HEALTH/ENVIRONMENTAL RISKS IN INFORMAL URBAN SETTLEMENTS

本申请是对RFA TW 03-005号文件的响应，标题为 发展。“由于经济发展趋势，包括东地中海地区在内的发展中世界许多地区的农村-城市移徙急剧增加。这在主要或城市中心周围建立了大型非正式住区，在那里，贫困、恶劣的住房条件和缺乏服务，再加上不安全的水、恶劣的卫生条件和空气污染等环境风险，被认为对健康和福祉产生了重大不利影响。我们的长期目标是改善居住在叙利亚非正式城市住区的居民的健康状况。作为这一进程的第一步，这项建议的目标是全面评估这些住区居民的健康需求和资源，特别是与环境风险有关的需求和资源。拟议研究的理由是，收集关于居民的健康状况和需求、环境危害和人口/社会经济特征的标准化数据，以及关于 在这一人群中可能具有重要意义的代表性接触和结果--空气质量和呼吸道症状--将指导制定有效的干预战略，以减轻这些社区面临的一些环境健康负担，并有助于改善整体健康。我们拥有一支由在新兴市场地区拥有专业知识的公共卫生、环境科学、呼吸医学、行为科学和城市规划研究人员组成的多学科团队，完全有能力开展这项拟议的研究。一旦我们完成了R21申请中提出的工作，我们预计将准备提交一份R01申请，建议开发和测试特定的干预策略。有了这样的介绍， 具体目标是：(1)通过对选定的室内空气污染物和呼吸功能进行形成性工作和客观测量，对阿勒颇非正式住区居民的健康和环境危害进行全面评估。(2)描述居住在阿勒颇非正式住区的人们的健康状况和环境风险，以及 审查目标1中收集的暴露与结果之间的可能联系，以评估与环境危害有关的健康负担；以及(3)通过提供培训机会和与地方和国家利益攸关方合作，建立地方、可持续的环境健康监测和研究能力。

This application is in response to RFA TW 03-005 entitled "Health, Environment and Economic Development." Rural-urban migration has risen dramatically in many parts of the developing world, including the Eastern Mediterranean (EM) region, as a result of economic development trends. This has created large informal settlements around maj or urban centers, where poverty, poor housing conditions and lack of services, in combination with environmental risks such as unsafe water, poor sanitation, and air pollution, are thought to have major adverse effects on health and well being. Our long-range goal is to improve the health status of residents living in informal urban settlements in Syria. As a first step in this process, the objective of this proposal is to comprehensively assess the health needs and resources of residents of these settlements, particularly in relation to environmental risks. The rationale for the proposed research is that the collection of standardized data on health status and needs, environmental hazards, and demographic/socioeconomic characteristics of residents, along with objective data on representative exposures and outcomes likely to be of great importance in this population--air quality and respiratory symptoms--will guide the development of effective intervention strategies to alleviate some of the environmental health burdens facing these communities and help to improve overall health. With a multidisciplinary team of public health, environmental science, respiratory medicine, behavioral science, and urban planning researchers with expertise in the EM region, we are well positioned to undertake the proposed research. Once we complete the work proposed in the R21 application, we expect to be prepared to submit an R01 application proposing to develop and test specific intervention strategies. With that introduction, the specific aims are to: (1) Perform comprehensive assessment of health and environmental hazards among residents of informal settlements in Aleppo by conducting formative work and objective measurement of selected indoor air pollutants and respiratory function. (2) Describe the health status and environmental risks of people living in informal settlements in Aleppo, and examine possible associations between exposures and outcomes collected in Aim 1 to assess the health burdens associated with environmental hazards; and (3) Establish local, sustainable environmental health surveillance and research capacity by providing training opportunities and partnering with local and national stakeholders.