Environmental Factor – April 2022: Advanced Precision Environmental Health by Exposure Research

NIEHS grant recipient takes air pollution research to a new level and expands knowledge of how weather events linked to climate change, such as wildfires, can affect maternal health and infant.

Habre directs exposure science research at the NIEHS-funded Southern California Environmental Health Science Center at USC, and she co-chairs the Geospatial Working Group of the Environmental Influences on Child Health Outcomes program. (Photo courtesy of Rima Habré)

Rima Habré, Sc.D.from the University of Southern California (USC), integrates various data on personal exposures and lifestyle factors to strengthen its research, and its team integrates innovative technology to capture complex personal exposures with greater accuracy .

“My work shows that we can move beyond generalizations and assumptions at the population level and contextualize our science at the individual level,” Habré said during his virtual NIEHS Keystone Science Lecture on March 9.

Precision Environmental Hygiene

Air pollution can come from outdoor air, indoor sources, and other exposures posed by our individual behaviors, according to Habré. Accounting for all of these sources of exposure helps scientists advance precision environmental health, she added. This research framework—a focal point for the NIEHS—integrates the analysis of exposures and an individual’s genetic makeup to better understand disease risk and aid prevention efforts.

“This is exactly what many members of the biomedical research community sought to promote when the Genes, Environment and Health (GEI) initiative was developed in 2006,” noted David Balshaw, Ph.D., responsible for the NIEHS Exposure, Response, and Technology Branch. The US Department of Health and Human Services and the National Institutes of Health launched the GEI to expand research on gene-environment interactions and their influence on human disease.

Habre’s work to refine and strengthen personal exposure analysis is critical to efforts at the NIEHS and beyond to advance precision environmental health, according to Balshaw.

Climate-related risks to maternal and child health

Air pollution is the most important environmental risk factor in the global burden of disease, Habré noted.

“Climate change contributes to this by worsening air quality, increasing wildfires and widening health disparities,” she added.

Wildfire burns in Los Angeles, California This photo shows a wildfire in Los Angeles, California. MADRES Center scientists are assessing personalized air pollution exposures among Hispanic and African-American pregnant women who live in the city. (Photo courtesy of PTZ Pictures/Shutterstock.com)

Habré is the director of exposure assessment at USC Maternal and Developmental Risks Related to Environmental and Social Stressors (MADRES) Center for Environmental Health Disparities. Here, researchers study air pollution, built environment factors, and wildfire exposures as well as social stressors that affect pregnant and postpartum women’s health, fetal growth, and infant health. MADRES attendees come primarily from the Hispanic and African-American communities of Los Angeles.

Personal exposure monitoring combined with geospatial modeling indicates that women experienced an average of 130.5 days, and up to 211 days, of wildfire smoke exposure during pregnancy between 2016 and 2020, with preliminary evidence of decreased fetal growth, according to Habre. The number of active wildfires in Southern California was also an issue, with up to 11 fires burning at the same time on any given day of pregnancy. Habre noted that wildfire smoke includes complex chemical mixtures that vary depending on what is being burned, such as natural materials like trees versus manufactured items.

His team uses industry-leading, commercial-grade sensor technology to monitor population-level exposures, and they combine that data with participant-provided information about personal behaviors, activity patterns, and mobility. Custom risk models can be developed by documenting locations and travel data (walking or driving), where participants spend time (outdoor parks or inside their homes), and sources of air pollution. household air such as second-hand smoke.

“A lot of science has gone into setting standards for risk at the population level, but the science also needs to happen at the individual level,” Habré said. “We are all so different and our personal environments will have varying sources, chemical composition and toxicity.”

Habre works on his research at USC's Public Health Air Quality Lab Habre works on her research at USC’s Public Health Air Quality Lab. (Photo courtesy of John Davis)

Expand exposure assessments

Personal monitoring devices and geospatial technologies enable scalable and personalized exposure assessment in health studies, according to Habre. She works with Alex Bui, Ph.D., of the University of California, Los Angeles (UCLA), and Sande Okelo, MD, Ph.D., of the UCLA Pediatric Asthma Center of Excellence, to investigate childhood asthma as part of the PRISMS center in Los Angeles.

The PRISM team developed the BREATHE kit (Biomedical REAL-Time Health Evaluation Kit) to combine environmental exposures, health records and location tracking using geolocation technology (see box). The kit includes wireless devices and platforms developed to collect specific data through smartphones, smartwatches and dedicated apps. Collected health information is overlaid on GPS and Bluetooth-enabled sensors and wearable devices that capture personal exposures, medications, and lung function.

BREATHE kit contains AirBEAM sensor, Propeller Health inhaler, Bluetooth spirometer and WearOS smartwatch and app The BREATHE kit harnesses the power of technology to improve understanding of personal environmental exposures. (Image courtesy of Rima Habré)

Health risk models created from these measurements can result in just-in-time, contextually intelligent and adaptive interventions, but that’s only the beginning of what’s possible, Habre noted.

“Precision medicine is the direction of all of this work,” she said, referring to efforts by the biomedical community to promote personalized diagnosis, prevention and treatment of disease.

Bui ATA, Hosseini A, Rocchio R, Jacobs N, Ross MK, Okelo S, Lurmann F, Eckel S, Dzubur E, Dunton G, Gilliland F, Sarrafzadeh M, Habre R. 2020. Biomedical REAL-Time Health Evaluation (BREATHE): Toward an mHealth Informatics Platform. JAMIE Open (3)2:190–200.

(Jennifer Harker, Ph.D., is a technical writer-writer in the Office of Communications and Public Liaison at NIEHS.)

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