Household Air Pollution and Intervention Network
During my time as an MPH student in the Environmental Health Department, I worked under Dr. Tom Clasen’s research team and have assisted faculty and students with various research activities related to the Household Air Pollution Intervention Network (HAPIN) Trial. This is a randomized controlled trial of liquid petroleum gas stove and fuel distribution in four low and middle income countries that is investigating potential health benefits among pregnant women and their children. My research interest is environmental influences on fetus and child development and this experience has allowed me to gain research skills in a field that I am passionate about.
This past year, I worked closely with Dr. Lisa Thompson, a principle investigator for the HAPIN Guatemala field site. I prepared study documents for IRB submission of a randomized control trial that is measuring adolescent girls’ exposure to plastic burning in rural Guatemala. I developed the study protocol, consents, questionnaires, and IRB application. The study will be taking place in HAPIN households this year, where plastic trash is usually burned at home in outdoor open fires or in indoor kitchen cook stoves. Investigators will also hold focus groups with the adolescents to identify ways of reducing, reusing, and recycling plastics without burning plastic in home fires. I also worked on a separate project where I assisted in the cleaning, organization, and analysis of data from a matched cohort study to assess the impact of improved water supply and sanitation in a rural population in Odisha, India on child health and nutrition.
My time on Dr. Clasen’s research team was a great learning experience and helped me grow as a public health student. I look forward to applying the skills I gained in my future research endeavors.
Interplay of Fetal Genetics, Environmental Exposures, and Birth Outcomes
During the two years of my MSPH program in Biostatistics, I was fortunate to work in the lab of Dr. Judith Fridovich-Keil in the Department of Human Genetics at Emory University. Generally, our research addresses the interplay of fetal genetics, environmental exposures, and birth outcomes. Specifically, I have been looking at metabolomic data derived from paired maternal serum and amniotic fluid samples from women carrying either a chromosomally normal fetus or a fetus with trisomy 21 (Down Syndrome). I am asking whether the presence of a third chromosome 21 alters the fetal response to a given environmental exposure, defined by finding traces of the exposure chemical in the corresponding maternal serum sample. We know that there is variability in trisomy 21 birth outcomes; for example, about half have heart defects and half don’t, but no genetic explanation for this has been found. Thus, we hypothesize that an environmental factor could contribute to these differential outcomes.
We currently have metabolomic data sets from maternal serum and second trimester amniotic fluid samples from 39 women whose fetus had an extra chromosome 21 (cases), and 81 women whose fetus was chromosomally normal (controls). Working collaboratively with the laboratory of Dr. Dean Jones, at the Emory School of Medicine, we identified triphenyl phosphate (TPP), a common flame retardant, and were able to quantify it in our maternal serum samples. TPP was selected because it is ubiquitous in the environment and has a long half-life, meaning it can be used as an indicator of chronic exposure. Using the differing levels of TPP as our outcome parameter, we attempted to identify different metabolic features, and thus different metabolic pathways, in both cases and controls that are significantly associated with the outcome; we are interested in examining the similarities and differences of the metabolic perturbations as a result of the exposure to TPP between the cases and controls. Currently, we are working on determining which metabolic pathways and features are dysregulated between cases and controls, and if there are any other distinguishing metabolic differences between the two groups. We are interested in observing how a T21 fetus may respond differently to this exposure. The intensity of different metabolites may correlate differently with TPP exposure in cases and controls.
Predicting PM2.5 Concentrations Using the Geostationary Ocean Color Imager (GOCI) Satellite in South Korea
In my first year as an Environmental Health-Epidemiology MSPH student, I had the opportunity to work as a graduate research assistant under Dr. Yang Liu from the Department of Environmental Health. The Liu Group utilizes satellite aerosol optical depth (AOD) data along with meteorology and other model-based data to develop sophisticated statistical models that estimate PM2.5 concentrations. In recent years, satellite remote sensing has been a novel method to retrieving surface PM2.5 levels due to the satellite’s wide coverage and continuous spatial distribution.
