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 ≤2.5μm (PM2.5), 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. https://doi.org/10.1289/EHP6407.

中文翻译：

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HAPIN 研究的设计和基本原理：评估液化石油气炉和连续燃料分配效果的多国随机对照试验。


背景技术 全球有近 30 亿人依靠固体燃料做饭和取暖，其中绝大多数居住在低收入和中等收入国家 (LMIC)。由此产生的家庭空气污染 (HAP) 是一个主要的环境风险因素，估计每年导致 160 万人过早死亡。以前对清洁炉灶的干预措施往往无法减少接触水平，从而产生有意义的健康改善。尚未对液化石油气（LPG）炉进行多国现场试验，这可能是最清洁的可扩展干预措施。目的 本文介绍了一项正在进行的随机对照试验 (RCT) 的设计和方法，该试验针对 4 个中低收入国家（印度、危地马拉、秘鲁和卢旺达）的 3,200 个家庭进行液化石油气炉灶和燃料分配。方法 我们在 4 个国际研究中心各招募了 800 名来自使用生物质燃料的家庭的孕妇。我们随机分配家庭接受液化石油气炉、18 个月的免费液化石油气供应以及控制臂的行为强化。母亲和她的孩子都受到跟踪，直到孩子一岁。生活在同一家庭的老年妇女（40 岁至<80 岁）也被纳入并在同一时期进行跟踪。主要健康结局是低出生体重、严重肺炎发病率、儿童发育迟缓以及老年妇女高血压 (BP)。次要健康结果也在评估中。我们正在评估炉灶和燃料的使用情况，对空气动力学直径≤2.5μm的细颗粒物（PM2.5）、一氧化碳（CO）和黑碳（BC）进行重复的个人和厨房暴露评估，并收集干燥的血点（ DBS）和尿液样本用于生物标志物分析。 招募和数据收集于 2018 年 5 月开始，并将持续到 2021 年 8 月。该试验已在 ClinicalTrials.gov 注册 (NCT02944682)。结论 这项研究将为国家和全球政策提供证据，以扩大弱势群体中液化石油气炉的使用。 https://doi.org/10.1289/EHP6407。