Exposure contrasts associated with a liquefied petroleum gas (LPG) intervention at potential field sites for the multi-country household air pollution intervention network (HAPIN) trial in India: results from pilot phase activities in rural Tamil Nadu

被引：16

作者：

Sambandam, Sankar ^{[1
]}

Mukhopadhyay, Krishnendu ^{[1
]}

Sendhil, Saritha ^{[1
]}

Ye, Wenlu ^{[2
]}

Pillarisetti, Ajay ^{[2
]}

Thangavel, Gurusamy ^{[1
]}

Natesan, Durairaj ^{[1
]}

Ramasamy, Rengaraj ^{[1
]}

Natarajan, Amudha ^{[1
]}

Aravindalochanan, Vigneswari ^{[1
]}

Vinayagamoorthi, A. ^{[1
]}

Sivavadivel, S. ^{[1
]}

Maheswari, R. Uma ^{[1
]}

Balakrishnan, Lingeswari ^{[1
]}

Gayatri, S. ^{[1
]}

Nargunanathan, Srinivasan ^{[1
]}

Madhavan, Sathish ^{[1
]}

Puttaswamy, Naveen ^{[1
]}

Garg, Sarada S. ^{[1
]}

Quinn, Ashlinn ^{[3
]}

Rosenthal, Josh ^{[3
]}

Johnson, Michael ^{[4
]}

Liao, Jiawen ^{[2
]}

Steenland, Kyle ^{[2
]}

Piedhrahita, Ricardo ^{[4
]}

Peel, Jennifer ^{[5
]}

Checkley, William ^{[6
]}

Clasen, Thomas ^{[2
]}

Balakrishnan, Kalpana ^{[1
]}

机构：

[1] Sri Ramachandra Inst Higher Educ & Res Deemed Uni, Fac Publ Hlth, ICMR Ctr Adv Res Air Qual Climate & Hlth, Dept Environm Hlth Engn, Chennai 600116, Tamil Nadu, India

[2] Emory Univ, Gangarosa Dept Environm Hlth, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA

[3] NIH, Div Epidemiol & Populat Studies, Fogarty Int Ctr, Bldg 10, Bethesda, MD 20892 USA

[4] Berkeley Air Monitoring Grp, Berkeley, CA USA

[5] Colorado State Univ, Dept Environm & Radiol Hlth Sci, Ft Collins, CO 80523 USA

[6] Johns Hopkins Univ, Sch Med, Div Pulm & Crit Care, Baltimore, MD USA

来源：

BMC PUBLIC HEALTH | 2020年 / 20卷 / 01期

基金：

比尔及梅琳达.盖茨基金会; 美国国家卫生研究院;

关键词：

HAPIN trial; LPG intervention; Household air pollution; PM2; 5; Personal exposures; Pregnant women; India; RANDOMIZED-CONTROLLED-TRIAL; COOKSTOVE INTERVENTION; STOVE INTERVENTION; PREGNANT-WOMEN; BLOOD-PRESSURE; HEALTH; CHILDREN; PNEUMONIA; COOKING; SYMPTOMS;

D O I：

10.1186/s12889-020-09865-1

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

BackgroundThe Household Air Pollution Intervention Network (HAPIN) trial aims to assess health benefits of a liquefied petroleum gas (LPG) cookfuel and stove intervention among women and children across four low- and middle-income countries (LMICs). We measured exposure contrasts for women, achievable under alternative conditions of biomass or LPG cookfuel use, at potential HAPIN field sites in India, to aid in site selection for the main trial.MethodsWe recruited participants from potential field sites within Villupuram and Nagapattinam districts in Tamil Nadu, India, that were identified during a feasibility assessment. We performed.(i) cross-sectional measurements on women (N =79) using either biomass or LPG as their primary cookfuel and (ii) before-and-after measurements on pregnant women (N =41), once at baseline while using biomass fuel and twice - at 1 and 2 months - after installation of an LPG stove and free fuel intervention. We involved participants to co-design clothing and instrument stands for personal and area sampling. We measured 24 or 48-h personal exposures and kitchen and ambient concentrations of fine particulate matter (PM2.5) using gravimetric samplers.ResultsIn the cross-sectional analysis, median (interquartile range, IQR) kitchen PM2.5 concentrations in biomass and LPG using homes were 134 mu g/m3 [IQR:71-258] and 27 mu g/m3 [IQR:20-47], while corresponding personal exposures were 75 mu g/m3 [IQR:55-104] and 36 mu g/m3 [IQR:26-46], respectively. In before-and-after analysis, median 48-h personal exposures for pregnant women were 72 mu g/m3 [IQR:49-127] at baseline and 25 mu g/m3 [IQR:18-35] after the LPG intervention, with a sustained reduction of 93% in mean kitchen PM2.5 concentrations and 78% in mean personal PM2.5 exposures over the 2month intervention period. Median ambient concentrations were 23 mu g/m3 [IQR:19-27). Participant feedback was critical in designing clothing and instrument stands that ensured high compliance.ConclusionsAn LPG stove and fuel intervention in the candidate HAPIN trial field sites in India was deemed suitable for achieving health-relevant exposure reductions. Ambient concentrations indicated limited contributions from other sources. Study results provide critical inputs for the HAPIN trial site selection in India, while also contributing new information on HAP exposures in relation to LPG interventions and among pregnant women in LMICs.Trial registrationClinicalTrials.Gov. NCT02944682; Prospectively registered on October 17, 2016.

引用

页数：13

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