Infant, Low Birth WeightHAPINNCT02944682
Household Air Pollution and Health: A Multi-country LPG Intervention Trial
A study testing Liquefied petroleum gas (LPG) cookstove in people with Infant, Low Birth Weight, run by Emory University at 4 sites in 4 countries.
Trial summary
This study is a randomized controlled trial of liquefied petroleum gas (LPG) stove and fuel distribution in 3,200 households in four countries (India, Guatemala, Peru, and Rwanda). Read more about this study
- Who is it for?
- Ages 18 to 79 years
- Conditions the study is for
- Infant, Low Birth Weight
- What is being tested?
- Liquefied petroleum gas (LPG) cookstove
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 6,704 participants
- Where
- 4 sitesin 4 countries
- Study dates
- 7 May 2018to 30 Jun 2025
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 79 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Confirmed pregnancy (human chorionic gonadotropin (hCG) positive blood or urine test)
- Aged 18 to <35 years (via self-report)
- Uses biomass stove predominantly
- Lives in study area
- 9 - <20 weeks gestation confirmed by ultrasound
- Singleton pregnancy (one fetus)
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- Viable fetus with normal fetal heart rate (120-180 beats per minute) at time of ultrasound
- Continued pregnancy at the time of randomization confirmed by self-report
- Agrees to participate with informed consent
Who cannot join
- Currently smokes cigarettes or other tobacco products
- Plans to move permanently outside study area in the next 12 months
- Uses LPG stove predominantly, or is likely to use LPG predominantly in the near future
- Inclusion Criteria for Older Adult Woman in the Same Household:
- Aged 40 to <80 years (via self-report)
- Exclusion Criteria for Older Adult Woman in the Same Household:
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- Currently smokes cigarettes or other tobacco products
- Pregnant (by self-report)
- Plans to move out of her current household in the next 12 months
Trial locations and contacts
4 sites in 4 countries.
4 sites in 4 countries
Guatemala1 site
Universidad del Valle de Guatemala
Guatemala City, Departamento de Guatemala, 01015
India1 site
Sri Ramachandra Institute of Higher Education and Research
Chennai, Tamil Nadu, 600116
Peru1 site
Puno Global Non-Communicable Disease Research Site, School of Medicine, Johns Hopkins University
Puno
Rwanda1 site
Rwanda Research Site, London School of Hygiene and Tropical Medicine, University of Liverpool
Kigali
About this study
This study is a randomized controlled trial of liquefied petroleum gas (LPG) stove and fuel distribution in 3,200 households in four countries (India, Guatemala, Peru, and Rwanda). Following a common protocol, each intervention site will recruit 800 pregnant women (aged 18-34 years, 9 - <20 weeks gestation) and will randomly assign half their households to receive LPG stoves and an 18-month supply of LPG. Control households are anticipated to continue to cook primarily with solid biomass fuels and will receive compensation based on a uniform set of trial-wide principles, customized to each site based on formative research. The mother will be followed along with her child until the child is 1 year old. The researchers estimate that 15% of households will have a second, non-pregnant older adult woman (aged 40 to <80 years) who will also be enrolled at baseline and followed during the 18-month follow-up period. To optimize intervention use, the researchers will implement behavior change strategies informed by previous experiences and formative research in Year 1. This study will assess cookstove use, conduct repeated personal exposure assessments of household air pollution, and collect dried blood spots and urinary samples for biomarker analysis and biospecimen storage. The primary outcomes are low birth weight, severe pneumonia incidence, and stunting of the child, and systolic blood pressure in the older adult woman. Participants in India, Guatemala and Rwanda will be followed until the child is 5 years old to assess the longer-term effects of the intervention.
Read the detailed description
Globally, nearly 3 billion people rely on solid fuels for cooking and heating, the vast majority in low- and middle-income countries (LMICs). The resulting household air pollution (HAP) is the third leading risk factor in the 2010 global burden of disease, accounting for an estimated 4.3 million deaths annually, largely among women and young children. Previous interventions have provided cleaner biomass-based cookstoves but have failed to reduce exposure to levels that produce meaningful health improvements. There have been no large-scale field trials with liquefied petroleum gas (LPG) cookstoves, likely the cleanest scalable intervention.
