Emory-Georgia Clean Air Research & Education (CARE) Program - SUMMARY/ABSTRACT Globally, 7 million deaths are attributable to the joint effects of indoor and ambient air pollution annually, with ~94% occurring in low- and middle-income countries (LMICs). In addition, secondhand smoke (SHS) is a major global health problem, causing ~600,000 deaths (1% of mortality) annually, with women and children being disproportionately affected by SHS. LMICs are also disproportionately impacted by SHS and related morbidity and mortality. The Republic of Georgia (GE) is notably impacted by air pollution and SHS. Adverse environmental exposures cause 21% of disease burden and 25% of deaths, including 30% of disease burden and 14% of deaths among children. Moreover, GE’s mortality index attributed to ambient and indoor air pollution is the 3rd highest in the world. Additionally, the smoking prevalence in GE is 58% in men (6th highest in the world) and 6% in women, implying significant impact of SHS in GE. Indeed, 42% of GE adults report daily SHS exposure. Underscoring the impact of these statistics, GE’s 2017-2021 National Environment and Health Action Plan indicates that addressing air pollution is among the most prominent public health priorities in GE. However, there is limited in-country capacity to conduct research regarding the impact of such environmental hazards on health. This application, the Emory-Georgia Clean Air Research and Education (EG-CARE) program, coincides with increased prioritization of research and policy to reduce air pollution and address NCDs in GE, and represents a uniquely strategic collaboration among Emory University, the GE National Center for Disease Control and Public Health (NCDC), the GE National Environmental Agency (NEA), and Tbilisi State Medical University (TSMU). Various existing collaborations and ongoing efforts will be leveraged, including Fogarty-funded grants to promote smoke-free air policies in GE (an R01) and to enhance TB research capacity in GE (a D43), as well as an NIEHS-funded center grant called HERCULES (a P30) and an NIEHS-funded T32 training program at Emory. Key leaders of these efforts and across these institutions will collaborate to implement this training program, with the long-term goal of enhancing capacity in GE to conduct research related to NCDs and environmental health (EH) and ultimately inform policy and practice to reduce NCDs. The overall objective of this application is to develop and implement a training program involving training, mentorship, and applied research opportunities to ultimately reach the long-term goal. Thematically, EG-CARE will focus on the intersection between NCDs and EH, particularly air pollution, and aim to: 1) enhance formal NCD and EH training opportunities and institutional infrastructure to support ongoing research training; 2) provide mentored NCD- and EH- related research opportunities spanning from the molecular to the population level, with a particular focus on air quality and pollution, to candidates with outstanding potential; and 3) emphasize research dissemination and knowledge translation to inform policy and practice. Leveraging the aforementioned ongoing efforts, this proposal addresses a timely, high-priority public health concern in GE, underscoring its potential impact. The program team is uniquely positioned to address these aims and enhance research capacity related to NCDs and EH in the next 5 years and in the long term.
