CHEP projects

Least developed countries (LDCs) are characterised by low incomes, low education levels, and high birth rates. In LDCs, children’s health is compromised by low access to environmental assets such as safe water and clean cooking fuel, the effects of unsustainable urbanisation and the impacts of climate change. This project uses a dynamic modelling approach to examine causal relationships between children’s health and its environmental, social, and economic influences in LDCs. Simulation modelling is performed for a case study LDC, Solomon Islands, and is used to simulate a range of children’s environmental health policy scenarios and predicted children’s health outcomes. 

Contact Paul Jagals 

Respiratory infections are the most commonly experienced illnesses throughout life, but especially during the first two years when infants may have six to eight infections each year. Emerging evidence indicates infections early in life along with other insults to developing airways in susceptible children may contribute to later development of chronic respiratory conditions such as asthma and chronic bronchitis.

We have previously collected detailed information on respiratory infections in the first two years of life for children who have participated in the ORChID study. The purpose of this study is to follow these children in early childhood up to the age of 7 years and track their lung function as a measure of respiratory health, as well as their immune response to common environmental allergens.

Contact: Dwan Vilcins

Collaborations with Queensland Alliance for Environmental Health Sciences (QAESH), The University of Queensland has already been established combining expertise in quantifying exposures to harmful chemicals in the environment with paediatric epidemiology and health outcome expertise. Strong collaborative links have been established, in particular with Professor Jochen Mueller, Professor Kevin Thomas and Dr Fisher Wang. 

Collaborative studies underway or in the planning include:

• Optimising techniques for assessing exposure of infants and young children to environmental chemicals
• Measuring biomarkers of environmental exposures
• Measuring environmental exposures and their health consequences in birth cohort studies.
• Determining the impact of prescribed burns on indoor air quality and associated health impacts for residents. 

Evidence is accumulating that climate change is resulting in a change in the distribution of infections, especially food, water, and vector-borne diseases.

Such changes will result in Australia facing an increase in diseases our work force is not trained to handle. Collaborations within CHRC (Infection, Inflammation and the Environment theme) and with The University of Queensland Australian Infectious Disease (AID) Research Centre will see CHEP well placed to contribute to an improved outcome for Australian children.

In addition, we have seen the impact on human health of zoonoses. Existing collaborations between CHRC and the School of Veterinary Science, The University of Queensland can be extended to help address such issues in children's health.

Contact Paul Jagals

Pollution caused three times more deaths in 2015 than AIDS, tuberculosis and malaria combined.  Exposure to air pollution and other environmental stressors have adverse effects on human health, including increasing susceptibility to acute respiratory illnesses (ARI) and chronic respiratory diseases.

While the epidemiological evidence is strong, the mechanism(s) underlying this phenomenon remains uncertain. Children exposed to second-hand tobacco smoke are at increased risk of ARI, including acute viral bronchiolitis, pneumonia and middle ear infections. Children exposed to household air pollution have increased rates of pneumonia and tuberculosis and exaggerated respiratory symptoms and ARI occur more frequently in children exposed to traffic related air pollution (TRAP). A common factor linking these combustion products is that they contain environmentally persistent free radicals (EPFRs). The premise of this research is that EPFRs cause adverse health consequences by inducing oxidative stress (OS). 

The EPFR project is in collaboration with LSU Superfund Research Center and is funded by National Institutes of Health (NIH). 

The project aims to understand the mechanisms by which EPFR exposure increases susceptibility to respiratory viral infections and to investigate mitigation strategies. It also looks at the EPFR role in the induction of steroid insensitive asthma. 

This project contains a human exposure study which aims to access the presence of EPFRs in household dust, and to understand which household characteristics affect the level of EPFRs in the home. This study uses an environmental monitoring protocol to visit homes in Brisbane and collect information on air quality, EPFRs and child health. 

Contact: Ayaho Yamamoto | Dwan Vilcins

A range of environmental factors can influence the health of the population. Environmental factors such as air pollution, temperature extremes, chemical exposures and polluted water can negatively impact the health of affected communities. Conversely, green space and good urban design can improve the health of communities. This project aims to examine the environmental factors associated with child health outcomes in Queensland, Australia.

Initial studies in the project will explore birth outcomes, neurodevelopmental disorders, infectious disease and asthma. 

