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STUDY PROTOCOL article

Front. Public Health

Sec. Children and Health

Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1485417

This article is part of the Research Topic Early Maternal and Child Health Management and the Impact of Living Environment View all 12 articles

A protocol for estimating health burden posed by early life exposure to ambient fine particulate matter and its heavy metal composition: A mother-child birth (ELitE) cohort from central India

Provisionally accepted
  • 1 Department of Environmental Health and Epidemiology, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
  • 2 Department of Environmental Monitoring and Exposure Assessment (Water and Soil), National Institute for Research in Environmental Health, Bhopal, India
  • 3 ICMR-National Institute for Research in Environmental Health, Bhopal, India
  • 4 Department of Environmental Biochemistry, ICMR-National Institute for Research in Environmental Health, Bhopal, India
  • 5 Department of Biostatistics and Bioinformatics, ICMR-National Institute for Research in Environmental Health, Bhopal, India
  • 6 Department of Child Health Research, National Institute for Research in Reproductive and Child Health (ICMR-NIRRCH), Mumbai, India
  • 7 Centre for Atmospheric Sciences, Indian Institute of Technology Delhi, New Delhi, Delhi, India
  • 8 Centre of Excellence for Research on Clean Air, Indian Institute of Technology, New Delhi, India

The final, formatted version of the article will be published soon.

    Background: Pregnant women and children are vulnerable to air pollution-related adverse health effects, especially those residing in low-resource and high-exposure settings like India. However, evidence regarding the effects of early-life exposure to air particulate matter (PM) on childhood growth/developmental trajectory is contradictory; evidence about specific constituents of PM, like heavy metals, is limited. Similarly, there are few Indian cohorts investigating PM exposure and the incidence of acute respiratory infection during infancy. This study protocol aims to fill these critical gaps in knowledge. Methods: We aim to establish a mother-child birth cohort through the enrolment of 1566 pregnant women residing in two urban areas of central India. Antenatally, we will collect socioeconomic, demographic, and clinical information and details of confounding variables from these pregnant women, who will then be followed up until childbirth to assess their exposure to air PM. Biomonitoring will also be conducted to evaluate heavy metal exposure. At birth, pregnancy outcomes will be noted, followed by postnatal follow-up of live-born children until the first year of life to assess their achievement of growth/development milestones and exposure to pollutants. We will also estimate the incidence of Acute Respiratory Infections (ARI) during infancy. Discussion: This manuscript describes the protocol for an Indian mother-child air pollution birth cohort study that aims to generate comprehensive evidence regarding the adverse effects of early-life (i.e., both pre-and post-natal) exposure to air PM and its constituent heavy metals among Indian children. This study will provide an epidemiological basis for further understanding in this context. Finally, by reporting our carefully planned study methods/outcome measures, which are comparable to those of published and ongoing birth cohorts, we aim to serve as the starting point for similar cohorts in the future, which, when considered together, would generate enough evidence to facilitate context-specific policy-making and development of appropriate prevention and mitigation strategies.

    Keywords: Acute respiratory infection, Air Pollution, Birth cohort, Child Development, Growth, heavy metals, India, Particulate Matter

    Received: 23 Aug 2024; Accepted: 31 Mar 2025.

    Copyright: © 2025 Trushna, Yadav, Kumar Mandal, Diwan, Tiwari, Ahirwar, Raj, Rana, Surve, Dey and Sabde. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yogesh Damodar Sabde, Department of Environmental Health and Epidemiology, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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