TY - JOUR
T1 - Exposure Contrasts of Pregnant Women during the Household Air Pollution Intervention Network Randomized Controlled Trial
AU - Johnson, Michael
AU - Pillarisetti, Ajay
AU - Piedrahita, Ricardo
AU - Balakrishnan, Kalpana
AU - Peel, Jennifer L.
AU - Steenland, Kyle
AU - Underhill, Lindsay J.
AU - Rosa, Ghislaine
AU - Kirby, Miles A.
AU - Díaz-Artiga, Anaité
AU - McCracken, John
AU - Clark, Maggie L.
AU - Waller, Lance
AU - Chang, Howard H.
AU - Wang, Jiantong
AU - Dusabimana, Ephrem
AU - Ndagijimana, Florien
AU - Sambandam, Sankar
AU - Mukhopadhyay, Krishnendu
AU - Kearns, Katherine A.
AU - Campbell, Devan
AU - Kremer, Jacob
AU - Rosenthal, Joshua P.
AU - Checkley, William
AU - Clasen, Thomas
AU - Naeher, Luke
N1 - Funding Information:
This study was funded by the U.S. National Institutes of Health (NIH; cooperative agreement 1UM1HL134590) in collaboration with the Bill & Melinda Gates Foundation (OPP1131279). Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission. A multidisciplinary, independent Data and Safety Monitoring Board (DSMB) appointed by the National Heart, Lung, and Blood Institute (NHLBI) monitors the quality of the data and protects the safety of patients enrolled in the HAPIN trial. NHLBI DSMB: N.R. Cook, S. Hecht, C. Karr (Chair), J. Millum, N. Sathiakumar, P.K. Whelton, G.G. Weinmann (Executive Secretary). Program Coordination: G. Rodgers, Bill & Melinda Gates Foundation; C.L. Thompson, National Institute of Environmental Health Science; M.J. Parascandola, National Cancer Institute; M. Koso-Thomas, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, U.S. Department of Health and Human Services; J.P. Rosenthal, Fogarty International Center; C.R. Nierras, NIH Office of Strategic Coordination Common Fund; K. Kavounis, D.-Y. Kim, A. Punturieri, and B.S. Schmetter, NHLBI.
Funding Information:
This study was funded by the U.S. National Institutes of Health (NIH; cooperative agreement 1UM1HL134590) in collaboration with the Bill & Melinda Gates Foundation (OPP1131279). Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission. A multidisciplinary, independent Data and Safety Monitoring Board (DSMB) appointed by the National Heart, Lung, and Blood Institute (NHLBI) monitors the quality of the data and protects the safety of patients enrolled in the HAPIN trial. NHLBI DSMB: N.R. Cook, S. Hecht, C. Karr (Chair), J. Millum, N. Sathiakumar, P.K. Whelton, G.G. Weinmann (Executive Secretary). Program Coordination: G. Rodgers, Bill & Melinda Gates Foundation; C.L. Thompson, National Institute of Environmental Health Science; M.J. Parascandola, National Cancer Institute; M. Koso-Thomas, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, U.S. Department of Health and Human Services; J.P. Rosenthal, Fogarty International Center; C.R. Nierras, NIH Office of Strategic Coordination Common Fund; K. Kavounis, D.-Y. Kim, A. Punturieri, and B.S. Schmetter, NHLBI. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the U.S. NIH or the U.S. Department of Health and Human Services.
Publisher Copyright:
© 2022, Public Health Services, US Dept of Health and Human Services. All rights reserved.