The aim of this study is to conduct a randomized controlled trial of LPG stove and fuel distribution in 3,200 households in four LMICs (India, Guatemala, Peru, and Rwanda) to deliver rigorous evidence regarding potential health benefits across the lifespan. Each intervention site will recruit 800 pregnant women (aged 18-34 years, 9 - <20 weeks gestation) and will randomly assign half their households to receive LPG stoves and an 18-month supply of LPG. Control households are anticipated to continue to cook primarily with solid biomass fuels and will receive compensation based on a uniform set of trial-wide principles, customized to each site based on formative research. The mother will be followed along with her child until the child is 1 year old. In households with a second, non-pregnant older adult woman (aged 40 to <80 years) the researchers will also enroll and follow her during the 18-month follow-up period in order to assess cardiopulmonary, metabolic, and cancer outcomes. To optimize intervention use, the researchers will implement behavior change strategies. This study will assess cookstove use, conduct repeated personal exposure assessments to HAP (PM2.5, black carbon, carbon monoxide), and collect dried blood spots and urinary samples for biomarker analysis and biospecimen storage on all participants at multiple time points. The primary outcomes are low birth weight, severe pneumonia incidence, and stunting of the child, and systolic blood pressure in the older adult woman.
This study will address the following specific aims: (1) using an intent-to-treat analysis, determine the effect of a randomized LPG stove and fuel intervention on health in four diverse LMIC populations using a common protocol; (2) determine the exposure-response relationships for HAP and health outcomes; and (3) determine relationships between LPG intervention and both targeted and exploratory biomarkers of exposure/health effects.
This study will provide evidence, including costs and implementation strategies, to inform national and global policies on scaling up LPG stoves among vulnerable populations. Ultimately, this will facilitate deeper policy-level discussions as well as identify requirements for initiating and sustaining HAP interventions globally.
The intervention delivery occurred until the child was one year of age. The researchers will continue to follow participants in India, Guatemala and Rwanda until the child is 5 years old to assess the longer-term effects of the intervention. Previous evidence suggests that the benefits of reduced exposure during the first, critical year of development will continue even if the intervention ends. The researchers will continue using methods employed during the HAPIN trial period. The HAPIN trial provides a unique context in which to address these questions, particularly given the successful intervention and exposure reduction. Participants are well-characterized and health and exposures to air pollution are being documented. Critically, because of its experimental design of the trial, continued follow-up of the cohort will provide rigorous causal inferences about the effects of this 500-day intervention over the most important period of early childhood development.
- Conditions
- Infant, Low Birth Weight
- Being tested
- Liquefied petroleum gas (LPG) cookstove
- Keywords
- Obstetrics, Pregnancy Outcomes, Pediatrics, Atherosclerosis, Cancer, Cardiovascular Disease, Public Health, Environmental Air Pollutants
- Medical subject headings
- Atherosclerosis, Neoplasms, Cardiovascular Diseases
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Liquefied petroleum gas (LPG) cookstoveOther
The intervention consists of a high-quality locally available liquefied petroleum gas (LPG) stove having at least two burners, a continuous supply of LPG fuel for 18 months, and the promotion of stove use on an exclusive basis for cooking. The intervention will be provided free of charge to all intervention households upon enrollment. On a weekly basis, study staff will examine stove condition, perform any necessary repairs, and measure and record weight of LPG tanks in order to anticipate need for refills.
| Study group | Role | What they receive |
|---|---|---|
| Liquefied petroleum gas cookstove | Experimental | Participants randomized to the experimental arm will receive a liquefied petroleum gas (LPG) cookstove and 18-month supply of LPG. Receives: Other: Liquefied petroleum gas (LPG) cookstove |
| Control | No intervention | Participants in the control group will not receive a liquefied petroleum gas (LPG) stove and will continue using traditional cooking methods (open fire or traditional stoves), or the cooking method of their choice. Control households will receive compensation based on a uniform set of trial-wide principles, customized to each site based on formative research. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Birth Weight
Birth weight is assessed by a trained nurse or health worker within 24 hours of birth. Infants are weighed naked or in a pre-weighed blanket. Weight is measured to the nearest 10 g using a digital electronic scale, if performed by the study field staff; otherwise, hospital medical records are used.
