Research Activities (U01)
The overall goal of our U01 proposal is to undertake the first large-scale population study to evaluate the health effects of household air pollution in Bangladesh.
Study physician performing carotid intima-media thickness test (CIMT)
Primary Aim 1:
To measure association between exposure to household air pollution (HAP) with subclinical measures of cardiovascular diseases and pulmonary function. We will measure exposure to HAP [particulate matter <2.5 micrometers (PM2.5), carbon monoxide (CO), and black carbon (BC)] through 24-hour personal monitors in 600 non smoking adults. In a random subset of 200 participants 48-hour personal monitoring will be conducted to assess long-term exposure taking into consideration potential seasonal variability for extrapolation to the total study population. We will enroll 300 participants in Matlab (200 women; 100 men), Chandpur District and 300 in Araihazar (200 women; 100 men)], Narayanganj District. We will evaluate exposure to air pollutants in relation to the following cardio-pulmonary measures:
- Pulmonary function measures including Forced Expiratory Volume in 1 second (FEV1), Forced Vital Capacity (FVC), and their ratio (FEV1/FVC).
- Subclinical measures of cardiovascular disease (CVD) hypothesized to be related to HAP including 1) endothelial dysfunction, measured by reactive hyperemia-peripheral arterial tonometry (RH-PAT); 2) atherosclerosis, measured by ultrasound-assessed carotid intima-media thickness (cIMT); 3) vascular stiffness, measured by brachial artery distensibility (BAD), and 4) indicators of arrhythmia, measured as QT/QTc intervals by EKG.
Primary aim 2:
To investigate whether HAP (PM2.5, CO, and BC) is associated with stable biomarkers of immune dysfunction and inflammation including proliferation of T-cells, cytokines/chemokines in culture supernatant of macrophage (MDM) and dendritic cells (MDDC) derived from monocytes in peripheral blood mononuclear cells (PBMC) in the same subset of 200 participants. We will collect blood sample from a subset of 200 women from those 400 women (100 women in each site who will participate along with their spouse)
Measurement of PM2.5 and CO using personal exposure monitoring device in the household
Research staff performing EndoPAT test
Primary aim 3:
Evaluate if the use of improved cook stove reduces exposure to air pollutants and thereby reduces the above-mentioned pre-clinical and molecular measures of cardio-pulmonary and immune dysfunctions, respectively, after two years in the above-mentioned 200 participants. This subset of 200 women as mentioned under aim 2 (100 in each site) will be provided with intervention stove and will be followed up for two years to evaluate if the use of improved cook stove reduces exposure to air pollutants and thereby reduces preclinical and molecular measures of cardio-pulmonary and immune dysfunctions, respectively . For this aim, all pre-clinical and molecular markers assessed for aims 1 and 2 will be re-measured after two years.
To explore whether HAP (PM2.5, CO, and BC) is associated with stable biomarkers of immune dysfunction and inflammation and makers of oxidative stress in children in a subset of 60 children.
- We will measure biomarkers of immune dysfunction and inflammation in terms of proliferation of T-cells (functional assessment), cytokines/chemokines in culture supernatant of macrophages (MDM) and dendritic cells (MDDC) derived from monocytes in peripheral blood mononuclear cells (PBMC).
- Markers of oxidative stress and damage will include 8-hydroxy-2-Deoxyguanosine ( 8-oxo-dG) and exposure to other metals in urine.
In addition to the main research aims on health effects of HAP (aims 1-3), we also propose two pilot studies exploring: a) health hazards of climate change, especially in relation to temperature variability; and b) occupational health hazards of uncontrolled industrialization, especially on young women’s health, within the context of the readymade garments industry. These pilot studies will mostly use existing data.
Research staff performing spirometry