Children's Health and Environment Program

Young children interact with the environment in their homes, and in educational or child care establishments through breathing air, consuming food and water, and through "mouthing behaviours" in which they put their hands, feet, and other objects into their mouths resulting in non-nutritive ingestion.

Trans-placental transfer, breast milk, and non-nutritive ingestion result in unique exposure pathways for children. It is therefore critical that we understand the level of contamination within these environments so that we can assess exposure and risk and health impacts.

Did you know that children breathe more air, drink more water, and eat more food per pound of body weight than adults? This means that they receive a higher “dose” of any toxicant in the environment which places them at higher risk of ill effects from harmful contaminants in the environment.

The global pattern and causes of disease have changed. The Lancet Commission on Pollution and Health states that pollution, in its broadest sense, is the largest cause of disease and premature death in the world today. Pollution caused three time more deaths than AIDS, tuberculosis, and malaria combined in 2015.

Globally, early childhood deaths and deaths from communicable, maternal, neonatal, and nutritional disorders have declined. In contrast, deaths from non-communicable diseases (NCDs) are increasing; accounting for 70 per cent of all deaths globally today.

The Australian situation is no different with high incidence of NCDs including obesity, type 2 diabetes, cardiovascular disease (CVD), asthma, chronic obstructive pulmonary disease (COPD), and neurobehavioral problems. As NCDs become more prevalent, the future costs of diagnosis and treatment are likely to increase dramatically, thus highlighting an imperative to intervene in early life, optimise nutrition, and prevent and reduce exposure to hazardous chemicals/toxicants.

Our modern Australian environments are contaminated by an increasing variety of chemicals that increase the risk of NCDs, yet public awareness of the risks, and of avoidable exposures, is low. Low awareness contributes to human behaviours that perpetuate and even increase exposures to these pollutants.

Ecological exposures include contamination of air, water, soil, and the food chain by environmental toxicants from large scale industries, such as extractive industries, flame retardants and per- and poly- fluoroalkyl substances (PFAS) from fire-fighting foam, and agricultural pesticides, potentially affecting populations living in the vicinity of these activities. As an example, extractive industries play an important role in the Australian economy but may pose a special risk to those living around them from environmental contamination, change in land use, social disruption, and population displacement.

Modern household exposures include plastics and plasticisers, flame retardants, pesticides, cleaning products, and personal care products – all of which can have adverse health effects.

Ambient air exposures include combustion-related products from traffic, wood smoke, bushfires, coal-fired power generation, and industrial emissions.

While the general public is becoming better informed and increasingly concerned about adverse environmental influences on health, the environmental threats to the health of children are not high on the research agenda in Australia.

From our location within the Centre for Children's Health Research (adjacent to the Queensland Children's Hospital), the Children's Health and Environment Program is well-placed to develop a coordinated and ambitious plan for children's environmental health research to improve outcomes for children in Australia and internationally.

Our research aims to keep children safe from DETRIMENTAL and AVOIDABLE environmental exposures, reduce life-long risk of non-communicable diseases (NCD), and improve clinical outcomes by investigating:

• how environmental exposures impact on NCD risk
• the mechanisms of NCD development following environmental exposures
• the populations within Australia that face the most risk at a population level
• how to protect children from environmental exposures so they can live safer, healthier lives.

Ultimately our goals are to:

• generate new knowledge and evidence of the links between environmental exposures and disease mechanisms
• translate research into improved public health policy and clinical practice
• train the health workforce to recognise and respond to environmental exposures
• collaborate widely to ensure public engagement and to positively influence environmental and public health policy for effective and efficient prevention for improving life-long health.

There is a general lack of awareness of the particular vulnerability of children to adverse environmental exposures. To raise awareness of environmental exposures and the risk to children, we are collaborating with schools at The University of Queensland to produce and deliver educational material on children's environmental health targeted to undergraduate and postgraduate students, the continuing education of health care professionals, environmental health officers, and interested members of the public.

Education for Higher Degree Students

CHEP has a focus on education and training, adding a children's environmental health component to Masters Level education and short summer courses in the School of Public Health, in conjunction with Dr Luke Knibbs. CHEP staff currently contribute to the supervision of 15 HDR students at UQ and have had 23 successful PhD completions since 2014.

Intern program

CHEP runs an Intern program which exposes participants to children’s environmental health projects.

Responsibilities may include:

• conducting research to update World Health Organization training modules
• drafting a monthly newsletter, assisting staff with researching, writing and editing publications
• assisting staff with the planning and reporting of workshops and events
• undertaking some administrative tasks.

Interns will gain vital skills and networking opportunities in environmental health and experience of children’s environmental health issues and research.

