# 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 R01** · EMORY UNIVERSITY · 2023 · $1,459,837

## Abstract

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.
Household air pollution emissions from cooking with solid fuels (carbon dioxide and black carbon) are also major
sources of climate warming gases at the global level. 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; data collection has been extended through age 2. The trial has
achieved excellent retention (92%), high adherence to the intervention, and a substantial reduction in personal
exposure to fine particulate matter (PM2.5) and black carbon, a contributor to climate change. Preliminary results
suggest the intervention improves length and weight at birth. Research 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 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 neurologic and physical development
(Aim 1). Further, given that the intervention ends at age 1, we will continue to characterize the children’s personal
exposure to PM2.5 and black carbon (Aim 2), allowing us the unique ability 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 and black carbon 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=2,175 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...

## Key facts

- **NIH application ID:** 10705216
- **Project number:** 5R01ES033530-02
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Thomas F Clasen
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $1,459,837
- **Award type:** 5
- **Project period:** 2022-09-16 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10705216

## Citation

> US National Institutes of Health, RePORTER application 10705216, 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 (5R01ES033530-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10705216. Licensed CC0.

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