Project Title: Climate, Health and Air pollution Research in India (CHAIR-India): Addressing Gaps in Achieving the Sustainable Development Goals on a global level linking air pollution and climate change with health.
PIs: Petter Ljungman, Poornima Prabhakaran & Joel Schwartz
Funding agency: FORMAS
This international multidisciplinary consortium, funded by FORMAS (Sweden) aims to estimate daily fine particulate matter pollution (PM2.5) and ambient air temperature at 1×1 km across India between 2008-2020 using spatiotemporal machine learning models. CHAIR-India will link environmental data to health datasets, and study associations of short and long-term air pollution and temperature with mortality and cardiometabolic and respiratory disease in rural and urban areas across India. The project aims to foster public awareness, collaboration, and policy change by providing an interactive tool and engaging multiple stakeholders and end users.
For more information, please visit https://www.chairindia.org/
2. Project Title: Effectiveness of Indoor Air Purifiers on Heart Failure Outcomes (The PURI-HF Trial)
PIs: Rajesh Vedanthan and Nitish Naik
Funding agency: National Institutes of Health and Indian Council of Medical Research
PURI-HF is a five-year-long trial to test out the effectiveness of a novel low-cost air purifier intervention on heart failure outcomes. The project encapsulates three concurrent themes; highlighting the need for innovative studies founded on scientific evidence to postulate and recommend newer strategies targeted towards cardiac rehabilitation; the need for scalable solutions that are suitable for low-middle-income contexts; and the ethos of the Make-in-India programme that boosts Indian initiatives (here an IIT-based start-up with a patented filter technology). Finally, this study is a step towards the cross-pollination of ideas and research capacity between India and the USA funded jointly by NIH and ICMR.
The study aims to evaluate the effectiveness of indoor air purifiers on HF functional capacity (6-minute walk test) among patients with reduced ejection fraction less than 40% (HFrEF) in Delhi, Ludhiana, and Thiruvananthapuram compared to the control group receiving a bacterial filter.
3. Project Title: Nutritional, psychosocial, and environmental determinants of neurodevelopment and child
mental health (COINCIDE): an integrated assessment approach using a developmental framework
PIs: Giridhara Babu, Poornima Prabhakaran & Siddhartha Mandal
Funding agency: Wellcome Trust-India Alliance
PHFI IIPH Bengaluru is leading a collaborative project (COINCIDE) that aims to evaluate the effects of nutritional, psychosocial, and environmental determinants of For internal circulation only Page 2 of 2 neurodevelopment and child mental health from Pregnancy to 9 years in two diverse Indian settings. The project is led by the Indian Institute of Public Health - Bengaluru in collaboration with the Center for Environmental Health, Public Health Foundation of India - Gurgaon, Sangath - Delhi, Institute of Public Health - Bengaluru & St. John’s Research Institute - Bengaluru. The project will be conducted at two sites. The rural North Indian setting led by Sangath includes 120 villages in the Rewari district of Haryana. The urban South Indian site led by IIPH Bengaluru is within the Bruhat Bengaluru Mahanagara Palike (BBMP) municipality limits of Bengaluru, Karnataka.
4. Project Title: Epidemiology Modelling for Ambient Air Pollution Investment Case Methods for India and
PIs: Dorairaj Prabhakaran, Poornima Prabhakaran & Siddhartha Mandal
Funding agency: RTI
Our team worked alongside RTI on a UNDP Funded Project estimating the cost of air pollution in Nigeria. We estimated the excess age and cause-specific burden attributable to PM2.5 exposure above WHO-recommended levels. The study used Integrated Exposure Response and baseline mortality and incidence estimates from the Global Burden of Disease to calculate the deaths and incidence of major cardiovascular and respiratory diseases attributable to PM2.5 in each state. RTI estimated the economic impact (both direct and indirect) on the country due to excess deaths and incidence of these diseases.
5. Project Title: Public Health Initiative on LMIC Air Pollution (PHILAP)
PIs: Dorairaj Prabhakaran and D. K. Arvind
Funding agency: Medical Research Council
The PHILAP (Public Health Initiative on LMIC Air Pollution) project brought together clinicians, public health professionals, designers, and social and data scientists to explore the effect of air pollution on asthmatic adolescents drawn from the different strata of Delhi. The vision of the study was to bring constructive interaction between different research methods and expertise for understanding urban air quality on individual, community, and population health. Through the fostering of academic and non-academic partnerships, the project had two aims:
i) to increase understanding of the relationships between outdoor air, personal exposure, and health effects;
(ii) to interpret the project’s findings as stylized visual narratives, a series of short animated MEMEs and
art installations, and through infographics on digital platforms.
