Prenatal and Early Childhood Biomass Smoke Exposure and Child Neurodevelopment

摘要 用于烹饪和加热的固体燃料燃烧产生的家庭空气污染（HAP）是十大污染之一。 全球疾病负担的主要贡献者。大约90%的农村家庭在发展中国家， 一些国家使用固体燃料，如木材、农业废料或煤来做饭和取暖。一 一项流行病学研究表明HAP与儿童神经发育之间存在关系，但尚不确定 由于结果不准确，因此无法得出结论。在斯里兰卡这个中低收入国家， 超过78%的人口使用未加工木材形式的生物质燃料。我们已经组建 斯里兰卡的600对母婴队列研究产前HAP暴露对婴儿的影响 在出生时和六个月大时评估神经发育。在本申请中，我们建议扩展 对同一出生队列进行3岁以下的随访，并评估生物质燃料烟雾的影响 通过儿童早期的神经发育，使我们能够捕捉到关键时期， 大脑的发展。它还将提供一个极好的机会，以评估产前和产后两种治疗的效果/影响。 出生后暴露于HAP对儿童神经发育的影响，暴露错误分类最小。我们 将通过问卷调查确定HAP暴露情况，并在300个城市测量PM2.5、PM1.0、PM10、CO和NO2 户使用这些信息和儿童的时间活动记录，将定量暴露概况 为研究中的600名儿童开发的。儿童神经发育将在18岁和36岁时进行评估 使用Bayley婴儿发育量表。然后，研究将评估 产前和儿童期HAP暴露对儿童神经发育的影响。这种先驱的诞生 队列研究解决了全球研究差距，并有可能导致范式转变， 解决斯里兰卡和其他国家的HAP暴露问题。

Abstract Household air pollution (HAP) from combustion of solid fuels used for cooking and heating is one of ten leading contributors to the global burden of disease. About 90% of rural households in developing countries use solid fuel such as wood, agricultural waste or coal for cooking and heating. One epidemiologic study suggests a relationship between HAP and child neurodevelopment, but no firm conclusions could be drawn as the result was imprecise. In Sri Lanka, a lower middle-income country, more than 78% of the population use biomass fuel in the form of unprocessed wood. We have assembled a cohort of 600 mother-infant pairs in Sri Lanka to study the effects of prenatal HAP exposure on infant neurodevelopment assessed at birth and at six months of age. In this application, we propose to extend the follow-up of the same birth cohort up to 3 years of age and evaluate effects of biomass fuel smoke exposure on child's neurodevelopment through early childhood allowing us to capture the crucial periods of brain development. It will also provide an excellent opportunity to assess effect/impact of both prenatal and postnatal exposure to HAP on child neurodevelopment with minimum exposure misclassification. We will ascertain HAP exposure from questionnaires and measure PM2.5, PM1.0, PM10, CO and NO2 in 300 households. Using this information and child's time activity record, quantitative exposure profiles will be developed for the 600 children in the study. Child neurodevelopment will be assessed at 18 and 36 months of age using the Bayley Scales of Infant Development. The study will then evaluate the association between prenatal and childhood HAP exposure on child neurodevelopment. This pioneer birth cohort study addresses a global research gap, and has the potential to cause a paradigm shift in addressing HAP exposure in Sri Lanka and in other countries.