Measured: Within 24 hours of birth (up to 5 months post-randomization of mother)
Incidence of HAPIN Defined Severe Pneumonia
The incidence of severe pneumonia among offspring during the first year of life is assessed as the number of offspring participants presenting at HAPIN health facilities with severe pneumonia. For this study pneumonia criteria are adapted from the WHO classification of childhood pneumonia (2014) and there are 3 algorithms for case criteria: 1) the presence of cough and/or difficult breathing and at least 1 general danger sign plus evidence of pneumonia on lung imaging (i.e., lung ultrasound or chest x-ray), or 2) the presence of cough and/or difficult breathing and hypoxemia (measured either via pulse oximetry (SpO2), or observing a child requiring advanced respiratory support (i.e., intubation and mechanical ventilation, non-invasive ventilation with continuous or bi-level positive airway pressure support, or high-flow nasal cannula oxygen), or 3) children who die prior to evaluation but their death is attributed to pneumonia by verbal autopsy.
Measured: Up to 12 months after birth
Number of Offspring With Stunting
The primary outcome measured is stunting at one year of age, defined as a length-for-age z-score (LAZ) that is 2 standard deviations below the median of the growth standard. Infant length is assessed at birth and quarterly thereafter, until the child is 12 months old. Z-scores are calculated using the 2006 World Health Organization (WHO) Multi-Growth Reference Standard (MGRS).
Measured: 12 months after birth
Systolic Blood Pressure Among Older Adult Women
Systolic blood pressure is assessed in the older adult women in the intervention and control arms using automatic sphygmomanometers (Omron HEM-907XL; Osaka, Japan). The study team used the procedures adapted from previously validated methods and cardiovascular outcome studies, following recommendations for the American Heart Association and the European Society of Hypertension. A systolic blood pressure of less than 120 is considered normal for adults. Systolic blood pressure collected at 3, 6, 9, 12, and 18 months post-randomization time points are averaged together for a single post-randomization value.
Measured: Baseline, Post-randomization (up to 18 months post-randomization)
Child Linear Growth During Extended Follow-up
Linear growth of children is assessed in centimeters of height.
Measured: 24, 36, 48 and 60 months of age
Caregiver Reported Early Childhood Development Instrument (CREDI) Score During Extended Follow-up
The CREDI is a population-level measure of early childhood development (ECD) for children from 0-3 years of age assessing 4 domains of child development: 1) motor (fine and gross motor), 2) language (expressive and receptive language), 3) cognitive (executive function, problem solving and reasoning, and pre-academic knowledge), and 4) social-emotional (emotional and behavioral self-regulation, emotional knowledge, and social competence). The CREDI long form consists of up to 108 items and the number of questions answered depends on the age of the child. Responses of "yes" are coded as 1 and "no" is coded as 0; certain items are reverse coded. Total raw scores increase by age (with developmental progression), and higher scores indicate increased development. Both domain-specific and overall z-scores are calculated (mean = 0, standard deviation = 1). Z-scores of 0 mean the child has a similar developmental status to the average child. Scores above 0 are higher than the sample reference.
Measured: 24 months of age
Malawi Developmental Assessment Tool (MDAT) Score
The MDAT measures gross motor (39 items), fine motor (42 items), language/cognition (40 items) and social skills (36 items). Originally developed and validated in rural Malawi, it has now been used in over 25 countries as both a clinical and research tool. The MDAT is a continuous test with start and stop rules. Most items are administered directly to the child and items that are not easily observed (e.g., child speaks in full sentences; child understands sharing with others; child can dress self) are administered by parent report. Children receive either a pass or fail for each item, and summed pass scores can produce a composite score as well as domain-specific scores. Total scores range from 0 to 157 where higher scores indicate greater neurodevelopment. Both domain-specific and overall z-scores are calculated (mean = 0, standard deviation = 1). Z-scores of 0 mean the child has a similar developmental status to the average child. Scores above 0 are higher than the sample reference.
Measured: 48 and 60 months of age
Secondary outcomes (21)
Maternal Systolic Blood Pressure
Blood pressure is assessed in the pregnant women in the intervention and control arms using automatic sphygmomanometers (OMRON HEM-907XL; Osaka, Japan). The study team will use the procedures adapted from previously validated methods and cardiovascular outcome studies, following recommendations for the American Heart Association and the European Society of Hypertension.
