Particulate matter and black carbon:Respiratory Health in Sri Lankan Children

世界上大约50%的人口，发展中国家90%的农村家庭和78%的斯里兰卡家庭依靠固体燃料做饭。固体燃料的不完全燃烧是造成室内空气污染的主要原因 在发展中国家在全球范围内，约有910，000例5岁以下儿童的急性下呼吸道感染（ALRI）死亡可归因于IAP。斯里兰卡固体燃料的主要类型是生物质。已知生物质燃料燃烧释放的颗粒物（PM）对人体健康特别是呼吸系统有害。研究表明，黑碳（BC）是PM的一种成分，可能是对健康影响的主要原因。BC也是全球变暖的第二大贡献者。全球约有20%的BC来自家庭生物质燃料的使用。对生物质燃料产生的PM2.5和对幼儿呼吸系统健康的不利影响的纵向研究有限;而对生物质燃料使用产生的生物质污染和对呼吸系统健康的不利影响的研究更是稀缺。拟议的前瞻性队列研究旨在评估暴露于PM2.5和BC与两岁以下儿童呼吸健康结果之间的关系。本研究将在斯里兰卡卡卢特勒卫生部（MOH）地区的低交通暴露区进行。我们的研究策略是随访475名儿童从出生到他们的第二个生日，以评估暴露于IAP和呼吸健康。将在25%的儿童家庭中测量PM2.5和BC暴露，每年两次，为期两年。这些接触测量值将用于估计其余没有监测数据的家庭中儿童的接触情况。儿童从出生之日到第二个生日的呼吸系统健康将利用一系列来源来确定，其中一些来源包括社区卫生工作者的评估和医生的诊断。关于协变量的信息将来自调查表和斯里兰卡初级卫生保健系统保存的数据。该项目为解决与PM2.5和BC以及呼吸系统健康有关的关键知识差距提供了机会，同时加强了斯里兰卡的IAP研究能力。在这样做的过程中，该项目将提供证据，这些证据可能转化为该国减少IAP暴露的实践和政策，并将效益扩大到包括减缓气候变化。

DESCRIPTION (provided by applicant): About 50% of the world's population, 90% of rural households in developing countries and 78% of Sri Lankan households rely on solid fuel for cooking. Incomplete combustion of solid fuel is the major contributor to indoor air pollution (IAP) in developing countries. Globally, about 910,000 acute lower respiratory infection (ALRI) deaths among d 5 year children can be attributed to IAP. The main type of solid fuel in Sri Lanka is biomass. Particulate Matter (PM) released from burning of biomass fuel is known to be hazardous to human health particularly to the respiratory system. Studies have suggested that black carbon (BC), a component of PM, may be primarily responsible for health effects. BC is also the second-largest contributor to global warming. Approximately 20% of global BC is emitted from household biomass fuel use. Longitudinal studies of PM2.5 from biomass fuel and adverse respiratory health effects of younger children are limited; while studies on BC from biomass fuel use and adverse respiratory health effects are even more scarce. The proposed prospective cohort study aims to evaluate the relationship between exposure to PM2.5 and BC and respiratory health outcomes among children below two years of age. The study will be conducted in a low traffic exposure area of the Kalutara Medical Officer of Health (MOH) area in Sri Lanka. Our research strategy is to follow-up 475 children from birth to their second birthdays to assess exposure to IAP and respiratory health. PM2.5 and BC exposure will be measured in the households of 25% of children, twice yearly for two years. These exposure measurements will be used to estimate exposure for children in the remaining households without monitoring data. Respiratory health of children from day of birth until the second birthday will be ascertained using an array of sources some of which include community health workers' assessments and physicians' diagnosis. Information on covariates will come from questionnaires and from data maintained by the Sri Lankan primary health care system. This project provides an opportunity to address crucial knowledge gaps pertaining to PM2.5 and BC and respiratory health, while strengthening Sri Lanka's IAP research capacity. In doing so, the project will provide the evidence that may be translated into practice and policy for IAP exposure reduction in the country with extension of the benefits to include climate change mitigation.