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

• Type of Material: Article
• Authors: Magdalena Fandino-Del-Rio, Johns Hopkins University; Dina Goodman, Johns Hopkins University; Josiah L. Kephart, Johns Hopkins University; Catherine H. Miele, Johns Hopkins University; Kendra N. Williams, Johns Hopkins University; Mitra Moazzami, Johns Hopkins University; Elizabeth C. Fung, Johns Hopkins University; Kirsten Koehler, Johns Hopkins University; Victor G. Davila-Roman, Washington University; Kathryn A. Lee, Johns Hopkins University; Saachi Nangia, Johns Hopkins University; Steven A. Harvey, Johns Hopkins University; Nelson Steenland, Emory University; Gustavo F. Gonzales, Universidad Peruana Cayetano Heredia; William Checkley, Johns Hopkins University
• Language: English
• Date: 2017-11-03
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © 2017 The Author(s).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s13063-017-2179-x
• Title of Journal or Parent Work: Trials
• ISSN: 1745-6215
• Volume: 18
• Issue: 1
• Start Page: 518
• End Page: 518
• Grant/Funding Information: Financial support was received from the Global Environmental and Occupational Health, Fogarty International Center, United States National Institutes of Health (1U2RTW010114-01); the Global Alliance for Clean Cookstoves of the United Nations Foundation (UNF 16-80), and the Johns Hopkins Center for Global Health.
• Keywords: ACUTE RESPIRATORY-INFECTIONS; Cardiopulmonary outcomes; Research & Experimental Medicine; Household air pollution; Indoor air pollution; AMERICAN-HEART-ASSOCIATION; LPG; Biomass fuel; PARTICULATE MATTER; INDOOR AIR-POLLUTION; LONG-TERM EXPOSURE; Science & Technology; Exclusive adoption; Behavior change; Life Sciences & Biomedicine; Personal exposure; Medicine, Research & Experimental; OBSTRUCTIVE PULMONARY-DISEASE; WOOD SMOKE EXPOSURE; INTIMA-MEDIA THICKNESS; CARDIOVASCULAR-DISEASE; Cookstove; BLOOD-PRESSURE
• Research Categories: Health Sciences, General; Health Sciences, Public Health

Abstract

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 participan ts. 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.