Effect of Cook Stove Exposure on Adverse Pregnancy Outcomes and Infant ALRI

 描述(申请人提供)：塔拉特·伊斯拉姆，MBBS，博士，环境流行病学家，在研究基因和环境对儿童呼吸健康结果的影响方面有着良好的记录。K01 IRSDA申请的目的是让伊斯拉姆博士在他的背景基础上再接再厉，扩展他的专业知识，通过在暴露评估、生殖和围产期流行病学方面的培训来开展母婴健康方面的国际研究。这项提议的科学目标是基于以下发现：暴露于传统厨灶产生的生物质燃料烟雾会导致不良妊娠结局和儿童急性下呼吸道感染(ALRI)。不良妊娠结局和急性呼吸窘迫综合征是孟加拉国妇幼健康的主要威胁。在孟加拉国，低出生体重(LBW-53%)、小于胎龄(SGA-70%)和早产(&lt；37周-22.5%)的发生率很高。在孟加拉国，每19名出生的儿童中就有一人在1岁之前死亡，ALRI占婴儿死亡率的50%以上。环境暴露，包括炉灶的空气污染和饮用水的砷(As)，可能会导致这些不利后果。在孟加拉国，用于烹饪的生物质燃料的普及率为88%，与饮用水一样暴露在&gt；10μgm/L中的情况很常见(33%)。因此，这项建议的主要目的是调查孟加拉国母亲接触生物质燃烧产物对妊娠结局和出生前6个月ALRI发生率的影响。我们还建议探索生物质燃烧暴露和砷暴露对这些结果的联合影响。一项关键的创新是开发了一种接触黑碳(BC)的模型，该模型是BMF不完全燃烧的产物，使用了适用于LMIC环境中大型流行病学研究的经济高效的新型监测器。我们还将测量新生儿脐带血中多环芳烃(PAH)的HB-DNA加合物，作为暴露于多环芳烃的生物有效剂量，并研究其可能与健康结局和母亲暴露于BMF的联系。这些目标的成功完成建立在候选人的专业知识的基础上，并将其扩展到全球研究环境中的暴露评估和生殖和围产期流行病学，这需要额外的培训和指导。应聘者将通过与相关领域的专家合作，通过正式的课程工作、有组织的指导培训和实验室工作，获得必要的专业知识。[该项目将通过备受尊敬的孟加拉国国际腹泻病研究中心(ICDDR，B)利用孟加拉国现有的基础设施，这将使候选人能够建立一个由900名妇女组成的怀孕队列，并以具有成本效益的方式对新生儿进行6个月的跟踪。]这笔赠款除了为将被确立为独立国际研究人员的候选人提供必要的培训外，还将解决关于炉灶暴露对孕产妇和儿童健康影响的证据方面的重要空白，并将为未来的研究提供资源。

 DESCRIPTION (provided by applicant): Talat Islam, MBBS, Ph.D., is an environmental epidemiologist with a strong track record in studying the effect of genes and environment on respiratory health outcomes in children. The purpose of this K01 IRSDA application is for Dr. Islam to build on his background and extend his expertise to conduct international research in maternal and child health through training in exposure assessment, and reproductive and perinatal epidemiology. The scientific aims of this proposal are based on the findings that exposure to biomass fuel smoke from traditional cook stoves can lead to adverse pregnancy outcomes and acute lower respiratory tract infection (ALRI) in children. Adverse pregnancy outcomes and ALRI are major threats to maternal and child health in Bangladesh. The prevalence of low birth weight (LBW-53%), small-for-gestational age (SGA-70%) and pre-term birth (<37 weeks-22.5%) is high in Bangladesh. One in every 19 children born in Bangladesh dies before their 1stbirthday and ALRI accounts for more than 50% of the infant mortality. Environmental exposures including air pollution from cook stoves and arsenic (As) from drinking water can contribute to these adverse outcomes. The prevalence of biomass fuel (BMF) used for cooking is 88%, and exposure to >10μgm/l As in drinking water is common (33%) in Bangladesh. Therefore, the major aim of this proposal is to investigate the effect of maternal exposure to biomass combustion products on pregnancy outcomes and ALRI incidence during the first 6 months of life in Bangladesh. We also propose to explore the joint effect of biomass combustion exposure and As exposure on those outcomes. A key innovation is the development of an exposure model for black carbon (BC), product of incomplete combustion of BMF, using cost-effective novel monitors suitable for large epidemiological studies in LMIC settings. We will also measure Hb-DNA adducts of polycyclic aromatic hydrocarbons (PAH) in the cord blood of a sub-population of new-born as a biologically effective dose for exposure to PAHs and investigate its possible link to study health outcomes and maternal exposure to BMF. Successful completion of these aims builds on the expertise of the candidate and extends it to exposure assessment and reproductive and perinatal epidemiology in a global research setting that requires additional training and mentorship. The candidate will attain the necessary expertise by working with experts in the relevant fields, through formal course work, structured mentored training and laboratory work. [This project will take advantage of the available infrastructure in Bangladesh through the highly respected LMIC research institution, International Center for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) that will enable the candidate to establish a pregnancy cohort of 900 women and follow the newborns for six month at a cost effective efficient manner.] This grant, beyond providing the necessary training to the candidate to be established as an independent international researcher, will address important gaps in evidence on the effects of cook stove exposure on maternal and child health, and will provide a resource for future studies.