Rollins Researchers Publish Rationale and Methods for HAPIN Trial

Household air pollution (HAP) is a leading risk factor for mortality globally, accounting for an estimated 1.6 million deaths annually, mainly in low- and middle-income countries (LMICs). It is a major cause of pneumonia, the leading killer of young children in low-income settings. It is also believed to contribute to low birth weight and stunting in children and to increased blood pressure and other cardiovascular and respiratory effects in adults. The main source of HAP is indoor cooking on traditional stoves using solid fuels, such as wood, coal, and charcoal. Globally, three billion people still cook or heat with open fires or traditional stoves using solid fuels.

The Rollins School at Public Health, in collaboration with schools of medicine at Johns Hopkins University and Colorado State University, are leading the Household Air Pollution Intervention Network (HAPIN) study, a multicountry randomized controlled field trial to assess the impact of cleaner burning cooking stoves on household air pollution and health in four low- and medium-income countries. The $30 million trial was funded by the National Institutes of Health with partial support through a grant from the Bill & Melinda Gates Foundation.

In a series of three papers published on April 29, 2020, in Environmental Health Perspectives, HAPIN investigators describe the rationale and overall design of the study and the key methods employed. Rollins authors on the papers include: Thomas Clasen, Dana Boyd Barr, Kyle Steenland, Ajay Pillarisetti, Jiawen Liao, Jeremy Sarnat, Miles A. Kirby, Howard Chang, Lance Waller, Savannah Gupton, and P. Barry Ryan. 

The papers correspond with the three aims of the study: (i) to determine the effect of a randomized LPG stove and fuel intervention on health in four diverse biomass-using LMIC populations across the world using a common protocol, (ii) to evaluate the exposure-response associations for HAP and health outcomes, and (iii) to evaluate the extent to which biomarkers of exposure and health effects, including targeted and exploratory (e.g., metabolomics) analyses, are associated with intervention status or exposure.

View the articles here: https://ehp.niehs.nih.gov/doi/full/10.1289/EHP6407

https://ehp.niehs.nih.gov/doi/full/10.1289/EHP5751

https://ehp.niehs.nih.gov/doi/full/10.1289/EHP6422