Over the past year, my project’s focus was on utilizing the AOD retrieved from the Geostationary Ocean Color Imager (GOCI) satellite to predict daily PM2.5 concentrations in South Korea between 2015-2018. To estimate ground-level PM2.5 concentrations, we will develop machine learning models using AOD, meteorological parameters, and geographical attributes. In my first semester, I spent most of my time learning about the GOCI satellite and visualizing my study domain on GIS. I also spent time collecting and downloading data necessary for future data processing steps such as population density, elevation, and meteorology. In my second semester with the Liu Group, I was able to develop my programming and data analysis skills in R by cleaning and processing raw meteorology data. My future goals for this project are to continue the work I have been doing and further develop my programming skills. Ultimately, I will produce a machine learning model that will estimate particulate matter levels in South Korea.
Rhode Island Child Health Study Website Creation
During the past year, I had to opportunity to work with Dr. Marsit’s lab and create a website to host information about the Rhode Island Children’s Health Study (RICHS). The goal was to create a central place for cohort maintenance and community building that would allow for information to reach cohort participants, other researchers, and the general community.
RICHS is a birth cohort of mother-child pairs in the Rhode Island area. This cohort allows teams from Emory and Brown/The Miriam Hospital to better understand how the placenta plays a role in the programming of children’s health and risk of disease. RICHS allows information to be gathered through genomic-specific methods that are used to investigate markers of environmental exposure in the placenta.
By using the Squarespace web design resources and some CSS code, I developed www.rhodeislandkidshealth.com. This website includes information about each team, the study, and frequently asked questions related to environmental genomics and RICHS. Cohort participants can see where RICHS made it into the news and access opportunities. Researchers are able to find more information on the data repositories made available through RICHS. Finally, there is a comprehensive list of publications that are related to RICHS.
I am very thankful to have had the opportunity to use the skills I gained in high school in the public health setting. It was rewarding to create a central hub for RICHS information, and it helped me obtain a short-term internship with the CDC that I completed during the Spring 2019 semester.
HERCULES Community Engagement Core
During my year of working with the Community Engagement Core (CEC), I have been able to participate and collaborate with various local community groups, organizations, and stakeholders that are interested in protecting their health through action at the community level. My role consisted of translating complex scientific articles into simple language to create communication tools like infographics and informational sheets that can be used to educate and inform all members of the community. I would also translate these infographics from English to Spanish to accommodate the growing Hispanic communities in Atlanta that also disproportionately face environmental health exposures and that increasingly interact with HERCULES. As exposome science advances, it is important to understand how the field develops and how the science is being implemented at the community level. To better understand this and to better serve the communities, I conducted a literature review on the exposome and how it has been defined and operationalized in studies and practice since the inception of the concept in 2005. I also conducted a literature review on concept mapping and how it is being used to help communities understand their health priorities and form action plans based on their concerns.
The CEC works with communities to explain the exposome, understand the health concerns of the community, and develop an action plan to address those concerns while providing grant funding to the community to achieve their goals. This work was the most fulfilling for me, and I was able to follow this process at different stages with three different metro-Atlanta communities. I conducted qualitative interviews with two communities during their grant processes to help the CEC understand how to best move forward with the community, and with another community I helped facilitate the initial meetings to help the community understand their exposome and develop an initial plan for addressing their concerns. My year with HERCULES has given me skills in community engagement and community health development, which is an increasingly important field as many public health initiatives take on a more local and contextual approach in fighting disease.
Community-Based Investigation of Childhood Exposure to Heavy Metals from Soil
It was my pleasure to work as a research assistant in Dr. Eri Saikawa‘s lab in the Department of Environmental Science. Investigating the soil in local community gardens for heavy metal contamination and working with the Historic Westside Gardens was an excellent learning experience. I began while the project was in the midst of soil collections at over 30 sites in west Atlanta neighborhoods. Soil testing in this area had high levels of lead and resulted in discovering many sites of contamination in close radius with a possible dumping site from year’s prior. The discovery required intervention by the Environmental Protection Agency.
We were also able to work with a few residents to grow plants used for soil remediation and decrease the levels of heavy metals in their personal gardens. From there I met many community members who were a part of the research from its start. We were able to get an idea of the level of resources and education residents had on the subject matter. This lead to me completing an IRB for community based research on community members’ knowledge of heavy metals in the soil and associated health issues. We gathered information from over 40 residents on knowledge of heavy metals, types of gardening skills and experience, and perceptions of heavy metal health effects. This community study resulted in me being a contributing author of an article with potential for publishing.
