EXPLORING RESPIRATORY HEALTH OUTCOMES FROM SUSTAINED USE OF EFFICIENT COOKSTOVES

探索持续使用高效炉灶对呼吸系统健康的影响

• 批准号: 8386057
• 负责人: Gautam Nagabhushan Yadama
• 金额: $ 26.6万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-17 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8386057
• 关键词: Acute respiratory infection; Address; Alveolar; Area; Asia; Attention; Biomass; Biometry; Burn injury; Carbon Black; Cessation of life; Child; Chronic Obstructive Airway Disease; Collaborations; Communities; Data; Developing Countries; Development; Economics; Enabling Factors; Engineering; Environmental Health; Environmental Impact; Evaluation; Failure; Foundations; Global Warming; Goals; Government; Health; Health Benefit; Heating; Household; India; Indoor Air Pollution; Intervention; Knowledge; Laboratories; Letters; Location; Lung; Measurement; Measures; Medicine; Mission; National Institute of Environmental Health Sciences; Outcome; Particulate Matter; Pilot Projects; Public Health; Pulmonary Function Test/Forced Expiratory Volume 1; Randomized; Research; Research Personnel; Risk Factors; Rural; Rural Health; Sample Size; Sampling; Security; Signal Transduction; Smoking; Social Sciences; Solid; Solutions; Source; Surface; Technology; Testing; Time; Toxin; Tracheobronchial; United States National Institutes of Health; Woman; Women' s Health; Wood material; Work; base; cooking; design; experience; follow-up; improved; meetings; premature; prevent; programs; randomized trial; research study; respiratory; response; social; uptake

DESCRIPTION (provided by applicant): Nearly 2 million people die annually due to indoor air pollution from solid biomass combustion and 99 percent of these deaths are in developing countries. Biomass combustion is a leading risk factor in acute respiratory infections (ARI) and Chronic Obstructive Pulmonary Disease (COPD), especially among women and children. Inefficient combustion of solid biomass leads to 400,000 annual premature deaths in India alone. Studies suggest that biomass combustion is an even greater risk factor for COPD than smoking, particularly in India where 156 million households still depend on solid biomass for cooking and heating. Clean - high efficiency and low emissions - cookstoves offer a solution to this public health challenge, but their uptake and prolonged use have been disappointing. Although more efficient and emissions-reducing stoves can be produced in the laboratory, designing them to meet the needs of users in various social, economic, cultural, and community contexts has proved challenging. Our pilot R21 study will facilitate a subsequent RO1 proposal focused on sustained and effective use of clean cookstoves by rural households, their effect on real time indoor emissions, and on resulting changes in the respiratory health of rural women and children. In this pilot, we will implement a two-year cluster-randomized trial to evaluate factors that enable and hinder sustained use of clean cookstove technologies. The study will compare the effect of traditional wood burning stoves (the control condition) to that of improved wood burning stoves on the respiratory health of women and children. We will implement this study in 120 households in Andhra Pradesh and Rajasthan, India. Our team of investigators comes from medicine, biostatistics, engineering, and social science with a strong transdisciplinary approach to examining barriers to improved cookstove use and with substantial experience doing research in rural India. The specific aims of this R21 are: 1) Evaluate factors which enable and hinder sustained use of clean cookstove technologies by the rural poor in India so we can develop a more refined pivotal intervention focused on improving respiratory health. 2) To generate effect size data that establish the feasibility and inform the sample size o a pivotal trial whose primary objective will be sustained improvements in the respiratory health (measured by FEV1) of women and children in rural India. 3) To generate preliminary emissions data (particulate matter - mass and surface area based, CO, SOX) from clean cookstove technology and its effect on respiratory health outcomes that will facilitate the development of a pivotal clean cookstove intervention. In achieving these aims, we will then have necessary preliminary data to proceed with a larger scale RO1 intervention to examine the effect of sustained use of clean cookstoves and respiratory health outcomes in women and children due to reduced indoor air pollution in rural India. Our study and research program are aligned with the NIEHS and Global Alliance for Clean Cookstoves' mission to address the health of women and children through effective use of clean and efficient cookstove technologies worldwide. PUBLIC HEALTH RELEVANCE: Our study is a direct response to address respiratory health of millions around the world who combust solid biomass as their primary source of fuel for cooking and heating. The NIH Global Alliance for Clean Cookstoves seeks to reduce Chronic Obstructive Pulmonary Disease (COPD) and prevent the premature deaths of 1.9 million children due to biomass combustion. The current proposal will facilitate the use of cleaner cookstoves in rural Indian households resulting in significant improved health and environmental benefits.