Measured: Baseline (9-20 weeks gestation), 24-28 and 32-36 weeks gestation
Maternal Diastolic Blood Pressure
Blood pressure is assessed in the pregnant women in the intervention and control arms using automatic sphygmomanometers (OMRON HEM-907XL; Osaka, Japan). The study team will use the procedures adapted from previously validated methods and cardiovascular outcome studies, following recommendations for the American Heart Association and the European Society of Hypertension. Diastolic blood pressure levels of less than 80 are considered normal.
Measured: Baseline (9-20 weeks gestation), 24-28 and 32-36 weeks gestation
Diastolic Blood Pressure Among Older Adult Women
Diastolic blood pressure is assessed in the older adult women in the intervention and control arms using automatic sphygmomanometers (Omron HEM-907XL; Osaka, Japan). The study team uses the procedures adapted from previously validated methods and cardiovascular outcome studies, following recommendations for the American Heart Association and the European Society of Hypertension. Diastolic blood pressure levels of less than 80 are considered normal. Diastolic blood pressure collected at 3, 6, 9, 12, and 18 months post-randomization time points are averaged together for a single post-randomization value.
Measured: Baseline, up to 18 months post-randomization
Mean Arterial Pressure
Mean arterial pressure is assessed in the older adult women in the intervention and control arms using automatic sphygmomanometers (Omron HEM-907XL; Osaka, Japan). Mean arterial pressure is calculated as DBP+(SBP-DBP)/3, where SBP=systolic blood pressure and DBP=diastolic blood pressure. Arterial blood pressure collected at 3, 6, 9, 12, and 18 months post-randomization time points are averaged together for a single post-randomization value.
Measured: Baseline, Up to 18 months post-randomization
Pulse Pressure
Pulse pressure is assessed in the older adult women in the intervention and control arms using automatic sphygmomanometers (Omron HEM-907XL; Osaka, Japan). pressure. Pulse pressure is the difference between systolic blood pressure (SBP) and diastolic blood pressure (DBP). A normal pulse pressure is 40 mmHg and pulse pressure tends to increase above age 50 as arteries stiffen. Pulse pressure collected at 3, 6, 9, 12, and 18 months post-randomization time points are averaged together for a single post-randomization value.
Measured: Baseline, Up to 18 months post-randomization
Fetal Growth Among Pregnant Women
Pregnant women have ultrasounds during gestation weeks 24-28 and gestation weeks 32-36 to measure fetal growth. Specifically, the researchers evaluated head circumference (HC), abdominal circumference (AC), femur length (FL) and estimated fetal weight (EFW) during gestation. The researchers calculated z-scores for head circumference, abdominal circumference, femur length and estimated fetal weight at the gestational age using World Health Organization (WHO) INTERGROWTH 21st standards. Z-scores have a mean of 0 and a standard deviation of 1. Z-scores over 0 indicate above average measurements, while a negative z-score indicates measurements are lower than average.
Measured: Gestation Week 24-28 and Gestation Week 32-36
Gestational Age at Birth
Gestational age at birth is measured in weeks, as a continuous outcome, among all live births.
Measured: Within 24 hours of birth (3-5 months post randomization)
Number of Offspring Born Preterm
Preterm birth is defined as delivery of a living infant prior to 37 completed weeks of gestation.
Measured: Within 24 hours of birth (3-5 months post randomization)
Number of Offspring With WHO Defined Non-severe Pneumonia
Cumulative incidence of WHO non-severe pneumonia (2014 definition and 2013 definition) during the first year of life. Cases of pneumonia are recorded whenever children present to HAPIN health facilities with respiratory symptoms.
Measured: Up to 12 months after birth
Number of Offspring With WHO Defined Severe Pneumonia
Cumulative incidence of WHO non-severe pneumonia (2014 definition and 2013 definition) during the first year of life. Cases of pneumonia are recorded whenever children present to HAPIN health facilities with respiratory symptoms.
Measured: Up to 12 months after birth
Number of Offspring Hospitalized for Respiratory Illness
Cumulative incidence of hospitalizations for a respiratory illness during the first year of life.
