LPG stove and fuel intervention among pregnant women reduce fine particle air pollution exposures in three countries: Pilot results from the HAPIN trial

Jiawen Liao; Miles A. Kirby; Ajay Pillarisetti; Ricardo Piedrahita; Kalpana Balakrishnan; Sankar Sambandam; Krishnendu Mukhopadhyay; Wenlu Ye; Ghislaine Rosa; Fiona Majorin; Ephrem Dusabimana; Florien Ndagijimana; John P. McCracken; Erick Mollinedo; Oscar de Leon; Anaité Díaz-Artiga; Lisa M. Thompson; Katherine A. Kearns; Luke Naeher; Joshua Rosenthal; Maggie L. Clark; Kyle Steenland; Lance A. Waller; William Checkley; Jennifer L. Peel; Thomas Clasen; Michael Johnson; Vigneswari Aravindalochanan; Gloriose Bankundiye; Dana Boyd Barr; Alejandra Bussalleu; Eduardo Canuz; Adly Castañaza; Yunyun Chen; Marilú Chiang; Rachel Craik; Victor G. Davila-Roman; Lisa de las Fuentes; Lisa Elon; Juan Gabriel Espinoza; Sarada Garg; Sarah Hamid; Stella Hartinger; Steven A. Harvey; Mayari Hengstermann; Ian Hennessee; Phabiola M. Herrera; Shakir Hossen; Penelope P. Howards; Lindsay Jaacks; Shirin Jabbarzadeh; Pattie Lenzen; Amy E. Lovvorn; Jane Mbabazi; Eric McCollum; Rachel Meyers; Lawrence Hale Moulton; Alexie Mukeshimana; Bernard Mutariyani; Durairaj Natesan; Azhar Nizam; Jean de Dieu Ntivuguruzwa; Aris Papageorghiou; Naveen Puttaswamy; Elisa Puzzolo; Ashlinn Quinn; Karthikeyan Dharmapuri Rajamani; Usha Ramakrishnan; Rengaraj Ramasami; Alexander Ramirez; P. Barry Ryan; Sudhakar Saidam; Jeremy A. Sarnat; Suzanne Simkovich; Sheela S. Sinharoy; Kirk R. Smith; Damien Swearing; Gurusamy Thangavel; Ashley Toenjes; Viviane Valdes; Kendra N. Williams; Bonnie N. Young

doi:10.1016/j.envpol.2021.118198

LPG stove and fuel intervention among pregnant women reduce fine particle air pollution exposures in three countries: Pilot results from the HAPIN trial

Jiawen Liao, Miles A. Kirby, Ajay Pillarisetti, Ricardo Piedrahita, Kalpana Balakrishnan, Sankar Sambandam, Krishnendu Mukhopadhyay, Wenlu Ye, Ghislaine Rosa, Fiona Majorin, Ephrem Dusabimana, Florien Ndagijimana, John P. McCracken, Erick Mollinedo, Oscar de Leon, Anaité Díaz-Artiga, Lisa M. Thompson, Katherine A. Kearns, Luke Naeher, Joshua RosenthalMaggie L. Clark, Kyle Steenland, Lance A. Waller, William Checkley, Jennifer L. Peel, Thomas Clasen, Michael Johnson, Vigneswari Aravindalochanan, Gloriose Bankundiye, Dana Boyd Barr, Alejandra Bussalleu, Eduardo Canuz, Adly Castañaza, Yunyun Chen, Marilú Chiang, Rachel Craik, Victor G. Davila-Roman, Lisa de las Fuentes, Lisa Elon, Juan Gabriel Espinoza, Sarada Garg, Sarah Hamid, Stella Hartinger, Steven A. Harvey, Mayari Hengstermann, Ian Hennessee, Phabiola M. Herrera, Shakir Hossen, Penelope P. Howards, Lindsay Jaacks, Shirin Jabbarzadeh, Pattie Lenzen, Amy E. Lovvorn, Jane Mbabazi, Eric McCollum, Rachel Meyers, Lawrence Hale Moulton, Alexie Mukeshimana, Bernard Mutariyani, Durairaj Natesan, Azhar Nizam, Jean de Dieu Ntivuguruzwa, Aris Papageorghiou, Naveen Puttaswamy, Elisa Puzzolo, Ashlinn Quinn, Karthikeyan Dharmapuri Rajamani, Usha Ramakrishnan, Rengaraj Ramasami, Alexander Ramirez, P. Barry Ryan, Sudhakar Saidam, Jeremy A. Sarnat, Suzanne Simkovich, Sheela S. Sinharoy, Kirk R. Smith, Damien Swearing, Gurusamy Thangavel, Ashley Toenjes, Viviane Valdes, Kendra N. Williams, Bonnie N. Young