Qualifications

Enrolled in or recently completed an undergraduate, honours, or master’s degree in public health, medicine, environmental health, international relations or a related field.

Excellent command of written and spoken English, experience with MS Office Applications (Word, Excel, PowerPoint), excellent communications skills, attention to detail, and ability to work independently are required.

Apply

The internship will be based in the Centre for Children’s Health Research in South Brisbane, and will be advertised on the UQ Jobs page when applications are open. Interns are provided with desk space, internet access and UQ library access.

This is an unpaid position with flexible hours. A time commitment of at least one regular day per week is required. Positions are held for 3 to 6 months

Education materials

Link between Air Pollution and Allergies

Our Collaborations

To maximise our impact, we have forged strong and active local and international collaborations.

Within The University of Queensland, we have strong partnerships with the Queensland Alliance for Environmental Health Sciences (QAEHS), formally known as the National Centre for Environmental Toxicology (ENTOX), the School of Public Health, and the Global Change Institute.

External to The University of Queensland, we collaborate regularly with:

• Department of Public Health, Environment and Social Determinants of Health, WHO (Geneva, Switzerland),
• The Pacific Basin Consortium (PBC) for the Environment & Health,
• The National Institute for Environmental Health Sciences Superfund Basic Research program,
• WHO Western Pacific Regional Office (Manila, Philippines),
• National Institute of Environmental Health Sciences (Durham, North Carolina, USA),
• Chulabhorn Research Institute (Bangkok,Thailand),
• Gwangju Institute for Science and Technology (Gwangju, South Korea),
• Murdoch Children’s Research Institute - (Melbourne, Australia),
• Edith Cowen University (Perth, Australia) - BIS
• Telethon Kids Institute (Perth, Australia) - Raine study
• A SHARED Future &
• Indigenous Environmental Health Risk Assessment Team - Developing An Indigenous Value-Based Approach to Environmental Health Risk Assessment 

We also work with scientists to conduct research programs in developing countries including Brazil, Thailand, China, Mexico, India, and South Africa. Collectively, these collaborations enable us to conduct research with global reach and relevance. It also means students and staff have the opportunity to gain exposure to, and experience with, major international and national environmental health groups.

Public Engagement

CHEP provides The University of Queensland with the opportunity to take a leadership role in engaging the public in children's environmental health and in child health advocacy. CHEP has recently taken over producing the Healthy Environments for Children Alliance newsletter, a joint venture from WHO and the United Nations Environment Program (UNEP). By engaging with public interest groups such as the National Toxics Network we can supply accurate information that will increase public awareness and ensure The University of Queensland is at the forefront of discourse relating to childhood environmental exposures.

• WHO, Department of Public Health, Environment and Social Determinants of Health: The role of the Department of Public Health, Environmental and Social Determinants of Health (PHE) within the overall work of WHO is to promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental and social threats to health. PHE develops and promotes preventive policies and interventions based on an understanding and an in-depth scientific analysis of the evidence base for environmental and social determinants of human health. 
• The Pacific Basin Consortium for Environment and Health: The Pacific Basin Consortium (PBC) was established in 1986 by a group of scientists and engineers to facilitate dialogue and cooperation among scientists, industry professionals, government officials, students and policy makers regarding the problems associated with hazardous waste production, management and remediation in the Pacific Basin. 
• Solving the E-waste Initiative (StEP): Solving the E-waste Initiative (StEP) is a platform for varied actors to proactively work on long-term solutions to the e-waste problem. StEP projects are grouped into five task forces: Policy, ReDesign, ReUse, ReCycle and Capacity Building. A recent addition to StEP’s activities is the E-waste Academy program. Involving scientists and policy makers, the E-waste Academy is a set of annual workshops aiming to foster communication and create connected experts in all spheres of e-waste management.
• Basel Convention: The Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and their Disposal was adopted on 22 March 1989 by the Conference of Plenipotentiaries in Basel, Switzerland, in response to a public outcry following the discovery, in the 1980s, in Africa and other parts of the developing world of deposits of toxic wastes imported from abroad. 
• CSIR Water Research Institute: The Water Research Institute (WRI) is one of the 13 research institutes of the Council for Scientific and Industrial Research (CSIR). Its mission is "to conduct research into water and related resources through the generation and provision of scientific information, strategies and services towards the rational development, utilisation and management of water resources of Ghana in support of socio–economic advancement of the country, especially in the agriculture, environment, health, industry, energy, transportation, education and tourism sectors." 

• Children's Environmental Health Center, Mount Sinai Hospital: The Children’s Environmental Health Center (CEHC) conducts groundbreaking research to identify the environmental causes of childhood disease. They translate these findings into solutions that protect children’s health — using research to educate families and change public policy. 

