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Your Environment. Your Health.

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

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Principal Investigator: Clasen, Thomas F
Institute Receiving Award Emory University
Location Atlanta, GA
Grant Number R56ES033530
Funding Organization National Institute of Environmental Health Sciences
Award Funding Period 25 Sep 2021 to 31 Aug 2022
DESCRIPTION (provided by applicant): PROJECT SUMMARY 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. 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. The trial, ending September 2021, has achieved excellent retention (94%), high adherence to the intervention, and a substantial reduction in personal exposure to fine particulate matter (PM2.5) in the pregnant mothers. Evidence 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 during this critical developmental period 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 neurological and physical development (Aim 1). Further, given that the intervention ends at age 1, we will continue to characterize exposure to PM2.5 (Aim 2), allowing us 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 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=2,260 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. Further, we are leveraging an intervention for which dramatic reductions in exposure due to the intervention have already been demonstrated, which is not the case in the vast majority of household air pollution trials to date.
Science Code(s)/Area of Science(s) Primary: 95 - Cookstoves Research - technology and health effects
Secondary: 03 - Carcinogenesis/Cell Transformation
Publications No publications associated with this grant
Program Officer Claudia Thompson
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