Research output: Contribution to journal › Article › peer-review

Abstract

The Household Air Pollution Intervention Network trial is a multi-country study on the effects of a liquefied petroleum gas (LPG) stove and fuel distribution intervention on women's and children's health. There is limited data on exposure reductions achieved by switching from solid to clean cooking fuels in rural settings across multiple countries. As formative research in 2017, we recruited pregnant women and characterized the impact of the intervention on personal exposures and kitchen levels of fine particulate matter (PM_2.5) in Guatemala, India, and Rwanda. Forty pregnant women were enrolled in each site. We measured cooking area concentrations of and personal exposures to PM_2.5 for 24 or 48 h using gravimetric-based PM_2.5 samplers at baseline and two follow-ups over two months after delivery of an LPG cookstove and free fuel supply. Mixed models were used to estimate PM_2.5 reductions. Median kitchen PM_2.5 concentrations were 296 μg/m³ at baseline (interquartile range, IQR: 158–507), 24 μg/m³ at first follow-up (IQR: 18–37), and 23 μg/m³ at second follow-up (IQR: 14–37). Median personal exposures to PM_2.5 were 134 μg/m³ at baseline (IQR: 71–224), 35 μg/m³ at first follow-up (IQR: 23–51), and 32 μg/m³ at second follow-up (IQR: 23–47). Overall, the LPG intervention was associated with a 92% (95% confidence interval (CI): 90–94%) reduction in kitchen PM_2.5 concentrations and a 74% (95% CI: 70–79%) reduction in personal PM_2.5 exposures. Results were similar for each site. Conclusions: The intervention was associated with substantial reductions in kitchen and personal PM_2.5 overall and in all sites. Results suggest LPG interventions in these rural settings may lower exposures to the WHO annual interim target-1 of 35 μg/m³. The range of exposure contrasts falls on steep sections of estimated exposure-response curves for birthweight, blood pressure, and acute lower respiratory infections, implying potentially important health benefits when transitioning from solid fuels to LPG.

Original language	English (US)
Article number	118198
Journal	Environmental Pollution
Volume	291
DOIs	https://doi.org/10.1016/j.envpol.2021.118198
State	Published - Dec 15 2021

Keywords

Clean cooking fuel
Cookstove
Household air pollution
Intervention
PM
Personal exposure

ASJC Scopus subject areas

Toxicology
Pollution
Health, Toxicology and Mutagenesis

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10.1016/j.envpol.2021.118198

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Liao, J., Kirby, M. A., Pillarisetti, A., Piedrahita, R., Balakrishnan, K., Sambandam, S., Mukhopadhyay, K., Ye, W., Rosa, G., Majorin, F., Dusabimana, E., Ndagijimana, F., McCracken, J. P., Mollinedo, E., de Leon, O., Díaz-Artiga, A., Thompson, L. M., Kearns, K. A., Naeher, L., ... Young, B. N. (2021). LPG stove and fuel intervention among pregnant women reduce fine particle air pollution exposures in three countries: Pilot results from the HAPIN trial. Environmental Pollution, 291, Article 118198. https://doi.org/10.1016/j.envpol.2021.118198

Liao, J, Kirby, MA, Pillarisetti, A, Piedrahita, R, Balakrishnan, K, Sambandam, S, Mukhopadhyay, K, Ye, W, Rosa, G, Majorin, F, Dusabimana, E, Ndagijimana, F, McCracken, JP, Mollinedo, E, de Leon, O, Díaz-Artiga, A, Thompson, LM, Kearns, KA, Naeher, L, Rosenthal, J, Clark, ML, Steenland, K, Waller, LA, Checkley, W, Peel, JL, Clasen, T, Johnson, M, Aravindalochanan, V, Bankundiye, G, Barr, DB, Bussalleu, A, Canuz, E, Castañaza, A, Chen, Y, Chiang, M, Craik, R, Davila-Roman, VG, de las Fuentes, L, Elon, L, Espinoza, JG, Garg, S, Hamid, S, Hartinger, S, Harvey, SA, Hengstermann, M, Hennessee, I, Herrera, PM, Hossen, S, Howards, PP, Jaacks, L, Jabbarzadeh, S, Lenzen, P, Lovvorn, AE, Mbabazi, J, McCollum, E, Meyers, R, Moulton, LH, Mukeshimana, A, Mutariyani, B, Natesan, D, Nizam, A, Ntivuguruzwa, JDD, Papageorghiou, A, Puttaswamy, N, Puzzolo, E, Quinn, A, Rajamani, KD, Ramakrishnan, U, Ramasami, R, Ramirez, A, Ryan, PB, Saidam, S, Sarnat, JA, Simkovich, S, Sinharoy, SS, Smith, KR, Swearing, D, Thangavel, G, Toenjes, A, Valdes, V, Williams, KN & Young, BN 2021, 'LPG stove and fuel intervention among pregnant women reduce fine particle air pollution exposures in three countries: Pilot results from the HAPIN trial', Environmental Pollution, vol. 291, 118198. https://doi.org/10.1016/j.envpol.2021.118198