Measured: Up to 12 months after birth
Number of Offspring With WHO Pocket Book Non-severe Pneumonia
Cumulative incidence of WHO non-severe pneumonia during the first year of life, as defined in the second edition of the "Pocket book of hospital care for children" (2013). Cases of pneumonia are recorded whenever children present to HAPIN health facilities with respiratory symptoms.
Measured: Up to 12 months after birth
Number of Offspring With WHO Pocket Book Severe Pneumonia
Cumulative incidence of WHO severe pneumonia during the first year of life, as defined in the second edition of the "Pocket book of hospital care for children" (2013). Cases of pneumonia are recorded whenever children present to HAPIN health facilities with respiratory symptoms.
Measured: Up to 12 months after birth
Number of Offspring With Hypoxemic Pneumonia
Cumulative incidence of hypoxemic pneumonia during the first year of life. Cases of pneumonia are recorded whenever children present to HAPIN health facilities with respiratory symptoms.
Measured: Up to 12 months after birth
Number of Offspring With Ultrasound or Radiograph Pneumonia
Cumulative incidence of lung ultrasound or chest radiograph pneumonia during the first year of life. Cases of pneumonia are recorded whenever children present to HAPIN health facilities with respiratory symptoms.
Measured: Up to 12 months after birth
Brachial Artery Reactivity Testing (BART)
Brachial artery reactivity testing (BART) measures endothelial function via flow-mediated dilation (FMD) in response to reactive hyperemia following release of arm blood-flow occlusion. Using ultrasound, the brachial artery is first imaged at rest to establish the baseline (pre-occlusion) diameter. A blood pressure cuff is then inflated to induce distal arm ischemia for 5 minutes. Upon cuff release, the resulting surge in blood flow (reactive hyperemia) stimulates the artery to dilate; the artery is imaged repeatedly during this period and the maximum post-occlusion diameter is identified. The outcome, FMD, is expressed as the maximum percent change in diameter relative to baseline: FMD% = (maximum post-occlusion diameter - baseline diameter) ÷ baseline diameter × 100. Higher values indicate greater dilation and better endothelial function; lower values indicate worse endothelial function.
Measured: Baseline, 18 months post-randomization
Carotid Intima-media Thickness (CIMT) Among Older Adult Women
The carotid intima-media thickness test (CIMT) is used to determine the extent of carotid atherosclerotic vascular disease. The test measures the thickness of the inner two layers (intima and media) of the carotid artery and can detect plaque build-up prior to physical symptoms being experienced. The carotid ultrasound will be performed with a portable ultrasound by trained sonographers. CIMT is a well-established imaging biomarker of atherosclerosis, where higher values indicate greater carotid arterial wall thickness and have been associated with higher cardiovascular disease risk.
Measured: Baseline, 18 months post-randomization
St. George Respiratory Questionnaire (SGRQ) Score
Adult respiratory health and well-being is assessed with the St. George Respiratory Questionnaire (SGRQ). The SGRQ measures impaired health and perceived well-being among individuals with chronic airway disease. The SGRQ has sections assessing symptoms, activities that cause breathlessness or are limited because of breathlessness, and the impacts of respiratory problems on employment, sense of control of health, panic, stigmatization, medication use, side effects of therapies, expectations for health and disturbances of daily life. The questionnaire includes multiple choice, true/false and open-ended questions.
Measured: Baseline, 18 months post-randomization
Short Form 36 Survey (SF-36) Score Among Older Adult Women
The Short Form 36 survey (SF-36) is a standardized, preference-based 36 item questionnaire evaluating quality of life. The survey has 8 sections (vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, and mental health). Possible scores range from 0 (lowest quality of life) to 100 (highest quality of life).
Measured: Baseline, 18 months post-randomization
Child Linear Growth Assessed as Length-for-Age Z-Scores
Linear growth of children is assessed in centimeters at birth and quarterly thereafter, until the child is 12 months old. Infant recumbent length was converted to a length-for-age z-score (LAZ) using the WHO Child Growth Standards. Z-scores have a mean of 0 and a standard deviation of 1. Z-scores above 0 indicate above average length-for-age, while a negative z-score indicates lower than average length-for-age.
