TY - JOUR
T1 - Nitrogen dioxide exposures from LPG stoves in a cleaner-cooking intervention trial
AU - CHAP Trial Investigators
AU - Kephart, Josiah L.
AU - Fandiño-Del-Rio, Magdalena
AU - Williams, Kendra N.
AU - Malpartida, Gary
AU - Lee, Alexander
AU - Steenland, N. Kyle
AU - Naeher, Luke P.
AU - Gonzales, Gustavo F.
AU - Chiang, Marilu
AU - Checkley, William
AU - Koehler, Kirsten
AU - Rosenthal, Joshua
AU - Aguilar, Theresa
AU - Burrowes, Vanessa
AU - Fung, Elizabeth C.
AU - Goodman, Dina
AU - Harvey, Steven A.
AU - Herrera, Phabiola
AU - Lee, Kathryn A.
AU - Miele, Catherine H.
AU - Moazzami, Mitra
AU - Moulton, Lawrence H.
AU - Nangia, Saachi
AU - Nicolaou, Laura
AU - O'Brien, Carolyn
AU - Simkovich, Suzanne
AU - Shade, Timothy
AU - Stashko, Lena
AU - Villegas-Gomez, Ariadne
AU - Winiker, Abigail
AU - Tarazona-Meza, Carla
AU - Davila-Roman, Victor
AU - de las Fuentes, Lisa
AU - Boyd, Dana Barr
AU - Jolly, Maria
AU - Rozo, Angela
N1 - Funding Information:
Financial support for the CHAP trial was received from the Global Environmental and Occupational Health, Fogarty International Center, United States National Institutes of Health (U01TW010107 and U2RTW010114); the Clean Cooking Alliance of the United Nations Foundation (UNF 16-810), the Johns Hopkins Center for Global Health, and the COPD Discovery Fund of Johns Hopkins University. The Center for Global Non-Communicable Disease Research and Training field site in Puno, Peru, also received generous support from Mr. William and Bonnie Clarke III. JLK and KNW were supported by the NIH Fogarty International Center, NINDS, NIMH, NHBLI and NIEHS under NIH Research Training Grant # D43 TW009340 and the Johns Hopkins Center for Global Health. JLK was also supported by the Ruth L. Kirschstein Institutional National Research Service Award (5T32ES007141-33) funded by the NIH/NIEHS. KNW was also supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number T32HL007534. MFDR was further supported by the Global Environmental and Occupational Health (GEOHealth), Fogarty International Center, and by the David Leslie Swift Fund of the Bloomberg School of Public Health, Johns Hopkins University . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
The authors would like to thank the field staff including Ida Luz Mamani, William Paucar, Julio Sucasaca, Edith Arocutipa, and Elena Morales (A.B. PRISMA, Puno, Peru), and the study participants in Puno, Peru. Financial support for the CHAP trial was received from the Global Environmental and Occupational Health, Fogarty International Center, United States National Institutes of Health (U01TW010107 and U2RTW010114); the Clean Cooking Alliance of the United Nations Foundation (UNF 16-810), the Johns Hopkins Center for Global Health, and the COPD Discovery Fund of Johns Hopkins University. The Center for Global Non-Communicable Disease Research and Training field site in Puno, Peru, also received generous support from Mr. William and Bonnie Clarke III. JLK and KNW were supported by the NIH Fogarty International Center, NINDS, NIMH, NHBLI and NIEHS under NIH Research Training Grant # D43 TW009340 and the Johns Hopkins Center for Global Health. JLK was also supported by the Ruth L. Kirschstein Institutional National Research Service Award (5T32ES007141-33) funded by the NIH/NIEHS. KNW was also supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number T32HL007534. MFDR was further supported by the Global Environmental and Occupational Health (GEOHealth), Fogarty International Center, and by the David Leslie Swift Fund of the Bloomberg School of Public Health, Johns Hopkins University. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2020 The Author(s)
PY - 2021/1
Y1 - 2021/1
N2 - Background: Liquefied petroleum gas (LPG) stoves have been promoted in low- and middle-income countries (LMICs) as a clean energy alternative to biomass burning cookstoves. Objective: We sought to characterize kitchen area concentrations and personal exposures to nitrogen dioxide (NO2) within a randomized controlled trial in the Peruvian Andes. The intervention included the provision of an LPG stove and continuous fuel distribution with behavioral messaging to maximize compliance. Methods: We measured 48-hour kitchen area NO2 concentrations at high temporal resolution in homes of 50 intervention participants and 50 control participants longitudinally within a biomass-to-LPG intervention trial. We also collected 48-hour mean personal exposures to NO2 among a subsample of 16 intervention and 9 control participants. We