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.

将近30亿人继续使用固体燃料（煤炭，生物质，动物粪便）来满足家庭能源需求， 低收入和中等收入国家的主要。用固体燃料烹饪引起的家用空气污染 估计每年估计有230万例过早死亡和额外的发病率燃烧。 用固体燃料（二氧化碳和黑色碳）烹饪的家庭空气污染排放也很重要 全球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）正在评估自由LPG（液化石油气）炉子和燃料的影响 在出生的4个国家（印度危地马拉，印度危地马拉，印度危地马拉）中的每个孕妇中的干预措施 成果和儿童健康至1岁；数据收集已扩展到2岁。试验已有 获得了出色的保留率（92％），对干预措施的高度依从性以及个人的大幅降低 暴露于精美的特定物质（PM2.5）和黑碳，这是导致气候变化的原因。初步结果 建议干预改善出生时的长度和体重。研究表明曝光经历了 在妊娠和早期生活中，与一系列长期结局有关，并减少的好处 即使干预结束，暴露也将继续。因此，我们建议继续跟随Hapin儿童 到5岁以评估原始HAPIN干预对神经和身体发育的影响 （目标1）。此外，鉴于干预措施在1岁结束时，我们将继续描述孩子的个人 暴露于PM2.5和黑碳（AIM 2），使我们有独特的能力来评估暴露响应 妊娠和幼儿时期的几个相关时期（AIM 3）。 HAPIN试验的独特位置为 解决了这些问题，试验期间有很大的暴露对比，并产生了丰富的数据集 鉴于对照家庭和所有人的暴露在暴露中的预期异质性，检查暴露回应 审判后的参与者在采用LMIC环境中典型的各种燃料和烹饪实践。选定的 健康成果得到了以前的文献的支持，并对政策具有重要意义。我们的总体 假设是1）原始干预对神经和身体发育具有长期益处 干预结束后，以及2）在关键发育期间，个人接触PM2.5和黑碳 时期将与神经系统和身体发育成反比。我们建议探索这些 印度危地马拉的Hapin儿童的目的和假设和卢旺达（n = 2,175名儿童留在3个 研究地点）。拟议的工作是建立在Hapin试验中已经进行的主要投资的基础上的 干预的益处是否超出了怀孕和孩子的第一年，利用了 在3个潜水员环境中的表征良好 对科学和政策都很重要。通过扩展我们的先前研究，我们正在最大程度地发挥成功的潜力 使用经验和经过验证的研究团队，与参与者建立牢固而持续的关系。