Household Air Pollution Concentrations after Liquefied Petroleum Gas Interventions in Rural Peru: Findings from a One-Year Randomized Controlled Trial Followed by a One-Year Pragmatic Crossover Trial

Household air pollution (HAP) from biomass fuel combustion remains a leading environmental risk factor for morbidity worldwide. Measure the effect of liquefied petroleum gas (LPG) interventions on HAP exposures in Puno, Peru. We conducted a 1-y randomized controlled trial followed by a 1-y pragmatic...

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Published in:Environmental health perspectives Vol. 130; no. 5; pp. 57007 - 18
Main Authors: Fandiño-Del-Rio, Magdalena, Kephart, Josiah L., Williams, Kendra N., Shade, Timothy, Adekunle, Temi, Steenland, Kyle, Naeher, Luke P., Moulton, Lawrence H., Gonzales, Gustavo F., Chiang, Marilu, Hossen, Shakir, Chartier, Ryan T., Koehler, Kirsten, Checkley, William
Format: Journal Article
Language:English
Published: United States National Institute of Environmental Health Sciences 01.05.2022
Environmental Health Perspectives
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ISSN:0091-6765, 1552-9924, 1552-9924
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Summary:Household air pollution (HAP) from biomass fuel combustion remains a leading environmental risk factor for morbidity worldwide. Measure the effect of liquefied petroleum gas (LPG) interventions on HAP exposures in Puno, Peru. We conducted a 1-y randomized controlled trial followed by a 1-y pragmatic crossover trial in 180 women age 25-64 y. During the first year, intervention participants received a free LPG stove, continuous fuel delivery, and regular behavioral messaging, whereas controls continued their biomass cooking practices. During the second year, control participants received a free LPG stove, regular behavioral messaging, and vouchers to obtain LPG tanks from a nearby distributor, whereas fuel distribution stopped for intervention participants. We collected 48-h kitchen area concentrations and personal exposures to fine particulate matter (PM) with aerodynamic diameter ( ), black carbon (BC), and carbon monoxide (CO) at baseline and 3-, 6-, 12-, 18-, and 24-months post randomization. Baseline (kitchen area concentrations vs. ; personal exposure vs. ), CO (kitchen vs. ; personal vs. ), and BC (kitchen vs. ; personal vs. ) were similar between control and intervention participants. Intervention participants had consistently lower concentrations at the 12-month visit for kitchen ( , , and ) and personal exposures ( , , and ) to , BC, and CO when compared to controls during the first year. In the second year, we observed comparable HAP reductions among controls after the voucher-based intervention for LPG fuel was implemented (24-month visit , BC, and CO kitchen mean concentrations of , , and and personal exposures of , , and , respectively), and average reductions were present among intervention participants even after free fuel distribution stopped (24-month visit , BC, and CO kitchen mean concentrations of , , and and personal exposures of , , and , respectively). Both home delivery and voucher-based provision of free LPG over a 1-y period, in combination with provision of a free LPG stove and longitudinal behavioral messaging, reduced HAP to levels below 24-h World Health Organization air quality guidelines. Moreover, the effects of the intervention on HAP persisted for a year after fuel delivery stopped. Such strategies could be applied in LPG programs to reduce HAP and potentially improve health. https://doi.org/10.1289/EHP10054.
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ISSN:0091-6765
1552-9924
1552-9924
DOI:10.1289/EHP10054