University of California, San Francisco

Mission

My area of research focuses on environmental factors that contribute to low birth weight and adverse perinatal outcomes, such as neonatal morbidity and mortality. My current research interests are to expand the evidence of an association between low birth weight and decreased anthropometric growth (primarily stunting and wasting) among children who are heavily exposed to particulate matter and carbon monoxide from solid-fuel cook stoves in lesser-developed countries. Currently I am working with nursing/midwifery and medical students from UCSF to conduct pilot studies in rural Guatemala and Peru.

I participate as a researcher in the children’s cohort study RESPIRE (Randomized Exposure Study of Pollution Indoors and Respiratory Effects)and in the follow-up cohort study CRECER (Chronic Respiratory Effects of Early Childhood Exposure to Respirable Particulate Matter) which is now in data analysis phase. These two studies, conducted in the rural highlands of Guatemala, followed a cohort of more than 500 children from birth to seven years of age to study the effects of exposure to woodsmoke from indoor cooking fires on pulmonary disease, including pneumonia and asthma. I analyzed the predictors of low birth weight among children born during the RESPIRE study, the anthropometric growth of these children during the first three years of age, and exposure assessment of the temazcal (traditional wood-fired steam bath used for bathing and healing practices) among women and children. My future research builds upon the experience I gained from this work and expands to new areas to explore new measures and hypotheses. Specifically, I am interested in measuring the impact of air pollutants generated from indoor cooking fires in resource-poor countries on neonatal outcomes such as preterm birth, fetal growth restriction, and neonatal neurobehavioral development.

Organization Type

Academia

Contact Information

Primary Contact	Dr. Lisa Thompson lisa.thompson@nursing.ucsf.edu	Secondary Contact
Address	2 Koret Way, Box 0606 Family Health Care Nursing San Francisco, CA 94143-0606 United States	Website	http://nurseweb.ucsf.edu/www/ffthoml.htm
		Phone	415-502-5628
		Fax	415-753-2161
		Calling/Fax Instructions

Our Focus

Primary Initiatives, Target Populations, and Scope of Work:
I am working with local traditional birth attendants in rural Guatemala to assess birth outcomes, including birth weight and newborn gestational age. We are conducting pilot studies to identify women in early pregnancy and measure exposures to carbon monoxide from cooking stove and temazcal use during pregnancy and the early post-partum period.
Fuels/Technologies:	Biomass	Sectors of Experience:	Behavior Change Education Gender Health	Countries of Operation:	Guatemala Peru United States

Our Experience And Interest In The Four PCIA Central Focus Areas

Social/Cultural barriers to using traditional fuels and stoves:

During CRECER-Guatemala, we conducted extensive training sessions with the 500+ household participants and local fieldworkers to reduce exposures to indoor air pollution from indoor cooking and heating fires. We developed audiovisual educational materials,including a video in Mam-language about the safe use of the temazcal.

I have conducted both quantitative (survey-based) and qualitative (focus groups and key informant interviews) studies to assess cultural practices that increase exposures to indoor air pollution among women during pregnancy and the post-partum period,and among newborns. I plan to target education among traditional birth attendants who recommend that post-partum women and their newborns rest by open fires and use the temazcal intensively (daily) for the first 30 days after birth.

Market development for improved cooking technologies:

No past experience. Currently working with Dr. Kirk Smith's research team at UC Berkeley to monitor use and adoption of a new, more efficient stove in schools and homes in the RESPIRE/CRECER study area.

Technology standardization for cooking, heating and ventilation:

Analyzing data from weekly fieldworker household visits to assess stove condition and maintain proper use of the improved chimney stove (plancha) used during the RESPIRE stove intervention trial in Guatemala.

Indoor air pollution exposure and health monitoring:

Monitoring of maternal and child personal carbon monoxide exposures during RESPIRE-Guatemala stove intervention trial from stove and temazcal (wood-fired sauna bath) use.

Relevant Publications or Studies

Thompson LM, Clark M, Cadman B, Canuz E, Smith KR. Exposures to high levels of carbon monoxide from wood-fired temazcal (steam bath) use in highland Guatemala. International Journal of Occupational and Environmental Health (Accepted, under revision, 2010).

Thompson LM, Levi AJ, Bly KC, Ha C, Keirns T, Romero C. Building capacity among Guatemalan traditional birth attendants to weigh newborns and to assess gestational age. Midwifery (Submitted, 2010).

Thompson LM, Bruce N, Eskenazi B, Diaz A, Pope D, Smith, KR. Maternal exposures to wood fuel smoke and newborn birth weight: Results from RESPIRE, a randomized trial of chimney cook stoves in Guatemala. Environmental Health Perspectives (Submitted, 2010).

Pope, D.P., Mishra, V., Thompson, L., Siddiqui, A.R., Rehfuess, E., Weber, M., Bruce, N.G. (2010). Risk of Low Birth Weight and Stillbirth Associated With Indoor Air Pollution From Solid Fuel Use in Developing Countries. Epidemiologic Reviews, advance online publication, 8 April 2010.

Smith, K.R., McCracken, J., Thompson, L., Edwards, R., Naumoff-Shields, K., Canuz, E., Bruce, N. (2009). Personal Carbon Monoxide Exposures in Infants and Mothers: Methods and Results from A Randomized Trial of Improved Wood-fired Cook stoves in Guatemala (RESPIRE). Journal of Exposure Science and Environmental Epidemiology, advance online publication, 17 June 2009; doi:10.1038/jes.2009.30.

Thompson, L., Diaz, J., Diaz, A., Jenny, A., Bruce, N., Balmes, J.R. (2007). Nxwisen, ntzarrin, or ntzolin? Mapping children's respiratory symptoms among indigenous populations in Guatemala. Social Science and Medicine, 65 (7), 1337-50.

Bruce, N., Diaz, A., Arana, B., Jenny, A., Thompson, L., Weber, M., McCracken, J.M., Dherani, D,Juarez, D., Ordonez, S., Klein, R., Smith, K.R. (2007). Pneumonia case-finding in the Guatemala indoor air pollution trial (RESPIRE): Standardizing methods for resource- poor settings. Bull World Health Organ, 85 (7): 535-44.

Smith-Siversten, T., Diaz, E., Bruce, N., Diaz, A., Khalakdina, A., Schei, M.A., McCracken, J., Arana, B., Klein, R., Thompson, L., Smith, K.R. (2004). Reducing indoor air pollution with a randomized intervention design - A presentation of the Stove Intervention Study in the Guatemalan Highlands. Norsk Epidemiologi, 14(2):137-143

Our Contribution to the Partnership

Dissemination of research findings and trainings in measuring health outcomes and conducting exposure assessment. I am a certified family nurse practitioner and have 20+ years experience providing direct patient care services to Spanish-speaking women and young infants in California.