HEALTH/ENVIRONMENTAL RISKS IN INFORMAL URBAN SETTLEMENTS

本申请是对RFA TW 03-005的响应，标题为“健康、环境和经济 发展“由于经济发展趋势，发展中世界的许多地方，包括东地中海区域，农村向城市的移徙急剧增加。这就在主要城市中心周围形成了大量的非正规住区，在这些住区中，贫困、住房条件差和缺乏服务，加上不安全的水、卫生条件差和空气污染等环境风险，被认为对健康和福祉产生了重大不利影响。我们的长期目标是改善生活在叙利亚非正规城市住区的居民的健康状况。作为这一进程的第一步，本提案的目标是全面评估这些定居点居民的健康需求和资源，特别是与环境风险有关的需求和资源。拟议研究的基本原理是，收集有关居民健康状况和需求、环境危害和人口/社会经济特征的标准化数据，沿着有关以下方面的客观数据： 对这一人群可能具有重要意义的典型暴露和后果-空气质量和呼吸道症状-将指导制定有效的干预战略，以减轻这些社区面临的某些环境健康负担，并帮助改善整体健康。凭借公共卫生，环境科学，呼吸医学，行为科学和城市规划研究人员在EM地区的专业知识的多学科团队，我们有能力进行拟议的研究。一旦我们完成了R21申请中提出的工作，我们预计将准备提交R 01申请，提出开发和测试具体的干预策略。通过这一介绍， 具体目标是：（1）对阿勒颇非正规住区居民的健康和环境危害进行全面评估，方法是开展形成性工作，并对选定的室内空气污染物和呼吸功能进行客观测量。(2)描述生活在阿勒颇非正规住区的人的健康状况和环境风险， 研究目标1中收集的接触与结果之间的可能联系，以评估与环境危害有关的健康负担;（3）通过提供培训机会并与地方和国家利益攸关方建立伙伴关系，建立地方可持续的环境健康监测和研究能力。

This application is in response to RFA TW 03-005 entitled "Health, Environment and Economic Development." Rural-urban migration has risen dramatically in many parts of the developing world, including the Eastern Mediterranean (EM) region, as a result of economic development trends. This has created large informal settlements around maj or urban centers, where poverty, poor housing conditions and lack of services, in combination with environmental risks such as unsafe water, poor sanitation, and air pollution, are thought to have major adverse effects on health and well being. Our long-range goal is to improve the health status of residents living in informal urban settlements in Syria. As a first step in this process, the objective of this proposal is to comprehensively assess the health needs and resources of residents of these settlements, particularly in relation to environmental risks. The rationale for the proposed research is that the collection of standardized data on health status and needs, environmental hazards, and demographic/socioeconomic characteristics of residents, along with objective data on representative exposures and outcomes likely to be of great importance in this population--air quality and respiratory symptoms--will guide the development of effective intervention strategies to alleviate some of the environmental health burdens facing these communities and help to improve overall health. With a multidisciplinary team of public health, environmental science, respiratory medicine, behavioral science, and urban planning researchers with expertise in the EM region, we are well positioned to undertake the proposed research. Once we complete the work proposed in the R21 application, we expect to be prepared to submit an R01 application proposing to develop and test specific intervention strategies. With that introduction, the specific aims are to: (1) Perform comprehensive assessment of health and environmental hazards among residents of informal settlements in Aleppo by conducting formative work and objective measurement of selected indoor air pollutants and respiratory function. (2) Describe the health status and environmental risks of people living in informal settlements in Aleppo, and examine possible associations between exposures and outcomes collected in Aim 1 to assess the health burdens associated with environmental hazards; and (3) Establish local, sustainable environmental health surveillance and research capacity by providing training opportunities and partnering with local and national stakeholders.