• Queensland Alliance for Environmental Health Sciences (QAEHS): As part of UQ's ongoing and successful environmental health partnership with Queensland Health, QAEHS is committed to establishing and maintaining multidisciplinary research expertise across a range of environmental health sciences. These include environmental aspects of toxicology, human health epidemiology, microbiology, health risk assessment, health risk communication, identification and analysis of emerging environmental health risks, and state-of-the art monitoring and analytical techniques, methodologies and technologies for environmental hazards and exposures.

• United Nations Industrial Development Organisation (UNIDO): UNIDO is the specialized agency of the United Nations that promotes industrial development for poverty reduction, inclusive globalization and environmental sustainability. 
• International Telecommunication Union (ITU): ITU is the United Nations specialized agency for information and communication technologies – ICTs. ITU aims to ensure networks and technologies seamlessly interconnect, and strive to improve access to ICTs to underserved communities worldwide.
• United Nations Environment Programme (UNEP): UNEP's mission is to provide leadership and encourage partnership in caring for the environment by inspiring, informing, and enabling nations and peoples to improve their quality of life without compromising that of future generations. 
• International Labour Organisation (ILO): The main aims of the ILO are to promote rights at work, encourage decent employment opportunities, enhance social protection and strengthen dialogue on work-related issues. 
• International Programme on the Elimination of Child Labour (IPEC): The overall goal of the ILO’s International Programme on the Elimination of Child Labour is the progressive elimination of child labour, which is to be achieved through strengthening the capacity of countries to deal with the problem and promoting a worldwide movement to combat child labour.
• United Nations University (UNU): The United Nations University (UNU) is a global think tank and postgraduate teaching organization headquartered in Japan. The mission of the UNU is to contribute, through collaborative research and education, to efforts to resolve the pressing global problems of human survival, development and welfare that are the concern of the United Nations, its Peoples and Member States. 
• Global Alliance on Health and Pollution (GAHP): The Global Alliance on Health and Pollution was formed in 2012 in response to the growing crises posed by toxic pollution. GAHP is a collaborative body that facilitates the provision of technical and financial resources to governments and communities to reduce the impacts of pollution on health in low- and middle-income countries.
• International Environmental Technology Centre (IETC): IETC have provided the manual on E-waste Volume III - WEEE/e-waste "Take back system". This manual aims to build the capacity of practitioners and decision makers to guide and assist them in understanding, planning, designing and implementing WEEE/e-waste take-back schemes. 
• Mesothelioma Centre at Asbestos.com: Asbestos exposure has been linked to the development of serious respiratory diseases and cancers, including mesothelioma, lung cancer, asbestosis, and other conditions. Asbestos exposure is most commonly related to occupational, environmental and secondhand factors.

​​​​​​Despite our relatively clean air in Australia, it has been found that large numbers of children live in areas that exceed the WHO air quality guideline limits. Our study explores exposure to air quality in early life and the risk of poor respiratory health in childhood. We focus on the role of air pollutants in inflammatory and oxidative stress responses, as well as understanding whether risk of adverse respiratory health is higher in children with a genetic susceptibility to oxidative stress.

Contact: Dwan Vilcins 

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 

Children with Cystic Fibrosis (CF) are born with structurally normal lungs but as they grow older, they are at risk of repeated respiratory infections that can damage the lungs.  Despite the advances in treatment and the overall better outcomes for children with CF, older children and adults still lose lung function. There is growing concern that CF lung disease begins very early in life and there has been much focus recently on trying to better understand early CF lung disease.

The Early Life Origins of CF Disease (ELO) Study is an observational study (no drug or therapy interventions) that is being conducted at The Queensland Children’s and Prince Charles Hospitals. Patients will be followed for three years and information relating to clinic and annual review visits will be collated. Our specific aims are (i) to better understand the mechanisms of early disease onset and how CF lung disease progresses throughout a patients’ life and (ii) improve/develop appropriate clinical outcome measures (lung function testing, biomarkers, imaging techniques) to improve CF management.

Contact: CLEAR@uq.edu.au.

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 bushfire smoke 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

You are welcome to read our children's book on Eddie the EPFR! 

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 10% of all subjects post HSCT yet this incidence is a gross underestimate due to the insensitivity of spirometry to detect peripheral lung changes where this process arises. This leads to late diagnosis, poor response to treatment, and poor prognosis (2-year and 5-year survival of 60% and 50%, respectively). 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 tests (multiple breath washout and oscillometry) in this setting. It will look at what we can learn from studies already performed by analysing both local data and pooled historical international data across 12 international centres (including both paediatric and adult data) – we will define the utility of these tools to detect pulmonary GVHD and their ability to provide earlier detection to facilitate earlier invention and improve outcomes. It will also explore novel applications of these tests in a prospective cohort 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 

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.

