1/2-GEOHealth Health Effects of Selected Environmental Exposomes Across the Life CourSe (HEALS)-India

项目摘要 空气污染是印度的一个主要公共健康威胁，影响到该国四分之一的人口， 极端水平。空气污染对健康影响的证据主要来自高收入国家， 不能转移到像印度这样的城市环境复杂、污染程度高的LMIC。该提案 题为“1/2-选定的环境暴露体在整个生命过程中对健康的影响 （HEALS）-印度“以正在进行的研究和基础设施为基础（将于 7/30/2021），空气污染和健康GEOHealth计划。在目前的提案中，我们的目标是扩大我们的曝光率， 评估包括一系列空气污染物：空气动力学直径<2.5微米的颗粒物（PM2.5）， 二氧化氮（NO2）和臭氧（O3），以及极端温度，以评估在罚款 印度不同地点（德里、钦奈、索尼帕特、维扎格、浦那、海得拉巴）的时空分辨率 Bikaner）。此外，我们还将评估这些地点的PM2.5成分，并测量真实的时间 在参与者的一个子集中暴露。这些疾病将与一系列慢性非- 使用交叉指状队列研究整个生命过程中的传染病。这将通过利用 印度现有的妊娠、儿童、成人和老年人队列。这将有助于我们系统地评估 弱势群体包括孕妇、婴儿、儿童、青少年、成人和老年人。我们 还将讨论环境问题如何与性别、社会经济地位、城乡 环境和预先存在的疾病对健康结果的影响。此外，我们还将复制 我们的表观基因组扫描（来自正在进行的研究）在更大的样本集，以验证DNA甲基化谱 与心肌梗死事件相关，并探讨这些表观遗传机制是否介导了 对心肌梗塞的影响。通过这一联合应用，我们将加快科学基础设施建设， 发展，加强研究培训，以支持研究所需的特点之间的关系， 环境问题和健康结果。这项研究将由Dr. 来自CCDC的Prabhakaran和来自PHFI的Reddy博士以及来自HSPH的Schwartz博士和Sieber博士，他们将在 由以下机构协助：1）外部咨询委员会; 2）行政监督委员会; 3）培训监督 委员会; 4）HSPH和CCDC的计划协调人员;以及5）个人监督小组 学员（印度人和HSPH导师）。拟议的研究结果将确定所需的政策改革， 我们的目标是减轻日益加重的空气污染负担，保护大量高危人群。印度科学家的培训 在环境卫生领域的相互联系的U2 R中，将建立进行相关研究和应用的能力， 未来的赠款，以解决在印度不利的环境暴露的威胁。

Project Summary Air pollution represents a major public health threat in India, affecting a quarter of the country’s population at extreme levels. The evidence on health impacts of air pollution, which mainly comes from high income countries, is not transferable to LMICs like India with complex urban environments and high pollution levels. The proposal entitled “1/2-GEOHealth Health Effects of Selected Environmental Exposomes Across the Life CourSe (HEALS)-India” builds on the research and infrastructure established in the ongoing (to be completed on 7/30/2021), Air pollution and Health GEOHealth Program. In the current proposal we aim to extend our exposure assessments to include a range of air pollutants: particulate matter with aerodynamic diameter <2.5m (PM2.5), nitrogen dioxide (NO2) and ozone (O3), and extremes of temperature to assess the exposomes at fine spatiotemporal resolutions across different locations in India (Delhi, Chennai, Sonipat, Vizag, Pune, Hyderabad and Bikaner). Additionally, we will evaluate the composition of PM2.5 in these locations and measure real time exposures in a subset of the participants. These exposomes will be related to a range of chronic non- communicable diseases across the life course using inter-digitating cohorts. This will be achieved by leveraging existing pregnancy, children, adult, and older adult cohorts across India. This will help us systematically assess the vulnerable populations across pregnancy, infancy, childhood, adolescence, adult and older adult groups. We will also address how environmental exposomes interact with gender, socio-economic status, rural-urban settings, and pre-existing illnesses in impacting the health outcomes. Further, we will replicate the findings from our epigenome-wide scan (from the ongoing study) in larger set of samples to validate DNA methylation profiles associated with incident myocardial infarction and explore if these epigenetic mechanisms mediate the effect of exposomes on myocardial infarction. Through this joint application, we will accelerate scientific infrastructure development, enhance research training to support research needed to characterize the relationship between environmental exposomes and health outcomes across the lifespan in India. The study will be led by Dr. Prabhakaran from CCDC and Dr. Reddy from PHFI and Dr. Schwartz and Dr. Sieber from HSPH, who will be assisted by the: 1) External Advisory Committee; 2) Administrative Oversight Committee; 3) Training Oversight Committee; 4) Program coordination personnel at HSPH and CCDC; and 5) Supervisory teams for individual trainees (Indian & HSPH mentors). The proposed study findings will identify the policy reforms needed to address the growing burden of air pollution and protect the large at-risk population. The training of the Indian scientists in the linked U2R in the area of environmental health will build capacity to undertake relevant studies and apply for future grants to address the threat from adverse environmental exposures in India.