Air Pollutant Exposure and Stove Use Assessment Methods for the Household Air Pollution Intervention Network (HAPIN) Trial

• Authors: Michael A. Johnson, Berkeley Air Monitoring Group; Kyle Steenland, Emory University; Ricardo Piedrahita, Berkeley Air Monitoring Group; Maggie L. Clark, Colorado State University; Ajay Pillarisetti, Emory University; Kalpana Balakrishnan, Sri Ramachandra Institute for Higher Education and Research; Jennifer L. Peel, Colorado State University; Luke P. Naeher, University of Georgia; Jiawen Liao, Emory University; Daniel Wilson, Geocene; Jeremy Sarnat, Emory University; Lindsay J. Underhill, Johns Hopkins University; Vanessa Burrowes, Johns Hopkins University; John P. McCracken, Universidad del Valle de Guatemala; Ghislaine Rosa, London School of Hygiene & Tropical Medicine; Joshua Rosenthal, National Institutes of Health; Sankar Sambandam, Sri Ramachandra Institute for Higher Education and Research; Oscar de Leon, Johns Hopkins University; Miles A. Kirby, Emory University; Katherine Kearns, Sri Ramachandra Institute for Higher Education and Research; William Checkley, Johns Hopkins University; Thomas CLASEN, Emory University; Lisa Thompson, Emory University
• Journal Title: Environmental Health Perspectives
• Volume: Volume 128, Number 4
• Publisher: EHP | 2020-04-01, Pages 47009-47009
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1289/EHP6422
• Subjects: Health Sciences, Toxicology; Health Sciences, Public Health; Environmental Sciences; Health Sciences, Epidemiology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Environmental Sciences; Public, Environmental & Occupational Health; Toxicology; Environmental Sciences & Ecology; Solid-fuel use; Particulate matter; Carbon monoxide; Black carbon; Children; Cooking; Risk; Cookstoves; Pneumonia; Proximity

Abstract

BACKGROUND: High quality personal exposure data is fundamental to understanding the health implications of household energy interventions, interpreting analyses across assigned study arms, and characterizing exposure-response relationships for household air pollution. This paper describes the exposure data collection for the Household Air Pollution Intervention Network (HAPIN), a multicountry randomized controlled trial of liquefied petroleum gas stoves and fuel among 3,200 households in India, Rwanda, Guatemala, and Peru. OBJECTIVES: The primary objectives of the exposure assessment are to estimate the exposure contrast achieved following a clean fuel intervention and to provide data for analyses of exposure-response relationships across a range of personal exposures. METHODS: Exposure measurements are being conducted over the 3-y time frame of the field study. We are measuring fine particulate matter [PM < 2.5μm in aerodynamic diameter (PM2.5)] with the Enhanced Children's MicroPEM™ (RTI International), carbon monoxide (CO) with the USB-EL-CO (Lascar Electronics), and black carbon with the OT21 transmissometer (Magee Scientific) in pregnant women, adult women, and children <1 year of age, primarily via multiple 24-h personal assessments (three, six, and three measurements, respectively) over the course of the 18-month follow-up period using lightweight monitors. For children we are using an indirect measurement approach, combining data from area monitors and locator devices worn by the child. For a subsample (up to 10%) of the study population, we are doubling the frequency of measurements in order to estimate the accuracy of subject-specific typical exposure estimates. In addition, we are conducting ambient air monitoring to help characterize potential contributions of PM2.5 exposure from background concentration. Stove use monitors (Geocene) are being used to assess compliance with the intervention, given that stove stacking (use of traditional stoves in addition to the intervention gas stove) may occur. CONCLUSIONS:The tools and approaches being used for HAPIN to estimate personal exposures build on previous efforts and take advantage of new technologies. In addition to providing key personal exposure data for this study, we hope the application and learnings from our exposure assessment will help inform future efforts to characterize exposure to household air pollution and for other contexts.