Measured: Birth (3-5 months post-randomization), 3, 6, 9 and 12 months of age
Caregiver Reported Early Childhood Development Instrument (CREDI) Score
The Caregiver Reported Early Childhood Development Instrument (CREDI) is a population-level measure of early childhood development (ECD) for children from 0-3 years of age. The CREDI assesses 4 domains of child development: 1) motor (fine and gross motor), 2) language (expressive and receptive language), 3) cognitive (executive function, problem solving and reasoning, and pre-academic knowledge), and 4) socio-emotional (emotional and behavioral self-regulation, emotional knowledge, and social competence). The CREDI long form consists of up to 108 items and the number of questions answered depends on the age of the child. Responses of "yes" are coded as 1 while responses of "no" are coded as 0; certain items are reverse coded. Norm-referenced, age standardized z-scores for overall and domain-specific CREDI scores were calculated. Z-scores have a mean of 0 and standard deviation of 1; values below 0 indicate ECD scores lower than the global CREDI norm-referenced population.
Measured: 12 months of age
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Oct 2016 (estimated)
- Study start7 May 2018
- Primary completion30 Jun 2025
- Study completion30 Jun 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (52)Papers the sponsor has linked to this study.
- Other trials for Infant, Low Birth WeightStudies of the same condition, open and under way.
- More trials run by Emory UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 6,704 participants (actual)
Sponsor and investigators
- Lead sponsor
- Emory University
- Sponsor type
- University, hospital or other
- Collaborators
- National Institutes of Health (NIH), National Heart, Lung, and Blood Institute (NHLBI), Bill and Melinda Gates Foundation, Berkeley Air Monitoring Group, Colorado State University, Global LPG Partnership, Harvard University, Johns Hopkins University, London School of Hygiene and Tropical Medicine, Asociacion Benefica Prisma, Sri Ramachandra University, Universidad del Valle, Guatemala, Universidad Peruana Cayetano Heredia, University of Georgia, Washington University School of Medicine, University of Rwanda, Eagle Research Center, University of Oxford, University of Liverpool
- Responsible party
- Principal investigator, Thomas Clasen, Emory University
- Investigators
- Thomas Clasen, PhD, Principal investigator, Emory UniversityJennifer Peel, PhD, Principal investigator, Colorado State UniversityWilliam Checkley, MD PhD, Principal investigator, Johns Hopkins School of Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02944682
- Sponsor's protocol ID
- IRB00089799
- Other IDs
- 1UM1HL134590-01, 2025P010488
- Acronym
- HAPIN
- Status last verified
- Aug 2026
- First submitted
- 17 Oct 2016
- Last updated
- 28 Sep 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Kearns KA, Naeher LP, McCracken JP, Boyd Barr D, Saikawa E, Hengstermann M, Mollinedo E, Panuwet P, Yakimavets V, Lee GE, Thompson LM. Estimating personal exposures to household air pollution and plastic garbage burning among adolescent girls in Jalapa, Guatemala. Chemosphere. 2024 Jan;348:140705. doi: 10.1016/j.chemosphere.2023.140705. Epub 2023 Nov 17.
PubMed 37981014Younger A, Ye W, Alkon A, Harknett K, Kirby MA, Elon L, Lovvorn AE, Wang J, Diaz-Artiga A, McCracken JP, Castanaza Gonzalez A, Alarcon LM, Mukeshimana A, Rosa G, Chiang M, Balakrishnan K, Garg SS, Pillarisetti A, Piedrahita R, Johnson MA, Craik R, Papageorghiou AT, Toenjes A, Williams KN, Underhill LJ, Hartinger SM, Nicolaou L, Chang HH, Naeher LP, Rosenthal J, Checkley W, Peel JL, Clasen TF, Thompson LM; Household Air Pollution Intervention Network (HAPIN) Investigators. Effects of a liquefied petroleum gas stove intervention on stillbirth, congenital anomalies and neonatal mortality: A multi-country household air pollution intervention network trial. Environ Pollut. 2024 Mar 15;345:123414. doi: 10.1016/j.envpol.2024.123414. Epub 2024 Jan 27.
PubMed 38286258Pillarisetti A, Ye W, Balakrishnan K, Rosa G, Diaz-Artiga A, Underhill LJ, Steenland K, Peel JL, Kirby MA, McCracken J, Waller L, Chang H, Wang J, Dusabimana E, Ndagijimana F, Sambandam S, Mukhopadhyay K, Kearns KA, Campbell D, Kremer J, Rosenthal J, Ghosh A, Clark M, Checkley W, Clasen T, Naeher L, Piedrahita R, Johnson M. Post-birth exposure contrasts for children during the Household Air Pollution Intervention Network randomized controlled trial. medRxiv [Preprint]. 2023 Jul 6:2023.07.04.23292226. doi: 10.1101/2023.07.04.23292226.