The study collected quantitative data to measure personal exposure to particulate pollution in real time along with the recording of the participant’s physical activity levels and ethnographic data provided by
the participants. PHILAP engaged the ethnographic data in a productive dialogue with the data derived from the personal monitoring and in turn inspired stylized animation sequences conveying pithy
messages on the problems associated with the unequal burden of air pollution in Delhi.
6. Project Title: Public parks and open gyms in Delhi – A situational assessment from a health perspective
and a case study
PI: Shifalika Goenka
Funding agency: WHO- SEARO
Green parks open to the public are known to increase physical activity levels and health, Open gyms
provide additional benefits. Parks provide health to people who are able to use them. Parks improve the
health of its citizens. Physical activity reduces sugar levels, reduces chances of diabetes, lowers blood
pressure, strengthens the bone, and keeps you younger along with improving mental health.
Approximately 33% of the risk of developing NCDs is attributed to physical inactivity according to WHO.
Greenery lowers air pollution levels and improves mental health.
All kinds of physical activity make you healthier. Large parks and urban forests within a 0.5 km radius of
every individual are recommended as it increases physical activity levels substantially. It is important to
exercise for a minimum of 45- 60 minutes every day. More activity beyond this further helps. Green parks
and small urban forests are known to have additional benefits as they not only increase physical activity in
people living close to them but also lower air pollution. They are known to decrease cancers, lower air
pollution, improve mental health and many other health ailments, and have benefits beyond just an
increase in physical activity.
The study has two components qualitative and quantitative. Observations of parks and their usage and
presence of open gyms and also feedback survey of users of the park. Also, detailed Case studies were
done. We found that the Parks and open gyms enhanced physical and mental health, gender equity and
socioeconomic equity, and cultural equity. They promoted healthy aging. Urban planning should make
large parks/urban forests within a 0.5 km radius a mandatory requirement in land allocation. All attempts
should be made to preserve the parks and prevent encroachments. Wide sidewalks to reach the parks are
recommended to enable safe access to parks. Parks in the vicinity had other wide-ranging benefits. They
helped towards many Sustainable development goals (SGDs: 2, 4, 5, 8, 9, 10, 11, 12, 13, 15, 16).
7. Project Title: Health and Environment Leadership Platform (H.E.L.P)
PI: Poornima Prabhakaran
Funding agency: HealthCare Without Harm
The Centre for Chronic Disease Control (CCDC) and Public Health Foundation of India (PHFI) in partnership with Health Care Without Harm (HCWH) established Health and Environment Leadership Platform (H.E.L.P.) in 2017. It is the India chapter of HCWH’s Global Green and Healthy Hospitals.
H.E.L.P is envisaged to be a knowledge-sharing and networking platform for hospitals, healthcare organisations, health systems, nursing associations, nurses, doctors, and individuals uniting and working to reduce the environmental footprint of the Indian healthcare sector and promoting public and environmental health.
H.E.L.P. is developed with the belief that sustained advocacy from a unified health sector has the
potential to drive transformational changes in policy and public opinion. Such an effort is also important to raise and place voices from the health sector on an inter-sectoral issue like the environment. The significant contribution of environmental risk factors for ill health in India has been highlighted through the Global Burden of Disease comparative risk assessment. India faces a high burden of diseases
because of environmental degradation and a lack of environmental awareness.
Issues like air pollution, access to clean water, and occupational exposures feature among the top ten
risks to public health. With air pollution alone contributing to over 2 million deaths and 41 million Disability Adjusted Life Years (DALYs) on an annual basis, a unified voice of the health sector is
imperative to tackle the growing environmental burden of disease.
For more information, visit https://greenhospitalsindia.com/
8. Project Title: Climate Risk and Resilience: Demonstrating the Power of Health Care to Decarbonize,
Reduce Economic Loss, and Protect People and Communities
PI: Poornima Prabhakaran
Funding agency: IKEA
The project aims to mobilize healthcare institutions and systems to assess their carbon emissions from various aspects of operations – buildings, energy, transport, pharmaceuticals, and supply chain. The project emphasizes decarbonizing healthcare delivery and building resilience because climate-smart healthcare is the solution that is needed to take on the challenges posed by climate change. Primary interventions include - assessing the climate footprint of the Indian Healthcare System, providing
technical support to public and private healthcare systems to map their carbon emissions, making decarbonization action plans, training, and capacity building.
