The overarching long-term goal is to be a leading scientist of environmental epidemiology and to develop a program of research that improves our understanding the role of environmental exposures in human health. The primary short-term research objective is to establish an independent and collaborative research agenda and projects at the University of Florida with a major focus on epidemiological research on environmental exposures, particularly on air pollution. This career development plan will provide the necessary resources to expand my inquiry into health problems related to air pollution by providing training in additional technique skills and formal mentorship to: (1) advance my knowledge of the impacts of air pollution on reproductive health;(2) gain further experiences in the conduct of research in environmental epidemiology, including study design, exposure assessment, large dataset management skills and statistical modeling;and (3) advance the skills which are essential for successful competition of independent grant funding, including scientific writing, manuscript development and grantsmanship. In particular, the goal of this mentored research is to investigate the health effects of air pollution on fetal health. The increasing rates of adverse pregnancy outcomes such as preterm delivery and low birth weight, which are major causes of mortality and/or morbidity in childhood and adulthood, have been reported in the USA and in Florida. Growing epidemiological evidence suggests associations between maternal exposure to ambient air pollution and adverse pregnancy outcomes. However, the findings have been inconsistent. The intent here is to evaluate the associations between ambient air pollution and adverse pregnancy outcome in Florida. This study will utilize three related datasets for the same geographic area and time periods: the Florida birth certificate data, US census data and the interpolated air quality data from the Hierarchical Bayesian (HB) space-time statistical model, which provides a better spatial resolution of air pollution levels for more accurately assessing exposure. In this study, one will: 1) use a population-based birth cohort to examine the associations between air pollution and adverse birth outcomes by emphasizing on detection of the critical windows of exposure and identification of the effect modifiers;2) apply multilevel models to further investigate these associations after considering the confounding effects and/or effect modification of neighborhood level factors (i.e. census tract- level variables);3) use a time-series analysis to assess the associations between air pollution and preterm births;4) develop a grant proposal for independent funding to conduct a study on air pollution and reproductive health. This study specifically addresses health effects of air pollution on adverse pregnancy outcomes with the ultimate goal of offering insight into their etiological causes, which can be modifiable in order to reduce these major reproductive health problems. Therefore, this work is of critical public health importance because of the increasing rates of adverse pregnancy outcomes, their long-term health consequences and the omnipresent nature of air pollution.

Public Health Relevance

Considering the increasing rates of adverse pregnancy outcomes and the omnipresent nature of air pollution, it is important to understand the role of air pollution in the development of adverse pregnancy outcomes, whether air pollution has adverse health effects on fetus and whether the associations will change if considering the confounding effects of additional neighborhood-level socially environmental factors. Furthermore, determining whether fetus at certain period of time during pregnancy is more sensitive to air pollution and whether fetus with certain characteristics is more vulnerable to adverse health effects of air pollution can help us better a causal relationship between them, which in turn guides us to reverse the increasing rates of adverse birth outcomes. This proposal seeks to better understand these relationships using 2004-2005 Florida birth registry data, census data and the modeled air quality data.

National Institute of Health (NIH)
National Institute of Environmental Health Sciences (NIEHS)
Research Scientist Development Award - Research & Training (K01)
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Special Emphasis Panel (ZES1-LWJ-V (01))
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Shreffler, Carol K
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University of Florida
Public Health & Prev Medicine
Schools of Public Health
United States
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Hu, Hui; Ha, Sandie; Xu, Xiaohui (2017) Ozone and hypertensive disorders of pregnancy in Florida: Identifying critical windows of exposure. Environ Res 153:120-125
Xu, Xiaohui; Hu, Hui; Ha, Sandie et al. (2016) Smartphone-assisted spatial data collection improves geographic information quality: pilot study using a birth records dataset. Geospat Health 11:482
Ha, Sandie; Hu, Hui; Mao, Liang et al. (2016) Potential selection bias associated with using geocoded birth records for epidemiologic research. Ann Epidemiol 26:204-11
Hu, Hui; Ha, Sandie; Henderson, Barron H et al. (2015) Association of Atmospheric Particulate Matter and Ozone with Gestational Diabetes Mellitus. Environ Health Perspect 123:853-9
Ha, Sandie; Hu, Hui; Roth, Jeffrey et al. (2015) Associations Between Residential Proximity to Power Plants and Adverse Birth Outcomes. Am J Epidemiol 182:215-24
Xu, Xiaohui; Hu, Hui; Ha, Sandie et al. (2014) Ambient air pollution and hypertensive disorder of pregnancy. J Epidemiol Community Health 68:13-20
Hu, Hui; Ha, Sandie; Roth, Jeffrey et al. (2014) Ambient Air Pollution and Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-analysis. Atmos Environ (1994) 97:336-345
Ha, Sandie U; Thompson, Lindsay A; Kearney, Greg et al. (2014) Population attributable risks of neurobehavioral disorders due to low birth weight in US children. Adv Pediatr Res 1:
Ha, Sandie; Hu, Hui; Roussos-Ross, Dikea et al. (2014) The effects of air pollution on adverse birth outcomes. Environ Res 134:198-204
Xu, Xiaohui; Ha, Sandie; Kan, Haidong et al. (2013) Health effects of air pollution on length of respiratory cancer survival. BMC Public Health 13:800

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