Relating Environment-use Scenarios in Pregnancy/Infanthood and Resulting airborne material Exposures to child health outcomes (RESPIRE)

Detrimental effects of air pollution on child health include altered function of the lungs, brain and heart and can begin during fetal development. Therefore, pregnant women have a unique position in efforts to understand and lessen the adverse effects of air pollution. Past years have seen a focus on outdoor pollution from traffic and industry but recently attention has moved to the effects of indoor air pollution. Most people spend more than 90% of their time indoors where they are exposed to pollutants from things like frying foods, wood burning stoves and to the chemicals in clothing, furniture and cleaning products. Outdoor air pollutants also accumulate in the home especially in the colder months; exposure to indoor air pollutants also occurs at work, in school and other places we visit. The little information we have about the effects of indoor air pollution exposures during pregnancy suggests that they have negative effects on the developing baby affecting birth weight and lung function; other effects have not been studied. Our studies are designed to determine how air pollution exposures of pregnant women pass to the baby to affect organ development and poor health in childhood. By sharing our findings with local and national government, business, charities and the public we will provide them with the evidence to make changes to policy and practice that will eventually reduce the ill-effects of pregnancy air pollution exposures on child health. We will study the effects of airborne materials on different biological samples collected from pregnant women at different trimesters, not pregnant women and men. These samples will include nasal samples as a source from the airways that is safe to use in pregnancy, peripheral and umbilical cord blood, placenta and sperm and we will develop a human lung model. Samples will be exposed to PM2.5, components of house dust and volatile organic compounds, such as the chemicals found in cleaning products, alone and in combination including with other airborne materials such as pollen and viruses. This will enable us to track the passage and propagation of the response to airborne materials from the maternal airways, through the circulation to the placenta and fetus. We will measure changes in gene, protein and metabolite expression to determine if the toxicological response made differs in pregnant women. To elucidate the link between these toxicological responses and fetal organ development we will study animal models in parallel to determine what effects the maternal exposures are having. We will also study pregnant women in the community to gather data about their indoor environment. This will be linked to already gathered data about the outdoor environment and to other data collected routinely about all of us such as health data to help us understand how pregnant women change their use of indoor and outdoor environments over pregnancy and what this means for birth outcomes and later health of the child. We will collect biological samples such as nasal fluid, blood, urine and placenta from women in this cohort to see if these tissues from women with natural exposures share changes in gene, protein and metabolite expression with our laboratory models. Overall, this approach will reveal pregnancy-specific toxicological responses to airborne materials that can affect the developing offspring. All participants will be from diverse backgrounds, geographical areas and socioeconomic circumstances incorporating the lowest to highest potential exposures within the UK ensuring broad applicability of our findings and revealing the effects of health inequalities. Our activities will be supported by citizen science and vigorous management structures to ensure cohesive UK-wide consortium activities. The unique insights garnered will shape guidelines and policy and provide a step change in the implementation of behaviours and interventions to truly engender long-term health benefits for children.