Dataset Information

Household Air Pollution Concentrations after Liquefied Petroleum Gas Interventions in Rural Peru: Findings from a One-Year Randomized Controlled Trial Followed by a One-Year Pragmatic Crossover Trial.

ABSTRACT:

Background

Household air pollution (HAP) from biomass fuel combustion remains a leading environmental risk factor for morbidity worldwide.

Objective

Measure the effect of liquefied petroleum gas (LPG) interventions on HAP exposures in Puno, Peru.

Methods

We conducted a 1-y randomized controlled trial followed by a 1-y pragmatic crossover trial in 180 women age 25-64 y. During the first year, intervention participants received a free LPG stove, continuous fuel delivery, and regular behavioral messaging, whereas controls continued their biomass cooking practices. During the second year, control participants received a free LPG stove, regular behavioral messaging, and vouchers to obtain LPG tanks from a nearby distributor, whereas fuel distribution stopped for intervention participants. We collected 48-h kitchen area concentrations and personal exposures to fine particulate matter (PM) with aerodynamic diameter ≤2.5μm (PM2.5), black carbon (BC), and carbon monoxide (CO) at baseline and 3-, 6-, 12-, 18-, and 24-months post randomization.

Results

Baseline mean [±standard deviation (SD)] PM2.5 (kitchen area concentrations 1,220±1,010 vs. 1,190±880 μg/m3; personal exposure 126±214 vs. 104±100 μg/m3), CO (kitchen 53±49 vs. 50±41 ppm; personal 7±8 vs. 7±8 ppm), and BC (kitchen 180±120 vs. 210±150 μg/m3; personal 19±16 vs. 21±22 μg/m3) were similar between control and intervention participants. Intervention participants had consistently lower mean (±SD) concentrations at the 12-month visit for kitchen (41±59 μg/m3, 3±6 μg/m3, and 8±13 ppm) and personal exposures (26±34 μg/m3, 2±3 μg/m3, and 3±4 ppm) to PM2.5, BC, and CO when compared to controls during the first year. In the second year, we observed comparable HAP reductions among controls after the voucher-based intervention for LPG fuel was implemented (24-month visit PM2.5, BC, and CO kitchen mean concentrations of 34±74 μg/m3, 3±5 μg/m3, and 6±6 ppm and personal exposures of 17±15 μg/m3, 2±2 μg/m3, and 3±4 ppm, respectively), and average reductions were present among intervention participants even after free fuel distribution stopped (24-month visit PM2.5, BC, and CO kitchen mean concentrations of 561±1,251 μg/m3, 82±124 μg/m3, and 23±28 ppm and personal exposures of 35±38 μg/m3, 6±6 μg/m3, and 4±5 ppm, respectively).

Discussion

Both home delivery and voucher-based provision of free LPG over a 1-y period, in combination with provision of a free LPG stove and longitudinal behavioral messaging, reduced HAP to levels below 24-h World Health Organization air quality guidelines. Moreover, the effects of the intervention on HAP persisted for a year after fuel delivery stopped. Such strategies could be applied in LPG programs to reduce HAP and potentially improve health. https://doi.org/10.1289/EHP10054.

SUBMITTER: Fandino-Del-Rio M

PROVIDER: S-EPMC9097958 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Household Air Pollution Concentrations after Liquefied Petroleum Gas Interventions in Rural Peru: Findings from a One-Year Randomized Controlled Trial Followed by a One-Year Pragmatic Crossover Trial.

Fandiño-Del-Rio Magdalena M Kephart Josiah L JL Williams Kendra N KN Shade Timothy T Adekunle Temi T Steenland Kyle K Naeher Luke P LP Moulton Lawrence H LH Gonzales Gustavo F GF Chiang Marilu M Hossen Shakir S Chartier Ryan T RT Koehler Kirsten K Checkley William W

Environmental health perspectives 20220512 5

<h4>Background</h4>Household air pollution (HAP) from biomass fuel combustion remains a leading environmental risk factor for morbidity worldwide.<h4>Objective</h4>Measure the effect of liquefied petroleum gas (LPG) interventions on HAP exposures in Puno, Peru.<h4>Methods</h4>We conducted a 1-y randomized controlled trial followed by a 1-y pragmatic crossover trial in 180 women age 25-64 y. During the first year, intervention participants received a free LPG stove, continuous fuel delivery, and ...[more]

