资源环境科技发展态势分析平台

Background:

Household air pollution (HAP) from biomass fuel combustion remains a leading environmental risk factor for morbidity worldwide.

Objective:

Measure the effect of liquefied petroleum gas (LPG) interventions on HAP exposures in Puno, Peru.

Methods:

We conducted a 1-y randomized controlled trial followed by a 1-y pragmatic crossover trial in 180 women age 25–64 y. During the first year, intervention participants received a free LPG stove, continuous fuel delivery, and regular behavioral messaging, whereas controls continued their biomass cooking practices. During the second year, control participants received a free LPG stove, regular behavioral messaging, and vouchers to obtain LPG tanks from a nearby distributor, whereas fuel distribution stopped for intervention participants. We collected 48-h kitchen area concentrations and personal exposures to fine particulate matter (PM) with aerodynamic diameter $\le 2.5\mathrm{\mu }\mathrm{m}$ (${\mathrm{PM}}_{2.5}$), black carbon (BC), and carbon monoxide (CO) at baseline and 3-, 6-, 12-, 18-, and 24-months post randomization.

Results:

Baseline $\text{mean\hspace{0.17em}}[\pm \text{standard deviation\hspace{0.17em}}(\text{SD}\left)\right]$${\mathrm{PM}}_{2.5}$ (kitchen area concentrations $\mathrm{1,220}\pm \mathrm{1,010}$ vs. $\mathrm{1,190}\pm 880{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$; personal exposure $126\pm 214$ vs. $104\pm 100{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$), CO (kitchen $53\pm 49$ vs. $50\pm 41\text{\hspace{0.17em}ppm}$; personal $7\pm 8$ vs. $7\pm 8\text{\hspace{0.17em}ppm}$), and BC (kitchen $180\pm 120$ vs. $210\pm 150{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$; personal $19\pm 16$ vs. $21\pm 22{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$) were similar between control and intervention participants. Intervention participants had consistently lower $\text{mean\hspace{0.17em}}\left(\pm \text{SD}\right)$ concentrations at the 12-month visit for kitchen ($41\pm 59{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$, $3\pm 6{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$, and $8\pm 13\text{\hspace{0.17em}ppm}$) and personal exposures ($26\pm 34{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$, $2\pm 3{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$, and $3\pm 4\text{\hspace{0.17em}ppm}$) to ${\mathrm{PM}}_{2.5}$, BC, and CO when compared to controls during the first year. In the second year, we observed comparable HAP reductions among controls after the voucher-based intervention for LPG fuel was implemented (24-month visit ${\mathrm{PM}}_{2.5}$, BC, and CO kitchen mean concentrations of $34\pm 74{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$, $3\pm 5{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$, and $6\pm 6\text{\hspace{0.17em}ppm}$ and personal exposures of $17\pm 15{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$, $2\pm 2{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$, and $3\pm 4\text{\hspace{0.17em}ppm}$, respectively), and average reductions were present among intervention participants even after free fuel distribution stopped (24-month visit ${\mathrm{PM}}_{2.5}$, BC, and CO kitchen mean concentrations of $561\pm \mathrm{1,251}{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$, $82\pm 124{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$, and $23\pm 28\text{\hspace{0.17em}ppm}$ and personal exposures of $35\pm 38{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$, $6\pm 6{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$, and $4\pm 5\text{\hspace{0.17em}ppm}$, respectively).

Discussion:

Both home delivery and voucher-based provision of free LPG over a 1-y period, in combination with provision of a free LPG stove and longitudinal behavioral messaging, reduced HAP to levels below 24-h World Health Organization air quality guidelines. Moreover, the effects of the intervention on HAP persisted for a year after fuel delivery stopped. Such strategies could be applied in LPG programs to reduce HAP and potentially improve health. https://doi.org/10.1289/EHP10054