描述（由申请人提供）：每年有近 200 万人因固体生物质燃烧造成的室内空气污染而死亡，其中 99% 的死亡发生在发展中国家。生物质燃烧是急性呼吸道感染（ARI）和慢性阻塞性肺疾病（COPD）的主要危险因素，特别是在妇女和儿童中。仅在印度，固体生物质的低效燃烧每年就会导致 40 万人过早死亡。研究表明，生物质燃烧是慢性阻塞性肺病的一个比吸烟更大的风险因素，特别是在印度，那里有 1.56 亿家庭仍然依赖固体生物质做饭和取暖。清洁 - 高效率和低排放 - 炉灶为这一公共卫生挑战提供了解决方案，但其接受度和长期使用令人失望。尽管实验室可以生产更高效、更减排的炉灶，但设计它们以满足不同社会、经济、文化和社区背景下用户的需求已被证明具有挑战性。我们的 R21 试点研究将促进后续的 RO1 提案，该提案的重点是农村家庭持续有效地使用清洁炉灶、其对实时室内排放的影响以及由此导致的农村妇女和儿童呼吸健康的变化。在该试点中，我们将实施为期两年的整群随机试验，以评估促进和阻碍清洁炉灶技术持续使用的因素。该研究将比较传统燃木炉（对照条件）与改良燃木炉对妇女和儿童呼吸健康的影响。我们将在印度安得拉邦和拉贾斯坦邦的 120 个家庭中实施这项研究。我们的研究团队来自医学、生物统计学、工程和社会科学领域，采用强大的跨学科方法来研究改善炉灶使用的障碍，并在印度农村进行研究，拥有丰富的经验。 R21 的具体目标是： 1) 评估促进和阻碍印度农村贫困人口持续使用清洁炉灶技术的因素，以便我们能够制定更完善的关键干预措施，重点关注改善呼吸系统健康。 2) 生成效应量数据，确定一项关键试验的可行性并告知样本量，该试验的主要目标是持续改善印度农村妇女和儿童的呼吸健康（以 FEV1 衡量）。 3) 生成清洁炉灶技术的初步排放数据（基于质量和表面积的颗粒物、CO、SOX）及其对呼吸系统健康结果的影响，这将有助于制定关键的清洁炉灶干预措施。为了实现这些目标，我们将获得必要的初步数据，以进行更大规模的 RO1 干预，以检查持续使用清洁炉灶的效果以及由于印度农村室内空气污染减少而对妇女和儿童的呼吸道健康结果的影响。我们的学习和研究计划与 NIEHS 和全球清洁炉灶联盟的使命相一致，即通过在全球范围内有效利用清洁高效的炉灶技术来解决妇女和儿童的健康问题。 公共卫生相关性：我们的研究是为了解决世界各地数百万人的呼吸健康问题而做出的直接反应，这些人燃烧固体生物质作为烹饪和取暖的主要燃料来源。 NIH 全球清洁炉灶联盟致力于减少慢性阻塞性肺病 (COPD) 并防止 190 万儿童因生物质燃烧而过早死亡。当前的提案将促进印度农村家庭使用更清洁的炉灶，从而显着改善健康和环境效益。