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

Liao, Jiawen, Kirby, Miles A, Pillarisetti, Ajay, Piedrahita, Ricardo, Balakrishnan, Kalpana, Sambandam, Sankar, Mukhopadhyay, Krishnendu, Ye, Wenlu, Rosa, Ghislaine, Majorin, Fiona
et al (show 73 more authors) (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. p. 118198.

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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<sub>2.5</sub>) in Guatemala, India, and Rwanda. Forty pregnant women were enrolled in each site. We measured cooking area concentrations of and personal exposures to PM<sub>2.5</sub> for 24 or 48 h using gravimetric-based PM<sub>2.5</sub> 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<sub>2.5</sub> reductions. Median kitchen PM<sub>2.5</sub> concentrations were 296 μg/m<sup>3</sup> at baseline (interquartile range, IQR: 158-507), 24 μg/m<sup>3</sup> at first follow-up (IQR: 18-37), and 23 μg/m<sup>3</sup> at second follow-up (IQR: 14-37). Median personal exposures to PM<sub>2.5</sub> were 134 μg/m<sup>3</sup> at baseline (IQR: 71-224), 35 μg/m<sup>3</sup> at first follow-up (IQR: 23-51), and 32 μg/m<sup>3</sup> 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<sub>2.5</sub> concentrations and a 74% (95% CI: 70-79%) reduction in personal PM<sub>2.5</sub> exposures. Results were similar for each site. CONCLUSIONS: The intervention was associated with substantial reductions in kitchen and personal PM<sub>2.5</sub> 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/m<sup>3</sup>. 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.

Item Type: Article
Uncontrolled Keywords: HAPIN Investigators, Humans, Air Pollutants, Petroleum, Air Pollution, Air Pollution, Indoor, Pregnancy, Child, Pregnant Women, Women's Health, Rural Population, Female, Particulate Matter, Cooking, Child Health
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 17 Dec 2021 09:47
Last Modified: 18 Jan 2023 21:19
DOI: 10.1016/j.envpol.2021.118198
Open Access URL: https://doi.org/10.1016/j.envpol.2021.118198
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3145548