Early-life liquefied petroleum gas cooking intervention and lung function in Guatemalan children: a randomized clinical trial

Abstract Rationale Household air pollution is a risk factor for obstructive lung diseases. Objectives We estimated the effect of an early-life liquefied petroleum gas cooking intervention on childhood lung function. Methods The multi-country Household Air Pollution Intervention Network trial randomized 800 pregnant women (9 to Results Valid oscillometry was obtained from 525/750 (70%) 3-year-olds. Among the 225 missed oscillometry tests, 129/225 (57%) were due to the children not being willing to perform the measurements. We did not find evidence of an effect on prespecified oscillometry outcomes. Exploratory analysis suggested that resistance across the frequency spectrum was lower in intervention than control participants (adjusted difference: −0.31 cm H2O*S/L, 95% CI: −0.59, −0.03). Conclusions Gas cooking compared to biomass cooking from mid-gestation through infancy was not associated with improved prespecified oscillometry outcomes in 3-year-old children. However, lowered resistance across all frequencies in the intervention arm suggests the intervention may have positively impacted airway caliber. Further studies are warranted, including exposure-response analysis and lung function trajectories. Trial registration Clinical trial registered at ClinicalTrials.gov (NCT 02944682).