CHAI · Cardiovascular Health effects of Air pollution in Andhra Pradesh, India

While there is convincing evidence that exposure to particulate air pollution causes cardiovascular mortality and morbidity, nearly all of this evidence is based on populations in high-income countries where concentrations are relatively low. There is large uncertainty regarding the relationship between combustion particles and cardiovascular risk for concentrations higher than outdoor concentrations in urban areas of high-income countries and lower than active smoking. Exposures for our study population are likely to be in this range.We will investigate the cardiovascular health effects of exposure to particles from outdoor and household sources within a prospective cohort in Andhra Pradesh, India. Firstly, we will characterise exposure of participants using an integrated approach utilising outdoor mobile monitoring, personal monitoring, and questionnaire data. We will then collect data on participants’ activities and location using ‘life-logging’ from which activities driving exposure can be identified. Finally, we will quantify the association between exposure to particles and biomarkers of atherosclerosis.This research will shed light on the relationship between particles and cardiovascular risk at concentration ranges where there is the largest uncertainty. It will provide some of the first evidence of the cardiovascular health effects of medium-term exposure to particulate air pollution outside of a high-income country. The research will also provide evidence regarding the relative contribution of sources and activities linked to high exposure, forming the basis of recommendations for exposure reduction.