Household Air Pollution Investigation Network (HAPIN)​

The Household Air Pollution Investigation Network (HAPIN) is a large NIH initiative designed to tackle the challenge of reducing the burden of disease from household air pollution (HAP). The World Health Organization (WHO) estimates that almost 3 billion people worldwide – mostly in low and middle income countries (LMIC) – depend on solid fuels (wood, dung, agricultural residue) for cooking and heating their homes. Burning solid fuels on open fires or traditional stoves produces high levels of dangerous HAP. Strong evidence suggests that HAP leads to numerous negative health outcomes, such as acute lower respiratory infections in children, and ischaemic heart disease, stroke, chronic obstructive pulmonary disease and lung cancer in adults. The WHO estimates that HAP is responsible for over 7.0% of the global mortality.

HAPIN will approach the problem of reducing the burden of disease from HAP by addressing two separate but complementary questions: 1) how “clean” must a stove be before meaningful reductions in health outcomes are observed? and 2) how do organizations and governments promote sustained adoption of clean cooking technology? HAPIN is addressing question 1 through a biomarker development and validation initiative as part of the trans-NIH Household Air Pollution (HAP) Health Outcomes Trial and question 2 through the Implementation Science Network.

Household Air Pollution (HAP) Health Outcomes Trial

The NHLBI-lead HAP trial is a public/private partnership between 6 NIH ICs, the Bill & Melinda Gates Foundation, the Global Alliance for Clean Cookstoves (GACC), and the Global Alliance for Chronic Diseases (GACD). The HAP trial aims to accomplish its goal of assessing the maximum health benefits that may result from reduced HAP through clean cooking intervention through two interrelated initiatives. Initiative 1: investigators will conduct a clinical trial across three or more LMIC settings to test improved stove and fuel interventions on health outcomes in exposed populations. Initiative 2: establish a biomarker center for the development and validation of clinical, physiological, chemical, biochemical and/or microbiological markers of exposure and pathophysiological responses. The biomarkers initiative is being funded by the NIH Common Fund.

Implementation Science Network

The NIH, in partnership with USAID, the CDC and the Global Alliance for Clean Cookstoves (GACC) has launched an Implementation Science Network (ISN) under FIC’s Center for Global Health Studies to advance the science of uptake and scale up of clean cooking technology in the developing world. Sustained adoption of clean cooking technology requires understanding and addressing many disparate issues; socioeconomic considerations of access to stoves and fuel, household behaviors, family roles, and environmental conditions. The goal of the ISN is to develop an implementation science platform to best understand how to improve the uptake and appropriate use of clean cooking interventions to maximize their benefits on the health of LMIC populations. The ISN is funded entirely by the Common Fund.

  • June 14, 2016
    ISN member Kiros Berhane, University of Southern California, recently wrote an editorial in Circulation highlighting new evidence linking indoor air pollution from kerosene/diesel with cardiovascular disease. Berhane suggests that the new evidence is interesting because it was obtained from trials in a higher-income country (Iran) than many other similar studies (Africa and Central America) and because it found that using kerosene/diesel (cleaner than solid fuels) still resulted in higher risk for cardiovascular disease. The results add to growing evidence that replacing solid fuels may not be sufficient to eliminate the harmful effects of indoor air pollution and that a transition to very clean fuels (e.g. natural gas, ethanol; much harder goal) may be necessary.
  • Visit FIC's Indoor Air Pollution website for additional news

Implementation Science Network-Generated Resources

  • The ISN published its initial manuscript in Environmental Health Perspectives outlining its goals and strategy to help replace traditional cooking methods with modern clean cooking technologies.
    Read the paper here or here.

Other Informational Resources

NIH Partner Organizations

  • The Global Alliance for Clean Cookstoves  (GACC) is a public-private partnership that seeks to save lives, improve livelihoods, empower women, and protect the environment by creating a thriving global market for clean and efficient household cooking solutions.
  • U.S. Agency for International Development  (USAID), in addition to working with the NIH on the ISN, is partnering with the GACC to reduce the adverse effects of household energy use by encouraging families to switch to cleaner, more efficient fuels and technologies.
  • The Centers for Disease Control and Prevention  (CDC), in addition to working with the NIH on the ISN, joined the GACC to raise awareness about the health risks of indoor air pollution and to promote safe, efficient, and affordable cookstoves in low– and middle-income countries.
  • The Global Alliance for Chronic Diseases (GACD funds, develops and facilitates innovative research collaborations between low- and middle-income and high-income countries in the fight against chronic diseases
  • The Bill & Melinda Gates Foundation is dedicated to improving the quality of life for individuals around the world by building partnerships that bring together resources, expertise, and vision—working with the best organizations around the globe to identify issues, find answers, and drive change. .

ISN Funded Research

New Funding Opportunities
The ISN invites proposals to develop evaluative case studies on historical or current clean cooking policy and intervention efforts. These case studies will provide the basis for analysis by the ISN and development of lessons learned for dissemination in a variety of forms. Apply here (required attachment). Application deadline is November 15, 2016.

Funded Projects
The ISN recently funded three proposals supporting research, evaluation and Implementation Science approaches for adoption and sustained use of clean cooking technologies in LMICs. NCI and CDC have funded a fourth proposal (Daniel Pope) that will also be part of the ISN. For more information.

  • Enhancing adoption and use of LPG: an implementation science approach to understanding key determinants and impacts of local interventions to address financial constraints. The LPG Adoption in Cameroon Evaluation-2 Study
    Daniel Pope, University of Liverpool
    The aim of Pope’s study is to use a mixed-methods approach to advance understanding of barriers and enablers to increasing adoption, exclusive and sustained use of LPG in peri-urban and rural Cameroon; examples include Photo Voice methodology to assess LPG use over time, pressure cooker intervention for foods requiring extended cooking times, and loan/credit intervention to fund initial start-up costs.

  • Prices, Peers, and Perceptions: Opportunities for Scaling up LPG Adoption in Northern Ghana
    Katherine Dickinson, University of Colorado Boulder and National Center for Atmospheric Research
    The aim of Dickinson’s study is to investigate how adoption of liquefied petroleum gas (LPG) can be expanded across the urban-rural gradient in Ghana through an in-depth assessment of supply- and demand-side barriers of adoption and through targeted supply, price, and peer-focused interventions.

  • Enhancing LPG Use during Pregnancy
    Kirk R. Smith, University of California, Berkeley
    The aim of Smith’s study is to explore, in below poverty households in rural India, whether a modest incentive (conditional cash transfer) for adopting LPG will measurably increase usage of LPG during pregnancy.

  • Understanding household, network, and organizational drivers of adoption, sustained use, and maintenance of clean cooking fuels in rural India
    Gautam N. Yadama, Washington University
    The aim of Yadama’s study is to understand how below poverty LPG adopter households in rural India vary from below poverty non-adopter households on factors of affordability, accessibility, and LPG awareness and how those factors affect sustained and exclusive use of LPG in adopter households.

This page last reviewed on March 3, 2017