摘要：Background:
Exposure to
PM
2.5
arising from solid fuel combustion is estimated to result in
∼
2.3
million premature deaths and 91 million lost disability-adjusted life years annually. Interventions attempting to mitigate this burden have had limited success in reducing exposures to levels thought to provide substantive health benefits.
Objectives:
This paper reports exposure reductions achieved by a liquified petroleum gas (LPG) stove and fuel intervention for pregnant mothers in the Household Air Pollution Intervention Network (HAPIN) randomized controlled trial.
Methods:
The HAPIN trial included 3,195 households primarily using biomass for cooking in Guatemala, India, Peru, and Rwanda. Twenty-four-hour exposures to
PM
2.5
, carbon monoxide (CO), and black carbon (BC) were measured for pregnant women once before randomization into control (
n
=
1,605
) and LPG (
n
=
1,590
) arms and twice thereafter (aligned with trimester). Changes in exposure were estimated by directly comparing exposures between intervention and control arms and by using linear mixed-effect models to estimate the impact of the intervention on exposure levels.
Results:
Median postrandomization exposures of particulate matter (PM) with aerodynamic diameter
≤
2.5
μ
m
(
PM
2.5
) in the intervention arm were lower by 66% at the first (71.5 vs.
24.1
μ
g
/
m
3
), and second follow-up visits (69.5 vs.
23.7
μ
g
/
m
3
) compared to controls. BC exposures were lower in the intervention arm by 72% (9.7 vs.
2.7
μ
g
/
m
3
) and 70% (9.6 vs.
2.8
μ
g
/
m
3
) at the first and second follow-up visits, respectively, and carbon monoxide exposure was 82% lower at both visits (1.1 vs.
0.2
ppm
) in comparison with controls. Exposure reductions were consistent over time and were similar across research locations.
Discussion:
Postintervention
PM
2.5
exposures in the intervention arm were at the lower end of what has been reported for LPG and other clean fuel interventions, with 69% of
PM
2.5
samples falling below the World Health Organization Annual Interim Target 1 of
35
μ
g
/
m
3
. This study indicates that an LPG intervention can reduce
PM
2.5
exposures to levels at or below WHO targets.
https://doi.org/10.1289/EHP10295
