Household Air Pollution and Health: A Multi-country LPG Intervention Trial

Summary

This study is a randomized controlled trial of liquefied petroleum gas (LPG) stove and fuel distribution in 3,200 households in four countries (India, Guatemala, Peru, and Rwanda). Following a common protocol, each intervention site will recruit 800 pregnant women (aged 18-34 years, 9 - \<20 weeks gestation) and will randomly assign half their households to receive LPG stoves and an 18-month supply of LPG. Control households are anticipated to continue to cook primarily with solid biomass fuels and will receive compensation based on a uniform set of trial-wide principles, customized to each site based on formative research. The mother will be followed along with her child until the child is 1 year old. The researchers estimate that 15% of households will have a second, non-pregnant older adult woman (aged 40 to \<80 years) who will also be enrolled at baseline and followed during the 18-month follow-up period. To optimize intervention use, the researchers will implement behavior change strategies informed by previous experiences and formative research in Year 1. This study will assess cookstove use, conduct repeated personal exposure assessments of household air pollution, and collect dried blood spots and urinary samples for biomarker analysis and biospecimen storage. The primary outcomes are low birth weight, severe pneumonia incidence, and stunting of the child, and systolic blood pressure in the older adult woman. Participants in India, Guatemala and Rwanda will be followed until the child is 5 years old to assess the longer-term effects of the intervention.

Conditions

• Infant, Low Birth Weight

Interventions

OTHER

Liquefied petroleum gas (LPG) cookstove

The intervention consists of a high-quality locally available liquefied petroleum gas (LPG) stove having at least two burners, a continuous supply of LPG fuel for 18 months, and the promotion of stove use on an exclusive basis for cooking. The intervention will be provided free of charge to all intervention households upon enrollment. On a weekly basis, study staff will examine stove condition, perform any necessary repairs, and measure and record weight of LPG tanks in order to anticipate need for refills.

Sponsors & Collaborators

• National Institutes of Health (NIH)

  collaborator NIH

• National Heart, Lung, and Blood Institute (NHLBI)

  collaborator NIH

• Bill and Melinda Gates Foundation

  collaborator OTHER

• Berkeley Air Monitoring Group

  collaborator OTHER

• Colorado State University

  collaborator OTHER

• Global LPG Partnership

  collaborator UNKNOWN

• Harvard University

  collaborator OTHER

• Johns Hopkins University

  collaborator OTHER

• London School of Hygiene and Tropical Medicine

  collaborator OTHER

• Asociacion Benefica Prisma

  collaborator OTHER

• Sri Ramachandra University

  collaborator OTHER

• Universidad del Valle, Guatemala

  collaborator OTHER

• Universidad Peruana Cayetano Heredia

  collaborator OTHER

• University of Georgia

  collaborator OTHER

• Washington University School of Medicine

  collaborator OTHER

• University of Rwanda

  collaborator OTHER

• Eagle Research Center

  collaborator UNKNOWN

• University of Oxford

  collaborator OTHER

• University of Liverpool

  collaborator OTHER

• Emory University

  lead OTHER

Principal Investigators

• Thomas Clasen, PhD · Emory University

• Jennifer Peel, PhD · Colorado State University

• William Checkley, MD PhD · Johns Hopkins School of Medicine

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

79 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2017-09-01

Primary Completion

2025-06-30

Completion

2025-06-30

Countries

• Guatemala
• India
• Peru
• Rwanda

Study Locations