monitored LPG and biomass stove use continuously throughout the trial. Results: In 367 post-intervention 24-hour kitchen area samples of 96 participants’ homes, geometric mean (GM) highest hourly NO2 concentration was 138 ppb (geometric standard deviation [GSD] 2.1) in the LPG intervention group and 450 ppb (GSD 3.1) in the biomass control group. Post-intervention 24-hour mean NO2 concentrations were a GM of 43 ppb (GSD 1.7) in the intervention group and 77 ppb (GSD 2.0) in the control group. Kitchen area NO2 concentrations exceeded the WHO indoor hourly guideline an average of 1.3 h per day among LPG intervention participants. GM 48-hour personal exposure to NO2 was 5 ppb (GSD 2.4) among 35 48-hour samples of 16 participants in the intervention group and 16 ppb (GSD 2.3) among 21 samples of 9 participants in the control group. Discussion: In a biomass-to-LPG intervention trial in Peru, kitchen area NO2 concentrations were substantially lower within the LPG intervention group compared to the biomass-using control group. However, within the LPG intervention group, 69% of 24-hour kitchen area samples exceeded WHO indoor annual guidelines and 47% of samples exceeded WHO indoor hourly guidelines. Forty-eight-hour NO2 personal exposure was below WHO indoor annual guidelines for most participants in the LPG intervention group, and we did not measure personal exposure at high temporal resolution to assess exposure to cooking-related indoor concentration peaks. Further research is warranted to understand the potential health risks of LPG-related NO2 emissions and inform current campaigns which promote LPG as a clean-cooking option.
AB - Background: Liquefied petroleum gas (LPG) stoves have been promoted in low- and middle-income countries (LMICs) as a clean energy alternative to biomass burning cookstoves. Objective: We sought to characterize kitchen area concentrations and personal exposures to nitrogen dioxide (NO2) within a randomized controlled trial in the Peruvian Andes. The intervention included the provision of an LPG stove and continuous fuel distribution with behavioral messaging to maximize compliance. Methods: We measured 48-hour kitchen area NO2 concentrations at high temporal resolution in homes of 50 intervention participants and 50 control participants longitudinally within a biomass-to-LPG intervention trial. We also collected 48-hour mean personal exposures to NO2 among a subsample of 16 intervention and 9 control participants. We monitored LPG and biomass stove use continuously throughout the trial. Results: In 367 post-intervention 24-hour kitchen area samples of 96 participants’ homes, geometric mean (GM) highest hourly NO2 concentration was 138 ppb (geometric standard deviation [GSD] 2.1) in the LPG intervention group and 450 ppb (GSD 3.1) in the biomass control group. Post-intervention 24-hour mean NO2 concentrations were a GM of 43 ppb (GSD 1.7) in the intervention group and 77 ppb (GSD 2.0) in the control group. Kitchen area NO2 concentrations exceeded the WHO indoor hourly guideline an average of 1.3 h per day among LPG intervention participants. GM 48-hour personal exposure to NO2 was 5 ppb (GSD 2.4) among 35 48-hour samples of 16 participants in the intervention group and 16 ppb (GSD 2.3) among 21 samples of 9 participants in the control group. Discussion: In a biomass-to-LPG intervention trial in Peru, kitchen area NO2 concentrations were substantially lower within the LPG intervention group compared to the biomass-using control group. However, within the LPG intervention group, 69% of 24-hour kitchen area samples exceeded WHO indoor annual guidelines and 47% of samples exceeded WHO indoor hourly guidelines. Forty-eight-hour NO2 personal exposure was below WHO indoor annual guidelines for most participants in the LPG intervention group, and we did not measure personal exposure at high temporal resolution to assess exposure to cooking-related indoor concentration peaks. Further research is warranted to understand the potential health risks of LPG-related NO2 emissions and inform current campaigns which promote LPG as a clean-cooking option.
KW - Biomass cookstove
KW - Clean cooking
KW - Household air pollution
KW - Liquefied petroleum gas
KW - Nitrogen dioxide
UR - http://www.scopus.com/inward/record.url?scp=85095720999&partnerID=8YFLogxK
U2 - 10.1016/j.envint.2020.106196
DO - 10.1016/j.envint.2020.106196
M3 - Article
C2 - 33160161
AN - SCOPUS:85095720999
SN - 0160-4120
VL - 146
JO - Environment International
JF - Environment International
M1 - 106196
ER -