Aim 1:
To evaluate the effects of a scalable educational intervention (using mHealth application) on adoption and exclusive use of clean fuel LPG for domestic cooking.
We will conduct a household level randomized trial (2×2 factorial design) in 400 households (800 non-smoking adults and 200 children) for 24-months by providing mobile phone based (mHealth) behavioral change communication (BCC) intervention. We will measure exposure to personal and ambient air pollution (particulate matter 2.5 (PM2.5) and Black Carbon (BC)) level at pre- and post-intervention.

Aim 2:
To examine the long-term effects of household air pollution (HAP) reduction on subclinical measures of cardio-vascular and pulmonary dysfunction.
We will consider the following cardiopulmonary markers:
i) Lung function and lung pathology: a). Forced Expiratory Volume in 1 second (FEV1), Forced Vital Capacity (FVC), and their ratio (FEV1/FVC), b). Chest X-ray (P-A view) and c). Computed tomography of the chest (HRCT).
ii) Subclinical measures of cardiovascular diseases (CVD): a. indicators of arrhythmia by ECG and blood pressure, and
iii) Markers of metabolic dysfunction: a). HbA1c, and b). fasting lipid profile.

Aim 3a:
To examine the long-term effects of HAP reduction on innate and inflammatory immune function among women (n=200).
To assess impaired cellular immune response and inflammation, we will:
i. conduct immune-profiling of peripheral blood mononuclear cells (PBMC);
ii. evaluate expression of cytotoxic and inflammatory response of PBMC,
iii. measure cellular stress or cytokine response in PBMC.

Aim 3b:
To investigate the influence of exposure to HAP on antibody response to vaccines (adaptive immunity).
We will measure B cell function and humoral adaptive immunity in relation to air pollution level.

Exploratory Aims: We will conduct two pilot studies exploring:
i. Presence of health compromising substances in fish-farming ponds and fishes of two districts in Bangladesh
ii. Assessment of respiratory symptoms and lung functions among cotton textile-mill workers in Bangladesh