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Assessing the Effects of Cool Roofs on Indoor Environments and Health (REFLECT)

A

Aditi Bunker

Status

Enrolling

Conditions

Aggression
Hospitalization
Heat-related Symptoms
Systolic Blood Pressure
Coping Ability
Indoor Air Temperature
Blood Glucose Control
Sleep Quality
Indoor Heat Index
Life Satisfaction
Dehydration
Physician Diagnosed Heat-related Illnesses
Household Energy Expenditure
Indoor Thermal Comfort
Food Insecurity
Cognition
Healthcare Provider Utilization
Diastolic Blood Pressure
Inner Ear Canal Temperature
Resting Heart Rate
Indoor Relative Humidity
Diet Quality
Health-related Quality of Life
Depression
Productivity

Treatments

Other: Cool roof

Study type

Interventional

Funder types

Other

Identifiers

NCT06579950
226745/Z/22/Z (Other Grant/Funding Number)
3728162

Details and patient eligibility

About

Ambient air temperatures in Asian, Latin American, African, and Pacific climate hotspots have broken record highs in 2024, driven by man-made climate change. Solutions are needed to reduce heat exposure in communities. Sunlight-reflecting cool roof coatings passively reduce indoor temperatures and energy use to protect home occupants from extreme heat. Occupants living in poor housing conditions globally - for example in informal settlements, slums, and low-socioeconomic households - are especially vulnerable to increased indoor heat exposure.

Heat exposure can instigate and worsen numerous physical, mental and social health conditions. The worst adverse health effects are being experienced in communities least able to adapt to heat exposure. By reducing indoor temperatures, cool roof use can promote physical, mental and social wellbeing in occupants.

The long-term research goal is to identify viable passive housing adaptation technologies with proven health and environmental benefits to reduce the burden of heat stress in communities affected by heat globally. To meet this goal, the investigators will conduct a cluster-randomized controlled trial to establish the effects of cool roof use on health, indoor environment and economic outcomes in four urban climate hotspots: Ouagadougou, Burkina Faso; Hermosillo, Mexico; Ahmedabad, India; and Niue, Oceania.

Full description

Increasing heat exposure from climate change is causing and exacerbating heat-related illnesses in millions worldwide - particularly in low resource settings. June 2024 was the 13th consecutive hottest month on record globally - shattering previous records. Heat exposure can instigate and worsen health conditions including cardiovascular, metabolic, endocrine and respiratory disease, heat-related illnesses, pregnancy complications, and mental health conditions. Adaptation is essential for protecting people from increasing heat exposure. The built environment, especially our homes, are ideal for deploying interventions to reduce heat exposure and accelerate adaptation efforts. However, currently there is a lack of evidence on a global scale - generated through empirical studies - guiding the uptake of interventions to reduce heat stress in low resource settings.

Sunlight-reflecting cool roof coatings passively reduce indoor temperatures and lower energy use, offering protection to home occupants from extreme heat. The investigators aim to conduct a global multi-centre cluster-randomized controlled trial investigating the effects of cool-roof use on health, environmental and economic outcomes in four urban climate hotspots - Ouagadougou, Burkina Faso (sub-Saharan Africa), Ahmedabad, India (Asia), Niue (Oceania), and Hermosillo, Mexico (Latin America). The sites represent hotspots where people experience a triple burden from heat exposure, chronic health issues and vulnerable housing conditions (slums, informal settlements and low socioeconomic housing). They also exhibit diversity in climate profiles, housing typology, level of socioeconomic development, population density and rates of urbanisation.

The trial will quantify whether cool roofs are an effective passive home cooling intervention with beneficial health effects for vulnerable populations in four locations. Findings will inform global policy responses on scaling cool roof implementation to protect people from increasing heat exposure driven by climate change.

Enrollment

3,200 estimated patients

Sex

All

Ages

18+ years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

  • Permanent household resident.

Exclusion criteria

  • Roof damage, inaccessible or instability of roof adversely affecting cool roof coating application.
  • Participant unable to provide written/verbal informed consent.

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Double Blind

3,200 participants in 2 patient groups

Cool roof
Experimental group
Description:
Households will receive sunlight reflecting 'cool roof' coating on their roofs.
Treatment:
Other: Cool roof
No cool roof
No Intervention group
Description:
No cool roof application. Households will keep their original roofing for the duration of the trial.

Trial contacts and locations

4

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Central trial contact

Collin Tukuitonga, Sir. Dr.; Aditi Bunker, Dr

Data sourced from clinicaltrials.gov

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