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Background: Measurement of biological indicators of physiological change may be useful in evaluating the effectiveness of stove models, which are intended to reduce indoor smoke exposure and potential health effects., Objectives: We examined changes in exhaled carbon monoxide (CO), percentage carboxy-hemoglobin, and total hemoglobin in response to the installation of a chimney stove model by the Juntos National Program in Huayatan, Peru in 2008., Methods: Biomarkers were measured in a convenience sample comprising 35 women who met requirements for participation, and were measured before and three weeks after installation of a chimney stove. The relationships between exposure to indoor smoke and biomarker measurements were also analyzed using simple linear regression models., Results: Exhaled CO reduced from 6.71 ppm (95% CI 5.84-7.71) to 3.14 ppm (95% CI 2.77-3.66) three weeks after stove installation (P < 0.001) while % COHb reduced from 1.76% (95% CI 1.62-1.91) to 1.18% (95% CI 1.12-1.25; P < 0.001). Changes in exhaled CO and % COHb from pre- to post-chimney stove installation were not correlated with corresponding changes in exposure to CO and PM2.5 even though the exposures also reduced after stove installation., Conclusion: Exhaled CO and % COHb both showed improvement with reduction in concentration after the installation of the chimney cook stoves, indicating a positive physiological response subsequent to the intervention.

High-altitude populations using biofuels for household energy may be at health risk due to a combination of altitudinal stress and indoor exposures to biomass smoke. In this article, the authors measure indoor and outdoor breathing level concentrations of PM(2.5) and CO during periods of meal preparation in a convenience sample of homes above 3000 m in Cusco, Peru. From July 10 to 21, 2005, 237 measurements were taken during a pilot study at 41 residences. Results show the highest levels of PM(2.5) and CO occurred during the early morning in the kitchen when dung and wood were used. Additionally, findings suggest that residential biomass fuel combustion in Cusco results in elevated indoor PM(2.5) and CO exposure levels that are of potential human health concern, an issue that may be exacerbated by the physiological impact of living in a high-altitude environment.