Enhancing the positive impacts of epidemiologic research: Rural air pollutants and children's health

Background: Most epidemiologic studies are designed to reduce error and improve estimation of exposure-outcome relationships without consideration for the potential side effects of conducting the research. Positive public health impacts can be increased by designing studies that provide benefits during the research process. We used this approach to study impacts of air pollution from industrial hog operations (IHOs), which are disproportionately located in North Carolina low income communities of color. Purpose: We present a study designed to provide immediate positive impacts through meaningful involvement of students, teachers, and community members in the research process. Methodology: University researchers and staff from the Rural Empowerment Association for Community Help chose research questions to be addressed with a panel study design. For three to five weeks, students in middle school science classes recorded respiratory health data and odor in a structured daily diary while particulate matter and hydrogen sulfide were monitored at the schools. Students and staff learned about air pollution, respiratory health, and research design. Trained community members facilitated daily research activities. Results: We enrolled 344 students in 15 classes from 3 schools with 90% participation. Most students mastered the protocol and enjoyed participating. School staff welcomed the opportunity to participate. Six community members served as school liaisons while the broader community organization was educated about air pollution from IHOs and research design. Conclusions: This participatory design has the potential to increase the capacity of polluted communities to oppose environmental injustice while quantifying dose-response relationships between air pollution and children's health.