Frederica P. Perera, DrPH, PhD

Mothers and Children Study in Poland: Krakow, Poland is a city with high levels of combustion-generated pollutants from coal burning, home heating, industry and traffic, as well as high rates of infant mortality, low birth weight, and cancer. CCCEH Investigators worked with a research team from Jagiellonian University in Krakow to study the developmental and respiratory effects, and potential cancer risk, from these air pollutants in a group of 400 pregnant women and their children. Exposure was measured by individual monitoring of pollutants in the air that women breathe in during pregnancy, and by the collection of biological samples to study various biomarkers. Associations between prenatal exposure to air pollution and lower birthweight, reduced intelligence scores, increased behavioral symptoms, and respiratory illness have been reported. The child health benefits of cleaner air in Krakow over the study period, largely from the ban on residential coal burning, were found to be substantial.

Mothers and Children Study in Tongliang, China: This study examined the benefit of reducing prenatal exposure to air pollutants from a coal-fired power plant on the health of newborns living in the immediate area of the plant. The power plant, located in the city center, was a major source of air pollution, burning more than 20,300 tons of coal per year. Two groups of mothers and children were enrolled, one before, and the other after the plant was shut down. Child exposure to polycyclic aromatic hydrocarbons (PAH) in polluted air was measured using a biomarker in cord and maternal blood collected at delivery by monitoring levels of air pollution over time. The investigators reported benefits of plant closure at the molecular and individual level, including lower levels of PAH-DNA adducts and increased concentrations of Brain Derived Neurotrophic Factor in cord blood. This study also examined the health and neurodevelopmental benefits to children of reducing prenatal exposure to such toxic air pollutants. A Geographic Information System was used to compare exposure levels of energy-related pollutants and related health effects. Results have been widely cited in policy circles to encourage similar regulatory actions.

Mothers and Children Study in Taiyuan, China: This was a multi-level research program in Taiyuan to monitor the benefits of broader policy reforms to reduce the burden of pollution. At the individual/molecular level, with our local research partners in China, four serial prospective cohorts of pregnant women and their newborns in Taiyuan were enrolled in two-year intervals (2009, 2011, 2013, 2016), during a time of rapid policy change. By doing so, we were able to assess the effectiveness of those policy changes in reducing air pollution, specifically PAH, and estimate the health and neurodevelopmental benefits to children in Taiyuan. In addition to this molecular epidemiologic research, at the population level, we tracked the impacts on environmental quality and population health of broad government actions in Taiyuan to reduce energy-related environmental pollution. The government instituted measures in the area including shutting down power plants, industrial pollution clean-up initiatives, encouraging innovative technological developments, and holding local leaders responsible for the pollution emitted in their jurisdictions. In August 2014, we published a manuscript in Environment International that documented the direct benefits of government policies enacted in Taiyuan over ten years (2000-2009) on air quality, population health, and economic measures. The estimated cost savings are 3.8 billion Yuan (or 618 million USD) from the reduction of air-pollution-related morbidity and mortality.