Pollution Research focuses on infants
The mainland will launch its first large study on the relationship between environmental pollution and children's health in the second half of next year, according to the project's US-trained leader.
It will join a global collaborative research project under way in developed countries, with Japan, Denmark and Norway having already started their own studies of 100,000 women each, and the US about to join them soon.
The study has attracted worldwide attention since British scientist Professor David Barker proposed a 'fetal and infant origins of adult disease' hypothesis in the 1990s, according to Chinese-American epidemiologist Dr Zhang Jun, who returned to lead the mainland's study in March last year.
'I think such a study is more significant in China than in other countries, because it touches on two sensitive aspects of mainland society: environment pollution, which is the result of China's fast economic development, and children, who are the focus of attention in Chinese families due to the one-child policy,' Zhang said.
Zhang said Barker's hypothesis suggests that many diseases, like heart disease, hypertension and diabetes, can be traced back to the first two years of a person's life, and even to the womb.
Causes of many diseases remain unknown. Sometimes doctors vaguely attribute these to 'environment pollution'.
'But we should provide strong evidence to support or refute the link between specific environment pollutants and specific diseases,' said Zhang. 'Our goal is to identify the hazardous elements and risk factors so we can prevent illnesses.'
He cited the example of the banning of Bisphenol A-tainted feeding bottles around the world based on the discovery that the chemical can possibly damage immunity and lead to tumours.
Zhang said the study could provide meaningful comparisons of health practices and traditions in different societies. For example, it was common for mainland expectant mothers to wear 'anti-radiation' vests which, their manufacturers claim, protect gestating fetuses from radiation given off by electrical machines, while pregnant Western women seldom used them. A large scale global study would be able to prove or refute such claims.
Next year, researchers would recruit 3,000 women volunteers in Shanghai who were pregnant, or planned to be, said Zhang, who is director of the Shanghai Key Laboratory of Children's Environmental Health at Xinhua Hospital, a leading paediatric institution in the city.
The study will follow the women before and during pregnancy, collecting extensive data on their social economic status, environmental exposure, nutrition, sleep habits, exercise and psychological stress before conception to birth and beyond. Blood, urine and even fingernails will be monitored.
After babies are born, the study will focus on child growth and development in an attempt to identify risk factors in childhood diseases.
Zhang said so far he had secured funding to canvass only 3,000 women in a three-year study.
But, according to this blueprint, the study will address a broad spectrum of health issues for women and their children.
Starting with the women who want to become pregnant, his research team hopes to identify the environmental, genetic and behavioural factors that affect a woman's ability to conceive, and later during pregnancy, what factors cause miscarriage, birth defects, preterm births and low birth weight.
In early childhood (up to age five) physical growth and mental development will be monitored. The main focus on schoolchildren will be to find causes of asthma, autism, attention deficit hyperactivity disorder, obesity and sexual prematurity. As the children enters adolescence, issues related to psychological and behavioural disorders will take centre stage.
'Our research project is very complex, involving experts in environment, gynaecology, obstetrics, paediatrics, immunology, nutrition and psychology. That's why it has taken most countries conducting such studies five years, on average, of preparation,' Zhang said. In the US, the study is being spearheaded by the National Institutes of Health, where Zhang worked before returning to the mainland last year.
He is also participating in the World Health Organisation's efforts to co-ordinate participating countries so that data they collect may be combined to study rare diseases in future such as childhood leukaemia.
Zhang said the particular illnesses targeted in his study were chosen because their occurrence is increasing. Researchers will avoid common ailments such as pneumonia that have been studied thoroughly, as well as rare diseases, such as leukaemia, because of the limited number of samples that can be obtained.
He said that a feature of mainland public health, where women are encouraged to undergo pre-marriage and pre-pregnancy check-ups, would provide a wealth of data on women who were preparing to become pregnant.
Zhang's predecessor at the Shanghai key laboratory is Dr Shen Xiaoming, who is also the vice-mayor of Shanghai. Zhang said Shen had considered a similar project some years ago to examine environmental factors in children's health, but was unable to launch the project because of his heavy workload as a city leader.
Zhang said ideally the study should follow 100,000 women and their children across the country.
'I have talked to various people, from government officials to ordinary citizens,' Zhang said. 'All of them recognise the importance of this project. Our immediate goal is to build a model in Shanghai as soon as possible that can be replicated in different parts of the country, so that the study can reach its targeted size and diversity.
'But, if we are to achieve our long-term goal, sufficient funding is crucial.'