Journal article
Cooking With Liquefied Petroleum Gas or Biomass and Quality of Life: Results From a Randomized Controlled Trial
Indoor air, v 2026(1), 9936046
01 Jan 2026
Abstract
Household air pollution from biomass fuel combustion affects approximately 36% of the world′s population and is associated with negative health, environmental, economic, and social impacts. Although randomized controlled trials (RCTs) designed to reduce household air pollution have largely focused on health and environmental outcomes, evidence regarding their impact on quality of life (QOL) and household financial status remains limited. We conducted an RCT to evaluate the impact of a liquefied petroleum gas (LPG) intervention on health outcomes among 180 women aged 25–64 years who were the primary cooks in their households. We randomly assigned half of the participants to receive an LPG stove, continuous fuel supply for 12 months, and behavioral reinforcement. The other half continued usual cooking practices. We assessed QOL as a secondary outcome using the Short Form 36 Version 2 (SF‐36‐v2) and the EuroQol‐5D‐3L (EQ‐5D). We also asked participants to report any perceived change in their household financial status 12 months after randomization. A total of 179 women (mean [±SD] age 48.3 ± 10.1 years) completed the surveys. In intention‐to‐treat analyses, participants in the intervention arm had similar SF‐36 scores at 12 months compared with controls (mental component score: 48.3 vs. 50.9, p = 0.59; physical component score: 53.1 vs. 47.6, p = 0.08) and EQ‐5D health state scores were also similar (67.0 vs. 71.7, p = 0.05). Exposure–response analyses did not reveal a significant association between personal PM2.5 exposure and QOL scores. However, a significantly larger proportion of women in the intervention group reported feeling financially better off (42% vs. 13%; p < 0.001) and higher income (33% vs. 9%; p < 0.001) at 12 months compared with baseline. Although the intervention did not result in measurable differences in QOL scores, participants perceived meaningful improvements in their household financial status. Future research should explore the broader QOL, social, and economic benefits of transitioning to cleaner cooking fuels.
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- Title
- Cooking With Liquefied Petroleum Gas or Biomass and Quality of Life: Results From a Randomized Controlled Trial
- Creators
- Suzanne M Simkovich - Johns Hopkins UniversityShakir Hossen - Johns Hopkins UniversityKendra N Williams - Johns Hopkins UniversityJosiah L Kephart - Johns Hopkins UniversityMagdalena Fandiño-Del-Rio - Johns Hopkins UniversityCarla Tarazona-Meza - Johns Hopkins UniversityDina Goodman - Johns Hopkins UniversityMitra Moazzami - Johns Hopkins MedicineVictor G Dávila-Román - Washington University in St. LouisKyle Steenland - Emory UniversityLaura Nicolaou - Johns Hopkins UniversityDavid Dowdy - Johns Hopkins UniversityKirsten Koehler - Drexel UniversityWilliam Checkley (Corresponding Author) - Johns Hopkins University
- Publication Details
- Indoor air, v 2026(1), 9936046
- Publisher
- Wiley
- Number of pages
- 11
- Grant note
- Johns Hopkins University United Nations Foundation: UNF-16-810 National Institutes of Health: D43TW011502, T32ES007141, K12HL137942, F32HL143909, T32HL007534, D43TW009340, U01TW010107
The Cardiopulmonary Outcomes and Household Air Pollution (CHAP) trial is funded by the U.S. National Institutes of Health (ClinicalTrials.gov, ID: NCT02994680; registered on 28 November 2016). Cardiopulmonary Outcomes and Household Air Pollution (CHAP) trial investigators: Steering Committee: William Checkley MD PhD (Johns Hopkins University, Baltimore, MD, USA), Gustavo F Gonzales MD (Universidad Peruana Cayetano Heredia, Lima, Peru), Luke Naeher PhD (University of Georgia, Athens, GA, USA), Joshua Rosenthal PhD (National Institutes of Health, Bethesda, MD, USA), and N Kyle Steenland PhD (Emory University, Atlanta, Georgia, USA). Johns Hopkins University Investigators: Theresa Aguilar, Vanessa Burrowes PhD, Magdalena Fandino-Del-Rio MSc PhD, Elizabeth C Fung MSPH, Dina Goodman MSPH, Steven A Harvey PhD, Phabiola Herrera MD, Josiah L Kephart PhD, Kirsten Koehler PhD, Alexander Lee, Kathryn A Lee MPH, Catherine H Miele MD MPH, Mitra Moazzami MSPH, Lawrence Moulton PhD, Saachi Nangia, Laura Nicolaou PhD, Carolyn O ' Brien MSPH, Suzanne Simkovich MD MS, Timothy Shade, Lena Stashko MSPH, Ariadne Villegas-Gomez MSPH, Kendra N Williams PhD, and Abigail Winiker MSPH. Asociacion Benefica PRISMA Investigators: Marilu Chiang MD MPH, Gary Malpartida, and Carla Tarazona-Meza MPH. Washington University Investigators: Victor Davila-Roman MD and Lisa de las Fuentes MD. Emory University Investigators: Dana Barr Boyd PhD, Maria Jolly MSPH, and Angela Rozo. RTI International: Ryan Chartier, PhD.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Environmental and Occupational Health
- Web of Science ID
- WOS:001740892600001
- Other Identifier
- 991022173639604721