Publications by authors named "Pillarisetti A"

Repeated measurements of household air pollution may provide better estimates of average exposure but can add to costs and participant burden. In a randomized trial of gas versus biomass cookstoves in four countries, we took supplemental personal 24-h measurements on a 10% subsample for mothers and infants, interspersed between protocol samples. Mothers had up to five postrandomization protocol measurements over 16 months, while infants had three measurements over one year.

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Exposure to household air pollution has been linked to adverse health outcomes among women aged 40-79. Little is known about how shifting from biomass cooking to a cleaner fuel like liquefied petroleum gas (LPG) could impact exposures for this population. We report 24-h exposures to particulate matter (PM), black carbon (BC), and carbon monoxide (CO) among women aged 40 to <80 years participating in the Household Air Pollution Intervention Network trial.

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Background: Air pollution may impair child growth and cognitive development, with potential markers including birth length and head circumference.

Methods: The Household Air Pollution Intervention Network (HAPIN) trial was an open label multi-country-randomized controlled trial, with 3200 pregnant women aged 18-34 years (9-19 weeks of gestation) randomly assigned in a 1:1 ratio to receive liquefied petroleum gas (LPG) stove intervention compared to women continuing to cook with solid fuels for 18 months. Particulate matter ≤ 2.

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Article Synopsis
  • Household air pollution is a major environmental risk, especially in low- and middle-income countries, contributing to approximately 1.6 million premature deaths, prompting the HAPIN study to evaluate the impact of liquefied petroleum gas (LPG) stoves on health outcomes.
  • The study involved 800 pregnant women from Guatemala, India, Peru, and Rwanda, randomly assigning them to receive LPG stoves or continue using traditional biomass fuels, and monitored health indicators for 18 months.
  • The HAPIN Data Management Core effectively used the REDCap platform to collect and manage over 50 million data points, ensuring quality control and real-time data access, despite facing some logistical challenges.
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  • Many households rely on inefficient biomass burning for cooking, causing $1.6 trillion in health and environmental damages each year.
  • Cleaner alternatives like gas and electricity are often unaffordable or unreliable for these households.
  • The text suggests that completely opposing fossil fuel subsidies ignores the potential benefits of subsidizing gas for cooking to improve health and reduce emissions.
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Background: Anemia is common in low- and middle-income countries (LMICs), causing significant health issues and social burdens. Exposure to household air pollution from using biomass fuels for cooking and heating has been associated with anemia, but the exposure-response association has not been studied.

Objectives: We evaluated the associations between personal exposure to air pollution and both hemoglobin levels and anemia prevalence among pregnant women in a multi-country randomized controlled trial.

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  • Residential biomass burning significantly contributes to black carbon (BC) exposure in rural communities, especially among pregnant women in low- and middle-income countries.
  • In a study involving 3103 pregnant women, those who received liquefied petroleum gas stoves showed much lower BC exposure (2.8 μg/m) compared to those using traditional biomass stoves (9.6 μg/m).
  • The study identified primary stove type as the strongest predictor of BC exposure, and highlights the need to consider various factors, such as kitchen location and adherence to stove use, to improve the efficacy of cookstove intervention trials.
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  • Approximately 3 billion people, mainly in low- and middle-income countries, use unclean fuels for everyday energy needs, leading to significant health issues like pneumonia and chronic lung disease.
  • A multidisciplinary group conducted a review of recent trials on clean cooking interventions to combat household air pollution (HAP) and reached 14 consensus recommendations for policy makers and practitioners.
  • While some interventions showed reduced exposure to HAP, there was no clear agreement on their effectiveness in improving health outcomes, highlighting the need for continued research and collaboration with policymakers.
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Background: Household air pollution might lead to fetal growth restriction during pregnancy. We aimed to investigate whether a liquefied petroleum gas (LPG) intervention to reduce personal exposures to household air pollution during pregnancy would alter fetal growth.

Methods: The Household Air Pollution Intervention Network (HAPIN) trial was an open-label randomised controlled trial conducted in ten resource-limited settings across Guatemala, India, Peru, and Rwanda.

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Article Synopsis
  • Household air pollution (HAP) from solid fuel cooking is linked to negative pregnancy outcomes, and the HAPIN trial aimed to assess the effects of using LPG stoves in various countries like Guatemala, India, Peru, and Rwanda.
  • The study involved 3200 pregnant women who were either assigned to use LPG stoves or kept in a control group, with regular monitoring of fetal and neonatal outcomes as well as personal exposure to pollutants like particulate matter and carbon monoxide.
  • Results indicated that the LPG intervention didn't significantly lower risks of stillbirth, congenital anomalies, or neonatal mortality, nor did higher exposure levels to pollutants show a strong statistical association with these adverse outcomes.
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  • Household air pollution from biomass cooking fuels may contribute to stunted growth in infants, raising questions about whether switching to cleaner liquefied petroleum gas (LPG) can help reduce this risk.
  • A randomized trial with 3200 pregnant women in low- and middle-income countries was conducted, comparing the impact of using LPG cookstoves against traditional biomass cookstoves on infant growth at 12 months old.
  • Results showed that the intervention group using LPG had significantly lower exposure to fine particulate matter and a stunting rate of 27.4%, while the control group had a slightly higher stunting rate of 25.2%, indicating a potential benefit of switching to LPG.
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  • * Conducted between May 2018 and September 2021, the trial involved 3,195 pregnant women who were randomly assigned to use either LPG stoves (intervention group) or biomass fuel (control group), and their children's exposure to air pollution was measured.
  • * Results showed a slight reduction in severe pneumonia incidents among infants in the LPG group compared to the biomass group, but the difference was not statistically significant, suggesting that while LPG reduced air pollution exposure, it did not significantly lower pneumonia rates.
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Exposure to heat is associated with a substantial burden of disease and is an emerging issue in the context of climate change. Heat is of particular concern in India, which is one of the world's hottest countries and also most populous, where relatively little is known about personal heat exposure, particularly in rural areas. Here, we leverage data collected as part of a randomized controlled trial to describe personal temperature exposures of adult women (40-79 years of age) in rural Tamil Nadu.

