Randomized Controlled Ethanol Cookstove Intervention and Blood Pressure in Pregnant Nigerian Women

Alexander, Donee; Northcross, Amanda; Wilson, Nathaniel; Dutta, Anindita; Pandya, Rishi; Ibigbami, Tope; Adu, Damilola; Olamijulo, John; Morhason-Bello, Imran O.; Karrison, Theodore; Ojengbede, Oladosu; Olopade, Christopher O.

doi:10.1164/rccm.201606-1177oc

Cited by 80 publications

(91 citation statements)

References 38 publications

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“…The use of polluting cooking fuels presents a serious global health risk due to household air pollution (HAP) exposure. Elevated levels of fine particulate matter of diameter <2.5 mm (PM 2.5 ) due to HAP (HAP-PM 2.5 ) have been linked to respiratory diseases (child pneumonia [3], COPD [4] and lung cancer [5]), adverse pregnancy outcomes [6,7], cataracts [8], precursors to cardiovascular diseases (CVD), including hypertension [9], and to CVD [10][11][12][13]. Exposure to HAP was the second highest environmental risk factor in the Global Burden of Disease 2017 [14], with an estimated 1.64 million attributable deaths [1,15].…”

Section: Introductionmentioning

confidence: 99%

Household, community, sub-national and country-level predictors of primary cooking fuel switching in nine countries from the PURE study

Shupler

Hystad

Gustafson

et al. 2019

Environ. Res. Lett.

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Introduction. Switching from polluting (e.g. wood, crop waste, coal) to clean (e.g. gas, electricity) cooking fuels can reduce household air pollution exposures and climate-forcing emissions. While studies have evaluated specific interventions and assessed fuel-switching in repeated cross-sectional surveys, the role of different multilevel factors in household fuel switching, outside of interventions and across diverse community settings, is not well understood. Methods. We examined longitudinal survey data from 24 172 households in 177 rural communities across nine countries within the Prospective Urban and Rural Epidemiology study. We assessed household-level primary cooking fuel switching during a median of 10 years of follow up (∼2005-2015). We used hierarchical logistic regression models to examine the relative importance of household, community, sub-national and national-level factors contributing to primary fuel switching. Results. One-half of study households (12 369) reported changing their primary cooking fuels between baseline and follow up surveys. Of these, 61% (7582) switched from polluting (wood, dung, agricultural waste, charcoal, coal, kerosene) to clean (gas, electricity) fuels, 26% (3109) switched between different polluting fuels, 10% (1164) switched from clean to polluting fuels and 3% (522) switched between different clean fuels. Among the 17 830 households using polluting cooking fuels at baseline, household-level factors (e.g. larger household size, higher wealth, higher education level) were most strongly associated with switching from polluting to clean fuels in India; in all other countries, community-level factors (e.g. larger population density in 2010, larger increase in population density between 2005 and 2015) were the strongest predictors of polluting-to-clean fuel switching. Conclusions. The importance of community and sub-national factors relative to household characteristics in determining polluting-to-clean fuel switching varied dramatically across the nine countries examined. This highlights the potential importance of national and other contextual factors in shaping large-scale clean cooking transitions among rural communities in low-and middle-income countries.

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Section: Introductionmentioning

confidence: 99%

Household, community, sub-national and country-level predictors of primary cooking fuel switching in nine countries from the PURE study

Shupler

Hystad

Gustafson

et al. 2019

Environ. Res. Lett.

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“…Evidence from observational studies is moderate for birth weight, pneumonia, and BP and still sparse for stunting. Recent trials have shown mixed results from clean cooking fuels, including ethanol and LPG (Alexander et al 2018;Olopade et al 2017;Alexander et al 2017). Taken together, by addressing multiple outcomes at different ages and studying several LMIC contexts, the HAPIN trial is well positioned to fill critical scientific gaps with direct relevance to national policies.…”

Section: Environmental Health Perspectivesmentioning

confidence: 99%

“…For example, the prevalence of low birth weight continues to be high in many LMICs, and preterm birth remains the leading cause of death among children under 5 years of age globally (Liu et al 2015). While substantial literature exists on the effect of active tobacco smoking and ambient air pollution on low birth weight and preterm birth, few studies have examined the effect of these in LMICs or specifically the effect of HAP exposures on these outcomes (Thakur et al 2018;Sambandam et al 2015;Balakrishnan et al 2013Balakrishnan et al , 2018Alexander et al 2017;Liu et al 2015;Amegah et al 2014;Wylie et al 2014). Only three studies have quantified the association between HAP and child developmental outcomes (Suter et al 2018;Dix-Cooper et al 2012;Munroe and Gauvain 2012), and only two quantified the association between HAP and stunting (Wylie et al 2017;Kim et al 2017), but none have done so using a longitudinal approach in children under 1 years of age.…”

Section: Environmental Health Perspectivesmentioning

confidence: 99%

Design and Rationale of the HAPIN Study: A Multicountry Randomized Controlled Trial to Assess the Effect of Liquefied Petroleum Gas Stove and Continuous Fuel Distribution

