Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Environ Health Perspect. 2020 Apr;128(4):47008. doi: 10.1289/EHP6407. Epub 2020 Apr 29.
Globally, nearly 3 billion people rely on solid fuels for cooking and heating, the vast majority residing in low- and middle-income countries (LMICs). The resulting household air pollution (HAP) is a leading environmental risk factor, accounting for an estimated 1.6 million premature deaths annually. Previous interventions of cleaner stoves have often failed to reduce exposure to levels that produce meaningful health improvements. There have been no multicountry field trials with liquefied petroleum gas (LPG) stoves, likely the cleanest scalable intervention.
This paper describes the design and methods of an ongoing randomized controlled trial (RCT) of LPG stove and fuel distribution in 3,200 households in 4 LMICs (India, Guatemala, Peru, and Rwanda).
We are enrolling 800 pregnant women at each of the 4 international research centers from households using biomass fuels. We are randomly assigning households to receive LPG stoves, an 18-month supply of free LPG, and behavioral reinforcements to the control arm. The mother is being followed along with her child until the child is 1 year old. Older adult women (40 to of age) living in the same households are also enrolled and followed during the same period. Primary health outcomes are low birth weight, severe pneumonia incidence, stunting in the child, and high blood pressure (BP) in the older adult woman. Secondary health outcomes are also being assessed. We are assessing stove and fuel use, conducting repeated personal and kitchen exposure assessments of fine particulate matter with aerodynamic diameter (), carbon monoxide (CO), and black carbon (BC), and collecting dried blood spots (DBS) and urinary samples for biomarker analysis. Enrollment and data collection began in May 2018 and will continue through August 2021. The trial is registered with ClinicalTrials.gov (NCT02944682).
This study will provide evidence to inform national and global policies on scaling up LPG stove use among vulnerable populations. https://doi.org/10.1289/EHP6407.
在全球范围内，近 30 亿人依赖固体燃料做饭和取暖，其中绝大多数生活在中低收入国家（LMICs）。由此产生的室内空气污染（HAP）是一个主要的环境风险因素，据估计每年导致 160 万人过早死亡。以前的清洁炉灶干预措施往往未能将暴露水平降低到产生显著健康改善的水平。没有进行过液化石油气（LPG）炉灶的多国实地试验，而 LPG 炉灶可能是最清洁的可扩展干预措施。
本文描述了正在进行的一项在四个中低收入国家（印度、危地马拉、秘鲁和卢旺达）的 3200 户家庭中进行的液化石油气炉和燃料分配的随机对照试验（RCT）的设计和方法。
我们正在四个国际研究中心从使用生物质燃料的家庭中招募 800 名孕妇。我们将家庭随机分配到接受液化石油气炉、18 个月的免费液化石油气供应和对照组的行为强化组。母亲将与她的孩子一起被跟踪，直到孩子 1 岁。同一家庭中年龄在 40 至 岁的老年妇女也被招募并在同一时期进行跟踪。主要健康结果是低出生体重、严重肺炎发病率、儿童发育迟缓以及老年妇女的高血压（BP）。也正在评估次要健康结果。我们正在评估炉子和燃料的使用情况，对室内空气中的细颗粒物（）、一氧化碳（CO）和黑碳（BC）进行反复的个人和厨房暴露评估，并收集干血斑（DBS）和尿液样本进行生物标志物分析。招募和数据收集始于 2018 年 5 月，将持续到 2021 年 8 月。该试验在 ClinicalTrials.gov 注册（NCT02944682）。
这项研究将提供证据，为在弱势人群中扩大液化石油气炉的使用提供国家和全球政策依据。https://doi.org/10.1289/EHP6407.