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Background: Cooking-related biomass smoke is a major source of household air pollution (HAP) and an important health hazard. Prior studies identified associations between HAP exposure and childhood stunting; less is known for underweight and wasting. Few studies had personal HAP measurements.

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Households that burn biomass in inefficient open fires - a practice that results in $1.6 trillion in global damages from health impacts and climate-altering emissions yearly - are often unable to access cleaner alternatives, like gas, which is widely available but unaffordable, or electricity, which is unattainable for many due to insufficient supply and reliability of electricity services. Governments are often reluctant to make gas affordable.

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Background: Reducing household air pollution (HAP) to levels associated with health benefits requires nearly exclusive use of clean cooking fuels and abandonment of traditional biomass fuels.

Methods: The Household Air Pollution Intervention Network (HAPIN) trial randomized 3,195 pregnant women in Guatemala, India, Peru, and Rwanda to receive a liquefied petroleum gas (LPG) stove intervention (n = 1,590), with controls expected to continue cooking with biomass fuels (n = 1,605). We assessed fidelity to intervention implementation and participant adherence to the intervention starting in pregnancy through the infant's first birthday using fuel delivery and repair records, surveys, observations, and temperature-logging stove use monitors (SUMs).

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Exposure to household air pollution is a leading cause of ill-health globally. The Household Air Pollution Intervention Network (HAPIN) randomized controlled trial evaluated the impact of a free liquefied petroleum gas stove and fuel intervention on birth outcomes and maternal and child health. As part of HAPIN, an extensive exposure assessment was conducted.

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Background: Reducing household air pollution (HAP) to levels associated with health benefits requires nearly exclusive use of clean cooking fuels and abandonment of traditional biomass fuels.

Methods: The Household Air Pollution Intervention Network (HAPIN) trial randomized 3,195 pregnant women in Guatemala, India, Peru, and Rwanda to receive a liquefied petroleum gas (LPG) stove intervention (n=1,590), with controls expected to continue cooking with biomass fuels (n=1,605). We assessed fidelity to intervention implementation and participant adherence to the intervention starting in pregnancy through the infant's first birthday using fuel delivery and repair records, surveys, observations, and temperature-logging stove use monitors (SUMs).

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Household air pollution from solid cooking fuel use during gestation has been associated with adverse pregnancy and birth outcomes. The Household Air Pollution Intervention Network (HAPIN) trial was a randomized controlled trial of free liquefied petroleum gas (LPG) stoves and fuel in Guatemala, Peru, India, and Rwanda. A primary outcome of the main trial was to report the effects of the intervention on infant birth weight.

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Background: Household air pollution (HAP) from solid fuel use is associated with adverse birth outcomes, but data for exposure-response relationships are scarce. We examined associations between HAP exposures and birthweight in rural Guatemala, India, Peru, and Rwanda during the Household Air Pollution Intervention Network (HAPIN) trial.

Methods: The HAPIN trial recruited pregnant women (9-<20 weeks of gestation) in rural Guatemala, India, Peru, and Rwanda and randomly allocated them to receive a liquefied petroleum gas stove or not (ie, and continue to use biomass fuel).

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Background: Nationwide household transitions to the use of clean-burning cooking fuels are a promising pathway to reducing under-5 lower respiratory infection (LRI) mortality, the leading cause of child mortality globally, but such transitions are rare and evidence supporting an association between increased clean fuel use and improved health is limited.

Objectives: This study aimed to investigate the association between increased primary clean cooking fuel use and under-5 LRI mortality in Ecuador between 1990 and 2019.

Methods: We documented cooking fuel use and cause-coded child mortalities at the canton (county) level in Ecuador from 1990 to 2019 (in four periods, 1988-1992, 1999-2003, 2008-2012, and 2015-2019).

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Direct exposure to household fine particulate air pollution (HAP) associated with inefficient combustion of fuels (wood, charcoal, coal, crop residues, kerosene, etc.) for cooking, space-heating, and lighting is estimated to result in 2.3 (1.

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Low-cost air quality (LCAQ) sensors are increasingly being used for community air quality monitoring. However, data collected by low-cost sensors contain significant noise, and proper calibration of these sensors remains a widely discussed, but not yet fully addressed, area of concern. In this study, several LCAQ sensors measuring nitrogen dioxide (NO) and ozone (O) were deployed in six cities in the United States (Atlanta, GA; New York City, NY; Sacramento, CA; Riverside, CA; Portland, OR; Phoenix, AZ) to evaluate the impacts of different climatic and geographical conditions on their performance and calibration.

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Cooking and heating using solid fuels can result in dangerous levels of exposure to household air pollution (HAP). HAPIN is an ongoing randomized controlled trial assessing the impact of a liquified petroleum gas stove and fuel intervention on HAP exposure and health in Guatemala, India, Peru, and Rwanda among households that rely primarily on solid cooking fuels. Given the potential impacts of HAP exposure on cardiovascular outcomes during pregnancy, we seek to characterize the relationship between personal exposures to HAP and blood pressure among pregnant women at baseline (prior to intervention) in the study.

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