4.7 Article

Effects of a Household Air Pollution Intervention with Liquefied Petroleum Gas on Cardiopulmonary Outcomes in Peru A Randomized Controlled Trial

Journal

Publisher

AMER THORACIC SOC
DOI: 10.1164/rccm.202006-2319OC

Keywords

household air pollution; lung function; blood pressure; respiratory symptoms

Funding

  1. NIH
  2. Fogarty International Center, National Institute of Environmental Health Sciences, National Cancer Institute, and Centers for Disease Control and Prevention [U01TW010107, U2RTW010114]
  3. Clean Cooking Alliance of the United Nations Foundation [UNF-16-810]
  4. NIH Research Training Grant - NIH [D43TW009340]
  5. National Institute of Neurological Disorders and Stroke, National Institute of Mental Health, NHLBI
  6. National Institute of Environmental Health Sciences
  7. Global Established Multidisciplinary Sites award from the Center for Global Health at Johns Hopkins University
  8. National Institute of Environmental Health Sciences of the NIH [T32ES007141]
  9. NHLBI of the NIH [T32HL007534, F32HL143909]
  10. Lietman Fellowship award of the Center for Global Health at Johns Hopkins University
  11. David Leslie Swift Fund of the Bloomberg School of Public Health, Johns Hopkins University
  12. Mr. William and Bonnie Clarke III
  13. Johns Hopkins University

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A study was conducted in rural Puno, Peru involving 180 women aged 25-64 to determine the impact of an intervention using Liquefied Petroleum Gas (LPG) on cardiopulmonary health outcomes. Despite high adherence to LPG stove usage in the intervention group, there were no significant differences in blood pressure, lung function, or respiratory symptoms compared to the control group over a 1-year period.
Rationale: Approximately 40% of people worldwide are exposed to household air pollution (HAP) from the burning of biomass fuels. Previous efforts to document health benefits of HAP mitigation have been stymied by an inability to lower emissions to target levels. Objectives: We sought to determine if a household air pollution intervention with liquefied petroleum gas (LPG) improved cardiopulmonary health outcomes in adult women living in a resource-poor setting in Peru. Methods: We conducted a randomized controlled field trial in 180 women aged 25-64 years living in rural Puno, Peru. Intervention women received an LPG stove, continuous fuel delivery for 1 year, education, and behavioral messaging, whereas control women were asked to continue their usual cooking practices. We assessed for stove use adherence using temperature loggers installed in both LPG and biomass stoves of intervention households. Measurements and Main Results: We measured blood pressure, peak expiratory flow (PEF), and respiratory symptoms using the St. George's Respiratory Questionnaire at baseline and at 3-4 visits after randomization. Intervention women used their LPG stove exclusively for 98% of days. We did not find differences in average postrandomization systolic blood pressure (intervention - control 0.7 mm Hg; 95% confidence interval, -2.1 to 3.4), diastolic blood pressure (0.3 mm Hg; -1.5 to 2.0), prebronchodilator peak expiratory flow/height(2) (0.14 L/s/m(2); -0.02 to 0.29), postbronchodilator peak expiratory flow/height(2) (0.11 L/s/m(2); -0.05 to 0.27), or St. George's Respiratory Questionnaire total score (-1.4; -3.9 to 1.2) over 1 year in intention-to-treat analysis. There were no reported harms related to the intervention. Conclusions: We did not find evidence of a difference in blood pressure, lung function, or respiratory symptoms during the year-long intervention with LPG.

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