Global Environmental and Occupational Health Research and Training for Eastern Africa

PROJECT SUMMARY/ABSTRACT This application requests renewal of an interdisciplinary mentored research program that will be supported by the linked U2R application (2/2: GEOHealth Hub for Research and Training in Eastern Africa – Ethiopia). Building on successes and lessons from the current program, the linked training and research programs of the Hub will advance research and the translation of locally-relevant findings into action around pressing public health issues related to air pollution exposure and health effects, and occupational exposure to extreme heat. The research and training program will be implemented in collaboration with Addis Ababa University (AAU) in Ethiopia, the Hub institution for the linked application. Spoke institutions are in Kenya (University of Nairobi) and Uganda (Makerere University). The research approach is structured around five aims. In Aim 1, the Hub will continue three activities that were successfully established during the first funding cycle, but that would be significantly enhanced by longitudinal data collection. Specifically, we propose to continue central site monitoring of air quality (fine particulate matter, or PM2.5) using infrastructure established in Cycle 1 in each city; to continue collecting hospital mortality and morbidity records in each city to enable time series studies linking air pollution and health; and to re-evaluate the respiratory health of the children included in the first cycle (the Eastern Africa Children’s Health Study – EACH) to examine the effect of PM2.5 on lung development trajectories. In Aim 2 we will measure personal air pollution exposure in 300 mother-child dyads in each city, supporting modeling of personal exposure in our entire child cohort and to establish a foundation for modeling personal exposure in our entire child cohort and for additional epidemiological studies of air pollution. Aim 3 will carry out a cross-sectional assessment of mothers of a subset of children in the EACH study to examine the effects of air pollution exposure on the respiratory and reproductive health of the woman/child dyad. In Aim 4, we seek to build on the enhanced capabilities and independence of the Hub investigators developed in Cycle 1 to conduct studies designed by each country based on local interest and relevance. In Ethiopia, we will implement a full version of a Cycle 1 pilot study of renal function and chronic kidney disease risk resulting from occupational heat stress. In Uganda we will assess ambulatory blood pressure in the subsample of EACH study children with personal exposure data. In Kenya, we will assess neurocognitive function in EACH study children using both test scores (full cohort) and psychometrics (personal exposure subsample). Aim 5 is to continue impacting policy and regulatory decisions via dissemination of study findings to central stakeholders at the local, national and regional level. This proposal brings together a transdisciplinary team of experts in environmental monitoring, epidemiology, and environmental policy; builds on the partners’ well-established research collaborations; and, promises to generate the evidence needed to support healthier environments and workplaces throughout Eastern Africa and beyond.