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title = "LPG stove and fuel intervention among pregnant women reduce fine particle air pollution exposures in three countries: Pilot results from the HAPIN trial",

abstract = "The Household Air Pollution Intervention Network trial is a multi-country study on the effects of a liquefied petroleum gas (LPG) stove and fuel distribution intervention on women's and children's health. There is limited data on exposure reductions achieved by switching from solid to clean cooking fuels in rural settings across multiple countries. As formative research in 2017, we recruited pregnant women and characterized the impact of the intervention on personal exposures and kitchen levels of fine particulate matter (PM2.5) in Guatemala, India, and Rwanda. Forty pregnant women were enrolled in each site. We measured cooking area concentrations of and personal exposures to PM2.5 for 24 or 48 h using gravimetric-based PM2.5 samplers at baseline and two follow-ups over two months after delivery of an LPG cookstove and free fuel supply. Mixed models were used to estimate PM2.5 reductions. Median kitchen PM2.5 concentrations were 296 μg/m3 at baseline (interquartile range, IQR: 158–507), 24 μg/m3 at first follow-up (IQR: 18–37), and 23 μg/m3 at second follow-up (IQR: 14–37). Median personal exposures to PM2.5 were 134 μg/m3 at baseline (IQR: 71–224), 35 μg/m3 at first follow-up (IQR: 23–51), and 32 μg/m3 at second follow-up (IQR: 23–47). Overall, the LPG intervention was associated with a 92% (95% confidence interval (CI): 90–94%) reduction in kitchen PM2.5 concentrations and a 74% (95% CI: 70–79%) reduction in personal PM2.5 exposures. Results were similar for each site. Conclusions: The intervention was associated with substantial reductions in kitchen and personal PM2.5 overall and in all sites. Results suggest LPG interventions in these rural settings may lower exposures to the WHO annual interim target-1 of 35 μg/m3. The range of exposure contrasts falls on steep sections of estimated exposure-response curves for birthweight, blood pressure, and acute lower respiratory infections, implying potentially important health benefits when transitioning from solid fuels to LPG.",

keywords = "Clean cooking fuel, Cookstove, Household air pollution, Intervention, PM, Personal exposure",

author = "Jiawen Liao and Kirby, {Miles A.} and Ajay Pillarisetti and Ricardo Piedrahita and Kalpana Balakrishnan and Sankar Sambandam and Krishnendu Mukhopadhyay and Wenlu Ye and Ghislaine Rosa and Fiona Majorin and Ephrem Dusabimana and Florien Ndagijimana and McCracken, {John P.} and Erick Mollinedo and {de Leon}, Oscar and Anait{\'e} D{\'i}az-Artiga and Thompson, {Lisa M.} and Kearns, {Katherine A.} and Luke Naeher and Joshua Rosenthal and Clark, {Maggie L.} and Kyle Steenland and Waller, {Lance A.} and William Checkley and Peel, {Jennifer L.} and Thomas Clasen and Michael Johnson and Vigneswari Aravindalochanan and Gloriose Bankundiye and Barr, {Dana Boyd} and Alejandra Bussalleu and Eduardo Canuz and Adly Casta{\~n}aza and Yunyun Chen and Maril{\'u} Chiang and Rachel Craik and Davila-Roman, {Victor G.} and {de las Fuentes}, Lisa and Lisa Elon and Espinoza, {Juan Gabriel} and Sarada Garg and Sarah Hamid and Stella Hartinger and Harvey, {Steven A.} and Mayari Hengstermann and Ian Hennessee and Herrera, {Phabiola M.} and Shakir Hossen and Howards, {Penelope P.} and Lindsay Jaacks and Shirin Jabbarzadeh and Pattie Lenzen and Lovvorn, {Amy E.} and Jane Mbabazi and Eric McCollum and Rachel Meyers and Moulton, {Lawrence Hale} and Alexie Mukeshimana and Bernard Mutariyani and Durairaj Natesan and Azhar Nizam and Ntivuguruzwa, {Jean de Dieu} and Aris Papageorghiou and Naveen Puttaswamy and Elisa Puzzolo and Ashlinn Quinn and Rajamani, {Karthikeyan Dharmapuri} and Usha Ramakrishnan and Rengaraj Ramasami and Alexander Ramirez and Ryan, {P. Barry} and Sudhakar Saidam and Sarnat, {Jeremy A.} and Suzanne Simkovich and Sinharoy, {Sheela S.} and Smith, {Kirk R.} and Damien Swearing and Gurusamy Thangavel and Ashley Toenjes and Viviane Valdes and Williams, {Kendra N.} and Young, {Bonnie N.}",

