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 - 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
SN - 0091-6765
VL - 130
JO - Environmental Health Perspectives
JF - Environmental Health Perspectives
IS - 9
M1 - 097005
ER -