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

Autor: Liao J; Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA; Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA., Kirby MA; Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Pillarisetti A; Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA; School of Public Health, University of California, Berkeley, CA, USA., Piedrahita R; Berkeley Air Monitoring Group, Berkeley, CA, USA., Balakrishnan K; SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute of Higher Education and Research, Chennai, India., Sambandam S; SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute of Higher Education and Research, Chennai, India., Mukhopadhyay K; SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute of Higher Education and Research, Chennai, India., Ye W; Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA., Rosa G; London School of Hygiene and Tropical Medicine, London, UK., Majorin F; London School of Hygiene and Tropical Medicine, London, UK., Dusabimana E; Eagle Research Center, Kigali, Rwanda., Ndagijimana F; Eagle Research Center, Kigali, Rwanda., McCracken JP; Center for Health Studies, Universidad del Valle De Guatemala, Guatemala City, Guatemala; College of Public Health, University of Georgia, Athens, GA, USA., Mollinedo E; Center for Health Studies, Universidad del Valle De Guatemala, Guatemala City, Guatemala; College of Public Health, University of Georgia, Athens, GA, USA., de Leon O; Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA; Center for Health Studies, Universidad del Valle De Guatemala, Guatemala City, Guatemala., Díaz-Artiga A; Center for Health Studies, Universidad del Valle De Guatemala, Guatemala City, Guatemala., Thompson LM; Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA; Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA., Kearns KA; College of Public Health, University of Georgia, Athens, GA, USA., Naeher L; College of Public Health, University of Georgia, Athens, GA, USA., Rosenthal J; Fogarty International Center, National Institutes of Health, Bethesda, MD, USA., Clark ML; Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA., Steenland K; Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA., Waller LA; Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA., Checkley W; Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Center for Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA., Peel JL; Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA., Clasen T; Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA., Johnson M; Berkeley Air Monitoring Group, Berkeley, CA, USA. Electronic address: mjohnson@berkeleyair.com.
Jazyk: angličtina
Zdroj: Environmental pollution (Barking, Essex : 1987) [Environ Pollut] 2021 Dec 15; Vol. 291, pp. 118198. Date of Electronic Publication: 2021 Sep 21.
DOI: 10.1016/j.envpol.2021.118198
Abstrakt: 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/m 3 at baseline (interquartile range, IQR: 158-507), 24 μg/m 3 at first follow-up (IQR: 18-37), and 23 μg/m 3 at second follow-up (IQR: 14-37). Median personal exposures to PM 2.5 were 134 μg/m 3 at baseline (IQR: 71-224), 35 μg/m 3 at first follow-up (IQR: 23-51), and 32 μg/m 3 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/m 3 . 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.
(Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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