Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE)
Overview of RESPIRE – The Guatemala Randomized Intervention Trial
What are we doing and why are we doing it?
Approximately half of the world’s population relies on biomass (wood, dung, crops) and coal for their household energy needs. This results in very high levels of indoor air pollution to which women and young children are exposed daily. Exposure to indoor air pollution has been shown to be associated with acute respiratory infections in children, particularly pneumonia, which is still the most important cause of death globally in children under 5 years of age.
Indoor air pollution is clearly a major global public health problem which requires much greater research and policy attention. In particular, research on health effects needs to be strengthened, especially for acute respiratory infections, in order to develop effective interventions to address the problem. In fact, a study group from the World Health Organization has recommended that additional research on this topic be carried out.
We carried out a study in the Western Highlands of Guatemala to better understand the relationship between acute respiratory infections in children and exposure to indoor air pollution. To do this, we chose several communities that are well suited for such a study and have installed an improved cookstove called a plancha in half of the participating households. We examined acute respiratory infections (ARI) in children 18 months of age over a 2 year period to see if there was a difference in the incidence of ARI in children who have the plancha compared to children who do not have the plancha. We measured levels of pollution in households that have the plancha and those without the plancha. After completing the study, all participating households received a plancha.
Why we chose to do this in Guatemala?
A large number of previous studies have examined the problem of indoor air pollution in the Western Highlands of Guatemala. These studies have shown that this area is well suited for our proposed study. This is because most households continue to use traditional cookstoves, the traditional cookstoves produce very high levels of indoor air pollution, infant mortality rates are high in the area, and acute respiratory infections are a leading cause of infant mortality. A number of studies have been done among the Mam to examine what treatment(s) children with ARI are given and why they are given these treatments. The results from these studies helped us manage ARI in children when we carried out the study.
We think that the indoor air pollution may be related to the high infant mortality rates from acute respiratory infections in this area, and we are currently analyzing the results of this study to determine the reduction in indoor air pollution from the plancha and incidence of pneumonia. This will provide important information to policy makers in Guatemala and other locations so that they may begin to address the problem.
Who is carrying out the study?
A team of researchers from the following institutions will carry out the study: