Effects of a Liquefied Petroleum Gas Stove Intervention on Gestational Blood Pressure: Intention-to-Treat and Exposure-Response Findings from the HAPIN Trial

Details

• Personal Author:
  Balakrishnan K ; Checkley W ; Clasen TF ; Davila-Roman VG ; Díaz-Artiga A ; Household Air Pollution Intervention Network (HAPIN) trial Investigators ; Johnson M ; Liao J ; McCracken JP ; Ndagijimana F ; Nicolaou L ; Ntivuguruzwa JDD ; Papageorghiou A ; Peel JL ; Pillarisetti A ; Quinn A ; Rosa G ; Rosenthal JP ; Steenland, Kyle ; Thompson LM ; Wang J ; Ye W
• Description:
  Background: Approximately 3 to 4 billion people worldwide are exposed to household air pollution, which has been associated with increased blood pressure (BP) in pregnant women in some studies. Methods: We recruited 3195 pregnant women in Guatemala, India, Peru, and Rwanda and randomly assigned them to intervention or control groups. The intervention group received a gas stove and fuel during pregnancy, while the controls continued cooking with solid fuels. We measured BP and personal exposure to PM2.5, black carbon and carbon monoxide 3× during gestation. We conducted an intention-to-treat and exposure-response analysis to determine if household air pollution exposure was associated with increased gestational BP. Results: Median 24-hour PM2.5 dropped from 84 to 24 µg/m3 after the intervention; black carbon and carbon monoxide decreased similarly. Intention-to-treat analyses showed an increase in systolic BP and diastolic BP in both arms during gestation, as expected, but the increase was greater in intervention group for both systolic BP (0.69 mm Hg [0.03-1.35]; P=0.04) and diastolic BP (0.62 mm Hg [0.05-1.19]; P=0.03). The exposure-response analyses suggested that higher exposures to household air pollution were associated with moderately higher systolic BP and diastolic BP; however, none of these associations reached conventional statistical significance. Conclusions: In intention-to-treat, we found higher gestational BP in the intervention group compared with controls, contrary to expected. In exposure-response analyses, we found a slight increase in BP with higher exposure, but it was not statistically significant. Overall, an intervention with gas stoves did not markedly affect gestational BP. [Description provided by NIOSH]
• Subjects:
  Air Pollution, Indoor Cardiovascular Diseases Cardiovascular System Environmental Exposure Fuel Oils Occupational Health Particulate Matter Pregnancy Safety Women
• Keywords:
  Author Keywords: Blood Pressure Blood Pressure Cardiovascular Disease Cardiovascular Diseases Cooking Equipment Environmental Exposure Fuels Indoor Air Pollution Inflammation Morbidity Particulates Pregnant Women

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• ISSN:
  0194-911X
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; Colorado ; Georgia ; Maryland ; Missouri ; 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
• Volume:
  79
• Issue:
  8
• NIOSHTIC Number:
  nn:20067200
• Citation:
  Hypertension 2022 Aug; 79(8):1887-1898
• Contact Point Address:
  Kyle Steenland, Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 560 Dutch Valley Rd, Atlanta, GA 30324
• Email:
  nsteenl@emory.edu
• Federal Fiscal Year:
  2022
• Performing Organization:
  University of California, Berkeley
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Hypertension
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:21d166e9ec69407c6890dd349a259b736ceb460afa11f0d46606c48a7e051fc359d0c98dc96f41da80486b22791ae10382b472a38700a2f7490fd407c5e9e226
• Download URL:
  https://stacks.cdc.gov/view/cdc/231333/cdc_231333_DS1.pdf
• File Type:
  [PDF - 378.69 KB ]