Prenatal and Early Childhood Biomass Smoke Exposure and Child Neurodevelopment

摘要 家庭空气污染(HAP)是由用于烹饪和取暖的固体燃料燃烧造成的 全球疾病负担的主要贡献者。约90%的农村家庭处于发展中 各国使用木头、农业废弃物或煤等固体燃料做饭和取暖。一 流行病学研究表明HAP与儿童神经发育有关，但没有确凿证据 由于结果不准确，可以得出结论。在斯里兰卡，一个中低收入国家， 超过78%的人口使用未经加工的木材形式的生物质燃料。我们已经集合好了 斯里兰卡600对母婴队列研究产前暴露HAP对婴儿的影响 在出生时和六个月大时评估神经发育。在本应用程序中，我们建议扩展 相同出生队列的3岁以下儿童的随访和生物质燃料烟雾的影响评估 通过对儿童早期神经发育的了解，我们可以捕捉到关键时期 关于大脑发育的问题。它还将提供一个极好的机会来评估这两种产前检查的效果/影响 和出生后暴露于HAP对儿童神经发育的影响，最小暴露错误分类。我们 将通过问卷调查确定HAP暴露情况，并测量300中的PM2.5、PM1.0、PM10、CO和NO2 家庭。使用这些信息和儿童的时间活动记录，定量暴露配置文件将是 为研究中的600名儿童开发的。18岁和36岁的儿童将接受神经发育评估 使用贝利婴儿发育量表测量婴儿的月龄。然后，该研究将评估 产前和儿童期HAP暴露与儿童神经发育的关系。这是先驱者的诞生 队列研究解决了全球研究差距，并有可能导致 解决斯里兰卡和其他国家的HAP暴露问题。

Abstract Household air pollution (HAP) from combustion of solid fuels used for cooking and heating is one of ten leading contributors to the global burden of disease. About 90% of rural households in developing countries use solid fuel such as wood, agricultural waste or coal for cooking and heating. One epidemiologic study suggests a relationship between HAP and child neurodevelopment, but no firm conclusions could be drawn as the result was imprecise. In Sri Lanka, a lower middle-income country, more than 78% of the population use biomass fuel in the form of unprocessed wood. We have assembled a cohort of 600 mother-infant pairs in Sri Lanka to study the effects of prenatal HAP exposure on infant neurodevelopment assessed at birth and at six months of age. In this application, we propose to extend the follow-up of the same birth cohort up to 3 years of age and evaluate effects of biomass fuel smoke exposure on child's neurodevelopment through early childhood allowing us to capture the crucial periods of brain development. It will also provide an excellent opportunity to assess effect/impact of both prenatal and postnatal exposure to HAP on child neurodevelopment with minimum exposure misclassification. We will ascertain HAP exposure from questionnaires and measure PM2.5, PM1.0, PM10, CO and NO2 in 300 households. Using this information and child's time activity record, quantitative exposure profiles will be developed for the 600 children in the study. Child neurodevelopment will be assessed at 18 and 36 months of age using the Bayley Scales of Infant Development. The study will then evaluate the association between prenatal and childhood HAP exposure on child neurodevelopment. This pioneer birth cohort study addresses a global research gap, and has the potential to cause a paradigm shift in addressing HAP exposure in Sri Lanka and in other countries.