The OBSTRUCT study is run by Dr Matthew Wong and commenced in 2019, to date 126 wheezy children and 57 healthy children have completed the initial stage of this study. Nearly 50% of preschool children worldwide experience an episode of asthma-like symptoms, but only 30% with recurrent wheeze go on to develop asthma past 6 years of age.

In this study we want to better understand the complex link between early childhood wheezing and asthma.

The goal of OBSTRUCT is to assess the longitudinal changes in intra-breath respiratory impedance and explore if temporal oscillometry can help identify which children are at risk of developing asthma later in life and, subsequently, which young children may benefit from asthma medications. Recruitment for the initial stage of this study has closed and plans to conduct follow-up home monitoring visits at 1 and 2 years post initial recruitment are underway. These follow-up visits through to early school age will further investigate the relationship between early childhood wheezing and persistent asthma.

For further information regarding this study please contact Dr Matthew Wong: matthew.wong@uq.edu.au

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 Murdoch Children’s Institute and uses data from the Barwon Infant Study, longitudinal cohort of children in Australia.

Contact: Dwan Vilcins 

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.

Contact: Paul Robinson 

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).

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.

This is a phase 3 multi-centre randomized placebo-controlled study of azithromycin in the primary prevention of radiologically-defined bronchiectasis in infants with cystic fibrosis. The purpose of this study is to see if we can prevent or delay the onset of lung disease in children with Cystic Fibrosis by giving them Azithromycin from when they are very young.

The study is funded by Cystic Fibrosis Foundation Therapeutics in the US and the sponsor for the study is Telethon Kids Institute. There are eight centres across Australia and New Zealand (Perth, Brisbane, Melbourne, Sydney, Adelaide and Auckland). Total of 130 participants have to be recruited for the study. The recruitment is still in progress for the study.

The children diagnosed with cystic fibrosis by New Born Screening can be enrolled in the study by six months of age. They will receive azithromycin or placebo thrice a week till the age of 3 years. There are 14 visits to the hospital with bronchoscopy at the first visit and then at the age of 1 ad 3 years and the CT scans are done at the age of 1 and 3 years.

For enquiries about the study please contact the clinical team on clear@uq.edu.au

(OM-85 in Prevention of Asthma in Children)

This is a phase 2, single-centre, double blind, randomised, placebo-controlled, study testing the primary prevention of persistent asthma in high risk children by protection against acute respiratory infections during early childhood using OM-85. Persistent asthma is a major problem yet none of the current therapies do more than control the condition. The long-term solution is to prevent asthma from progressing to the persistent form. The purpose of this study is to see if we can prevent asthma by stopping some of the events that happen early in life which may cause asthma. These are events like respiratory tract infections (colds and flu), wheezing and sensitisation to allergens.

OM-85 is an immune-stimulant which primes the immune system so that the body can respond quickly to infections and reduce damage to the lungs to prevent asthma from developing. OM-85 is a capsule and powder from capsule is dissolved in water and given to the child. The child receives OM-85 or placebo as five blocks of 10 days treatment plus 20 days no treatment for two winters and then they are followed up in the third year without any treatment.

This study is funded by the National Health and Medical Research Council and is being conducted at the Lady Cilento Children’s Hospital in Brisbane. Child Health Research Centre at The University of Queensland is the sponsor for the study. The recruitment for this study has been completed.

OMPAC final report is now available.

CHEP Annual Reports

• Annual Report 2022
• Annual Report 2021
• Annual Report 2020
• Annual Report 2019
• Annual Report 2018
• Annual Report 2017
• Annual Report 2016
• Annual Report 2014
• Annual Report 2013
• Annual Report 2011

WHO Collaborating Centre Annual Reports

• Annual Report 2023
• Annual Report 2022
• Annual Report 2021
• Annual Report 2020
• Annual Report 2019
• Annual Report 2018
• Annual Report 2017
• Annual Report 2016
• Annual Report 2015
• Annual Report 2014

WHO Collaborating Centre, Children's Enviromental Health Programme

• Children's Environmental Health (CEH) Report 2022
• Children's Environmental Health (CEH) Report 2021

WHO Publications in Environmental Health

• WHO (2017) Inheriting a sustainable world? Atlas on children’s health and the environment

Other

Global Initiative on Advancing Children's Right to a Health Environment: Outcome report for the Regional Expert Consultation for East Asia and the Pacific