1/2-GEOHealth Hub: Improving Agricultural Health in Southeast Asia-Thailand

 描述(由申请人提供)：在我们的规划拨款中，我们发现泰国的农业工人(占工作人口的42%)是个体户(非正规部门)，几乎没有经济保障，没有正式的职业健康和安全保护，并且大量接触杀虫剂。因此，他们代表了需要对政策倡议进行研究的人群。我们的GEOHealth中心(泰国Mahidol大学和美国马萨诸塞大学)的初步研究将集中在农业健康研究问题上，即一些在东南亚农业中广泛使用的杀虫剂是否会作为内分泌干扰物，改变内分泌激素平衡，并导致代谢综合征和相关疾病(如糖尿病、中风和冠心病)的风险增加，所有这些在泰国都在上升。在配对研究应用(1/2-GEOHealth Hub：改善东南亚-泰国的农业健康)中，我们假设下丘脑-垂体-甲状腺(HPT)轴和下丘脑-垂体-肾上腺轴(HPA)激素稳态的破坏是代谢紊乱发展的风险的生物标记物，并且几种广泛使用的杀虫剂作为HPT/HPA干扰物。为了评估我们的假设，我们将：1)使用泰国全民医疗保健系统的数据对不同职业的代谢紊乱进行横断面研究；2)评估泰国有机和农药使用农民中HPT和HPA激素的纵向亚慢性变化；3)检查农药喷洒事件对选定杀虫剂和除草剂的急性内分泌影响；4)评估基因多态对农药新陈代谢的影响。这个拟议的研究项目代表了我们地球健康中心最初的重点，但未来的项目将扩大农业健康研究的范围，并扩展到其他相关的职业和环境健康主题(气候变化、其他慢性病、神经行为健康和其他工作部门)。GEOHealth中心的配套培训计划侧重于机构能力建设，该计划通过在我们的合作机构(最初是Mahidol大学和泰国公共卫生部)为15名初级教职员工和医务人员提供为期5年的指导性研究培训计划。每个学员将有一个导师团队(泰国和美国的导师)。培训计划将包括：a)1个月Mahidol的GeOHealth计划入门；b)6个月的美国(马萨诸塞州大学、罗格斯大学或Mt.(C)在导师团队的支持下，从批准的研究项目中收集、分析和手稿(S)。该计划旨在建立一个国际性的、跨学科的协作研究小组，该小组将在未来继续合作。该培训计划将通过扩展当前的项目目标和扩大农业卫生研究范围的试点项目，将与我们拟议的研究项目联系起来，帮助地球卫生中心扩大其研究能力。随着中心的发展，我们将增加来自泰国和东南亚其他大学和机构的新培训合作伙伴。我们将利用短期培训，通过现有的公共卫生网络(泰国、东南亚和亚太卫生网络)招募未来的机构合作伙伴，并为中心成员创造机会，为农业卫生研究的新方法互动和发展想法。研究结果和工具以及培训材料将通过我们的网站和我们的短期培训讲习班和研讨会传播。我们预计，研究能力的提高将体现在出版物(数量和质量)、外部资金、多学科合作、新研究领域的开发和农业卫生政策的变化上。

 DESCRIPTION (provided by applicant): In our planning grant we found that agricultural workers in Thailand (42% of the working population) were self- employed (informal sector), with little economic security, no formal occupational health & safety protections and significant exposures to pesticides. Thus they represent a population in need of research to policy initiatives. The initial research of our GEOHealth HUB (Mahidol University, Thailand & University of Massachusetts, USA) will focus on the agricultural health research question of whether some pesticides, widely used in Southeast Asian agriculture, act as endocrine disrupters, altering endocrine hormone homeostasis and resulting in increased risk of metabolic syndrome and associated diseases such as diabetes, stroke and coronary heart disease, all of which are on the rise in Thailand. In the paired research application (1/2-GEOHealth HUB: Improving Agricultural Health in Southeast Asia-Thailand), we hypothesize that disruption of the hypothalamic-pituitary-thyroid (HPT) axis and hypothalamic-pituitary-adrenal (HPA) axis hormone homeostasis is a biomarker of risk for the development of metabolic disorders, and that several widely used pesticides act as HPT/HPA disrupters. To evaluate our hypothesis we will: 1) Use the Thai Universal Health Care System data to conduct a cross-sectional study of metabolic disorders by occupation; 2) Evaluate sub-chronic changes in HPT & HPA hormones longitudinally among Thai organic and pesticide using farmers; 3) Examine the acute endocrine impacts of pesticide spraying events for selected insecticides & herbicides; 4) Evaluate the impact of genetic polymorphisms on pesticide metabolism. This proposed research project represents the initial focus of our GEOHealth Hub, but future projects will extend the range of agricultural health research and expand into other related occupational & environmental health topics (climate change, other chronic diseases, neurobehavioral health and other work sectors). The matched training program for the GEOHealth Hub focuses on institutional capacity building through a program of mentored research training for 15 junior faculty and medical staff over 5 years at our partner institutions (initially Mahidol University and the Thai Ministry of Public Health). Each trainee will have a Mentorship Team (Thai and U.S. mentors). The training program will include: a) 1 month Introduction to GEOHealth program at Mahidol; b) 6 months of research specific training and mentorship in the U.S. (UMass, Rutgers or Mt. Sinai), resulting in a funded interdisciplinary project that extends the research being conducted in the paired research application; c) data collection, analysis and manuscript(s) from the approved research project, supported by Mentorship Team. The program is designed to establish an international, interdisciplinary collaborative research group that will continue to work together in the future. The training program will link with our proposed research project through extensions of the current project aims and pilot projects that extend the scope of the research in agricultural health, aiding the GEOHealth Hub to expand its research capacity. As the Hub develops, we will add new training partners from other Thai and Southeast Asian universities and institutions. We will use short term training to recruit future institutional partners through existing public healt networks (ThaiPHEIN, SEAPHEIN & APACPH) and to create opportunities for Hub members to interact and develop ideas for new approaches to agricultural health research. Research findings and tools, as well as training materials will be disseminated via our website and through our short term training workshops and seminars. We expect increased research capacity will be reflected in publications (number and quality), extramural funding, multidisciplinary collaborations, development of new research areas and agricultural health policy changes.