Background: The Household Air Pollution Intervention Network (HAPIN) trial measures pregnant women’s exposures to and concentrations of household air pollutants (HAP) in four low- and middle-income countries (LMICs). Objectives: 1) To measure nitrogen dioxide (NO2) in households enrolled in the HAPIN trial, 2) characterize exposures to HAP including household waste burning (fine particulate matter, PM2.5; black carbon, BC; polycyclic aromatic hydrocarbons, PAHs), and exposure to plastics (bisphenol A, BPA; phthalates), in adolescent girls in rural Guatemala, 3) compare gravimetric data between three HAPIN laboratories in Guatemala, India, and the U.S., and to highlight the launch of the newly-established Guatemala laboratory that resulted from this work, and 4) explore sources of PM2.5 in Guatemala and Rwanda via source apportionment. Methods: We used passive sampling to measure 24h concentrations of NO2 in households in Guatemala (n=151), Peru (n=101), and Rwanda (n=36). In Guatemala, we assessed exposures to HAP and plastics via air monitoring and biomarkers analysis, respectively, in n=56 adolescent girls. As part of capacity building and validation, we used Bland-Altman analyses to compare PM2.5 and BC measurements between the three laboratories. Finally, we conducted source apportionment on filter samples from Guatemala (n=64) and Rwanda (n=59). Results: Study-wide, we observed significant reductions in NO2 concentrations in homes with gas stoves compared to homes with biomass stoves. In adolescent girls in Guatemala, exposures to PM2.5, BC, and PAHs were significantly lower in gas stove compared to biomass participants. BPA and phthalates were not significantly different between study arm, indicating that exposure was independent of study arm. For capacity building, we observed repeatability in measurements between all three laboratories and launched the Guatemala laboratory for use in later stages of the HAPIN trial. Source apportionment resolved four potential sources of PM2.5 in Guatemala and Rwanda including biomass, crustal, agricultural, and gasoline. Conclusions: We characterized various HAP-related exposures in susceptible populations: pregnant women, new mothers, and adolescent girls in LMICs, which are disproportionately impacted by HAP. Our results suggest that LPG stoves can help reduce exposures to multiple household air pollutants that are associated with adverse health effects.
