Characterization of the external exposome and its contribution to the clinical respiratory and early biological effects in children: The PROMESA cohort study protocol

PLoS One. 2023 Jan 20;18(1):e0278836. doi: 10.1371/journal.pone.0278836. eCollection 2023.

Abstract

Background: Air pollution contains a mixture of different pollutants from multiple sources. However, the interaction of these pollutants with other environmental exposures, as well as their harmful effects on children under five in tropical countries, is not well known.

Objective: This study aims to characterize the external exposome (ambient and indoor exposures) and its contribution to clinical respiratory and early biological effects in children.

Materials and methods: A cohort study will be conducted on children under five (n = 500) with a one-year follow-up. Enrolled children will be followed monthly (phone call) and at months 6 and 12 (in person) post-enrolment with upper and lower Acute Respiratory Infections (ARI) examinations, asthma development, asthma control, and genotoxic damage. The asthma diagnosis will be pediatric pulmonologist-based and a standardized protocol will be used. Exposure, effect, and susceptibility biomarkers will be measured on buccal cells samples. For environmental exposures PM2.5 will be sampled, and questionnaires, geographic information, dispersion models and Land Use Regression models for PM2.5 and NO2 will be used. Different statistical methods that include Bayesian and machine learning techniques will be used for the ambient and indoor exposures-and outcomes. This study was approved by the ethics committee at Universidad Pontificia Bolivariana.

Expected study outcomes/findings: To estimate i) The toxic effect of particulate matter transcending the approach based on pollutant concentration levels; ii) The risk of developing an upper and lower ARI, based on different exposure windows; iii) A baseline of early biological damage in children under five, and describe its progression after a one-year follow-up; and iv) How physical and chemical PM2.5 characteristics influence toxicity and children's health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Air Pollutants* / analysis
  • Air Pollutants* / toxicity
  • Air Pollution* / analysis
  • Asthma* / chemically induced
  • Asthma* / epidemiology
  • Bayes Theorem
  • Child
  • Cohort Studies
  • Environmental Exposure / adverse effects
  • Environmental Exposure / analysis
  • Environmental Pollutants*
  • Exposome*
  • Humans
  • Mouth Mucosa / chemistry
  • Particulate Matter / analysis

Substances

  • Air Pollutants
  • Particulate Matter
  • Environmental Pollutants

Grants and funding

DM is the principal investigator. Grant number 121080763273, Contract 757-2018. This work was funded by the Colombian Ministry of Science, Technology and Innovation (https://minciencias.gov.co/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. JMA and JSM, coinvestigators. Healthcare Company, SURA (https://www.epssura.com/). The funder provided support in the form of salaries for authors [JMA, JSM], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.” JJB, coinvestigador. GENES laboratory (https://laboratoriogenes.com/). The funder provided support in the form of salary for author JJB, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific role of this author is articulated in the ‘author contributions’ section.