PubMed 37461598Simkovich SM, Hossen S, McCollum ED, Toenjes AK, McCracken JP, Thompson LM, Castanaza A, Diaz A, Rosa G, Kirby MA, Mukeshimana A, Myers R, Lenzen PM, Craik R, Jabbarzadeh S, Elon L, Garg SS, Balakrishnan K, Thangavel G, Peel JL, Clasen TF, Davila-Roman VG, Papageorghiou AT, de las Fuentes L, Checkley W; HAPIN Investigators. Lung Ultrasound Protocol and Quality Control of Image Interpretation Using an Adjudication Panel in the Household Air Pollution Intervention Network (HAPIN) Trial. Ultrasound Med Biol. 2023 May;49(5):1194-1201. doi: 10.1016/j.ultrasmedbio.2023.01.005. Epub 2023 Feb 19.
PubMed 36801180Williams KN, Quinn A, North H, Wang J, Pillarisetti A, Thompson LM, Diaz-Artiga A, Balakrishnan K, Thangavel G, Rosa G, Ndagijimana F, Underhill LJ, Kirby MA, Puzzolo E, Hossen S, Waller LA, Peel JL, Rosenthal JP, Clasen TF, Harvey SA, Checkley W; HAPIN Investigators. Fidelity and adherence to a liquefied petroleum gas stove and fuel intervention: The multi-country Household Air Pollution Intervention Network (HAPIN) trial. Environ Int. 2023 Sep;179:108160. doi: 10.1016/j.envint.2023.108160. Epub 2023 Aug 19.
PubMed 37660633Younger A, Alkon A, Harknett K, Kirby MA, Elon L, Lovvorn AE, Wang J, Ye W, Diaz-Artiga A, McCracken JP, Castanaza Gonzalez A, Monroy Alarcon L, Mukeshimana A, Rosa G, Chiang M, Balakrishnan K, Garg SS, Pillarisetti A, Piedrahita R, Johnson M, Craik R, Papageorghiou AT, Toenjes A, Quinn A, Williams KN, Underhill L, Chang HH, Naeher LP, Rosenthal J, Checkley W, Peel JL, Clasen TF, Thompson LM; HAPIN investigators. Effects of a LPG stove and fuel intervention on adverse maternal outcomes: A multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN). Environ Int. 2023 Aug;178:108059. doi: 10.1016/j.envint.2023.108059. Epub 2023 Jun 28.
PubMed 37413928Checkley W, Hossen S, Rosa G, Thompson LM, McCracken JP, Diaz-Artiga A, Balakrishnan K, Simkovich SM, Underhill LJ, Nicolaou L, Hartinger SM, Davila-Roman VG, Kirby MA, Clasen TF, Rosenthal J, Peel JL, On Behalf Of Household Air Pollution Intervention Network Hapin Investigators. Facing the Realities of Pragmatic Design Choices in Environmental Health Studies: Experiences from the Household Air Pollution Intervention Network Trial. Int J Environ Res Public Health. 2022 Mar 23;19(7):3790. doi: 10.3390/ijerph19073790.
PubMed 35409475Hennessee I, Kirby MA, Misago X, Mupfasoni J, Clasen T, Kitron U, Rosenthal JP, Hakizimana E. Assessing the Effects of Cooking Fuels on Anopheles Mosquito Behavior: An Experimental Study in Rural Rwanda. Am J Trop Med Hyg. 2022 Feb 21;106(4):1196-1208. doi: 10.4269/ajtmh.21-0997. Print 2022 Apr 6.
PubMed 35189594Johnson M, Pillarisetti A, Piedrahita R, Balakrishnan K, Peel JL, Steenland K, Underhill LJ, Rosa G, Kirby MA, Diaz-Artiga A, McCracken J, Clark ML, Waller L, Chang HH, Wang J, Dusabimana E, Ndagijimana F, Sambandam S, Mukhopadhyay K, Kearns KA, Campbell D, Kremer J, Rosenthal JP, Checkley W, Clasen T, Naeher L; the Household Air Pollution Intervention Network (HAPIN) Trial Investigators. Exposure Contrasts of Pregnant Women during the Household Air Pollution Intervention Network Randomized Controlled Trial. Environ Health Perspect. 2022 Sep;130(9):97005. doi: 10.1289/EHP10295. Epub 2022 Sep 16.
