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Author Notes:

Correspondence: wcheckl1@jhmi.edu

See publication for full list of author contributions.

The authors would like to thank Phabiola Herrera (Johns Hopkins University, Baltimore, MD, USA), David Danz (A.B. PRISMA, Puno, Peru), Juan Gabriel Espinoza (A.B. PRISMA, Lima, Peru), Lisa de las Fuentes (Washington University School of Medicine, St. Louis, MO, USA), Dana Boyd Barr (Rollins School of Public Health, Atlanta, GA, USA), Luke Naeher (University of Georgia, Athens, GA, USA), Ryan Chartier (RTI International, Chapel Hill, NC, USA), and Joshua Rosenthal (Fogarty International Center, National Institutes of Health, Bethesda, MD, USA) for their help with this study.

The trial received approval by Johns Hopkins School of Public Health Institutional Review Board (IRB00007128), A.B. PRISMA Ethical Institutional Committee (CE2402.16), and Universidad Peruana Cayetano Heredia Institutional Review Board (SIDISI 66780).

We will be requesting verbal consent to participate from all participants at the time of enrollment.

Any amendments will undergo ethical review board approval at all institutions involved.

Written informed consent was obtained from the participant for publication of their individual details and accompanying images in this manuscript.

The Consent Form is held by the authors and is available for review by the Editor-in-Chief.

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The authors declare that they have no competing interests.

The content is solely the responsibility of the authors and does not necessarily represent the official views of these organizations.


Research Funding:

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.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Medicine, Research & Experimental
  • Research & Experimental Medicine
  • Cookstove
  • LPG
  • Indoor air pollution
  • Household air pollution
  • Personal exposure
  • Biomass fuel
  • Cardiopulmonary outcomes
  • Behavior change
  • Exclusive adoption

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

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Journal Title:



Volume 18, Number 1


, Pages 518-518

Type of Work:

Article | Final Publisher PDF


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.

Copyright information:

© 2017 The Author(s).

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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