Training in Environmental Health to Reduce Chronic Disease in Latin America

描述(由申请人提供)：生命早期的环境暴露极大地促进了儿童中一些最常见的慢性非传染性疾病的发生，并可能在一生中产生影响。例如：1)哮喘，这是儿童最常见的慢性疾病，由环境因素引起或加重，包括室内过敏原、空气污染和烟草烟雾；2)肥胖和糖尿病在发达国家流行，在发展中国家正以惊人的速度增加。与日益城市化相关的建成环境中的暴露导致了这两种情况。3)在发展中国家，铅和其他重金属以及杀虫剂等神经毒素的暴露仍在继续，并在以后的生活中对神经行为产生影响。尽管儿童时期暴露在环境中会加重慢性病的负担，但很少有儿科医生或其他保健提供者接受过研究、诊断、治疗或预防源于环境的疾病的培训。西奈山医学院社区和预防医学部国际卫生司的目标是培训拉丁美洲的卫生专业人员，以实施识别、治疗和预防环境起源的慢性疾病的研究和服务计划。具体目标是：1)培训医疗专业人员，以实施旨在通过确定儿童暴露在环境中来改善慢性疾病的临床和研究做法。2)创建一个在线参考工具和远程学习方案，以接触到拉丁美洲的大量卫生专业人员。3)培养和支持儿科环境健康关键领导。通过利用西奈山现有国际培训方案的资源，将有可能为通过上述方案接受培训的拉丁美洲研究人员提供指导研究机会。培训的接受者最初将通过与哥斯达黎加、墨西哥、哥伦比亚和乌拉圭的机构建立伙伴关系来挑选，随后几年将扩大到其他拉丁美洲国家。预计该计划将导致在拉丁美洲开设至少三个新的PEHSU，有可能在这些国家实施研究计划，从而确保本提案范围之外的连续性。公共卫生相关性：相当大比例的慢性非传染性疾病起源于儿童时期的环境暴露，包括哮喘、一些神经障碍、肥胖和糖尿病。在发展中国家，这些疾病正在上升，并正在对不断增长的人口的健康造成重大损害。该计划将为拉丁美洲的医疗保健提供者和科学家提供识别、预防、研究和治疗儿科环境健康方面的培训。

DESCRIPTION (provided by applicant): Environmental exposures early in life contribute significantly to some of the most common, chronic non-communicable diseases in children and can have an effect throughout the lifespan. Examples are: 1) asthma, the most common chronic disease in children is caused or aggravated by environmental factors including indoor allergens, air pollution and tobacco smoke; 2) obesity and diabetes are epidemic in developed countries and are increasing alarmingly in the developing world. Exposures in the built environment related to increasing urbanization contribute to both conditions. 3) exposure to lead and other heavy metals and neurotoxins such as pesticides continue in the developing world and contribute to neurobehavioral effects later in life. Despite the contribution of childhood environmental exposures to the burden of chronic disease, few pediatricians or other health care providers are trained to study, diagnose, treat or prevent disease of environmental origin. The goal of the Division of International Health of the Department of Community and Preventive Medicine at Mount Sinai School of Medicine is to train health professionals in Latin America to implement research and service programs that identify, treat and prevent chronic disease of environmental origin. Specific Aims are: 1) Train medical professionals to implement clinical and research practices that aim to ameliorate chronic disease by identifying environmental exposures in children. 2) To create an online reference tool and distance learning program to reach a large number of health professionals in Latin America. 3) To train and support key leaders in pediatric environmental health. By leveraging resources from existing international training programs at Mount Sinai, it will be possible to offer mentored research opportunities to Latin American researchers who are trained through the offerings described above. Recipients of the training will initially be selected through partnerships with institutions in Costa Rica, Mexico, Colombia and Uruguay, to be expanded in later years to other Latin American nations. It is expected that this program will result in the opening of at least three new PEHSUs in Latin America with the potential to implement research programs in those countries, thus ensuring continuity beyond the scope of this proposal. PUBLIC HEALTH RELEVANCE: A significant proportion of chronic non-communicable diseases have an origin in environmental exposures during childhood including asthma, some neurological disorders, obesity and diabetes. In the developing, these diseases are on the rise and are taking a significant toll on health of the growing populations. This program will provide training in the identification, prevention, research, and treatment pediatric environmental health for Latin American health care providers and scientists.