# Assessing the 5-Year Effects of a 500-day Liquefied Petroleum Gas Cooking Intervention:  Continued Follow up of Participants from the Household Air Pollution Intervention Network (HAPIN) trial

> **NIH NIH R56** · EMORY UNIVERSITY · 2021 · $926,167

## Abstract

PROJECT SUMMARY
Nearly 3 billion people continue to use solid fuels (coal, biomass, animal dung) for household energy needs,
primarily in low- and middle-income countries. The household air pollution resulting from cooking with solid fuels
is responsible for an estimated 2.3 million premature deaths and additional morbidity burden each year. Our
Household Air Pollution Intervention Network (HAPIN) trial (NIH UM1HL134590) is evaluating the effect of a free
LPG (liquefied petroleum gas) stove and fuel intervention among 800 pregnant women in each of 4 countries
(Guatemala, India, Peru, Rwanda) on birth outcomes and child health through age 1. The trial, ending September
2021, has achieved excellent retention (94%), high adherence to the intervention, and a substantial reduction in
personal exposure to fine particulate matter (PM2.5) in the pregnant mothers. Evidence suggests that exposure
experienced during gestation and early life is linked to a range of longer-term outcomes, and that the benefits of
reduced exposure during this critical developmental period will continue even if the intervention ends. Therefore,
we propose to continue to follow HAPIN children through age 5 to evaluate the effects of the original HAPIN
intervention on neurological and physical development (Aim 1). Further, given that the intervention ends at age
1, we will continue to characterize exposure to PM2.5 (Aim 2), allowing us to evaluate exposure-response for
several relevant periods of gestation and early childhood (Aim 3). The HAPIN trial is uniquely positioned to
address these questions, with a large exposure contrast during the trial and the generation of a rich dataset to
examine exposure-response given the expected heterogeneity in exposures among control households and all
participants post-trial as they adopt the various fuels and cooking practices typical in LMIC settings. The selected
health outcomes are supported by previous literature and have important implications for policy. Our overarching
hypotheses are that 1) the original intervention has longer-term benefits for neurologic and physical development
after the intervention ends, and 2) that personal exposure to PM2.5 during critical developmental periods will be
inversely associated with neurologic and physical development. We propose to explore these aims and
hypotheses in HAPIN children in Guatemala, India, and Rwanda (n=2,260 children remaining in the 3 study
sites). The proposed work builds on the major investment already made in the HAPIN trial by evaluating whether
the benefits of the intervention extend beyond pregnancy and the child's first year of life, leveraging a well-
characterized cohort in 3 diverse settings, providing rigorous and widely generalizable answers to questions
important for both science and policy. We are maximizing potential for success by extending our prior research,
using an experienced and proven research team, with strong and ongoing relationships with participants. Furt...

## Key facts

- **NIH application ID:** 10480209
- **Project number:** 1R56ES033530-01
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Thomas F Clasen
- **Activity code:** R56 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $926,167
- **Award type:** 1
- **Project period:** 2021-09-25 → 2022-09-15

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10480209

## Citation

> US National Institutes of Health, RePORTER application 10480209, Assessing the 5-Year Effects of a 500-day Liquefied Petroleum Gas Cooking Intervention:  Continued Follow up of Participants from the Household Air Pollution Intervention Network (HAPIN) trial (1R56ES033530-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10480209. Licensed CC0.

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