Effect of Cook Stove Exposure on Adverse Pregnancy Outcomes and Infant ALRI

 描述（由申请人提供）：Talat Islam，MBBS，博士，是一位环境流行病学家，在研究基因和环境对儿童呼吸系统健康结果的影响方面有着良好的记录。该K 01 IRSDA应用程序的目的是伊斯兰博士以他的背景为基础，通过暴露评估以及生殖和围产期流行病学方面的培训，扩展他的专业知识，以开展孕产妇和儿童健康方面的国际研究。这项提案的科学目的是基于这样的研究结果，即接触传统炉灶的生物质燃料烟雾可导致不良妊娠结局和儿童急性下呼吸道感染。不良妊娠结局和ALRI是孟加拉国孕产妇和儿童健康的主要威胁。在孟加拉国，低出生体重（LBW-53%）、小于胎龄儿（SGA-70%）和早产（<37周-22.5%）的发生率很高。在孟加拉国，每19名出生的儿童中就有一名在1岁之前死亡，ALRI占婴儿死亡率的50%以上。环境暴露，包括来自炉灶的空气污染和来自饮用水的砷（As），可能会导致这些不良后果。在孟加拉国，用于烹饪的生物质燃料的普及率为88%，饮用水中砷含量>10微克/升的情况很常见（33%）。因此，本提案的主要目的是调查孟加拉国母亲暴露于生物质燃烧产品对妊娠结局和出生后前6个月ALRI发病率的影响。我们还建议探讨生物质燃烧暴露和As暴露对这些结果的联合影响。一个关键的创新是黑碳（BC），BMF不完全燃烧的产物，使用具有成本效益的新型监测器适合在LMIC设置的大型流行病学研究的暴露模型的发展。我们还将测量新生儿亚群脐带血中多环芳烃（PAH）的Hb-DNA加合物，作为暴露于PAH的生物有效剂量，并调查其与研究健康结果和母亲暴露于BMF的可能联系。成功地完成这些目标建立在候选人的专业知识，并将其扩展到全球研究环境中的暴露评估以及生殖和围产期流行病学，这需要额外的培训和指导。候选人将通过与相关领域的专家合作，通过正式课程、有系统的指导培训和实验室工作，获得必要的专门知识。[This该项目将利用孟加拉国的现有基础设施，通过备受尊敬的LMIC研究机构，孟加拉国国际腹泻病研究中心（ICDDR，B），使候选人能够建立一个900名妇女的妊娠队列，并以具有成本效益的方式对新生儿进行为期六个月的随访。]这笔赠款除了为将成为独立国际研究员的候选人提供必要的培训外，还将填补关于接触炉灶对孕产妇和儿童健康影响的证据方面的重要空白，并将为今后的研究提供资源。

 DESCRIPTION (provided by applicant): Talat Islam, MBBS, Ph.D., is an environmental epidemiologist with a strong track record in studying the effect of genes and environment on respiratory health outcomes in children. The purpose of this K01 IRSDA application is for Dr. Islam to build on his background and extend his expertise to conduct international research in maternal and child health through training in exposure assessment, and reproductive and perinatal epidemiology. The scientific aims of this proposal are based on the findings that exposure to biomass fuel smoke from traditional cook stoves can lead to adverse pregnancy outcomes and acute lower respiratory tract infection (ALRI) in children. Adverse pregnancy outcomes and ALRI are major threats to maternal and child health in Bangladesh. The prevalence of low birth weight (LBW-53%), small-for-gestational age (SGA-70%) and pre-term birth (<37 weeks-22.5%) is high in Bangladesh. One in every 19 children born in Bangladesh dies before their 1stbirthday and ALRI accounts for more than 50% of the infant mortality. Environmental exposures including air pollution from cook stoves and arsenic (As) from drinking water can contribute to these adverse outcomes. The prevalence of biomass fuel (BMF) used for cooking is 88%, and exposure to >10μgm/l As in drinking water is common (33%) in Bangladesh. Therefore, the major aim of this proposal is to investigate the effect of maternal exposure to biomass combustion products on pregnancy outcomes and ALRI incidence during the first 6 months of life in Bangladesh. We also propose to explore the joint effect of biomass combustion exposure and As exposure on those outcomes. A key innovation is the development of an exposure model for black carbon (BC), product of incomplete combustion of BMF, using cost-effective novel monitors suitable for large epidemiological studies in LMIC settings. We will also measure Hb-DNA adducts of polycyclic aromatic hydrocarbons (PAH) in the cord blood of a sub-population of new-born as a biologically effective dose for exposure to PAHs and investigate its possible link to study health outcomes and maternal exposure to BMF. Successful completion of these aims builds on the expertise of the candidate and extends it to exposure assessment and reproductive and perinatal epidemiology in a global research setting that requires additional training and mentorship. The candidate will attain the necessary expertise by working with experts in the relevant fields, through formal course work, structured mentored training and laboratory work. [This project will take advantage of the available infrastructure in Bangladesh through the highly respected LMIC research institution, International Center for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) that will enable the candidate to establish a pregnancy cohort of 900 women and follow the newborns for six month at a cost effective efficient manner.] This grant, beyond providing the necessary training to the candidate to be established as an independent international researcher, will address important gaps in evidence on the effects of cook stove exposure on maternal and child health, and will provide a resource for future studies.