Prenatal and Early Childhood Biomass Smoke Exposure and Child Neurodevelopment

描述(申请人提供)：家庭空气污染(HAP)燃烧用于烹饪和取暖的固体燃料是造成全球负担的十大因素之一 疾病。发展中国家约90%的农村家庭使用木头、农业废弃物或煤炭等固体燃料做饭和取暖。一项流行病学研究表明，HAP与儿童神经发育之间存在关系，但由于结果不准确，因此无法得出确切的结论。在斯里兰卡这个中低收入国家，超过78%的人口使用未经加工的木材形式的生物质燃料。我们在斯里兰卡召集了600对母婴，研究产前接触HAP对婴儿神经发育的影响，在出生时和6个月大时进行评估。在这项应用中，我们建议将同一出生队列的随访延长至3岁，并评估生物质燃料烟雾暴露对儿童早期神经发育的影响，使我们能够捕捉大脑发育的关键时期。它还将提供一个极好的机会来评估产前和出生后暴露于HAP对儿童神经发育的影响，并将暴露错误降至最低。我们将通过问卷调查确定HAP的暴露情况，并测量300户家庭的PM2.5、PM1.0、PM10、CO和NO2。利用这些信息和儿童的时间活动记录，将开发出定量的暴露曲线 这项研究中的600名儿童。将在18个月和36个月大时使用贝利婴儿发育量表对儿童神经发育进行评估。然后，这项研究将评估产前和儿童时期接触HAP对儿童神经发育的影响。这项开创性的出生队列研究解决了一个全球研究空白，并有可能导致斯里兰卡和其他国家解决HAP暴露问题的范式转变。

DESCRIPTION (provided by applicant): 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.