Educational attainment and self-reported environmental exposures of pregnant women living in Nairobi, Kenya

Environmental exposures experienced by pregnant women living in cities of low- and middle-income countries are poorly described. We collected information on housing characteristics, household and ambient air pollution, and work-related exposures through questionnaires in a cohort of 400 pregnant women in Nairobi, Kenya and examined exposures in relation to educational attainment, a proxy for socioeconomic status. Participants were median 26 years of age, mostly married (85%) and self-described homemakers (54%), with at least some secondary school education (74%). Housing generally consisted of one room (58%) with one window (57%), access to electricity (94%), and no piped water (88%). Participants commonly reported living near sewers (55%) and the Dandora dumpsite (34%). Liquified petroleum gas (LPG) was the primary domestic cooking fuel, followed by kerosene, with 65% and 32%, respectively, reporting use most days to daily. Most participants reported exposure to outdoor cooking smoke (73%) and vehicle exhaust (66%) most days to daily. Employed participants (N = 151) reported work-related exposure to vehicle exhaust (68%), cigarettes (37%), marijuana (33%), dusty/unpaved roads (32%), welding (30%), and the dumpsite (30%) most days to daily. Exposure to rubbish burning was reported by 4.5% of participants at home, by 24% outdoors, and by 25% related to work most days to daily. Relative to women with primary school education or lower, women with at least secondary school education were more likely to use LPG (p