Effects of Cooking with Liquefied Petroleum Gas or Biomass on Stunting in Infants

Details

• Personal Author:
  Aravindalochanan V ; Balakrishnan K ; Chang HH ; Checkley W ; Chen Y ; Chiang M ; Clasen TF ; Dávila-Román VG ; Díaz-Artiga A ; Garg SS ; Hartinger SM ; Hossen S ; Jabbarzadeh S ; Johnson M ; Kirby MA ; McCollum ED ; McCracken JP ; Moulton LH ; Mukeshimana A ; Naeher LP ; Ndagijimana F ; Nicolaou L ; Papageorghiou AT ; Peel JL ; Pillarisetti A ; Ramakrishnan U ; Rosa G ; Rosenthal J ; Sinharoy SS ; Steenland, Kyle ; Thangavel G ; Thompson LM ; Underhill LJ ; Waller L ; Wang J ; Williams KN
• Corporate Authors:
  Household Air Pollution Intervention Network Investigators
• Description:
  BACKGROUND: Household air pollution is associated with stunted growth in infants. Whether the replacement of biomass fuel (e.g., wood, dung, or agricultural crop waste) with liquefied petroleum gas (LPG) for cooking can reduce the risk of stunting is unknown. METHODS: We conducted a randomized trial involving 3200 pregnant women 18 to 34 years of age in four low- and middle-income countries. Women at 9 to less than 20 weeks' gestation were randomly assigned to use a free LPG cookstove with continuous free fuel delivery for 18 months (intervention group) or to continue using a biomass cookstove (control group). The length of each infant was measured at 12 months of age, and personal exposures to fine particulate matter (particles with an aerodynamic diameter of ≤2.5 µm) were monitored starting at pregnancy and continuing until the infants were 1 year of age. The primary outcome for which data are presented in the current report - stunting (defined as a length-for-age z score that was more than two standard deviations below the median of a growth standard) at 12 months of age - was one of four primary outcomes of the trial. Intention-to-treat analyses were performed to estimate the relative risk of stunting. RESULTS: Adherence to the intervention was high, and the intervention resulted in lower prenatal and postnatal 24-hour personal exposures to fine particulate matter than the control (mean prenatal exposure, 35.0 µg per cubic meter vs. 103.3 µg per cubic meter; mean postnatal exposure, 37.9 µg per cubic meter vs. 109.2 µg per cubic meter). Among 3061 live births, 1171 (76.2%) of the 1536 infants born to women in the intervention group and 1186 (77.8%) of the 1525 infants born to women in the control group had a valid length measurement at 12 months of age. Stunting occurred in 321 of the 1171 infants included in the analysis (27.4%) of the infants born to women in the intervention group and in 299 of the 1186 infants included in the analysis (25.2%) of those born to women in the control group (relative risk, 1.10; 98.75% confidence interval, 0.94 to 1.29; P=0.12). CONCLUSIONS: An intervention strategy starting in pregnancy and aimed at mitigating household air pollution by replacing biomass fuel with LPG for cooking did not reduce the risk of stunting in infants. [Description provided by NIOSH]
• Subjects:
  Air Pollution, Indoor Fuel Oils Occupational Health Particulate Matter Pregnancy Safety
• Keywords:
  Children Cooking Equipment Fuels Indoor Air Pollution Intervention Effectiveness Liquified Petroleum Gas LPG Particulates
• ISSN:
  0028-4793
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; Colorado ; Georgia ; Maryland ; Massachusetts ; Missouri ; OSHA Region 1 ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 7 ; OSHA Region 8 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  44-54
• Volume:
  390
• Issue:
  1
• NIOSHTIC Number:
  nn:20069300
• Citation:
  N Engl J Med 2024 Jan; 390(1):44-54
• Contact Point Address:
  Dr. Checkley, Division of Pulmonary and Critical Care, Johns Hopkins University, 1830 E. Monument St., Ste. 555, Baltimore, MD 21287
• Email:
  wcheckl1@jhmi.edu
• Federal Fiscal Year:
  2024
• Performing Organization:
  University of California, Berkeley
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  New England Journal of Medicine
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d5338b80b9c24e8a9e031fae2a8f06385548be23b28602a380a7dfc310ef499176f2747d375ce3549620c67eb00a42e6ffd30af461e4da765edc1a01dcbada23
• Download URL:
  https://stacks.cdc.gov/view/cdc/207803/cdc_207803_DS1.pdf
• File Type:
  [PDF - 554.18 KB ]