Enhancement and Maintenance of the HEALS cohort

项目总结 水和空气污染是环境暴露的两个来源，它们导致大量死亡和 世界各地的发病率。由于基础设施较差，监管执法和意识不足， 在发展中国家，水和空气污染的健康负担不成比例地更大，特别是在 南亚。该提案主要通过有针对性的维护来解决这两个环境问题 和丰富了我们长期的环境流行病学队列《砷对健康的纵向影响》 研究(治愈)“是由阿赫桑博士及其孟加拉国和美国同事于2000年发起的。到目前为止， COARTEL主要研究饮酒中砷暴露对健康影响的问题 水。通过维持队列基础设施，对新的健康结果进行更长时间的跟踪和确定， 我们将大幅提高评估砷暴露对健康影响的能力。此外，通过扩展 我们的暴露评估计划增加了对新的空气污染监测的全面评估，加上 有了有针对性的生物样本采集和结果确定，我们将(为研究人员)打开新的机会 通过利用我们独特的队列，有效地调查空气污染对健康的影响 基础设施。具体地说，我们建议：i)通过确定空气污染来改进我们的队列维护活动 通过有针对性地充实临床结果评估基础设施来实现相关的健康结果；二)加强 通过建立空气污染暴露评估基础设施来确定该队列的暴露特征；以及 Iii)丰富我们的生物储存库，开始收集唾液样本，以便将来在#年调查口腔微生物群 与环境健康影响的关系。医治资源已被广泛使用 调查砷、饮食和生活方式暴露对健康影响的研究人员干部，如果得到资助， 拟议的浓缩和维护活动将为有效调查健康状况打开新的大门 空气污染的影响、潜在的生物学和预防途径。

PROJECT SUMMARY Water and air pollutions are two sources of environmental exposures that lead to significant mortality and morbidity across the world. Due to poorer infrastructure, inadequate regulatory enforcement and awareness, the health burden of water and air pollution is disproportionately greater in developing countries, especially in South Asia. This proposal addresses primarily these two environmental problems through targeted maintenance and enrichment of our long-standing environmental epidemiology cohort “Health Effects of Arsenic Longitudinal Study (HEALS)” which was initiated by Dr. Ahsan and his Bangladesh and US colleagues in 2000. Thus far, the cohort has been mainly addressing research questions on the health effects of arsenic exposure from drinking water. By maintaining the cohort infrastructure with longer follow-up and ascertainment of new health outcomes, we will substantially enhance our ability to evaluate health effects of arsenic exposure. In addition, by extending our exposure assessment scheme to add a comprehensive assessment of novel air pollution monitoring, coupled with targeted biosample acquisition and outcome ascertainment, we will open new opportunities (to researchers at large) for efficient investigation of health effects of air pollution by taking advantage of our unique cohort infrastructure. Specifically, we propose to: i) refine our cohort maintenance activities by ascertaining air-pollution related health outcomes through targeted enrichment of clinical outcome assessment infrastructure; ii) augment the exposure characterization of the cohort by instituting air pollution exposure assessment infrastructure; and iii) enrich our biorepository by initiating saliva sample collection for future investigation of the oral microbiome in relation to environmental health effects. The HEALS resource has already been successfully used by a wide cadre of researchers investigating the health effects of As, dietary and lifestyle exposures and, if funded, the proposed enrichment and maintenance activities will open new doors for efficient investigation of the health effects of air pollution, the underlying biology, and prevention avenues.