PMID: 35549716

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Project description:BackgroundExisting efforts to promote cleaner fuels have not achieved exclusive use. We investigated whether receiving 12 months of free liquefied petroleum gas (LPG) and behavioral support could motivate continued purchase and use.MethodsThe Cardiopulmonary outcomes and Household Air Pollution (CHAP) trial enrolled 180 women. Half were randomly assigned to an intervention group, which included free LPG delivered in months 1-12 followed by a post-intervention period in which they no longer received free fuel (months 13-24). For the purposes of comparison, we also include months 1-12 of data from control participants. We tracked stove use with temperature monitors, surveys, and observations, and conducted in-depth interviews with 19 participants from the intervention group at the end of their post-intervention period.ResultsParticipants from the intervention group used their LPG stove for 85.4 % of monitored days and 63.2 % of cooking minutes during the post-intervention months (13-24) when they were not receiving free fuel from the trial. They used a traditional stove (fogón) on 45.1 % of days post-intervention, which is significantly lower than fogón use by control participants during the intervention period (72.2 % of days). In months 13-24 post-intervention, participants from the intervention group purchased on average 12.3 kg and spent 34.1 soles (10.3 USD) per month on LPG. Continued LPG use was higher among participants who said they could afford two tanks of LPG per month, did not cook for animals, and removed their traditional stove. Women described that becoming accustomed to LPG, support and training from the project, consistent LPG supply, choice between LPG providers, and access to delivery services facilitated sustained LPG use. However, high cost was a major barrier to exclusive use.ConclusionA 12-month period of intensive LPG support achieved a high level of sustained LPG use post-intervention, but other strategies are needed to sustain exclusive use.

Project description:BackgroundReducing household air pollution (HAP) to levels associated with health benefits requires nearly exclusive use of clean cooking fuels and abandonment of traditional biomass fuels.MethodsThe Household Air Pollution Intervention Network (HAPIN) trial randomized 3,195 pregnant women in Guatemala, India, Peru, and Rwanda to receive a liquefied petroleum gas (LPG) stove intervention (n = 1,590), with controls expected to continue cooking with biomass fuels (n = 1,605). We assessed fidelity to intervention implementation and participant adherence to the intervention starting in pregnancy through the infant's first birthday using fuel delivery and repair records, surveys, observations, and temperature-logging stove use monitors (SUMs).ResultsFidelity and adherence to the HAPIN intervention were high. Median time required to refill LPG cylinders was 1 day (interquartile range 0-2). Although 26% (n = 410) of intervention participants reported running out of LPG at some point, the number of times was low (median: 1 day [Q1, Q3: 1, 2]) and mostly limited to the first four months of the COVID-19 pandemic. Most repairs were completed on the same day as problems were reported. Traditional stove use was observed in only 3% of observation visits, and 89% of these observations were followed up with behavioral reinforcement. According to SUMs data, intervention households used their traditional stove a median of 0.4% of all monitored days, and 81% used the traditional stove < 1 day per month. Traditional stove use was slightly higher post-COVID-19 (detected on a median [Q1, Q3] of 0.0% [0.0%, 3.4%] of days) than pre-COVID-19 (0.0% [0.0%, 1.6%] of days). There was no significant difference in intervention adherence pre- and post-birth.ConclusionFree stoves and an unlimited supply of LPG fuel delivered to participating homes combined with timely repairs, behavioral messaging, and comprehensive stove use monitoring contributed to high intervention fidelity and near-exclusive LPG use within the HAPIN trial.

Project description:BackgroundReducing household air pollution (HAP) to levels associated with health benefits requires nearly exclusive use of clean cooking fuels and abandonment of traditional biomass fuels.MethodsThe Household Air Pollution Intervention Network (HAPIN) trial randomized 3,195 pregnant women in Guatemala, India, Peru, and Rwanda to receive a liquefied petroleum gas (LPG) stove intervention (n=1,590), with controls expected to continue cooking with biomass fuels (n=1,605). We assessed fidelity to intervention implementation and participant adherence to the intervention starting in pregnancy through the infant's first birthday using fuel delivery and repair records, surveys, observations, and temperature-logging stove use monitors (SUMs).ResultsFidelity and adherence to the HAPIN intervention were high. Median time required to refill LPG cylinders was 1 day (interquartile range 0-2). Although 26% (n=410) of intervention participants reported running out of LPG at some point, the number of times was low (median: 1 day [Q1, Q3: 1, 2]) and mostly limited to the first four months of the COVID-19 pandemic. Most repairs were completed on the same day as problems were reported. Traditional stove use was observed in only 3% of observation visits, and 89% of these observations were followed up with behavioral reinforcement. According to SUMs data, intervention households used their traditional stove a median of 0.4% of all monitored days, and 81% used the traditional stove <1 day per month. Traditional stove use was slightly higher post-COVID-19 (detected on a median [Q1, Q3] of 0.0% [0.0%, 3.4%] of days) than pre-COVID-19 (0.0% [0.0%, 1.6%] of days). There was no significant difference in intervention adherence pre- and post-birth.ConclusionFree stoves and an unlimited supply of LPG fuel delivered to participating homes combined with timely repairs, behavioral messaging, and comprehensive stove use monitoring contributed to high intervention fidelity and near-exclusive LPG use within the HAPIN trial.

Dataset Information

Household Air Pollution Concentrations after Liquefied Petroleum Gas Interventions in Rural Peru: Findings from a One-Year Randomized Controlled Trial Followed by a One-Year Pragmatic Crossover Trial.

Background

Objective

Methods

Results

Discussion

Publications

Household Air Pollution Concentrations after Liquefied Petroleum Gas Interventions in Rural Peru: Findings from a One-Year Randomized Controlled Trial Followed by a One-Year Pragmatic Crossover Trial.

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