note = "Publisher Copyright: {\textcopyright} 2021 The Authors",

year = "2021",

month = dec,

day = "15",

doi = "10.1016/j.envpol.2021.118198",

language = "English (US)",

volume = "291",

journal = "Environmental Pollution",

issn = "0269-7491",

publisher = "Elsevier Limited",

}

TY - JOUR

T1 - LPG stove and fuel intervention among pregnant women reduce fine particle air pollution exposures in three countries

T2 - Pilot results from the HAPIN trial

AU - Liao, Jiawen

AU - Kirby, Miles A.

AU - Pillarisetti, Ajay

AU - Piedrahita, Ricardo

AU - Balakrishnan, Kalpana

AU - Sambandam, Sankar

AU - Mukhopadhyay, Krishnendu

AU - Ye, Wenlu

AU - Rosa, Ghislaine

AU - Majorin, Fiona

AU - Dusabimana, Ephrem

AU - Ndagijimana, Florien

AU - McCracken, John P.

AU - Mollinedo, Erick

AU - de Leon, Oscar

AU - Díaz-Artiga, Anaité

AU - Thompson, Lisa M.

AU - Kearns, Katherine A.

AU - Naeher, Luke

AU - Rosenthal, Joshua

AU - Clark, Maggie L.

AU - Steenland, Kyle

AU - Waller, Lance A.

AU - Checkley, William

AU - Peel, Jennifer L.

AU - Clasen, Thomas

AU - Johnson, Michael

AU - Aravindalochanan, Vigneswari

AU - Bankundiye, Gloriose

AU - Barr, Dana Boyd

AU - Bussalleu, Alejandra

AU - Canuz, Eduardo

AU - Castañaza, Adly

AU - Chen, Yunyun

AU - Chiang, Marilú

AU - Craik, Rachel

AU - Davila-Roman, Victor G.

AU - de las Fuentes, Lisa

AU - Elon, Lisa

AU - Espinoza, Juan Gabriel

AU - Garg, Sarada

AU - Hamid, Sarah

AU - Hartinger, Stella

AU - Harvey, Steven A.

AU - Hengstermann, Mayari

AU - Hennessee, Ian

AU - Herrera, Phabiola M.

AU - Hossen, Shakir

AU - Howards, Penelope P.

AU - Jaacks, Lindsay

AU - Jabbarzadeh, Shirin

AU - Lenzen, Pattie

AU - Lovvorn, Amy E.

AU - Mbabazi, Jane

AU - McCollum, Eric

AU - Meyers, Rachel

AU - Moulton, Lawrence Hale

AU - Mukeshimana, Alexie

AU - Mutariyani, Bernard

AU - Natesan, Durairaj

AU - Nizam, Azhar

AU - Ntivuguruzwa, Jean de Dieu

AU - Papageorghiou, Aris

AU - Puttaswamy, Naveen

AU - Puzzolo, Elisa

AU - Quinn, Ashlinn

AU - Rajamani, Karthikeyan Dharmapuri

AU - Ramakrishnan, Usha

AU - Ramasami, Rengaraj

AU - Ramirez, Alexander

AU - Ryan, P. Barry

AU - Saidam, Sudhakar

AU - Sarnat, Jeremy A.

AU - Simkovich, Suzanne

AU - Sinharoy, Sheela S.

AU - Smith, Kirk R.

AU - Swearing, Damien

AU - Thangavel, Gurusamy

AU - Toenjes, Ashley

AU - Valdes, Viviane

AU - Williams, Kendra N.

