Environmental exposures are major contributors to illness and premature death in countries around the world.
Air pollution is especially concerning as it promotes chronic cardiometabolic disease and can trigger acute
cardiac events. In rapidly urbanizing India, an estimated 1.67 million deaths per year are attributed to air
pollution, making it a factor in nearly 18% of total deaths and 11.5% of total disability adjusted life years. While
the link between air pollution and ill health is becoming clearer, we need to learn more how the components of
air pollution interact with each other and with other elements of the exposome such as heat, to affect health This
is especially important in LMIC cities, where industry and traffic generate pollution and climate change is causing
unprecedented heat waves. We also need to identify sensitive ages where air pollution exposure can be
particularly detrimental. Children pass through critical windows of development when they are highly sensitive
to exposures. Older adults are more likely to experience cardiac events when air pollution and heat levels rise.
In addition, exposures differ for people of different ages, gender, occupations, and socioeconomic status. To
address this complex situation, India needs experts trained in environmental health to carry out research and
recommend effective policies to mitigate air pollution exposure and protect those most vulnerable to its effects.
In this proposed project, entitled, “2/2-GEOHealth Health Effects of Selected Environmental Exposomes
Across the Life CourSe (HEALS)-US,” our multidisciplinary team of researchers, mentors and faculty from the
Harvard T.H. Chan School of Public Health (HSPH) and the Centre for Chronic Disease Control (CCDC) will
build on knowledge gained in our original GEOHealth project in which trainees and mentors developed models
to estimate levels of ambient PM2.5 in Indian cities and quantified the links between air pollution exposure and
cardiometabolic disease and death in Delhi. In addition, three students earned master’s degrees from HSPH
and one earned a Doctor of Public Health (DrPH). The proposed project will focus on training early career faculty
and researchers and recent post-docs in designing a research study, writing up a proposal, and carrying out
research on topics related to the research aims of characterizing the exposome and identifying groups most
vulnerable to the effects of air pollution. Two additional DrPH students will also be trained. The project will be led
by Dr.Sieber and Dr.Schwartz from HSPH and by Dr. Prabhakaran of CCDC and Dr. Reddy of the Public Health
Foundation of India who will be assisted by the: 1) Administrative Oversight Committee; 2) Training Oversight
Committee; 3) Program coordination personnel at HSPH and CCDC; and 4) Supervisory teams to provide
oversight for individual trainees. Evidence from the research conducted under the linked U01 will directly inform
Indian government agencies and policy makers on how to reduce air pollution exposures and how to protect the
most vulnerable groups to reduce the consequent burden of disease. The proposed training of Indian scientists
will build capacity to apply for future funding and to fully understand and address this environmental threat.
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