120 - Air Pollution Exposures in Early Life and Brain Development in Children - the ABC-Kenya Study

Poster Number: 120
Publication Number: 120.108

Catherine J. Karr, University of Washington School of Medicine, Seattle, WA, United States; Elizabeth Maleche-Obimbo, University of Nairobi, Nairobi, Nairobi Area, Kenya; Faridah H. Were, University of Nairobi, Nairobi, Nairobi Area, Kenya; Michael J. Gatari, University of Nairobi, Institute of Nuclear Science and Technology, Nairobi, Nairobi Area, Kenya; Beatrice C. Mutai, University of Nairobi, Nairobi, Nairobi Area, Kenya; Edmund Seto, University of Washington, Seattle, WA, United States; Brent Collett, University of Washington School of Medicine, Seattle, WA, United States; Megan McHenry, Indiana University School of Medicine, Indianapolis, IN, United States; Susan W. Wamithi, Aga Khan University, Nairobi, Nairobi, Nairobi Area, Kenya; Vincent K. Kipter, University of Nairobi, Nairobi, Nairobi Area, Kenya; Timothy Larson, University of Washington, Seattle, WA, United States; Julian Marshall, University of Washington, Seattle, WA, United States; Christopher Simpson, University of Washington, Seattle, WA, United States; Raymond S. McClelland, University of Washington School of Medicine, Seattle, WA, United States; Orly Stampfer, University of Washington, Seattle, WA, United States; Christopher Zuidema, University of Washington, Seattle, WA, United States; Sarah Benki Nugent, University of Washington School of Public Health, Seattle, WA, United States; Barbra A. Richardson, University of Washington, Seattle, WA, United States; John Kinuthia, Kenyatta National Hospital, Nairobi, Nairobi Area, Kenya

Background: Air pollution is linked with neurodevelopmental outcomes in high and middle-income countries. Research and clinical capacity to characterize developmental neurotoxicants in Sub-Saharan Africa (SSA) are limited and exposures are often magnitudes higher. Research is needed to inform policy.

Objective: To collaboratively design a longitudinal cohort study to understand the impact of early life exposure to air pollutants on child neurodevelopment in Nairobi, Kenya.

Design/Methods: Pilot research, training workshops, and a capacity building program fostered a new team incorporating environmental health, exposure science, and maternal child health at the University of Washington, University of Nairobi, Kenyatta National Hospital, Aga Khan University Hospital, Indiana University, and RTI International. Pilot household air pollution monitoring and recruitment of a cohort of pregnant women (Nf400) in the Dandora community is in progress. Exposure assessment includes determination of urinary biomarkers of polycyclic aromatic hydrocarbons which are common products of combustion from cooking, transport, industrial processes, refuse burning, etc., as well as in-home and nearby ambient levels of particulate matter (PM2.5), carbon monoxide (CO), and additional novel assessment of ultrafine particles (UFP) and black carbon (BC). Neurodevelopmental assessment capacity is being established by conducting Bayley Scales of Infant Development at age 1, 2 and 3 years and a validated tablet-based measure of executive function (EF Touch) at age 3 years.

Results: Pilot sampling of four homes with varied cooking fuel use shows feasibility of 24-hour air sampling indoors and outdoors for gravimetric PM2.5 as well as real-time CO and PM using low cost sensors. Significant variability was observed in pollution levels (range: 48-151 ug/m3 PM2.5 indoors). Only short-term sampling (~10 min/session) of BC and UFP was feasible due to concerns for instrument security. Indoor concentrations exceeded concurrent measures outdoors for all pollutants. All indoor and most outdoor PM2.5 measures exceeded WHO targets. CO levels were within targets with strong indoor peaks consistent with cooking activities. Lessons learned, key study design, and collaboration elements in this new pediatric environmental health research program in SSA will be described.Conclusion(s): This study addresses a major data gap on air pollution and child neurodevelopment in SSA and establishes capacity for ongoing pediatric environmental epidemiological research and research-to-policy translation.