Women's airborne exposure and kidney health in Guatemala

项目总结/摘要 至少20年前，在年轻的农业工人中出现了一种不明原因的肾病流行病， 中美洲。原因不明的慢性肾脏病（CKDu）的流行导致过早 死亡率，主要影响农村社区。CKDu不是由传统的风险因素引起的， 糖尿病或高血压。这项研究的假设是，接触高浓度的 空气中的污染物将与危地马拉有CKDu风险的女性的肾损伤有关。 迄今为止，几乎所有的研究都集中在男性身上，忽视了初步数据，这些数据表明， 农业和生活在农业社区的人也受到CKDu的影响。此外，迄今为止的研究已经 在很大程度上忽视了空气污染物作为CKDu病因学贡献者的考虑。在本提案中，我们将 表征 在 （目标 个月 在24小时监测期内重复暴露于空气中的颗粒物（PM）和金属 50名女性甘蔗工人和50名非甘蔗部门女性社区成员 1）。24小时监测期将在每例受试者的两个时间点进行，约为3 apart.此外，我们将通过硅胶对125种有机化学品进行定量筛选 参与者在7天内佩戴的腕带（目标2）。我们将评估 个体暴露（PM、金属和有机化学品）和肾脏效应生物标志物（肌酐）（目标1 和2）。这项研究的总体目标是增加对女性CKDu风险因素的了解， 促进今后有针对性的研究和预防战略。拟议的研究是新颖的，解决了 研究知识差距不足，弱势群体，并将作为一个重要的 巴特勒-道森医生的职业发展之路 博士巴特勒-道森的计划将通过指导研究、正式课程、 结构化教程和实践经验：（1）提高我在环境流行病学方面的技能;（2） 发展暴露科学的技能;（3）获得先进的生物统计技术的经验， 水平建模和解释;（4）有效地传达科学概念，并进一步 培养领导能力。她的导师，约翰·阿德盖特博士，教授和系主任， 环境和职业健康，以及她的委员会成员，李纽曼博士（职业 卫生和安全从业人员）、凯瑟琳詹姆斯（环境流行病学家）、理查德约翰逊 （肾脏病学家）和James Crooks（生物统计学家）将在整个过程中为她提供强有力的指导 项目概述的K 01奖项将为严格的培训和指导提供受保护的时间和资源 期间和随后过渡到一个成功的环境流行病学独立研究员。

Project Summary/Abstract An epidemic of unexplained kidney disease in young agriculture workers appeared at least two decades ago in Central America. The epidemic of chronic kidney disease of unknown origin (CKDu) causes premature mortality and predominantly affects rural communities. CKDu is not caused by traditional risk factors such as diabetes or hypertension. The hypothesis for the proposed study is that exposure to high concentrations of airborne contaminants will be associated with kidney injury in females at-risk for CKDu in Guatemala. Nearly all research to date has focused on males, neglecting preliminary data showing that females working in agriculture and living in agricultural communities are also affected by CKDu. Additionally, studies to date have largely overlooked consideration of air pollutants as contributors to CKDu etiology. In this proposal, we will characterize in (Aim months repeat airborne exposure to particulate matter (PM) and metals over a 24-hour monitoring period 50 female sugarcane workers and in 50 female community members not involved in the sugarcane sector 1). The 24-hour monitoring period will occur at two time points for each participant approximately 3 apart. In addition,we will conduct a quantitative screen of 125 organic chemicals via a silicone wristband worn by the participants over a 7-day period (Aim 2). We will evaluate the relationships between individual exposures (PM, metals, and organic chemicals) and a kidney biomarker of effect (creatinine) (Aims 1 and 2). The overall goal of the study is to increase understanding of risk factors for CKDu in women in order to facilitate targeted future research and prevention strategies. The proposed research is novel, addresses a research knowledge gap in an understudied, vulnerable population, and will serve as an important avenue for Dr. Butler-Dawson's career development. Dr. Butler-Dawson's plan will address four career objectives through mentored research, formal courses, structured tutorials, and practical experiences: (1) to increase my skill-set in environmental epidemiology; (2) to develop skills in exposure science; (3) to gain experience in advanced biostatistical techniques for multi- level modeling and interpretation; and (4) to effectively communicate scientific concepts and further develop leadership skills. Her mentor, Dr. John Adgate, Professor and Chair in the Department of Environmental and Occupational Health, as well as her committee members, Drs. Lee Newman (occupational health and safety practitioner), Katherine James (environmental epidemiologist), Richard Johnson (nephrologist), and James Crooks (biostatistician) will provide her with strong mentorship throughout this project. The outlined K01 award will provide protected time and resources for a rigorous training and mentoring period and subsequent transition to a successful independent researcher in environmental epidemiology.