Exposure to the household air pollution (HAPIN) is a leading health risk in populations in LMICs and accounts for an estimated 2.3 million premature deaths annually and 91.5 million disability-adjusted life years (Bennitt et al, 2021).The HAPIN trial is a multicentre, parallel-group, individually randomized controlled trial with liquefied petroleum gas (LPG) stove and fuel distribution intervention for 18 months with four primary outcomes: infant birth weight, growth stunting in infants, severe pneumonia in infants, and systolic blood pressure in women living in the same household as the pregnant women (Clasen T et al, 2020). The results of HAPIN trial show no significant difference in birth weight of infants of women who used LPG cookstoves and those born to women who used biomass cookstoves. Despite a substantial reduction in air pollution from the LPG stove intervention, the achieved levels were still seven times higher than the WHO guideline value, potentially indicating ongoing health risks. The intervention's implementation during the second trimester might have limited its impact on birth weight, suggesting that earlier interventions in pregnancy could be more effective.
The HAPIN study in India has recruited 800 pregnant women for the RCT and is following the children after the completion of the trial. HAPIN India sites do have contrasting HAP exposures and evaluating the association between population level HAP exposures at sites and NDD outcomes gives a better understanding of long-term outcomes of HAP on Neurodevelopmental disorders. This research was conducted to screen for Autism Spectrum Disorder (ASD) using modified checklist for autism in toddlers (M-CHAT) among children of 2-3 years at the HAPIN India site and elucidate distinct association between Household Air Pollutants i.e PM2.5, Black Carbon, and CO and the presence of Autism Spectrum Disorder.
The Autism spectrum disorder risk as screened by MCHAT is 12.9 % in rural Tamilnadu. Variation in pollutant levels between HAPIN sites indicate a differential exposure scenario, with higher levels correlating with increased ASD risk. A robust and statistically significant association exists between Household Air Pollution (HAP) exposure, particularly PM 2.5, BC, and CO, and ASD risk categories emphasising the potential impact of indoor air quality on children's neurodevelopment. These findings emphasize the urgent need for targeted interventions to mitigate indoor air pollution and promote healthier living environments for improved neurodevelopmental outcomes in children.
References:
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2. S S, K M, S S, et al. Exposure contrasts associated with a liquefied petroleum gas (LPG) intervention at potential field sites for the multi-country household air pollution intervention network (HAPIN) trial in India: results from pilot phase activities in rural Tamil Nadu. BMC Public Health; 20. Epub ahead of print 26 November 2020. DOI: 10.1186/s12889-020-09865-1.
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