Medicine, Department of Pediatrics, and Comer Children’s Hospital, Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA

5 Department of Pediatrics, University of Chicago, 5721 S. Maryland Avenue, MC 8000, Suite K-160, Chicago, IL 60637, USA

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BMC Pediatrics 2014, 14:12  doi:10.1186/1471-2431-14-12

Published: 17 January 2014



Symptoms of sleep apnea are markedly increased in children exposed to smoke from biomass fuels and are reduced by kitchen stoves that improve indoor biomass pollution. However, the impact of adherence to the use of improved stoves has not been critically examined.


Sleep-related symptom questionnaires were obtained from children <15 years of age in 56 families residing in the communities of Lliupapuquio, Andahuaylas province in Peru before and 2 years after installation of less-polluting Inkawasi cooking stoves.


82 children with lifetime exposures to indoor fuel pollution were included. When compared to those alternating between both types of stoves or those using traditional stoves only, those children who exclusively used Inkawasi cooking stoves showed significant improvements in sleep and respiratory related symptoms, but some minor albeit significant improvements occurred when both stoves were concomitantly used.


Improvements in respiratory and sleep-related symptoms associated with elevated indoor biomass pollution occur only following implementation and exclusive utilization of improved kitchen stoves.

Biomass fuel pollution; Sleep; Respiration; Kitchen stoves