Environmental and occupational health are critical problems in developing nations. Indoor air pollution is a particular problem in both Chile and Peru where large numbers of people lack effective stoves and frequently burn wood for heating and cooking. Outdoor air pollution is also a large problem, due to both particulates in the air, high ozone, and lead. Water contamination by metals is an important problem in both Peru and Chile, where mining has increased and mine wastes have contaminated water and soils Ongoing Fogarty studies funded under our current grant are addressing these problems in Chile and Peru. Occupational hazards are also frequently worse in developing countries. In Peru research studies funded by the current Fogarty grant to Emory have demonstrated that pesticide applicators in the Majes valley of Peru do not use protective equipments when using organophosphate pesticides. Two other Peruvian Fogarty studies funded via Emory showed a similar situation with informal gold miners using mercury and nurses using cytostatic drugs. An additional specific problem in Peru and Chile is altitude sickness. In important percentage of the population in both these countries live in high altitude. For example in Peru, 9 million out of a population of 27 million live above 2,000 meters. Health effects of working and living in high altitude include high stillbirth rates, low birthweights, and high prevalence of acute and chronic mountain sickness. In Chile mining activities in altitudes between 2.000 and 5.000 meters have increased dramatically in the last ten years, with the hiring of about 30.000 new workers. Research studies funded by Emory's current Fogarty grant have discovered that testing in a hyperbarmetric chamber at sea level can predict which workers going to altitude will get mountain sickness. Other Fogarty funded research in Peru has demonstrated the link between low birthweight and altitude. As indicated by the above examples, Emory University has been working with colleagues in Chile and Peru for the past five years, sponsoring research and training via our current Fogarty ITREOH grant. Training has occurred for dozens of students passing through our partners'Masters programs in environmental health, and by special courses in Mexico and Atlanta. We hope to continue our work over the next five years, and extend it by creating a new Center for Air Pollution Studies in Peru with the help of a new collaborator from the University of Georgia who has extensive experience with air pollution and in doing work in Peru. We also plan on research regarding the effect of interventions.
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