AU - Young, Bonnie N.

PY - 2021/12/15

Y1 - 2021/12/15

N2 - The Household Air Pollution Intervention Network trial is a multi-country study on the effects of a liquefied petroleum gas (LPG) stove and fuel distribution intervention on women's and children's health. There is limited data on exposure reductions achieved by switching from solid to clean cooking fuels in rural settings across multiple countries. As formative research in 2017, we recruited pregnant women and characterized the impact of the intervention on personal exposures and kitchen levels of fine particulate matter (PM2.5) in Guatemala, India, and Rwanda. Forty pregnant women were enrolled in each site. We measured cooking area concentrations of and personal exposures to PM2.5 for 24 or 48 h using gravimetric-based PM2.5 samplers at baseline and two follow-ups over two months after delivery of an LPG cookstove and free fuel supply. Mixed models were used to estimate PM2.5 reductions. Median kitchen PM2.5 concentrations were 296 μg/m3 at baseline (interquartile range, IQR: 158–507), 24 μg/m3 at first follow-up (IQR: 18–37), and 23 μg/m3 at second follow-up (IQR: 14–37). Median personal exposures to PM2.5 were 134 μg/m3 at baseline (IQR: 71–224), 35 μg/m3 at first follow-up (IQR: 23–51), and 32 μg/m3 at second follow-up (IQR: 23–47). Overall, the LPG intervention was associated with a 92% (95% confidence interval (CI): 90–94%) reduction in kitchen PM2.5 concentrations and a 74% (95% CI: 70–79%) reduction in personal PM2.5 exposures. Results were similar for each site. Conclusions: The intervention was associated with substantial reductions in kitchen and personal PM2.5 overall and in all sites. Results suggest LPG interventions in these rural settings may lower exposures to the WHO annual interim target-1 of 35 μg/m3. The range of exposure contrasts falls on steep sections of estimated exposure-response curves for birthweight, blood pressure, and acute lower respiratory infections, implying potentially important health benefits when transitioning from solid fuels to LPG.

AB - The Household Air Pollution Intervention Network trial is a multi-country study on the effects of a liquefied petroleum gas (LPG) stove and fuel distribution intervention on women's and children's health. There is limited data on exposure reductions achieved by switching from solid to clean cooking fuels in rural settings across multiple countries. As formative research in 2017, we recruited pregnant women and characterized the impact of the intervention on personal exposures and kitchen levels of fine particulate matter (PM2.5) in Guatemala, India, and Rwanda. Forty pregnant women were enrolled in each site. We measured cooking area concentrations of and personal exposures to PM2.5 for 24 or 48 h using gravimetric-based PM2.5 samplers at baseline and two follow-ups over two months after delivery of an LPG cookstove and free fuel supply. Mixed models were used to estimate PM2.5 reductions. Median kitchen PM2.5 concentrations were 296 μg/m3 at baseline (interquartile range, IQR: 158–507), 24 μg/m3 at first follow-up (IQR: 18–37), and 23 μg/m3 at second follow-up (IQR: 14–37). Median personal exposures to PM2.5 were 134 μg/m3 at baseline (IQR: 71–224), 35 μg/m3 at first follow-up (IQR: 23–51), and 32 μg/m3 at second follow-up (IQR: 23–47). Overall, the LPG intervention was associated with a 92% (95% confidence interval (CI): 90–94%) reduction in kitchen PM2.5 concentrations and a 74% (95% CI: 70–79%) reduction in personal PM2.5 exposures. Results were similar for each site. Conclusions: The intervention was associated with substantial reductions in kitchen and personal PM2.5 overall and in all sites. Results suggest LPG interventions in these rural settings may lower exposures to the WHO annual interim target-1 of 35 μg/m3. The range of exposure contrasts falls on steep sections of estimated exposure-response curves for birthweight, blood pressure, and acute lower respiratory infections, implying potentially important health benefits when transitioning from solid fuels to LPG.

KW - Clean cooking fuel

KW - Cookstove

KW - Household air pollution

KW - Intervention

KW - PM

KW - Personal exposure

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U2 - 10.1016/j.envpol.2021.118198

DO - 10.1016/j.envpol.2021.118198

M3 - Article

C2 - 34740288

AN - SCOPUS:85116506611

SN - 0269-7491

VL - 291

JO - Environmental Pollution

JF - Environmental Pollution

M1 - 118198

ER -

LPG stove and fuel intervention among pregnant women reduce fine particle air pollution exposures in three countries: Pilot results from the HAPIN trial

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