Contact: Dwan Vilcins 

Children are uniquely vulnerable to harmful environments, due to their physiology, developmental windows of susceptibility and age-related behaviours. The urban environment is undergoing rapid transformation, as populations grow, children spend more time indoors, and the effects of climate change are starting to be experienced worldwide. Urban green space, the area of an urban area occupied with photosynthetic vegetation such as grass, shrubs and trees, is perhaps the best example of an environmental factor that may act as a public health good. Research has identified health benefits associated with green space, such as improvement in mental wellbeing, reduction in cortisol, an increase in physical activity, improved neighbourhood cohesion, and exposure to beneficial microbiota. Green space may play a role in ameliorating hazardous environmental exposures, such as air pollution and temperature extremes.

The aim of this study is match environmental data to a cohort of Australian children and examine the association between maternal and child exposure to environmental factors with the health of the child. Birth outcomes, lung health and neurodevelopmental outcomes will be explored.

Contact: Dwan Vilcins  

Chronic Graft-vs-Host Disease affects 60% of Haematopoeitic Stem Cell Transplant (HSCT) survivors by 6 years after their transplant, affecting multiple organs including skin, liver, gastrointestinal tract and lungs. Gold standard for pulmonary GVHD diagnosis is abnormal spirometry and subsequent CT-based imaging. Pulmonary GVHD is estimated to affect 20% of all subjects post HSCT yet this incidence is a gross underestimate due to the insensitivity of spirometry to detect peripheral lung changes. This leads to late diagnosis, poor response to treatment, and poor prognosis (5-year mortality is 85%). Better tools to detect and monitor pulmonary GVHD are urgently required.

This research program builds on previous work highlighting the potential utility of novel peripheral airway function test in this setting. It will analyse both local data and pooled international data across 12 international centres (including both paediatric and adult data) to define the utility of these tools to provide an earlier diagnosis of pulmonary GVHD to facilitate earlier invention and improve outcomes. It will also explore novel applications of these tests to enhance detection further in the initial period post HSCT to predict and detect those at risk.

Lower respiratory illnesses in the first year or two of life, especially those associated with wheeze and/or fever, are major risk factors for poor respiratory health. Recent data suggests that bacteria and viruses commonly found in the nose in early life may increase the risk of subsequent disease.

This project will take advantage of a unique, community-based birth cohort (ELLF), in whom the presence of respiratory viruses and bacteria in the upper airway and respiratory symptoms during the first 2 years of life have been determined from weekly nasal swabs and a daily symptom diary. This project will determine how nasal cells obtained from either adults (asthmatic or healthy) and the children birth cohort respond in laboratory-based culture when infected with bacteria, in addition to assessing the cell response when co-infected with respiratory viruses.

Contact: Ayaho Yamamoto

The airway epithelium provides the first line of innate immune protection to defend against environmental stressors and infections. A decline in airway epithelial innate immune system functionality is associated with many medical conditions and can result in chronic inflammation and compromised immunity of the lung. Oxidative stress can be generated by environmental exposure. Increase in oxidative stress cause airway and lung damage, which may initiate or worsen respiratory disease. Redox regulation maintains the equilibrium of pro-oxidant/anti-oxidant reactions but can be disturbed by environmental exposures. How this impacts on respiratory disease and whether anti-oxidants can provide protection is unknown.

This project aims to investigate the innate immune responses in environmental exposure; how the airway epithelium response to oxidative stress; and examine the utility of antioxidants to restore redox homeostasis.

The preschool years represent a crucial period in lung development. Longitudinal studies have shown that deficits in lung function start in early life with long term consequences into adulthood. This highlights the importance of being able to reliably and accurately measure the lung function of preschool aged children to aid in the diagnosis, treatment and management of children with suspected or known respiratory disease.

Contact: Paul Robinson

Macrophages are key cells in innate immune responses and play a critical role in orchestrating both initiation and resolution of pulmonary inflammation. In response to immune insults or injury, monocytes originated from bone-marrow migrate to the tissues, differentiate into macrophages (M0) and polarize into pro-inflammatory (classically activated or M1) or inflammation-resolving (alternatively activated or M2) phenotypes. These two compartments are well characterized in mouse model. In human, the border line between M1 and M2 polarization was vague until recently. Therefore macrophage responses in cystic fibrosis (CF) were mostly studied in mouse model. We have developed an ex-vivo model of human macrophages that reliably separates un-polarized (M0), M1 and M2 macrophages. Using this model we recently reported that activation of inflammation-resolving M2 macrophages were impaired in CF. In addition, we observed early expression of pro-inflammatory M1 macrophage markers in monocyte-derived M0 macrophages in patients with CF. Similar M1 and M2 markers expression was observed when macrophages from healthy donors were treated with CFTR channel inhibitor suggesting that defection M2 polarization is CFTR-dependent. We are aiming to study the link between CFTR function and macrophage polarization and functions.

