With $25,000 pilot grants from the Duke Global Health Institute (DGHI), two Duke research teams are collaborating with partners in China and Sri Lanka on global environmental health projects.
One study will explore the effect of maternal exposure to electronic waste on birth outcomes in Guiyu, China, and the other will investigate whether pollutant mixtures in well water may cause chronic kidney disease in Anuradhapura, Sri Lanka.
How Does Maternal Exposure to Electronic Waste Affect their Babies?
DGHI affiliate faculty member Liping Feng, assistant professor of obstetrics and gynecology, is leading the study on maternal exposure to electronic waste in China.
In many low and middle income countries, handling and disposal of discarded electrical or electronic equipment (e-waste) is unregulated. E-waste contains hazardous elements such as lead, mercury, chromium and flame retardants. Concern about health effects related to contamination in air, soil, and water for people working and living near e-waste processing sites is increasing, and pregnant women and children are among the people most vulnerable to this contamination.
Efforts have been underway to move toward a more sustainable, environmentally secure e-waste disposal process in Guiyu, China. By the end of 2015, all unregulated electronic-waste workshops were moved to a new industrial park in Guiyu. This change paves the way for a comparative study of the effect of e-waste contamination on birth outcomes between 2001-2008 and 2009-2016.
The team hypothesizes that the e-waste exposure level among pregnant women in this region is decreasing and birth outcomes are improving. To explore this hypothesis, they plan to:
- Initiate a birth cohort from three hospitals in Guiyu to evaluate the e-waste exposure among pregnant women and birth outcomes for those women
- Collect and analyze drinking water, water from Lian River (the major river in Guiyu), soil, food, air and industrial indoor dust for pollutants
- Develop a local education program to improve the awareness of the adverse health effects of e-waste exposure and prevention strategies among women
Feng is collaborating with Jim Zhang, professor of global and environmental health at Duke and Duke Kunshan University, and Xia Huo, professor of environmental medicine and developmental toxicology at Jinan University in Guangzhou, China. The team hopes the pilot funding will help them build a long-term collaboration with China and provide a foundation for securing external funding to continue their work.
Are Chemical Mixtures a Toxic Recipe for Chronic Kidney Disease?
Richard Di Giulio, professor of environmental toxicology at Duke, is leading the study on the potential link between pollutant mixtures in well water and chronic kidney disease in Sri Lanka.
Chronic kidney disease, a growing global health concern, typically results from disorders such as diabetes, hypertension, environmental contaminants and other factors. But in some instances, the etiology of the disease remains unknown. Chronic kidney disease of unknown etiology (CKDu) has become a serious public health epidemic in Sri Lanka over the last ten years. The disease is most prevalent in the country’s Anuradhapura district—or “dry zone”—where it affects about 15 percent of adults.
Ingestion of environmental contaminants is thought to contribute to CKDu, but a specific role for individual chemicals has been repeatedly tested without compelling positive results. The research team hypothesizes that the synergistic and interactive toxic effects of chemical mixtures may cause CKDu.
To explore this hypothesis, they’ll investigate the biological effects of chemical mixtures derived from drinking water wells used by CKDu patients in Anuradhapura. They’ll compare these results with wells belonging to families who are not affected by CKDu from Anuradhapura and from a distant region (Galle district), in collaboration with researchers at the University of Ruhuna, one of DGHI’s priority partnership locations. Ninety families will be identified, with 30 wells per group. The researchers will test well toxicity using zebrafish assays followed by cell culture studies at the University of Sri Jayewardenepura in Sri Lanka.
The overall project goals are to test the plausibility of chemical mixture effects as drivers of CKDu and ultimately help mitigate this critical, yet poorly understood, health problem.
Di Giulio’s co-investigators include:
- Nishad Jayasundara, postdoctoral researcher, Nicholas School of the Environment
- Truls Ostbye, professor of community and family medicine, nursing and global health
- Joel Meyer, associate professor of environmental toxicology and DGHI affiliate faculty member
- Gayani Tillekeratne, assistant research professor of global health
- Kamani Wanigasuriya, professor of nephrology at the University of Sri Jayewardenepura
This pilot funding will enable the team to build on their past work in this area, strengthen and expand DGHI’s and Duke’s partnerships in Sri Lanka, and—they hope—secure external funding to expand the study. The project will also provide important training opportunities for Jayasndara and for graduate students at the Duke Global Health Institute and the Sri Lankan universities involved in the study.