About the HAPIN Trial

Photo Credit: Naveen Puttawasmy

The Problem

Globally, nearly 3 billion people rely on solid fuels (e.g., wood, coal, crop waste, and dung) for cooking and heating, the vast majority in low- and middle-income countries. The resulting household air pollution is a leading risk factor for mortality globally, accounting for an estimated 2.9 million deaths annually in 2015, largely among women and children. 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 restricted growth in children and to increased blood pressure, cancer and other cardiovascular and respiratory effects in adults. 

The HAPIN Trial

This study is a randomized controlled trial of liquefied petroleum gas (LPG) stove and fuel distribution in 3,200 households in four countries. The research team will establish trial sites in Guatemala, India, Peru, and Rwanda that will each recruit 800 pregnant women, their 800 infants, and 200 older adult women into the study. Half of the participating households will be randomly assigned to receive a LPG cookstove and fuel, and the other half will serve as controls using their customary cooking practices. Participating households will be followed for 18 months with extensive monitoring of stove use and personal exposure to household air pollution, as well as extensive assessments of health outcomes including preterm birth, birth weight, growth and respiratory infections in children and respiratory function, blood pressure, inflammation, and other indicators of heart disease in adults.  

Completion of the trial will provide compelling, robust evidence on the effects of a LPG cookstove and fuel intervention on reducing exposure to household air pollution and on child health and development as well as adult chronic disease. These data are urgently needed to inform policies on the health gains that can be obtained by scaling up LPG stoves or other interventions to reduce household air pollution among vulnerable populations.

The HAPIN trial is funded by the National Institutes of Health (NIH) and the Bill & Melinda Gates Foundation. Participating NIH components are the National Heart, Lung, and Blood Institute (NHLBI), the National Cancer Institute, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Environmental Health Sciences, the NIH Common Fund of the NIH Office of the Director, and the Fogarty International Center.  The Global Alliance for Clean Cookstoves and the Global LPG Partnership provide expert advice to the consortium.