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In 1973, a fire retardant containing polybroximinated biphenyl (PBB) was accidentally mixed with animal feed on Michigan farms. By the time the chemical contaminants were identified, at least 4,000 people were potentially exposed through contaminated meat and dairy products. PBB accumulates in fatty tissue in the body and is stored for years. Working with epidemiologist Michele Marcus, ARCS scholar Chanley Small is project director of a long-term NIH study on the reproductive health consequences in women exposed to PBB in utero and as infants. The women, now in their 30s, experienced puberty at younger ages than normal.
     Small is examining how genetic variants both independently and in combination with environmental exposures affect reproductive health. "We're trying to determine whether variations in a gene called CYP17 affect hormone levels in premenopausal women," she says. "We've found that women with a specific variant often have higher estrogen levels. This gene has been associated with endometrial and ovarian cancers and, possibly, breast cancer."
     Small, who has a master's degree in biology and three small children of her own, is working with Emory geneticist Stephanie Sherman to determine genotype for CYP17 in the blood of 170 women. "The ARCS funding has given me a great opportunity to collaborate with a renowened geneticist," Small says.
     After graduation at the end of this year, Small plans to continue her collaboration on the PBB study. "Ultimately, I'd like to teach and do research at a university like Emory," she says.




The Kamalapur district of Dhaka, Bangladesh, is one of the most heavily populated urban slums in the world. Here, throughout the day, one substance or another is burned in most households for cooking or heating or to repel mosquitos. And, according to ARCS scholar Erin Murray, 01MSPH, that's very hard on the lungs.
     Murray's goal is to learn as much as she can about the high incidence of acute lower respiratory infections among Bangladeshi children. Her dissertation in epidemiology focuses on pneumonia in children under five who live in Kamalapur, where the incidence of acute lower respiratory infections is one per child per year for children under 2. In rural areas of Bangladesh, the incidence is .23 per child per year.
     The problem is complex, fueled by the interplay of seasonal changes like monsoons, indoor and oudoor air polution, and the high density of the population. About 77,000 people are crammed into every square mile of this slum, and households and beds are generally crowded. By contrast, Atlanta has 3,100 people per square mile.
     Murray has designed a questionnaire for parents of children under 5, gathering informaiton such as how many people and children live in the household, the number of rooms in the house, and the number of people sharing a bed with the child. It also surveys parents about the cooking and heating fuels used, environmental tobacco exposure, and mosquito repellent. "While a lot of households use natural gas for cooking, many use wood and crop residues, which are very hard on the lungs," says Murray.
     With the help of the International Centre for Diarrheal Disease Research, Bangladesh, and CDC, Murray's questionnaire will be administered every three months for one year. The study period will account for changing factors based on the seasons, such as fuel use and prevalence of certain viruses and bacteria during specific times of the year.
     Murray's work has been slowed somewhat by Bangladesh's recent severe flooding, which has displaced many of the families enrolled in her study. However, she is still on track to graduate by 2006, and her goal is to become a member of CDC's Epidemic Intelligence Service and eventually work in developing countries.
     "My PhD work has shown me that I can have a greater impact on health by working on problems affecting developing countries," she says. "I feel so lucky. I am getting absolutely everything I wanted to get out of my PhD experience. I have been able to apply for funding, design my portion of the study, and see a study from start to finish. And I've had an amazing international experience. The ARCS funding has made an incredible difference for me. Without it, I would really be struggling right now."

Valerie Gregg is a freelance writer in Atlanta and a former editor of this magazine.



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