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Marín D, Basagaña X, Amaya F, Aristizábal LM, Muñoz DA, Domínguez A, Molina F, Ramos CD, Morales-Betancourt R, Hincapié R, Rodríguez-Villamizar L, Rojas Y, Morales O, Cuellar M, Corredor A, Villamil-Osorio M, Bejarano MA, Vidal D, Narváez DM, Groot H, Builes JJ, López L, Henao EA, Lopera V, Hernández LJ, Bangdiwala SI, Marín-Ochoa B, Oviedo AI, Sánchez-García OE, Toro MV, Riaño W, Rueda ZV. Early-life external exposome in children 2-5 years old in Colombia. Environ Res 2024; 252:118913. [PMID: 38643821 DOI: 10.1016/j.envres.2024.118913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 04/07/2024] [Accepted: 04/08/2024] [Indexed: 04/23/2024]
Abstract
Exposome studies are advancing in high-income countries to understand how multiple environmental exposures impact health. However, there is a significant research gap in low- and middle-income and tropical countries. We aimed to describe the spatiotemporal variation of the external exposome, its correlation structure between and within exposure groups, and its dimensionality. A one-year follow-up cohort study of 506 children under 5 in two cities in Colombia was conducted to evaluate asthma, acute respiratory infections, and DNA damage. We examined 48 environmental exposures during pregnancy and 168 during childhood in eight exposure groups, including atmospheric pollutants, natural spaces, meteorology, built environment, traffic, indoor exposure, and socioeconomic capital. The exposome was estimated using geographic information systems, remote sensing, spatiotemporal modeling, and questionnaires. The median age of children at study entry was 3.7 years (interquartile range: 2.9-4.3). Air pollution and natural spaces exposure decreased from pregnancy to childhood, while socioeconomic capital increased. The highest median correlations within exposure groups were observed in meteorology (r = 0.85), traffic (r = 0.83), and atmospheric pollutants (r = 0.64). Important correlations between variables from different exposure groups were found, such as atmospheric pollutants and meteorology (r = 0.76), natural spaces (r = -0.34), and the built environment (r = 0.53). Twenty principal components explained 70%, and 57 explained 95% of the total variance in the childhood exposome. Our findings show that there is an important spatiotemporal variation in the exposome of children under 5. This is the first characterization of the external exposome in urban areas of Latin America and highlights its complexity, but also the need to better characterize and understand the exposome in order to optimize its analysis and applications in local interventions aimed at improving the health conditions and well-being of the child population and contributing to environmental health decision-making.
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Affiliation(s)
- Diana Marín
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia.
| | - Xavier Basagaña
- ISGlobal, Barcelona, 08003, España, Spain; Universitat Pompeu Fabra (UPF), Barcelona, 08003, Spain; CIBER Epidemiology and Public Health (CIBERESP), Spain
| | - Ferney Amaya
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | | | - Diego Alejandro Muñoz
- Department of Mathematics, National University of Colombia, Medellín, 050034, Colombia
| | - Alan Domínguez
- ISGlobal, Barcelona, 08003, España, Spain; Universitat Pompeu Fabra (UPF), Barcelona, 08003, Spain; CIBER Epidemiology and Public Health (CIBERESP), Spain
| | - Francisco Molina
- Environmental School, School of Engineering, Universidad de Antioquia UdeA, Medellin, 050010, Colombia
| | - Carlos Daniel Ramos
- Environmental School, School of Engineering, Universidad de Antioquia UdeA, Medellin, 050010, Colombia
| | | | - Roberto Hincapié
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | - Laura Rodríguez-Villamizar
- Department of Public Health, School of Medicine, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Yurley Rojas
- School of Engineering, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Olga Morales
- School of Medicine, Pediaciencias Group, Universidad de Antioquia, Noel Clinic Medellin, 050010, Colombia; Department of Pediatrics, Hospital San Vicente Fundación, Medellín, 050010, Colombia
| | - Martha Cuellar
- School of Medicine, Pediaciencias Group, Universidad de Antioquia, Noel Clinic Medellin, 050010, Colombia; Department of Pediatrics, SOMER Clinic, Medellín, Colombia