PY - 2022/9
Y1 - 2022/9
N2 - BACKGROUND: Exposure to PM2:5 arising from solid fuel combustion is estimated to result in ∼ 2:3 million premature deaths and 91 million lost disability-adjusted life years annually. Interventions attempting to mitigate this burden have had limited success in reducing exposures to levels thought to provide substantive health benefits. OBJECTIVES: This paper reports exposure reductions achieved by a liquified petroleum gas (LPG) stove and fuel intervention for pregnant mothers in the Household Air Pollution Intervention Network (HAPIN) randomized controlled trial. METHODS: The HAPIN trial included 3,195 households primarily using biomass for cooking in Guatemala, India, Peru, and Rwanda. Twenty-four-hour exposures to PM2:5, carbon monoxide (CO), and black carbon (BC) were measured for pregnant women once before randomization into control (n = 1,605) and LPG (n = 1,590) arms and twice thereafter (aligned with trimester). Changes in exposure were estimated by directly comparing exposures between intervention and control arms and by using linear mixed-effect models to estimate the impact of the intervention on exposure levels. RESULTS: Median postrandomization exposures of particulate matter (PM) with aerodynamic diameter ≤2:5 lm (PM2:5) in the intervention arm were lower by 66% at the first (71.5 vs. 24:1 lg=m3), and second follow-up visits (69.5 vs. 23:7 lg=m3) compared to controls. BC exposures were lower in the intervention arm by 72% (9.7 vs. 2:7 lg=m3) and 70% (9.6 vs. 2:8 lg=m3) at the first and second follow-up visits, respectively, and carbon monoxide exposure was 82% lower at both visits (1.1 vs. 0:2 ppm) in comparison with controls. Exposure reductions were consistent over time and were similar across research locations. DISCUSSION: Postintervention PM2:5 exposures in the intervention arm were at the lower end of what has been reported for LPG and other clean fuel interventions, with 69% of PM2:5 samples falling below the World Health Organization Annual Interim Target 1 of 35 lg=m3 . This study indicates that an LPG intervention can reduce PM2:5 exposures to levels at or below WHO targets.
AB - BACKGROUND: Exposure to PM2:5 arising from solid fuel combustion is estimated to result in ∼ 2:3 million premature deaths and 91 million lost disability-adjusted life years annually. Interventions attempting to mitigate this burden have had limited success in reducing exposures to levels thought to provide substantive health benefits. OBJECTIVES: This paper reports exposure reductions achieved by a liquified petroleum gas (LPG) stove and fuel intervention for pregnant mothers in the Household Air Pollution Intervention Network (HAPIN) randomized controlled trial. METHODS: The HAPIN trial included 3,195 households primarily using biomass for cooking in Guatemala, India, Peru, and Rwanda. Twenty-four-hour exposures to PM2:5, carbon monoxide (CO), and black carbon (BC) were measured for pregnant women once before randomization into control (n = 1,605) and LPG (n = 1,590) arms and twice thereafter (aligned with trimester). Changes in exposure were estimated by directly comparing exposures between intervention and control arms and by using linear mixed-effect models to estimate the impact of the intervention on exposure levels. RESULTS: Median postrandomization exposures of particulate matter (PM) with aerodynamic diameter ≤2:5 lm (PM2:5) in the intervention arm were lower by 66% at the first (71.5 vs. 24:1 lg=m3), and second follow-up visits (69.5 vs. 23:7 lg=m3) compared to controls. BC exposures were lower in the intervention arm by 72% (9.7 vs. 2:7 lg=m3) and 70% (9.6 vs. 2:8 lg=m3) at the first and second follow-up visits, respectively, and carbon monoxide exposure was 82% lower at both visits (1.1 vs. 0:2 ppm) in comparison with controls. Exposure reductions were consistent over time and were similar across research locations. DISCUSSION: Postintervention PM2:5 exposures in the intervention arm were at the lower end of what has been reported for LPG and other clean fuel interventions, with 69% of PM2:5 samples falling below the World Health Organization Annual Interim Target 1 of 35 lg=m3 . This study indicates that an LPG intervention can reduce PM2:5 exposures to levels at or below WHO targets.
UR - http://www.scopus.com/inward/record.url?scp=85138452047&partnerID=8YFLogxK
U2 - 10.1289/EHP10295
DO - 10.1289/EHP10295
M3 - Article
C2 - 36112539
AN - SCOPUS:85138452047
VL - 130
JO - Environmental Health Perspectives
JF - Environmental Health Perspectives
SN - 0091-6765
IS - 9
M1 - 097005
ER -