Public Health Goes to China
ST. LOUIS -- Saint Louis University School of Public Health researchers are building strong collaborative relationships with prominent physicians, scientists and public health professionals in China to study the connection between air pollution in Wuhan, China, and poor pregnancy outcomes.
The study examines the link between the environment and the health of 100,000 infants, said Zhengmin Qian, M.D., Ph.D., associate professor and departmental chair of epidemiology at Saint Louis University School of Public Health and principal investigator.
The study is expected to take about four years to complete. It is supported by the Health Effects Institute, a nonprofit organization that funds research on the impact of air pollution on health, and by the Chinese government, which has an elaborate system of computerized air quality monitors.
"We have wonderful collaborators in Wuhan who already have outstanding infrastructures for public health research and practice in place. Completing the study will require the collaboration and cooperation of all health entities in the city of Wuhan and the Hubei province and we are excited to work together," said Qian, who calls Wuhan his hometown."The China CDC, China EPA, major universities, large hospitals and community health centers already are teaming up with us and fully engaged in building upon their new partnership with Saint Louis University."
Qian, who spent June in Wuhan, plans to be in the city for extended visits twice a year to supervise the research.
He is leading more than 100 collaborators in evaluating the relationship between high levels of sulfur dioxide, nitrogen dioxide, ozone and carbon monoxide in the air and pre-term birth, low birth weight and babies who are small for their gestational age.
With 9.1 million residents, Wuhan is the most populated city in central China, and like many large cities, has problems with air quality.
China has made a concerted effort to improve the health of babies. Wuhan doctors and nurses educate young women of child-bearing age about vitamins, nutrition and exercise so they can give their babies a jumpstart on a healthy beginning.
"There's much we can learn about how the Chinese health system focuses on improving the health of young women so they can be the mothers of a healthy generation," said Edwin Trevathan, M.D., MPH, dean and professor at SLU's School of Public Health who visited Wuhan in December.
"The work they are doing now will mean better health for children five to 25 years from now. Our Chinese friends and colleagues see the Wuhan study as critical to the overall health of their society."
To support China's commitment to protect the health of its children, Saint Louis University researchers will look at how exposure during various stages of pregnancy to air pollution, which varies throughout the year, affects babies. The first leg of the research looks at records of more than 100,000 mothers-to-be in Wuhan. The second part will focus on gathering data door-to-door from 10,000 pregnant women and looking at the impact on birth outcomes of additional factors such as family income, smoking and alcohol consumption.
"They're very concerned about the impact of air pollution on the next generation," Trevathan said. "We'll help them find out and in so doing, learn about what we can do to help our kids.
"This project is not only going to help us learn more about how to improve the health of women and children. It will help us in solidifying our relationship with Chinese colleagues in Wuhan, which is one of the most important relationships we have in global health."
Qian said he is working on the research project with childhood friends who still live in Wuhan. He has designed the research protocol and his Chinese colleagues are doing much of the information gathering because of their experience implementing large projects.
"Like St. Louis, Wuhan is located at the intersection of two major rivers. We feel a special kinship to Wuhan because it is an official sister city of St. Louis," Qian said. "What we learn from this type of global research also can be used by the people of St. Louis. We will do the study internationally and the result will benefit our local community."
Qian sees the research collaboration as a springboard to other studies, such as future research on the relationship between air pollution and birth defects.
The Wuhan research fits well into Saint Louis University School of Public Health's focus on maternal and child health epidemiology, added Trevathan.
Locally, the school is leading the National Children's Study, the largest study of child health ever conducted in the United States. Researchers are following more than 100,000 children from before birth to age 21 from diverse backgrounds and communities to learn about the effects of the environment and genetics on the growth, development and health of children.
Accredited since 1991, Saint Louis University School of Public Health is the only accredited school of public health in Missouri. It is one of 48 fully accredited public health schools in North America and the only accredited Jesuit or Catholic school of public health.
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