Clasen

Checkley

Peel

et al. 2020

Environ Health Perspect

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BACKGROUND: Globally, nearly 3 billion people rely on solid fuels for cooking and heating, the vast majority residing in low-and middle-income countries (LMICs). The resulting household air pollution (HAP) is a leading environmental risk factor, accounting for an estimated 1.6 million premature deaths annually. Previous interventions of cleaner stoves have often failed to reduce exposure to levels that produce meaningful health improvements. There have been no multicountry field trials with liquefied petroleum gas (LPG) stoves, likely the cleanest scalable intervention. OBJECTIVE: This paper describes the design and methods of an ongoing randomized controlled trial (RCT) of LPG stove and fuel distribution in 3,200 households in 4 LMICs (India, Guatemala, Peru, and Rwanda). METHODS: We are enrolling 800 pregnant women at each of the 4 international research centers from households using biomass fuels. We are randomly assigning households to receive LPG stoves, an 18-month supply of free LPG, and behavioral reinforcements to the control arm. The mother is being followed along with her child until the child is 1 year old. Older adult women (40 to <80 years of age) living in the same households are also enrolled and followed during the same period. Primary health outcomes are low birth weight, severe pneumonia incidence, stunting in the child, and high blood pressure (BP) in the older adult woman. Secondary health outcomes are also being assessed. We are assessing stove and fuel use, conducting repeated personal and kitchen exposure assessments of fine particulate matter with aerodynamic diameter ≤2:5 lm (PM 2:5), carbon monoxide (CO), and black carbon (BC), and collecting dried blood spots (DBS) and urinary samples for biomarker analysis. Enrollment and data collection began in May 2018 and will continue through August 2021. The trial is registered with ClinicalTrials.gov (NCT02944682). CONCLUSIONS: This study will provide evidence to inform national and global policies on scaling up LPG stove use among vulnerable populations.

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“…Household air pollution was listed as one of the top ten largest contributors . Five of these articles focused on exposures to cooking or biomass fuel use in the home (Quinn et al, 2016;Alexander et al, 2017;Olopade et al, 2017;Quinn et al, 2017;Arku et al, 2018). Respiratory disease represented another major health outcome impacted by indoor air pollution; evaluated as the primary outcome of interest or a relevant co-morbidity in 77 of the identified indoor air pollution articles.…”

Section: Indoor Air Pollutionmentioning

confidence: 99%

Environmental Health Research in Africa: Important Progress and Promising Opportunities

Joubert

Mantooth²,

McAllister

2020

Front. Genet.

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The World Health Organization in 2016 estimated that over 20% of the global disease burden and deaths were attributed to modifiable environmental factors. However, data clearly characterizing the impact of environmental exposures and health endpoints in African populations is limited. To describe recent progress and identify important research gaps, we reviewed literature on environmental health research in African populations over the last decade, as well as research incorporating both genomic and environmental factors. We queried PubMed for peer-reviewed research articles, reviews, or books examining environmental exposures and health outcomes in human populations in Africa. Searches utilized medical subheading (MeSH) terms for environmental exposure categories listed in the March 2018 US National Report on Human Exposure to Environmental Chemicals, which includes chemicals with worldwide distributions. Our search strategy retrieved 540 relevant publications, with studies evaluating health impacts of ambient air pollution (n=105), indoor air pollution (n = 166), heavy metals (n = 130), pesticides (n = 95), dietary mold (n = 61), indoor mold (n = 9), per-and polyfluoroalkyl substances (PFASs, n = 0), electronic waste (n = 9), environmental phenols (n = 4), flame retardants (n = 8), and phthalates (n = 3), where publications could belong to more than one exposure category. Only 23 publications characterized both environmental and genomic risk factors. Cardiovascular and respiratory health endpoints impacted by air pollution were comparable to observations in other countries. Air pollution exposures unique to Africa and some other resource limited settings were dust and specific occupational exposures. Literature describing harmful health effects of metals, pesticides, and dietary mold represented a context unique to Africa. Studies of exposures to phthalates, PFASs, phenols, and flame retardants were very limited. These results underscore the need for further focus on current and emerging environmental and chemical health risks as well as better integration of genomic and environmental factors in African research studies. Environmental exposures with distinct routes of exposure, unique co-exposures and co-morbidities, combined with the extensive genomic diversity in Africa may lead to the identification of novel mechanisms underlying complex disease and promising potential for translation to global public health.

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Randomized Controlled Ethanol Cookstove Intervention and Blood Pressure in Pregnant Nigerian Women

Cited by 80 publications

References 38 publications

Household, community, sub-national and country-level predictors of primary cooking fuel switching in nine countries from the PURE study

Household, community, sub-national and country-level predictors of primary cooking fuel switching in nine countries from the PURE study

Design and Rationale of the HAPIN Study: A Multicountry Randomized Controlled Trial to Assess the Effect of Liquefied Petroleum Gas Stove and Continuous Fuel Distribution

Environmental Health Research in Africa: Important Progress and Promising Opportunities

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