Biomass Reduction and Environmental Air Towards Health Effects in Africa - BREATHE partnership

生物质燃料烟雾暴露对健康构成直接威胁，影响到全世界10亿多人。此外，生物质燃料的使用具有生态破坏性，并通过对气候变化的影响对所有人构成间接威胁。这个由国际专家、非洲调查人员和其他利益相关者组成的伙伴关系将启动和管理共享项目，这些项目将充分利用最近800万英镑的赠款投资提供的实地和团队，以减少家庭空气污染对健康的影响。世界上有一半的人口，包括非洲的7亿人，使用生物质燃料（动物或植物材料）为烹饪、取暖和照明提供能源。使用生物质燃料的人（主要是妇女）和幼儿-特别是做饭时母亲背上的婴儿-由于燃料的部分燃烧和通风方法不良，他们遭受大量烟雾暴露。这种家庭空气污染在几个方面对健康构成了公认的威胁，包括不良的妊娠和新生儿后果、急性下呼吸道感染（世卫组织估计，2004年5岁以下儿童中有870 000人死亡）、慢性阻塞性肺病和肺癌。目前有三项干预试验旨在测试改善家庭空气质量对健康的影响--两项在非洲，一项在尼泊尔。所有这些调查人员都参与了这一伙伴关系。至关重要的是，要最大限度地利用这些试验提供的机会，无论是对所有年龄段的健康影响，还是对受影响最严重的国家的健康相关研究和政策变革的能力建设。全球清洁炉灶联盟（www.cleancookstoves.org）成立于2010年，致力于“到2020年促进1亿个家庭采用清洁炉灶和燃料”，以“拯救生命、改善生计、增强妇女权能和应对气候变化”。GACC与世卫组织（GACC的创始合作伙伴）一起确定了研究之间建立伙伴关系的必要性，并支持这一应用，世卫组织也积极促进这一伙伴关系。我们将填补重要的知识空白，并提供研究能力建设的机会，非洲研究人员的伙伴关系，通过与一个非常成功的研究能力倡议，已在非洲运行了6年（泛非胸科学会方法在临床流行病学和业务研究）。伙伴关系的目标1。召集主要室内空气污染试验的专家和调查人员，以分享当前的发现、计划和数据。协调试验设计，以确保暴露监测和健康影响评估在积极的试验之间具有可比性，并确保新的研究受益于过去的经验。3.确保用于试验（以及随后的推广）的干预燃料/技术满足家庭需求，并大幅降低接触水平。4.利用目前试验提供的但尚未得到这些研究资助的资源，优化发现可用于显示人类受试者暴露减少的烟雾暴露措施的机会。通过自下而上的方法，在大型、区域相关研究项目的范围内，提供有指导的研究培训和新项目，使非洲受训人员参与新的研究。确保通过积极管理实现这些目标，包括为期一周的年度会议和临时主题工作，如实习生项目和试验中心合作。BREATHE伙伴关系会议将包括专题会议，介绍数据，但也包括a）协调病例定义，干预措施实施，样本和数据收集以及家庭空气污染干预试验实践的其他方面，这将受益于合议工作和B）工作组计划未来的活动。

Biomass fuel smoke exposure presents a direct threat to health affecting more than a billion people world- wide. Further, biomass fuel use is ecologically destructive and an indirect threat to all by the effect on climate change. This Partnership of international experts, African investigators and other stakeholders will initiate and manage shared projects that make the best use of field sites and teams provided by £8m of recent grant investment directed at reducing the health effects of household air pollution. BackgroundHalf the world's population including 700 million people in Africa use biomass fuel (animal or plant material) to provide energy for cooking, heating and lighting. People (mainly women) using biomass fuel and young children - particularly babies carried on the backs of their mothers while cooking - experience substantial smoke exposure, due to both partial combustion of fuel and poor ventilation methods. This household air pollution (HAP) is an established threat to health in several ways including adverse pregnancy and neonatal outcomes, acute lower respiratory tract infections (WHO estimates 870,000 deaths among the under 5s in 2004), chronic obstructive pulmonary disease and lung cancer. There are three current intervention trials designed to test the health impact of improved household air quality - two in Africa and one in Nepal. All of these investigators are involved in this Partnership. It is of critical importance to maximise the opportunities presented by these trials, both for measured health impact in all ages, capacity development in health related research and policy change in most affected countries. The Global Alliance for Clean Cookstoves (www.cleancookstoves.org) formed in 2010 and is committed to " foster the adoption of clean cook stoves and fuels in 100 million households by 2020" in order to "save lives, improve livelihoods, empower women, and combat climate change". The GACC, together with WHO (which is is a founding partner of GACC), have identified the need for a Partnership between studies and support this application, with WHO also actively contributing to the partnership. We will fill important knowledge gaps and offer research capacity building opportunities to African researchers within the Partnership by linking with a highly successful research capacity initiative that has been running in Africa for 6 years (Pan African Thoracic Society Methods in Clinical Epidemiologic and Operations Research). Objectives of the Partnership1. Draw together experts and investigators in major indoor air pollution trials in order to share current findings, plans and data.2. Harmonise trial design to ensure that exposure monitoring and health effect evaluation are comparable among active trials and that new studies benefit from past experience.3. Ensure intervention fuels/technologies used for trials (and subsequent scaling-up) meet household needs and deliver substantially reduced exposure levels. 4. Optimise the opportunity to discover measures of smoke exposure that can be used to show exposure reduction in human subjects, using resource made accessible by current trials but not yet funded by those studies.5. Engage African trainees in new studies by a bottom-up approach offering mentored research training and new projects in the context of large, regionally relevant research projects.6. Ensure that these objectives are achieved with active management including an Annual Meeting for a week and interim theme work such as trainee projects and trial site collaborations.The BREATHE Partnership conference will include thematic sessions where data are presented but also a) Workshops to harmonise case definitions, intervention implementation, sample and data collection and other aspects of household air pollution intervention trial practice that will benefit from collegiate working and b) Working Groups to plan future activity.