I was lastly able to participate in the planning of the Atlanta Science Festival event, which had over 200 community participants who learned about gardening, soil testing, and remediating heavy metals in contaminated soil.
Occupational Exposures of Mothers of Children with Down Syndrome
During my second year as an MPH Epidemiology student, I had the opportunity to continue working for Dr. Stephanie Sherman of the Department of Human Genetics at Emory’s School of Medicine. We were able to complete our research objectives investigating the association between maternal occupation and chromosome 21 nondisjunction. A collaboration with NIOSH enabled us to evaluate environmental exposures within our dataset and determine if these exposures were associated with chromosome 21 nondisjunction. This has been an exciting project to be a part of during my MPH program.
Through this opportunity I was able to work within genetic and environmental epidemiology, which is a research area that is of great interest to me. I learned how to use NIOSH’s Industry and Occupation Computerized Coding System (NIOCCS) for occupation coding, develop multivariate logistic regression models, write statistical programs and perform statistical analyses using SAS. Additionally, I was able to work with a team of experts to collaboratively write a manuscript with our results, and I got the opportunity to present this research at a translational science meeting this past Spring.
This research experience has helped me to grow as an MPH student. It provided me ample opportunity to apply what I have been learning in a meaningful way. Results from this project suggest that occupational and/or environmental exposures may increase the likelihood of chromosome 21 nondisjunction, however, future research is necessary to determine toxigenic profiles that could be associated.
PFAS Chemicals and Body Composition and Related Metabolomic Outcomes
I have had the great pleasure of working on my MPH thesis with Jessica Alvarez, Ph.D, RD, and Thomas Ziegler, MD, from the Emory School of Medicine, Division of Endocrinology, Lipids and Metabolism. This thesis assessed the relationship between perfluoroalkyl substances (PFASs) in the blood and body composition and related metabolic outcomes in the Emory-Georgia Tech Predictive Health Institute’s Center for Health Discovery and Well Being (CHDWB) cohort using high-resolution metabolomics methods. These PFAS chemicals are in every day consumer products, such as non-stick cookware (Teflon), waterproof and breathable textiles, protective coatings for paper, food packing materials, and carpets. We hypothesized that higher PFASs in plasma were linked to higher visceral and subcutaneous adipose tissue, insulin resistance, cholesterol, inflammation, and oxidative stress.
Working collaboratively with Dean Jones, Ph.D., and the Clinical Biomarkers Laboratory, high-resolution metabolomics data was used to identify plasma PFASs in 180 participants of the CHDWB cohort. Three PFASs were found in plasma samples, including perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexanesulfonic acid (PFHxS), which are known persistent organic pollutants and endocrine disrupting chemicals. We then used multiple linear regression models to assess the relationships between PFASs and body composition and the related metabolic outcomes.
In addition to working on my thesis, I had the opportunity to assist the team with data entry, management, and analysis for various other research studies. I was even invited by the department to participate as the ‘clinical correlations’ guest speaker for the first-year medical students.
Working on a HERCULES project for my MPH thesis has allowed me to put the skills I learned in my classes into practice. This experience has opened my eyes to the endless opportunities that conducting research has to offer and taught me that I want to include clinical research in my future career.
E-cigarette Vapor Exposure in Children
For my REAL position I worked with Drs. Jeannie Rodriguez and Irene Yang in the School of Nursing on the MPEEK study. The purpose of the MPEEK study was to assess for non-invasive methods to diagnose e-cigarette vapor exposure in children so further studies on health effects could be run in the future. Participating parents were given a survey to fill out before contributing their samples, which included an oral microbiome, urine, and a collection of the liquid components of their breath. Over the course of the academic year, I assisted in recruitment, sample collections and home visits, lab processing of the samples, creation of the redcap database, and analysis of the survey results.
The survey is meant to be used for both cases (parents who vape) as well as controls (parents who don’t) to assess demographics, vaping behaviors, child exposure to vaping, cigarettes, and marijuana, child’s history of skin or lung conditions and dental health, and a brief assessment of dental hygiene habits. The survey totaled 202 questions, and included multiple choice, numeric responses, text responses, and ‘select all that apply’ responses, as well as a skip pattern where it was relevant. At the close of the study, I imported the redcap results into SAS for analysis. I used SAS to run tests for statistical significance for the demographics, health history, and dental habits sections.