PubMed 36112539Kaufman JD. Invited Perspective: A Critical Part of a Real-World Environmental Health Trial Is to Demonstrate That the Intervention Reduced Exposure. Environ Health Perspect. 2022 Sep;130(9):91304. doi: 10.1289/EHP11697. Epub 2022 Sep 16. No abstract available.
PubMed 36112540Nicolaou L, Underhill L, Hossen S, Simkovich S, Thangavel G, Rosa G, McCracken JP, Davila-Roman V, de las Fuentes L, Quinn AK, Clark M, Diaz A, Pillarisetti A, Steenland K, Waller LA, Jabbarzadeh S, Peel JL, Checkley W; HAPIN Investigators. Cross-sectional analysis of the association between personal exposure to household air pollution and blood pressure in adult women: Evidence from the multi-country Household Air Pollution Intervention Network (HAPIN) trial. Environ Res. 2022 Nov;214(Pt 4):114121. doi: 10.1016/j.envres.2022.114121. Epub 2022 Aug 24.
PubMed 36029836Rajamani KD, Sambandam S, Mukhopadhyay K, Puttaswamy N, Thangavel G, Natesan D, Ramasamy R, Sendhil S, Natarajan A, Aravindalochan V, Pillarisetti A, Johnson M, Rosenthal J, Steenland K, Piedhrahita R, Peel J, Clark ML, Boyd Barr D, Rajkumar S, Young B, Jabbarzadeh S, Rosa G, Kirby M, Underhill LJ, Diaz-Artiga A, Lovvorn A, Checkley W, Clasen T, Balakrishnan K. Visualizing Field Data Collection Procedures of Exposure and Biomarker Assessments for the Household Air Pollution Intervention Network Trial in India. J Vis Exp. 2022 Dec 23;(190). doi: 10.3791/64144.
PubMed 36622010Ye W, Thangavel G, Pillarisetti A, Steenland K, Peel JL, Balakrishnan K, Jabbarzadeh S, Checkley W, Clasen T; HAPIN Investigators. Association between personal exposure to household air pollution and gestational blood pressure among women using solid cooking fuels in rural Tamil Nadu, India. Environ Res. 2022 May 15;208:112756. doi: 10.1016/j.envres.2022.112756. Epub 2022 Jan 20.
PubMed 35065931Ye W, Steenland K, Quinn A, Liao J, Balakrishnan K, Rosa G, Ndagijimana F, Ntivuguruzwa JD, Thompson LM, McCracken JP, Diaz-Artiga A, Rosenthal JP, Papageorghiou A, Davila-Roman VG, Pillarisetti A, Johnson M, Wang J, Nicolaou L, Checkley W, Peel JL, Clasen TF; Household Air Pollution Intervention Network (HAPIN) trial Investigators. Effects of a Liquefied Petroleum Gas Stove Intervention on Gestational Blood Pressure: Intention-to-Treat and Exposure-Response Findings From the HAPIN Trial. Hypertension. 2022 Aug;79(8):1887-1898. doi: 10.1161/HYPERTENSIONAHA.122.19362. Epub 2022 Jun 16.
PubMed 35708015Davila-Roman VG, Toenjes AK, Meyers RM, Lenzen PM, Simkovich SM, Herrera P, Fung E, Papageorghiou AT, Craik R, McCracken JP, Thompson LM, Balakrishnan K, Rosa G, Peel J, Clasen TF, Hossen S, Checkley W, de las Fuentes L; HAPIN Investigators. Ultrasound Core Laboratory for the Household Air Pollution Intervention Network Trial: Standardized Training and Image Management for Field Studies Using Portable Ultrasound in Fetal, Lung, and Vascular Evaluations. Ultrasound Med Biol. 2021 Jun;47(6):1506-1513. doi: 10.1016/j.ultrasmedbio.2021.02.015. Epub 2021 Apr 1.
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