William Checkley1,2, Kendra N Williams1,2, Josiah L Kephart2,3, Magdalena Fandiño-Del-Rio2,3, N Kyle Steenland4, Gustavo F Gonzales5,6, Luke P Naeher7, Steven A Harvey8, Lawrence H Moulton9, Victor G Davila-Roman10, Dina Goodman1,2, Carla Tarazona-Meza2,11, Catherine H Miele1,2, Suzanne Simkovich1,2, Marilu Chiang11, Ryan T Chartier12, Kirsten Koehler2,3. 1. Division of Pulmonary and Critical Care, Department of Medicine, and. 2. Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland. 3. Department of Environmental Health and Engineering. 4. Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia. 5. Department of Biological and Physiological Sciences and. 6. Laboratory for Research and Development, School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru. 7. Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia. 8. Department of International Health, Program in Social Behavioral Interventions, and. 9. Department of International Health, Program in Global Disease Epidemiology and Control, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland. 10. Cardiovascular Division, John T. Milliken Department of Internal Medicine, Cardiovascular Imaging and Clinical Research Core Lab, School of Medicine, Washington University in St. Louis, St. Louis, Missouri. 11. Biomedical Research Unit, PRISMA, Lima, Peru; and. 12. RTI International, Durham, North Carolina.
Abstract
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/height2 (0.14 L/s/m2; -0.02 to 0.29), postbronchodilator peak expiratory flow/height2 (0.11 L/s/m2; -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. Clinical trial registered with www.clinicaltrials.gov (NCT02994680).
RCT Entities:
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/height2 (0.14 L/s/m2; -0.02 to 0.29), postbronchodilator peak expiratory flow/height2 (0.11 L/s/m2; -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. Clinical trial registered with www.clinicaltrials.gov (NCT02994680).
Entities:
Keywords:
blood pressure; household air pollution; lung function; respiratory symptoms
Authors: Magdalena Fandiño-Del-Rio; Josiah L Kephart; Kendra N Williams; Timothy Shade; Temi Adekunle; Kyle Steenland; Luke P Naeher; Lawrence H Moulton; Gustavo F Gonzales; Marilu Chiang; Shakir Hossen; Ryan T Chartier; Kirsten Koehler; William Checkley Journal: Environ Health Perspect Date: 2022-05-12 Impact factor: 11.035
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