HAPIN Trial

The Household Air Pollution Intervention Network (HAPIN) Trial is an international multi-center study aimed at assessing the impact of a liquefied petroleum gas (LPG) cooking stove and fuel intervention on health. HAPIN Trial centers are located in four countries: Guatemala, India, Peru and Rwanda.

The HAPIN Trial was launched in 2017 with formative research. Main trial enrollment started in 2018 and follow-up of participants ended in September 2021. More than 7,200 study participants were enrolled and will help the HAPIN Trial find answers to questions about LPG cookstoves and health. Currently the investigators are analyzing data for the primary outcomes: low birth weight, severe pneumonia incidence, and stunting in the child, and blood pressure in the older adult woman. Secondary outcomes include preterm birth and child development in the child, maternal blood pressure during pregnancy, and endothelial function, respiratory impairment, atherosclerosis, carcinogenic metabolites, and quality of life in the older adult woman. The team has been publishing manuscripts throughout project implementation - see Publications.

The 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.  NHLBI leads administration of the trial on behalf of the consortium. The Global LPG Partnership provides expert advice. We are thankful for the guidance of our advisory committee:  Patrick Brysse, Donna Spiegelman, and Joel Kaufman.

Research suggests that exposure experienced during gestation and early life is linked to a range of longer-term outcomes, and that the benefits of reduced exposure will continue even if the intervention ends. Therefore, we submitted a proposal and received funding to continue to follow HAPIN children at three of the research sites (Guatemala, India and Rwanda) through age 5, to evaluate the effects of the original HAPIN intervention on neurologic and physical development. The work builds on the major investment already made in the HAPIN trial by evaluating whether the benefits of the intervention extend beyond pregnancy and the child’s first year of life, leveraging a well-characterized cohort in 3 diverse settings, providing rigorous and widely generalizable answers to questions important for both science and policy. We are maximizing potential for success by extending our prior research, using an experienced and proven research team with strong and ongoing relationships with participants.