Phase 1: Research Projects
Effects of a Liquefied Petroleum Gas Stove Intervention on Pollutant Exposure and Adult Cardiopulmonary Outcomes: the Cardiopulmonary and Household Air Pollution (CHAP) Trial
Household air pollution (HAP) from combustion of biomass fuels is a leading risk factor for disease burden worldwide. Globally, approximately 50% of all households and 90% of rural households use biomass fuels as the main domestic source of energy.
The burning of biomass fuels (typically comprised of wood, dung, and agricultural crop waste) is most pervasive in low and middle-income countries (LMIC), and is recognized as a leading risk factor for COPD, childhood pneumonia, low birthweight, and all-cause mortality.
Our primary objective is to conduct a field intervention trial of liquefied-petroleum gas (LPG) stove use and fuel distribution in the southern Peruvian region of Puno, compared to standard cooking practices with open-fire biomass burning stoves, and determine if provision of cleaner fuels will result in important reductions of household air pollution and consequently an improvement in cardiopulmonary outcomes over a one-year period. Publications resulted from this work:
Household air pollution (HAP) from combustion of biomass fuels is a leading risk factor for disease burden worldwide. Globally, approximately 50% of all households and 90% of rural households use biomass fuels as the main domestic source of energy.
The burning of biomass fuels (typically comprised of wood, dung, and agricultural crop waste) is most pervasive in low and middle-income countries (LMIC), and is recognized as a leading risk factor for COPD, childhood pneumonia, low birthweight, and all-cause mortality.
Our primary objective is to conduct a field intervention trial of liquefied-petroleum gas (LPG) stove use and fuel distribution in the southern Peruvian region of Puno, compared to standard cooking practices with open-fire biomass burning stoves, and determine if provision of cleaner fuels will result in important reductions of household air pollution and consequently an improvement in cardiopulmonary outcomes over a one-year period. Publications resulted from this work:
- Effects of a liquefied petroleum gas stove intervention on pollutant exposure and adult cardiopulmonary outcomes (CHAP): study protocol for a randomized controlled trial. Trials, 2017
- An evaluation of the Fondo de Inclusión Social Energético program to promote access to liquefied petroleum gas in Peru. Energy for Sustainable Development, 2018
- Perceptions of Improved Biomass and Liquefied Petroleum Gas Stoves in Puno, Peru: Implications for Promoting Sustained and Exclusive Adoption of Clean Cooking Technologies. Int. J. Environ. Res. Public Health, 2017
- Effects of a Cleaner Energy Intervention on Cardiopulmonary Outcomes in Peru: A Randomized Controlled Trial. American Journal of Respiratory and Critical Care Medicine, 2020
Air Pollution and Cardio-Respiratory Diseases in Lima, Peru
Lima is one of the most polluted cities in Latin America, according to a recent WHO report. Air pollution by particulate matter less than 2.5 microns (PM 2.5) is known as a cause of premature death from cardio-respiratory diseases.
Several studies associate exposure to environmental contaminants with the increase to emergency room visits for acute respiratory and cardiovascular diseases in children and adults. We are performing an ecological study of time series to determine the relationship between outdoor air pollution in metropolitan Lima (daily measurements) and its effect on daily admissions to emergency rooms in large hospital (level II and III) due to respiratory and cardiovascular diseases. Likewise, a sub-study will determine if proximity to points of greatest concentration of pollutants increase the risk of cardiovascular or respiratory diseases.
No such time series study has been conducted in Perú and we believe such a study has potential public health policy implications.
Publications resulted from this work:
Lima is one of the most polluted cities in Latin America, according to a recent WHO report. Air pollution by particulate matter less than 2.5 microns (PM 2.5) is known as a cause of premature death from cardio-respiratory diseases.
Several studies associate exposure to environmental contaminants with the increase to emergency room visits for acute respiratory and cardiovascular diseases in children and adults. We are performing an ecological study of time series to determine the relationship between outdoor air pollution in metropolitan Lima (daily measurements) and its effect on daily admissions to emergency rooms in large hospital (level II and III) due to respiratory and cardiovascular diseases. Likewise, a sub-study will determine if proximity to points of greatest concentration of pollutants increase the risk of cardiovascular or respiratory diseases.
No such time series study has been conducted in Perú and we believe such a study has potential public health policy implications.
Publications resulted from this work:
- Developing an Advanced PM2.5 Exposure Model in Lima, Peru. Remote Sensing, 2018
- Reordenamiento vehicular y contaminación de material particulado (PM10, PM2.5). Rev. Peru. Med. Exp. Salud Publica, 2018
- Increased Outdoor PM2.5 Concentration Is Associated with Moderate/Severe Anemia in Children Aged 6–59 Months in Lima, Peru. Journal of Environmental and Public Health, 2019
- Modeling Study of the Particulate Matter in Lima with the WRF-Chem Model: Case Study of April 2016. International Journal of Applied Engineering Research , 2018
Impact of Rotavirus Vaccination and Piped Water Access on Childhood Diarrhea Rates in Peru, 2005-2015
In the past two decades Perú has made significant progress toward increasing access to improved water and sanitation facilities and has seen large declines in the burden of morbidity from diarrheal disease. While improved water and sanitation coverage have increased at the national level, large disparities still persist between urban and rural areas. Regions that have made substantial gains toward lowering diarrheal disease rates may have these trends slowed or reversed as climate change brings additional challenges. Temperature increases associated with climate change are expected to greatly increase the global risk of diarrhea by the end of the century. In addition to having disparities in improved water and sanitation coverage and underlying rates of diarrheal illnesses, Perú has several diverse climatic zones, thus challenges in reducing diarrheal disease in light of climate change may vary widely throughout the country. Better understanding of health risks related to climate change can draw attention to the consequences changing climatic conditions and may inform methods of adaptation to such changes.
