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The Health Effects Institute

HEI International

In keeping with its Strategic Plan 2005-2010 (660 KB), HEI is bringing an increasingly international perspective to its work, both as a means to bring the best of global science to bear on its extensive work to inform policy decisions in the US, and to help build the scientific capacity in other regions of the world.  

For more than a decade, HEI has drawn the world’s best air pollution and health researchers into its strategic research program through its competitive research selection process. The results of those efforts – policy-relevant studies on particulate matter, diesel exhaust, air toxics, and other topics – are an integral part of our scientific program, and can be found in our Publications Database.

This page will provide information on international initiatives as it becomes available.

Public Health and Air Pollution in Asia (PAPA)
Multicity Time-Series Study in Latin America (ESCALA)
Air Pollution, Poverty, and Health in Ho Chi Minh City

News from HEI’s Current International Initiatives:

Among its broader international activities, HEI is implementing Public Health and Air Pollution in Asia (PAPA)— a program to build better understanding of the effects of air pollution on health in Asia. PAPA was launched at the Better Air Quality Conference and annual meeting of the Clean Air Initiative for Asian Cities held in Hong Kong in December of 2002 and has been actively engaged in identifying and working with science and scientists in the region.

For the latest on PAPA, check the following:

  • Requests for Applications – Spring 2009 NEW
    The Spring 2009 Research Agenda contains two requests issued under the Public Health and Air Pollution in Asia (PAPA) program. Request for Applications 09-2, Impact of Air Pollution on Infant and Children's Health in Asia, seeks proposals on the health effects of air pollution in developing countries in Asia with respect to 1) adverse pregnancy outcomes, including low birth weight, pre-term birth, and birth defects, and/or 2) acute lower respiratory infection in children and other children’s health outcomes. Request for Statements of Information and Qualification (RFIQ) 09-3, Studies of Long-Term Exposure to Air Pollution and Chronic Cardiovascular and Respiratory Disease in Asia, seeks to identify scientific teams interested in conducting epidemiologic studies of long-term exposure to air pollution and chronic cardiovascular and respiratory disease in developing countries in Asia. Please refer to our funding page for more information.
  • HEI PAPA Progress: Public Health and Air Pollution in Asia, Winter 2008- 2009
    The winter 2008-2009 issue of PAPA Progress highlights the most recent accomplishments and future activities of the Public Health and Air Pollution in Asia (PAPA) program:
    • Environmental Health Perspective's publication of key results on the short-term effects of air pollution from the first four PAPA studies in Bangkok, Hong Kong, Shanghai, and Wuhan
    • The expanded use of PAPA methods developed to assess the relationship between air pollution and mortality, in the newly launched nine-city China Air Pollution and Health Effects Study (CAPES)
    • The investigation of air pollution, poverty and health in Ho Chi Minh City
    • The upcoming review on the health effects of air pollution in Asia that focuses on the rapidly developing countries of East, South, and Southeast Asia
    • HEI's presentation of a broad range of new science on the health effects of air pollution at the 2008 Better Air Quality (BAQ) meeting in Bangkok, Thailand

  • Communication 13: Public Health and Air Pollution in Asia (PAPA): Key Results from Bangkok, Hong Kong, Shanghai, and Wuhan, 2008.
    The September issue of Environmental Health Perspectives published the first systematic presentation of the HEI-funded PAPA studies in Bangkok, Hong Kong, Shanghai, and Wuhan, as well as a combined analysis and accompanying editorial. These articles have been reprinted and are currently available as HEI Communication 13. The detailed studies and accompanying HEI commentaries will be published by the Institute this spring. To download Communications 13,     please click here.

    These studies comprise the first coordinated and combined analyses of air pollution and daily mortality in Asia, and were designed and conducted by local investigators in concert with local air pollution and public health officials and international experts. Investigators developed and followed a common, state-of-the-art time-series protocol, allowing for comparison both within Asia and between Asia and other regions (such as North America and Europe) which have a larger body of evidence. This common protocol also facilitated a combined analysis including all cities. To download a copy of the PAPA Protocol for Coordinated Time-Series Studies of Daily Mortality in Asian Cities, please click here.

