Assessing the 5-Year Effects of a 500-day Liquefied Petroleum Gas Cooking Intervention: Continued Follow up of Participants from the Household Air Pollution Intervention Network (HAPIN) trial

评估 500 天液化石油气烹饪干预措施的 5 年效果：对家庭空气污染干预网络 (HAPIN) 试验参与者的持续随访

• 批准号: 10539989
• 负责人: Thomas F Clasen
• 金额: $ 146.79万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-16 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10539989
• 关键词: Address; Adherence; Adopted; Adult; Age; Age-Months; Air Pollution; Animals; Assessment tool; Behavior; Biomass; Birth; Carbon Black; Carbon Dioxide; Cessation of life; Charcoal; Child; Child Development; Child Health; Climate; Coal; Control Groups; Cooking Practices; Country; Data; Data Collection; Data Set; Development; Economics; Educational Status; Energy-Generating Resources; Enrollment; Environmental Exposure; Evaluation; Exposure to; Gases; Generations; Growth; Growth and Development function; Guatemala; Health; Health Benefit; Heterogeneity; Hour; Household; Household Air Pollution; India; Infrastructure; Intention; Intervention; Investments; Length; Life; Link; Literature; Malawi; Measurement; Measures; Monitor; Morbidity - disease rate; Mothers; Neurologic; Outcome; Participant; Particulate Matter; Persons; Peru; Petroleum; Policies; Positioning Attribute; Pregnancy; Pregnant Women; Productivity; Randomized; Research; Resource-limited setting; Rwanda; Science Policy; Site; Source; United States National Institutes of Health; Weight; Wood material; Work; arm; biomass fuel; climate change; cohort; cooking; critical developmental period; critical period; design; disorder risk; early childhood; early life exposure; experience; fine particles; follow-up; improved; insight; intervention effect; low and middle-income countries; policy implication; post intervention; premature; response; solid fuel; success; successful intervention; treatment arm

Nearly 3 billion people continue to use solid fuels (coal, biomass, animal dung) for household energy needs, primarily in low- and middle-income countries. The household air pollution resulting from cooking with solid fuels is responsible for an estimated 2.3 million premature deaths and additional morbidity burden each year. Household air pollution emissions from cooking with solid fuels (carbon dioxide and black carbon) are also major sources of climate warming gases at the global level. Our Household Air Pollution Intervention Network (HAPIN) trial (NIH UM1HL134590) is evaluating the effect of a free LPG (liquefied petroleum gas) stove and fuel intervention among 800 pregnant women in each of 4 countries (Guatemala, India, Peru, Rwanda) on birth outcomes and child health through age 1; data collection has been extended through age 2. The trial has achieved excellent retention (92%), high adherence to the intervention, and a substantial reduction in personal exposure to fine particulate matter (PM2.5) and black carbon, a contributor to climate change. Preliminary results suggest the intervention improves length and weight at birth. Research suggests that exposure experienced during gestation and early life is linked to a range of longer-term outcomes, and that the benefits of reduced exposure will continue even if the intervention ends. Therefore, we propose to continue to follow HAPIN children through age 5 to evaluate the effects of the original HAPIN intervention on neurologic and physical development (Aim 1). Further, given that the intervention ends at age 1, we will continue to characterize the children’s personal exposure to PM2.5 and black carbon (Aim 2), allowing us the unique ability to evaluate exposure-response for several relevant periods of gestation and early childhood (Aim 3). The HAPIN trial is uniquely positioned to address these questions, with a large exposure contrast during the trial and the generation of a rich dataset to examine exposure-response given the expected heterogeneity in exposures among control households and all participants post-trial as they adopt the various fuels and cooking practices typical in LMIC settings. The selected health outcomes are supported by previous literature and have important implications for policy. Our overarching hypotheses are that 1) the original intervention has longer term benefits for neurologic and physical development after the intervention ends, and 2) that personal exposure to PM2.5 and black carbon during critical developmental periods will be inversely associated with neurologic and physical development. We propose to explore these aims and hypotheses in HAPIN children in Guatemala, India, and Rwanda (n=2,175 children remaining in the 3 study sites). The proposed work builds on the major investment already made in the HAPIN trial by evaluating whether the benefits of the intervention extend beyond pregnancy and the child’s first year of life, leveraging a well-characterized cohort in 3 diverse settings, providing rigorous and widely generalizable answers to questions important for both science and policy. We are maximizing potential for success by extending our prior research, using an experienced and proven research team, with strong and ongoing relationships with participants.

近30亿人继续使用固体燃料（煤、生物质、动物粪便）满足家庭能源需求，