Clinical, Epidemiological and Experimental Approaches to Assess Adverse Health Outcomes of Indoor Biomass Smoke Exposure: Conclusions from An Indo-Swedish Workshop in Mysuru, January 2020
Mahesh Padukudru Anand,
Kjell Larsson,
Gunnar Johanson,
Harish C. Phuleria,
P. Veeranna Ravindra,
Lena Ernstgård,
Ulaganathan Mabalirajan,
Murali Krishna,
Lena Palmberg,
Krystal J. Godri Pollitt,
Swapna Upadhyay,
Koustav Ganguly
Affiliations
Mahesh Padukudru Anand
JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Department of Pulmonary Medicine, Mysuru 570015, India
Kjell Larsson
Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, SE-171 77 Stockholm, Sweden
Gunnar Johanson
Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, SE-171 77 Stockholm, Sweden
Harish C. Phuleria
Environmental Science and Engineering Department, Indian Institute of Technology Bombay Powai, Mumbai 400076, India
P. Veeranna Ravindra
CSIR—Central Food Technological Research Institute, Mysuru 570015, India
Lena Ernstgård
Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, SE-171 77 Stockholm, Sweden
Ulaganathan Mabalirajan
CSIR-Indian Institute of Chemical Biology, Kolkata 700032, India
Murali Krishna
Foundation for Research and Advocacy in Mental Health, Mysuru 570015, India
Lena Palmberg
Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, SE-171 77 Stockholm, Sweden
Krystal J. Godri Pollitt
Department of Environmental Health Sciences, School of Public Health, Yale University, New Haven, CT 06510, USA
Swapna Upadhyay
Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, SE-171 77 Stockholm, Sweden
Koustav Ganguly
Unit of Integrative Toxicology, Institute of Environmental Medicine (IMM), Karolinska Institutet, SE-171 77 Stockholm, Sweden
This report summarizes the outcome of a workshop held in Mysuru, India in January 2020 addressing the adverse health effects of exposure to biomass smoke (BMS). The aim of the workshop was to identify uncertainties and gaps in knowledge and possible methods to address them in the Mysuru study on Determinants of Health in Rural Adults (MUDHRA) cohort. Specific aims were to discuss the possibility to improve and introduce new screening methods for exposure and effect, logistic limitations and other potential obstacles, and plausible strategies to overcome these in future studies. Field visits were included in the workshop prior to discussing these issues. The workshop concluded that multi-disciplinary approaches to perform: (a) indoor and personalized exposure assessment; (b) clinical and epidemiological field studies among children, adolescents, and adults; (c) controlled exposure experiments using physiologically relevant in vitro and in vivo models to understand molecular patho-mechanisms are warranted to dissect BMS-induced adverse health effects. It was perceived that assessment of dietary exposure (like phytochemical index) may serve as an important indicator for understanding potential protective mechanisms. Well trained field teams and close collaboration with the participating hospital were identified as the key requirements to successfully carry out the study objectives.
