Vanessa Burrowes, a Ph.D. candidate at the Johns Hopkins Bloomberg School of Public Health and a Fogarty Global Health fellow, is investigating how fuel interventions can affect exposures to hazardous indoor air pollution and improve health outcomes. Her research is part of the NIH Household Air Pollution Investigation Network (HAPIN) Trial, an international study being conducted in Guatemala, India, Peru, and Rwanda to assess the health effects of household air pollution and a liquified petroleum gas (LPG) intervention among pregnant women, their infants, and older adult women.
The HAPIN Trial and the Fogarty Global Health Program for Fellows and Scholars are funded in part by NIEHS. Throughout Burrowes’ fellowship, she has been mentored by Gwen Collman, Ph.D., director of the NIEHS Division of Extramural Research and Training, and has worked alongside William Checkley, M.D., Ph.D., a HAPIN Trial principal investigator affiliated with the Johns Hopkins University Center for Global Non-Communicable Disease Research and Training. With their support, Burrowes is conducting her dissertation research on quantifying personal exposure to indoor air pollution.
About 3 billion people around the world cook and heat their homes using traditional solid fuels such as wood, coal, crop waste, and dung, according to the World Health Organization. This practice produces hazardous air pollutants in the form of carbon monoxide, black carbon, and fine particulates (PM2.5), leaving women and children vulnerable to a range of health effects, including increased risk of pneumonia, lung cancer, and heart disease. In each country, the HAPIN Trial follows 800 pregnant women throughout the pregnancy, from their first trimester to 18 months after birth, and an additional 200 adult women over the age of 40 to determine the degree of exposures to those most affected by indoor air pollution.
Burrowes has been working with the Peruvian organization Asociación Benéfica PRISMA in Puno, Peru, for the last two years comparing household air pollution exposures from traditional and LPG cookstoves. “We are trying to figure out not only the health effects from household air pollution to mothers, but also the resulting health effects to their children,” said Burrowes. “Through fuel interventions, we can see a difference, especially in particulate matter pollution, in the level of household air pollution exposures between households using traditional and improved gas stoves.”
In the HAPIN Trial, Burrowes’ team uses Enhanced Children’s MicroPEM sensors to gather real-time data on an individual’s exposure to air pollution. This wearable device has been used across the four HAPIN Trial study sites. “We have had a lot of challenges with trying to make systematic protocols across four different cultural contexts,” explained Burrowes. “We had to do some testing within communities that we are working in. For example, in India, for a while they were using a sari to hold the device but have since adapted their device-holding clothing to a vest model. In Guatemala and Peru, we are using aprons that women regularly buy in the local markets. In Rwanda, they are using a similar vest to India’s model. It has been a dynamic trial the whole way.”
The HAPIN Trial’s international, multicenter scope separates it from other studies. The trial is funded by six NIH institutes and centers, including NIEHS; and engages dozens of universities and research centers; and community partners in the U.S. and host countries.
Burrowes sees the study as an opportunity for international training and capacity building. “We are in a really good position to train local workers and give them skills they can take into other jobs or careers,” said Burrowes. “One thing that I want to work on is getting co-authors on our papers from the countries where we work. It’s a small thing, but it will definitely help them if they want to continue in academic careers.”
Burrowes’ passion for environmental health expands beyond indoor air pollution. She previously conducted trials on water, sanitation, and hygiene interventions in decreasing the incidence of diarrheal disease in children, and examined risk factors for household transmission of cholera in Bangladesh. “It has been a good knowledge building exercise to get the big picture of both air contamination and water contamination,” said Burrowes. “I try to make myself a generalist rather than a specialist because public health risks are changing all the time. I believe you are a more well-rounded scientist with a broader body of work.”
Burrowes is grateful for the opportunities she has had through the fellowship program to work on the ground in Peru. “I am still at this point in my career where I want to be out in the field,” explained Burrowes. “If I can touch my data, then I feel closer to it and understand it better. I want to do this for as long as I can.”