9. Project Title: Prospective study: Association between exposure to PM2.5 and blood pressure among
participants May Measurement Month 2021 in four Southeast Asian countries
Retrospective Study: Association between exposure to PM2.5 and blood pressure among participants of
the globally conducted May Measurement Month 2018-2019
PI: Dorairaj Prabhakaran
Funding agency: CDC [Collaborating with Imperial College, London]
The May Measurement Month (MMM) screening campaign is a globally conducted cross-sectional survey of adults (≥18 years) who volunteered to have their blood pressure (BP) measured at any of the MMM screening sites. We used the participants of the screening camps and assigned exposure assigned using coordinate information of the screening sites and investigated the association between ambient PM2.5 and blood pressure. In the retrospective study (MMM18,19), participants from 29 countries were used to study the effect of 1-month, 3-month, 6-month, and 1-year exposures. Whereas, the prospective study
was conducted on 4 Southeast Asian countries from MMM 2021, studying the effects of only short-term ambient PM2.5 (1 day, 1 week, and 1 month) on BP.
10. Project Title: Air Pollution Investment Case: Amritsar and Gurugram
PI: Poornima Prabhakaran
Funding agency: UNDP
The epidemiological modelling exercise with RTI was applied in the Indian context to assess the burden of major cardiovascular and respiratory diseases attributable to PM2.5 in Amritsar and Gurugram. We partnered with PGIMER, Chandigarh to estimate the economic impact of non-communicable diseases attributable to PM2.5 exposure above WHO recommended levels. Our team will provide solutions to reduce PM2.5 in the cities and conduct a return on investment based on stakeholder recommendations
to compare intervention and non-intervention scenarios.
Project Title: Pilot project on personal monitoring of air pollution
PI: Kishore Kumar
Funding agency: NIH (GEOHealth)
We monitored real-time personal PM2.5 exposures of 85 adults belonging to various socio-economic status during the summer and winter seasons of 2019-2020. The project was nested in the Center for Cardiometabolic Risk Reduction in South Asia (CARRS) prospective cohort in Delhi, investigating PM2.5 levels in relation to cardio-metabolic risk factors and outcomes, funded by the National Institutes of Health (NIH), USA. We used a personal DataRAM aerosol monitor (Model: pDR 1500, Thermo Scientific., Waltham, MA) for monitoring PM2.5 levels and a Global Positioning System (GPS) sensor (Model: eTrex 10, Garmin., Olathe, KS) to track participant locations and their real-time proximity to major roads and other prominent PM2.5 sources. The study included participants from 17 neighborhoods in Delhi who
are employed in more than 40 different professions. The filters were analyzed to characterize black
carbon and heavy metals levels in PM2.5 exposures.
2. Project Title: Pregnancy-related exposures and neurodevelopment in children
PI: Monica Chaudhary
Funding agency: Department of Science and Technology
Pesticides play a crucial role in enhancing economic growth worldwide by increasing agricultural output and controlling vector-borne diseases. Ninety-eight percent of sprayed pesticides reach a destination other than the targeted species through the air, water, bottom sediments, and food, all segments of the population are exposed to the pesticides. Infants and children particularly have a higher risk of getting affected by chronic pesticide exposure due to their biological makeup, behaviour, and physiology.
Four of the commonly used pesticide groups- organochlorine (OC), organophosphate (OP), synthetic pyrethroids (SP), and carbamates have been known to interrupt early-stage neurodevelopmental processes, affecting the motor and mental capabilities of the child.
The current study aims to find the association between (prenatal and postnatal) pesticide exposure in a newborn and his/her neurodevelopment at the age of 6 and 12 months. It has two objectives (i) To examine the association between the pesticide organochlorine (OC), organophosphate (OP), synthetic pyrethroids (OC, OP & SP) residue levels detected in maternal blood, cord blood, as well as breast milk with the neurodevelopment score assessed at the age of 6 and 12 months; (ii) To estimate the correlation between the pesticide organochlorine (OC), organophosphate (OP), synthetic pyrethroids (OC, OP & SP) residues in maternal blood and the extent of its transfer in cord blood, secretion in the breast milk. This study has been planned on a cohort (DHANI) of an ongoing clinical trial in Belgaum, Karnataka. DHANI (Maternal DHA Supplementation and offspring Neurodevelopment in India) is examining the effects of
in-utero and early-life DHA exposure (through maternal supplementation) on postnatal neurodevelopment and body size of Indian infants (NCT01580345). Biochemical samples already
collected so far at 3 points (maternal venous blood at baseline, cord blood at delivery, and breast milk
at 1 month postpartum) under DHANI have been utilized to assess pesticide exposure by QuEChERS (quick, easy, cheap, effective, rugged, and safe) method.