标题：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
摘要：Background:
Household air pollution (HAP) from biomass fuel combustion remains a leading environmental risk factor for morbidity worldwide.
Objective:
Measure the effect of liquefied petroleum gas (LPG) interventions on HAP exposures in Puno, Peru.
Methods:
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
≤
2.5
μ
m
(
PM
2.5
), black carbon (BC), and carbon monoxide (CO) at baseline and 3-, 6-, 12-, 18-, and 24-months post randomization.
Results:
Baseline
mean
[
±
standard deviation
(
SD
)
]
PM
2.5
(kitchen area concentrations
1,220
±
1,010
vs.
1,190
±
880
μ
g
/
m
3
; personal exposure
126
±
214
vs.
104
±
100
μ
g
/
m
3
), CO (kitchen
53
±
49
vs.
50
±
41
ppm
; personal
7
±
8
vs.
7
±
8
ppm
), and BC (kitchen
180
±
120
vs.
210
±
150
μ
g
/
m
3
; personal
19
±
16
vs.
21
±
22
μ
g
/
m
3
) were similar between control and intervention participants. Intervention participants had consistently lower
mean
(
±
SD
)
concentrations at the 12-month visit for kitchen (
41
±
59
μ
g
/
m
3
,
3
±
6
μ
g
/
m
3
, and
8
±
13
ppm
) and personal exposures (
26
±
34
μ
g
/
m
3
,
2
±
3
μ
g
/
m
3
, and
3
±
4
ppm
) to
PM
2.5
, 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
PM
2.5
, BC, and CO kitchen mean concentrations of
34
±
74
μ
g
/
m
3
,
3
±
5
μ
g
/
m
3
, and
6
±
6
ppm
and personal exposures of
17
±
15
μ
g
/
m
3
,
2
±
2
μ
g
/
m
3
, and
3
±
4
ppm
, respectively), and average reductions were present among intervention participants even after free fuel distribution stopped (24-month visit
PM
2.5
, BC, and CO kitchen mean concentrations of
561
±
1,251
μ
g
/
m
3
,
82
±
124
μ
g
/
m
3
, and
23
±
28
ppm
and personal exposures of
35
±
38
μ
g
/
m
3
,
6
±
6
μ
g
/
m
3
, and
4
±
5
ppm
, respectively).
Discussion:
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