| | - Andrea Corredor
- Department of Pediatrics, ONIROS Centro Especializado en Medicina Integral del Sueño, Bogotá, Colombia
| | - Milena Villamil-Osorio
- Department of Pediatrics, Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia
| | | | - Dolly Vidal
- Department of Pediatrics, Hospital Universitario San José, Popayán, 190003, Colombia
| | - Diana M Narváez
- Human Genetics Laboratory, Universidad de los Andes, Bogotá, 111711, Colombia
| | - Helena Groot
- Human Genetics Laboratory, Universidad de los Andes, Bogotá, 111711, Colombia
| | - Juan José Builes
- Department of Paternity Testing. GENES Laboratory, Medellín, 050024, Colombia
| | - Lucelly López
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | | | - Verónica Lopera
- Secretariat of Health, Medellin Mayor's Office, Medellin, 050015, Colombia
| | | | - Shrikant I Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, L8S 4K1, Canada; Statistics Department, Population Health Research Institute, McMaster University, Hamilton, ON, L8L 2X2, Canada
| | - Beatriz Marín-Ochoa
- School of Social Sciences, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | - Ana Isabel Oviedo
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | | | - María Victoria Toro
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | - Will Riaño
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia; School of Medicine, Pediaciencias Group, Universidad de Antioquia, Noel Clinic Medellin, 050010, Colombia
| | - Zulma Vanessa Rueda
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, R3E 0J9, Canada
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Marín D, Orozco LY, Narváez DM, Ortiz-Trujillo IC, Molina FJ, Ramos CD, Rodriguez-Villamizar L, Bangdiwala SI, Morales O, Cuellar M, Hernández LJ, Henao EA, Lopera V, Corredor A, Toro MV, Groot H, Villamil-Osorio M, Muñoz DA, Hincapié RC, Amaya F, Oviedo AI, López L, Morales-Betancourt R, Marín-Ochoa BE, Sánchez-García OE, Marín JS, Abad JM, Toro JC, Pinzón E, Builes JJ, Rueda ZV. 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; 18:e0278836. [PMID: 36662732 PMCID: PMC9858469 DOI: 10.1371/journal.pone.0278836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 11/01/2022] [Indexed: 01/21/2023] Open
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.
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Affiliation(s)
- Diana Marín
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Luz Yaneth Orozco
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia
- School of Engineering, Universidad de Antioquia, Medellín, Colombia
| | | | | | | | | | - Laura Rodriguez-Villamizar
- Department of Public Health, School of Health, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Shrikant I. Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
- Statistics Department, Population Health Research Institute, McMaster University, Hamilton, Canada
| | - Olga Morales
- School of Medicine, Pediaciencias Group, Universidad de Antioquia, Noel Clinic, Medellín, Colombia
- Department of Pediatrics, Hospital San Vicente Fundación, Medellín, Colombia
| | - Martha Cuellar
- School of Medicine, Pediaciencias Group, Universidad de Antioquia, Noel Clinic, Medellín, Colombia
- Department of Pediatrics, SOMER Clinic, Medellín, Colombia
| | | | | | - Verónica Lopera
- Secretaría de Salud, Alcaldía de Medellín, Medellín, Colombia
| | - Andrea Corredor
- Department of Pediatrics, ONIROS Centro Especializado en Medicina Integral del Sueño, Bogotá, Colombia
| | - María Victoria Toro
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Helena Groot
- Human Genetics Laboratory, Universidad de los Andes, Bogotá, Colombia
| | - Milena Villamil-Osorio
- Department of Pediatrics, Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia
| | | | | | - Ferney Amaya
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Ana Isabel Oviedo
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Lucelly López
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia
| | | | - Beatriz Elena Marín-Ochoa
- School of Social Communications and Journalism, Universidad Pontificia Bolivariana, Medellín, Colombia
| | | | | | | | | | - Eliana Pinzón
- Secretaria distrital de Salud, Alcaldia de Bogota, Bogota, Colombia
| | | | - Zulma Vanessa Rueda
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
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