Emory-Georgia Clean Air Research & Education (CARE) Program

SUMMARY/ABSTRACT
Globally, 7 million deaths are attributable to the joint effects of indoor and ambient air pollution annually, with ~94%
occurring in low- and middle-income countries (LMICs). In addition, secondhand smoke (SHS) is a major global health
problem, causing ~600,000 deaths (1% of mortality) annually, with women and children being disproportionately affected
by SHS. LMICs are also disproportionately impacted by SHS and related morbidity and mortality. The Republic of
Georgia (GE) is notably impacted by air pollution and SHS. Adverse environmental exposures cause 21% of disease
burden and 25% of deaths, including 30% of disease burden and 14% of deaths among children. Moreover, GE’s mortality
index attributed to ambient and indoor air pollution is the 3rd highest in the world. Additionally, the smoking prevalence in
GE is 58% in men (6th highest in the world) and 6% in women, implying significant impact of SHS in GE. Indeed, 42% of
GE adults report daily SHS exposure. Underscoring the impact of these statistics, GE’s 2017-2021 National Environment
and Health Action Plan indicates that addressing air pollution is among the most prominent public health priorities in GE.
However, there is limited in-country capacity to conduct research regarding the impact of such environmental hazards on
health. This application, the Emory-Georgia Clean Air Research and Education (EG-CARE) program, coincides with
increased prioritization of research and policy to reduce air pollution and address NCDs in GE, and represents a uniquely
strategic collaboration among Emory University, the GE National Center for Disease Control and Public Health (NCDC),
the GE National Environmental Agency (NEA), and Tbilisi State Medical University (TSMU). Various existing
collaborations and ongoing efforts will be leveraged, including Fogarty-funded grants to promote smoke-free air policies
in GE (an R01) and to enhance TB research capacity in GE (a D43), as well as an NIEHS-funded center grant called
HERCULES (a P30) and an NIEHS-funded T32 training program at Emory. Key leaders of these efforts and across these
institutions will collaborate to implement this training program, with the long-term goal of enhancing capacity in GE to
conduct research related to NCDs and environmental health (EH) and ultimately inform policy and practice to reduce
NCDs. The overall objective of this application is to develop and implement a training program involving training,
mentorship, and applied research opportunities to ultimately reach the long-term goal. Thematically, EG-CARE will focus
on the intersection between NCDs and EH, particularly air pollution, and aim to: 1) enhance formal NCD and EH training
opportunities and institutional infrastructure to support ongoing research training; 2) provide mentored NCD- and EH-
related research opportunities spanning from the molecular to the population level, with a particular focus on air quality
and pollution, to candidates with outstanding potential; and 3) emphasize research dissemination and knowledge
translation to inform policy and practice. Leveraging the aforementioned ongoing efforts, this proposal addresses a timely,
high-priority public health concern in GE, underscoring its potential impact. The program team is uniquely positioned to
address these aims and enhance research capacity related to NCDs and EH in the next 5 years and in the long term.

Grant Number: 5D43ES030927-05
NIH Institute/Center: NIH
Principal Investigator: William Caudle