1/2-Bangladesh Center for Global Environmental and Occupational Health- Bangladesh

项目总结 全世界近30亿人，包括孟加拉国89%的人，暴露在有害的环境中 生物质燃烧产生的家庭空气污染物(木材、农业残渣、牛粪、 等)烹饪所用的燃料。虽然与空气污染相关的健康风险已经在 在发达国家，几乎没有证据表明通过清洁燃料减少HAP可以带来健康益处 使用，特别是在低收入和中等收入国家。孟加拉国地质健康中心已经建立了一个 生物质燃料使用者队列(n=660)。我们观察到，HAP暴露增加与肺相关。 功能下降，血压升高，先天免疫和适应性免疫功能紊乱。我们 观察到独家使用液化石油气(LPG)炉子24小时后，HAP暴露大幅减少 几个月后，妇女和儿童的免疫和炎症反应发生了变化。然而， 慢性心肺标记物的变化具有挑战性，主要是因为随访时间较短。在……里面 寻求具有成本效益、适应性和可扩展性的创新干预作为下一步的可能，我们 计划通过使用移动设备进行教育干预，进行大规模家庭水平的随机对照试验 基于电话(MHealth)技术。此外，我们将继续跟踪队列，并将严格执行 对PM2.5和黑碳(BC)进行重复的个性化(24-48小时)和面积(超过5天)评估 暴露观察HAP降低对心肺和肺功能亚临床指标的长期影响 免疫功能障碍，包括HAP暴露对疫苗抗体应答的影响。我们还将使用深度 学习识别与HAP相关的肺病理的方法。最后，我们提出了两项探索性研究。 工业废物和制衣业工作对健康的影响。这项研究的目的具有重要的科学意义。 与政策直接相关，并与地球健康计划议程保持一致。 1

PROJECT SUMMARY Almost 3 billion people worldwide, including 89% people in Bangladesh, are exposed to harmful household air pollutants (HAP) emitted from combustion of biomass (wood, agricultural residue, cow dung, etc.) fuel use for cooking. While health risks associated with air-pollution have been reasonably well-studied in developed countries, there is little evidence on health benefits achievable by HAP reduction through clean fuel use, especially in low- and middle-income countries (LMICs). Bangladesh GEOHealth hub has established a cohort of biomass fuel users (n=660). We observed that an increased HAP exposure was associated with lung function decline, increased blood pressure and disruption of innate and adaptive immune function. We observed a drastic reduction in HAP exposure by exclusive liquified petroleum gas (LPG) stove use for 24 months, resulting changes in immune and inflammatory responses in women and in children. However, changes in chronic cardio-pulmonary markers were challenging mostly due to short duration of follow up. In quest for an innovative cost effective, adaptable, and scalable intervention as the possible next step, we planned to conduct a large household level randomized controlled trial by educational intervention using mobile phone (mHealth) based technology. In addition, we will continue following the cohort and will conduct rigorous and repeated personalized (24-48 hours) and area (over 5 days) assessments of PM2.5 and black carbon (BC) exposure to examine the long-term effects of HAP reduction on subclinical measures of cardio-pulmonary and immune dysfunction including effect of HAP exposure on antibody response to vaccine. We will also use deep learning methods to identify lung pathology in relation to HAP. Finally, we propose two exploratory studies on health effects of industrial waste and garment industry work. The aims of this study are scientifically important and directly policy-relevant and consistent with the GEOHealth program agenda. 1