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: 10705216
• 负责人: Thomas F Clasen
• 金额: $ 145.98万
• 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/10705216
• 关键词: Address; Adherence; Adopted; Adult; Age; Age Months; Air Pollution; Animals; Assessment tool; Behavior; Biomass; Birth; Carbon; 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; Persons; Peru; Petroleum; Policies; Policy Maker; Positioning Attribute; Pregnancy; Pregnant Women; Productivity; Randomized; Research; Resource-limited setting; Rwanda; Science; 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(煤炭、生物质、动物粪便)满足家庭能源需求， 主要是在低收入和中等收入国家。用固体燃料做饭造成的家庭空气污染 据估计，每年有230万人过早死亡，并造成额外的发病率负担。 使用固体燃料(二氧化碳和黑碳)做饭的家庭空气污染排放也是主要的。 全球范围内气候变暖气体的来源。我们的家庭空气污染干预网络(HAPIN) 试验(NIH UM1HL134590)正在评估免费液化石油气(LPG)炉子和燃料的效果 对4个国家(危地马拉、印度、秘鲁、卢旺达)的800名孕妇进行分娩干预 结果和儿童健康一直持续到1岁；数据收集已经延长到2岁。 实现了出色的保留率(92%)，对干预措施的高度坚持，并大幅减少了个人 接触细颗粒物(PM2.5)和黑碳，这是气候变化的一个贡献者。初步结果 建议进行干预，以改善出生时的身长和体重。研究表明，暴露于 在妊娠期和早期生命与一系列较长期的结果有关，减少 即使干预结束，风险敞口仍将继续。因此，我们建议继续关注HAPIN儿童 通过5岁评估最初的HAPIN干预对神经和身体发育的影响 (目标1)。此外，鉴于干预在1岁时结束，我们将继续描述儿童的个人特征 暴露于PM2.5和黑碳(目标2)，使我们能够评估暴露-响应 几个相关的妊娠期和幼儿期(目标3)。HAPIN试验的独特之处在于 解决这些问题，在试验期间使用较大的曝光对比度，并生成丰富的数据集以 在对照组家庭和所有家庭的暴露预期异质性的情况下，检查暴露反应 参与者在试验后采用了LMIC环境中典型的各种燃料和烹饪方法。选定的 健康结果得到了先前文献的支持，并对政策产生了重要影响。我们最重要的是 假设是1)最初的干预对神经和身体发育有更长期的好处。 在干预结束后，以及2)在发育关键时期个人暴露于PM2.5和黑碳 月经将与神经和身体发育成反比。我们建议探讨这些问题 危地马拉、印度和卢旺达HAPIN儿童的目标和假设(n=2,175名儿童留在3个国家 学习站点)。拟议的工作建立在已经对HAPIN试验进行的主要投资的基础上，通过评估 干预的好处是否延伸到怀孕和孩子出生的第一年，利用 在3个不同的环境中充分描述了队列的特点，为问题提供了严谨和广泛概括的答案 对科学和政策都很重要。我们正在通过扩展我们之前的研究来最大限度地发挥成功的潜力， 使用一支经验丰富、久经考验的研究团队，与参与者建立牢固和持续的关系。