  • PAPA-SAN (Public Health and Air Pollution in Asia—Science Access on the Net) is the world’s largest database of research reports on the health effects of air pollution in Asia. It was systematically compiled from the peer-reviewed scientific literature in English, Chinese, Japanese, and Korean. PAPA-SAN is a unique resource for scientists, policy-makers, international lending organizations, and other stakeholders seeking access to the latest air pollution research from across the region. This new version of PAPA-SAN has been expanded by the addition of more than 140 new reports and now includes 421 reports from 11 Asian countries, published between 1980 and September 2007. For the first time, reports from Bangladesh, Pakistan, and Sri Lanka are included, as well as reports on studies of biomarkers of exposure to benzene and lead. For each report, PAPA-SAN provides the citation, a summary of findings, other key data and, when available, a link to the abstract. Results are presented in table form, sorted by country or region, study design, pollutant, and health outcome as well as in written form by country.

    PAPA-SAN was produced by HEI’s Public Health and Air Pollution in Asia (PAPA) program in partnership with the Clean Air Initiative for Asian Cities (CAI-Asia). It is the latest update of a database originally published in HEI’s Special Report 15: Health Effects of Outdoor Air Pollution in Developing Countries of Asia (2004). We will continue to search the literature periodically to make sure PAPA-SAN is up to date. Please visit PAPA-SAN to learn more about the project, download the result tables, and read the summaries.

  • Special Report 15: Health Effects of Outdoor Air Pollution in Developing Countries of Asia, 2004. This first publication to come from the PAPA Program was undertaken to help inform the Clean Air Initiative for Asian Cities. This special report has identified and summarized more than 135 studies of air pollution and health conducted across Asia. In addition, it critically reviews for the first time a key subset of these studies: 28 studies of daily mortality. The report is a valuable resource for policy makers in Asia and beyond. Please click here to access Special Report 15.

To learn more about PAPA follow these links:

PAPA Time-Series Studies
The following studies have been funded under PAPA; all studies have been completed and their reports are currently undergoing review:

Bangkok, Thailand
"Estimating the Mortality Effects of Air Pollution in Bangkok, Thailand"
Dr. Nuntavarn Vichit-Vadakan, Chulalongkorn University, Bangkok, Thailand
Hong Kong, China
"Interaction Between Air Pollution and Respiratory Viruses: Time-series Studies for Daily Mortality and Hospital Admission"
Dr. Chit-Ming Wong, University of Hong Kong, Hong Kong, China
Shanghai, China
"A Time-series Study of Ambient Air Pollution and Daily Mortality in Shanghai, China"
Dr. Haidong Kan, Fudan University, Shanghai, China
Wuhan, China
"Ambient Air Pollution and Daily Mortality in Wuhan"
Dr. Zhengmin Qian, Pennsylvania State University, College Park, USA
Chennai, India
"Developing Exposure-response Functions for Air Pollutants from Time-series Analyses – A Pilot Exercise in Chennai, India"
Dr. Kalpana Balakrishnan, Sri Ramachandra Medical College & Research Institute, Chennai, India
Delhi, India
"Time-series Study on Air Pollution and Mortality in Delhi, India"
Dr. Uma Rajarathnam, The Energy and Resources Institute, Delhi, India

Multicity Time-Series Study in Latin America (ESCALA)

ESCALA (Estudio de Salud y Contaminación del Aire en Latinoamérica), led by Dr. Romieu and colleagues, is using a common analytic framework to examine the association between daily levels of air pollution and mortality in Mexican, Brazilian, and Chilean cities, with special attention to the impact of air pollution on infants and young children. This study is also evaluating whether socio-economic status influences the relation between air pollution and mortality.

For additional information please see:
Winter 2007-2008 Newsletter
Spring 2006 Newsletter
Summer 2005 Newsletter

Air Pollution, Poverty, and Health in Ho Chi Minh City

The program entitled Air Pollution, Poverty, and Health in Ho Chi Minh City (HCMC) is being jointly funded by the Asian Development Bank through its Poverty Reduction Cooperation Fund, by HEI, and by the HCMC government. The conduct of the studies has been led by an interdisciplinary collaborative working group, which has been refining feasible approaches to assess the health impact of air pollution among poor families in HCMC. The project has two main research components: (1) a hospital-based study to estimate effects of short-term exposure to air pollution on hospital admissions for acute lower respiratory infections (ALRI) in children younger than 5 years, and to compare the magnitude of the effects of air pollution on poor children compared with children who are not poor; and (2) a household-based study to estimate personal exposures to air pollution and to evaluate the association between ambient air pollutant concentrations and personal exposures in poor families and families who are not poor.

For additional information please see articles in:
Winter 2006-2007 Newsletter
Summer 2005 Newsletter

For more information on these studies, please contact Sumi Mehta (+1-617-488-2335 ext 2306)

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May 29, 2009