Given presentations:
In the past two decades Perú has made significant progress toward increasing access to improved water and sanitation facilities and has seen large declines in the burden of morbidity from diarrheal disease. While improved water and sanitation coverage have increased at the national level, large disparities still persist between urban and rural areas. Regions that have made substantial gains toward lowering diarrheal disease rates may have these trends slowed or reversed as climate change brings additional challenges. Temperature increases associated with climate change are expected to greatly increase the global risk of diarrhea by the end of the century. In addition to having disparities in improved water and sanitation coverage and underlying rates of diarrheal illnesses, Perú has several diverse climatic zones, thus challenges in reducing diarrheal disease in light of climate change may vary widely throughout the country. Better understanding of health risks related to climate change can draw attention to the consequences changing climatic conditions and may inform methods of adaptation to such changes.
Given presentations:
- Delahoy MJ, Carcamo C, Ordoñez L, Vasquez V, Lopman B, Clasen T, Gonzales GF, Steenland K, Levy K. Impact of rotavirus vaccination and piped water access on childhood diarrhea rates in Peru, 2005-2015. International Society for Environmental Epidemiology annual conference; 2019 Aug 25-28; Utrecht, the Netherlands. Oral presentation.
- Delahoy MJ, Carcamo C, Ordoñez L, Vasquez V, Lopman B, Clasen T, Gonzales GF, Steenland K, Levy K. Impact of rotavirus vaccination at differing levels of piped water and sewerage access: an analysis of childhood clinic visits for diarrhea in Peru, 2005-2015. 20th International Symposium on Health Related Water Microbiology. 2019 Sep 15-20; Vienna, Austria. Poster.
- Delahoy MJ, Carcamo C, Ordoñez L, Huerta A, Lavado W, Escajadillo Y, Vasquez V, Lopman B, Clasen T, Gonzales GF, Steenland K, Levy K. Association between ambient temperature and childhood diarrhea in Peru 2005-2015: pre- and post-rotavirus vaccine introduction. UNC Water & Health Conference; 2019 Oct 7-11; Chapel Hill, North Carolina. Oral presentation.
Impact of Inorganic Arsenic in Drinking Water on Adverse Birth Outcomes in Tacna, Peru
Arsenic is a semi-metallic element widely distributed in the geosphere. As other inorganic compounds, it can suffer biomodifications, especially methylations, which make it easier to be excreted from the body but still may be toxic. Arsenic-related health problems are associated with inorganic arsenic (iAs), which is known to increase the risk of different kinds of cancer, and cardio-respiratory diseases. It can to pass through the hemato-placenta barrier, potentially increasing the risk of abortions, preterm births, low birth weight, etc. Although arsenic is mainly geogenic, its levels tend to rise due to human activities like fossil fuels combustion, pesticides use, mining, etc. The city of Tacna, located in the South of Peru, is primarily a mining city, being the fourth copper producer in Peru. A previous study found levels in Tacna drinking water 5 times the recommended WHO levels. We are conducting a pilot study in Tacna to determine birth outcomes in relation to urinary arsenic. This project is made with a collaboration with our partners from the GEOHealth Hub in Suriname.
Publications:
Arsenic is a semi-metallic element widely distributed in the geosphere. As other inorganic compounds, it can suffer biomodifications, especially methylations, which make it easier to be excreted from the body but still may be toxic. Arsenic-related health problems are associated with inorganic arsenic (iAs), which is known to increase the risk of different kinds of cancer, and cardio-respiratory diseases. It can to pass through the hemato-placenta barrier, potentially increasing the risk of abortions, preterm births, low birth weight, etc. Although arsenic is mainly geogenic, its levels tend to rise due to human activities like fossil fuels combustion, pesticides use, mining, etc. The city of Tacna, located in the South of Peru, is primarily a mining city, being the fourth copper producer in Peru. A previous study found levels in Tacna drinking water 5 times the recommended WHO levels. We are conducting a pilot study in Tacna to determine birth outcomes in relation to urinary arsenic. This project is made with a collaboration with our partners from the GEOHealth Hub in Suriname.
Publications:
- Arsenic Concentrations in Household Drinking Water: A Cross-Sectional Survey of Pregnant Women in Tacna, Peru, 2019. Expo Health, 2019.
- Reproductive outcomes in pregnant women and its association with arsenic contamination in drinking water, in a region characterized by high birth weight rates in Peru [published online ahead of print, 2019 Dec 16]. J Matern Fetal Neonatal Med. 2019
