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，影响着全国四分之一的人口。 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城市环境复杂、污染水平高的低收入国家。这项建议 题为《1/2-选定环境曝露在生命过程中对地质健康的影响》 (治愈)-印度“建立在正在进行的研究和基础设施的基础上(将于 7/30/2021)，空气污染与健康地球健康计划。在目前的提案中，我们的目标是扩大我们的敞口 评估应包括一系列空气污染物：空气动力学直径小于等于2.5m(PM2.5)的颗粒物； 二氧化氮(NO2)和臭氧(O3)，以及极端温度，以评估晴天的曝光物 印度不同地区(德里、金奈、索尼帕特、维扎格、浦那、海得拉巴)的时空分辨率 和Bikaner)。此外，我们将评估这些地点的PM2.5组成，并进行实时测量 在参与者的子集中暴露。这些暴露将与一系列慢性非 在整个生命过程中使用交叉指代队列的传染病。这将通过杠杆作用来实现 印度各地现有的怀孕、儿童、成人和老年人队列。这将有助于我们系统地评估 弱势群体涵盖孕期、婴儿期、儿童期、青春期、成人和老年群体。我们 还将讨论环境曝光如何与性别、社会经济地位、城乡 环境，以及影响健康结果的既往疾病。此外，我们将从以下方面复制研究结果 我们的表观基因组扫描(来自正在进行的研究)在更大的样本集合中验证DNA甲基化图谱 并探索这些表观遗传机制是否介导了心肌梗死的影响 关于心肌梗死的曝光。通过这次联合应用，我们将加快科学基础设施的建设 发展，加强研究培训，以支持需要表征的研究之间的关系 印度人一生中的环境暴露和健康后果。这项研究将由Dr。 CCDC的Prabhakaran和PHFI的Reddy博士以及HSPH的Schwartz博士和Sieber博士，他们将是 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的项目协调人员；5)个人监督小组 实习生(印度人和HSPH导师)。拟议的研究结果将确定需要解决的政策改革 减少日益加重的空气污染负担，保护广大高危人群。印度科学家的培训 在相关联的U2R环境健康领域将建设能力，进行相关研究和应用 用于未来的赠款，以应对印度不利环境暴露的威胁。

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.