Biomass Reduction and Environmental Air Towards Health Effects in Africa - BREATHE partnership

生物质燃料烟雾暴露对健康构成直接威胁，影响全世界超过10亿人。此外，生物质燃料的使用具有生态破坏性，并因其对气候变化的影响而对所有人构成间接威胁。这个由国际专家、非洲调查人员和其他利益相关者组成的伙伴关系将启动和管理共享项目，充分利用最近800万英镑赠款投资提供的实地地点和团队，旨在减少家庭空气污染对健康的影响。世界上有一半的人口，包括7亿非洲人，使用生物质燃料（动物或植物材料）来提供烹饪、取暖和照明的能源。使用生物质燃料的人们（主要是妇女）和幼儿——特别是母亲背着的婴儿做饭时——由于燃料的部分燃烧和通风方法不佳，暴露在大量烟雾中。这种家庭空气污染在若干方面对健康构成了确定的威胁，包括不良妊娠和新生儿结局、急性下呼吸道感染（世卫组织估计2004年5岁以下儿童中有87万人死亡）、慢性阻塞性肺病和肺癌。目前有三个干预试验旨在测试改善家庭空气质量对健康的影响——两个在非洲，一个在尼泊尔。所有这些调查人员都参与了这次合作。至关重要的是，最大限度地利用这些试验提供的机会，既可以对所有年龄段的健康产生可衡量的影响，也可以促进卫生相关研究方面的能力发展，还可以促进受影响最严重国家的政策改变。全球清洁炉灶联盟（www.cleancookstoves.org）成立于2010年，致力于“到2020年在1亿个家庭中推广使用清洁炉灶和燃料”，以“拯救生命、改善生计、增强妇女权能和应对气候变化”。GACC与世卫组织（世卫组织是GACC的创始合作伙伴）一起确定了在研究之间建立伙伴关系并支持这一应用的必要性，世卫组织也积极为这一伙伴关系作出贡献。我们将填补重要的知识空白，并通过与在非洲运行了6年的非常成功的研究能力倡议（泛非胸科学会临床流行病学和运筹学方法）相联系，为该伙伴关系内的非洲研究人员提供研究能力建设机会。合作伙伴关系的目标召集主要室内空气污染试验的专家和调查人员，以分享当前的发现、计划和数据。2 .协调试验设计，以确保在现行试验中暴露监测和健康影响评估具有可比性，并确保新的研究受益于过去的经验。确保用于试验（以及随后的推广）的干预燃料/技术满足家庭需求，并大大降低暴露水平。4. 利用当前试验可获得但尚未得到这些研究资助的资源，优化发现可用于显示人类受试者暴露减少的烟雾暴露措施的机会。5 .在与区域有关的大型研究项目的范围内，通过自下而上的方法，提供有指导的研究培训和新项目，使非洲受训人员参与新的研究。通过积极的管理确保这些目标的实现，包括为期一周的年度会议和临时主题工作，如实习生项目和试验现场合作。“呼吸伙伴关系”会议将包括提供数据的专题会议，但也包括：a)协调案例定义、干预措施实施、样本和数据收集以及家庭空气污染干预试验实践的其他方面的研讨会，这些将受益于学院的工作；b)工作组计划未来的活动。

Biomass fuel smoke exposure presents a direct threat to health affecting more than a billion people world- wide. Further, biomass fuel use is ecologically destructive and an indirect threat to all by the effect on climate change. This Partnership of international experts, African investigators and other stakeholders will initiate and manage shared projects that make the best use of field sites and teams provided by £8m of recent grant investment directed at reducing the health effects of household air pollution. BackgroundHalf the world's population including 700 million people in Africa use biomass fuel (animal or plant material) to provide energy for cooking, heating and lighting. People (mainly women) using biomass fuel and young children - particularly babies carried on the backs of their mothers while cooking - experience substantial smoke exposure, due to both partial combustion of fuel and poor ventilation methods. This household air pollution (HAP) is an established threat to health in several ways including adverse pregnancy and neonatal outcomes, acute lower respiratory tract infections (WHO estimates 870,000 deaths among the under 5s in 2004), chronic obstructive pulmonary disease and lung cancer. There are three current intervention trials designed to test the health impact of improved household air quality - two in Africa and one in Nepal. All of these investigators are involved in this Partnership. It is of critical importance to maximise the opportunities presented by these trials, both for measured health impact in all ages, capacity development in health related research and policy change in most affected countries. The Global Alliance for Clean Cookstoves (www.cleancookstoves.org) formed in 2010 and is committed to " foster the adoption of clean cook stoves and fuels in 100 million households by 2020" in order to "save lives, improve livelihoods, empower women, and combat climate change". The GACC, together with WHO (which is is a founding partner of GACC), have identified the need for a Partnership between studies and support this application, with WHO also actively contributing to the partnership. We will fill important knowledge gaps and offer research capacity building opportunities to African researchers within the Partnership by linking with a highly successful research capacity initiative that has been running in Africa for 6 years (Pan African Thoracic Society Methods in Clinical Epidemiologic and Operations Research). Objectives of the Partnership1. Draw together experts and investigators in major indoor air pollution trials in order to share current findings, plans and data.2. Harmonise trial design to ensure that exposure monitoring and health effect evaluation are comparable among active trials and that new studies benefit from past experience.3. Ensure intervention fuels/technologies used for trials (and subsequent scaling-up) meet household needs and deliver substantially reduced exposure levels. 4. Optimise the opportunity to discover measures of smoke exposure that can be used to show exposure reduction in human subjects, using resource made accessible by current trials but not yet funded by those studies.5. Engage African trainees in new studies by a bottom-up approach offering mentored research training and new projects in the context of large, regionally relevant research projects.6. Ensure that these objectives are achieved with active management including an Annual Meeting for a week and interim theme work such as trainee projects and trial site collaborations.The BREATHE Partnership conference will include thematic sessions where data are presented but also a) Workshops to harmonise case definitions, intervention implementation, sample and data collection and other aspects of household air pollution intervention trial practice that will benefit from collegiate working and b) Working Groups to plan future activity.