Contact: Abdullah Tarique 

Maternal alcohol use in pregnancy is a known risk factor for subsequent harm to the developing foetus. The most recent report of alcohol use in Australia found that around 35% of women consume alcohol during their pregnancy, with approximately 55% of women consuming alcohol before they become aware of their pregnancy. Pre-clinical evidence has found that prenatal alcohol use inhibits lung development and cellular growth. Prenatal alcohol use has been associated with lower levels of surfactant protein  expression, detrimental effects on alveolar macrophages and decreases in both T and B cells. Our team is currently undertaking a study exploring the effect of maternal alcohol on lung function and lung health.

Contact: Dwan Vilcins 

CHEP is collaborating on several projects investigating the impact of environmental exposures on neurodevelopment and mental health in children. CHEP and Queensland Alliance for Environmental Health Sciences (QAESH) are providing expertise in environmental monitoring to the Barwon Infant Study, co-ordinated by Dr. Peter Vuillermin and Professor Anne-Louise Ponsonby, Murdoch Children's Research Institute, Melbourne.

There is an increasing body of evidence showing an association between plasticisers and allergic disease. Exposure to phthalates during pregnancy has been associated with increased risk of allergic diseases in resulting offspring. This study explores the association between phthalates and BPA measured in maternal urine during pregnancy, and the risk of allergic disease in children up to 4 years of age. Mediating factors will be explored, to test for potential casual mechanisms. Most notably the role of oxidative stress and genetic predisposition to oxidative stress will be explored as a potential modifying variable. This study is being conducted in collaboration with the Murdock Children’s Institute and uses data from the Barwon Infant Study, longitudinal cohort of children in Australia.

Contact: Dwan Vilcins 

Air pollution is a major killer and cause of considerable burden of disease. The burden falls unevenly, affecting vulnerable groups, especially children, living in low and middle-income countries excessively. Also, children living in big cities are exposed to high levels of traffic-related air pollution (TRAP), especially when travelling to and from school. In these countries, public transport is poor, and most children travel to and from school on motorbikes, increasing TRAP exposure. Such exposure increases the risk of acute and chronic respiratory diseases, such as pneumonia and asthma, and increases their risk of hospitalization. Such exposure is avoidable, at least in theory. Facemasks can reduce exposure and prevent symptoms in adults with cardiovascular disease; however, similar data are absent for children. In our project, we aim to develop the capacity of Vietnamese researchers to measure children’s exposure to TRAP, assess the effect of TRAP exposure on children’s respiratory health and to undertake a randomized control trial of wearing a mask to reduce TRAP exposure. In research methodology, we will measure lung function in young children, use induced sputum to assess personal TRAP exposure and measure urinary biomarkers to assess the mechanisms by which TRAP exposure reduces respiratory health.

This is a collaborative research project between CHEP and University of Medicine and Pharmacy in Ho Chi Minh City, Vietnam, and is funded by National Health and Medical Research Council (NHMRC - Grant ID. APP1155241) and Vietnam National Foundation for Science and Technology Development (NAFOSTED - Grant ID. NHMRC.108.03-2018.04).

Childhood asthma mortality remains substantial, and rates of hospitalisation are increasing globally in young children. This is driven by poor asthma control (which affects 50% of asthmatics) and ongoing exacerbations (which affects 25%). Of the 40,000 admissions each year, 80% are preventable! Current symptom-based management approaches fail – limited by poor perception/reporting by children and parents - and conventional spirometry/peak flow is insensitive or too challenging for this setting. In addition, the preschool age range is a critical period in asthma pathogenesis: symptoms emerge, airway structure changes, and a window for intervention exists before permanent lung function deficit is established by early school age. Preschool symptom-based diagnostic and/or predictive tools (for later asthma) perform poorly and ignore lung function due to spirometry’s limitations. Improved ability to differentiate early asthma phenotypes is a priority of international societies.

This research program consists of a series of projects to analyse existing, and collect new, data to define the clinical utility of a unique remote home-based monitoring strategy focused on the day-to-day variability of a novel and sensitive lung function test. Studies will investigate its ability to correctly identify evolving asthma, detect loss of asthma control and provide an early signal of an impending asthma exacerbation to improve long term asthma outcomes.

We have a number of opportunities for parents and children to participate in our research.

Current studies are listed on the Participate in our research section of our website.