Journal Article

Effects of a liquefied petroleum gas stove intervention on pollutant exposure and adult cardiopulmonary outcomes (CHAP): study protocol for a randomized controlled trial

Harvey, Steven A., Kephart, Josiah L., Nangia, Saachi, Fandiño-Del-Rio, Magdalena, Williams, Kendra N., Lee, Kathryn A., Miele, Catherine H., Davila-Roman, Victor G., Fung, Elizabeth C., Gonzales, Gustavo F., Moazzami, Mitra, Steenland, Kyle, Koehler, Kirsten, Goodman, Dina, Checkley, William

2017

Overview

Background Biomass fuel smoke is a leading risk factor for the burden of disease worldwide. International campaigns are promoting the widespread adoption of liquefied petroleum gas (LPG) in resource-limited settings. However, it is unclear if the introduction and use of LPG stoves, in settings where biomass fuels are used daily, reduces pollution concentration exposure, improves health outcomes, or how cultural and social barriers influence the exclusive adoption of LPG stoves. Methods We will conduct a randomized controlled, field intervention trial of LPG stoves and fuel distribution in rural Puno, Peru, in which we will enroll 180 female participants aged 25–64 years and follow them for 2 years. After enrollment, we will collect information on sociodemographic characteristics, household characteristics, and cooking practices. During the first year of the study, LPG stoves and fuel tanks will be delivered to the homes of 90 intervention participants. During the second year, participants in the intervention arm will keep their LPG stoves, but the gas supply will stop. Control participants will receive LPG stoves and vouchers to obtain free fuel from distributors at the beginning of the second year, but gas will not be delivered. Starting at baseline, we will collect longitudinal measurements of respiratory symptoms, pulmonary function, blood pressure, endothelial function, carotid artery intima-media thickness, 24-h dietary recalls, exhaled carbon monoxide, quality-of-life indicators, and stove-use behaviors. Environmental exposure assessments will occur six times over the 2-year follow-up period, consisting of 48-h personal exposure and kitchen concentration measurements of fine particulate matter and carbon monoxide, and 48-h kitchen concentrations of nitrogen dioxide for a subset of 100 participants. Discussion Findings from this study will allow us to better understand behavioral patterns, environmental exposures, and cardiovascular and pulmonary outcomes resulting from the adoption of LPG stoves. If this trial indicates that LPG stoves are a feasible and effective way to reduce household air pollution and improve health, it will provide important information to support widespread adoption of LPG fuel as a strategy to reduce the global burden of disease. Trial registration ClinicalTrials.gov, ID: NCT02994680 , Cardiopulmonary Outcomes and Household Air Pollution (CHAP) Trial. Registered on 28 November 2016.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Air pollution / Air Pollution, Indoor - adverse effects / Air Pollution, Indoor - prevention & control / Biomass energy / Biomass fuel / Biomedicine / Blood pressure / Bronchitis / Cardiovascular disease / Cardiovascular diseases / Cardiovascular System - physiopathology / Chronic obstructive pulmonary disease / Clinical trials / Cooking - instrumentation / Cookstove / Cross-sectional studies / Environmental aspects / Environmental Monitoring - methods / Equipment Design / Female / Gases / Health aspects / Health Sciences / Heart Diseases - diagnosis / Heart Diseases - etiology / Heart Diseases - physiopathology / Heart Diseases - prevention & control / Household air pollution / Household Articles / Households / Housing / Humans / Indoor air pollution / Inhalation Exposure - adverse effects / Inhalation Exposure - prevention & control / Intervention / Kerosene / Liquefied petroleum gas / Longitudinal studies / LPG / Lung - physiopathology / Lung diseases / Lung Diseases - diagnosis / Lung Diseases - etiology / Lung Diseases - physiopathology / Lung Diseases - prevention & control / Medicine / Medicine & Public Health / Middle Aged / Ovens & stoves / Personal exposure / Peru / Petroleum - adverse effects / Planning / Pneumonia / Research Design / Risk Factors / Rural areas / Rural Health / Statistics for Life Sciences / Stoves / Study Protocol / Time Factors / Womens health