PLoS ONE (Jan 2023)

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

  • Diana Marín,
  • Luz Yaneth Orozco,
  • Diana María Narváez,
  • Isabel Cristina Ortiz-Trujillo,
  • Francisco José Molina,
  • Carlos Daniel Ramos,
  • Laura Rodriguez-Villamizar,
  • Shrikant I Bangdiwala,
  • Olga Morales,
  • Martha Cuellar,
  • Luis Jorge Hernández,
  • Enrique Antonio Henao,
  • Verónica Lopera,
  • Andrea Corredor,
  • María Victoria Toro,
  • Helena Groot,
  • Milena Villamil-Osorio,
  • Diego Alejandro Muñoz,
  • Roberto Carlos Hincapié,
  • Ferney Amaya,
  • Ana Isabel Oviedo,
  • Lucelly López,
  • Ricardo Morales-Betancourt,
  • Beatriz Elena Marín-Ochoa,
  • Oscar Eduardo Sánchez-García,
  • Juan Sebastián Marín,
  • José Miguel Abad,
  • Julio Cesar Toro,
  • Eliana Pinzón,
  • Juan José Builes,
  • Zulma Vanessa Rueda

DOI
https://doi.org/10.1371/journal.pone.0278836
Journal volume & issue
Vol. 18, no. 1
p. e0278836

Abstract

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BackgroundAir 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.ObjectiveThis 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 methodsA 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/findingsTo 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.