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Outdoor air pollution continues to be a concern to the public, health care professionals and the government. Our current research programme addresses three main areas. First, the potential health effects of long-term exposure to pollution concentrations below current European limit values. St George’s are part of a three year, multi-centre collaborative research project funded by the US Health Effects Institute, to study health effects associated with current European air pollution levels. Secondly, the London focus of recent studies continued with an MRC funded study, in conjunction with colleagues at King’s College and Imperial, which assessed both long- and short-term exposure to air pollution. Finally, systematic reviews in air pollution epidemiology – the institute is currently part of an international team supporting the review of the WHO air pollution guidelines.
We have undertaken, with King’s College London, the largest randomised trial examining the effects of the early introduction of allergenic foods in infants with food allergy, the EAT study. The study showed that early introduction of allergenic foods reduced the risk of developing food allergy; the analysis of study data is continuing to throw light on determinants of allergic disease in childhood.
The role of bathing in the development of eczema and its persistence once established is uncertain. We are undertaking randomised trials to clarify the situation. Previous research has suggested that bathing may impair the skin barrier. Once eczema is established, there is significant debate as to how frequently children with eczema should be bathed. Through large randomised trials, we hope to establish a firm evidence base for the optimal management of individual children with eczema and public health recommendations to inform the advised bathing frequency of newborn infants.
In our studies of emerging obesity and type 2 diabetes risk in children, we made detailed assessments of dietary intakes and behaviours and objective physical activity measurements. Having identified dietary patterns and dietary behaviours associated with the risk of being overweight and developing diabetes, our recent work includes developing nutritional interventions in children, targeting specific aspects of the diet which are associated with the risk of developing diabetes.
We have also developed a web calculator to more accurately assess the body mass index (BMI) of UK children of of South Asian and black African origin.
The PACE trials are evaluating the use of short pedometer-based walking interventions to increase physical activity and reduce long-term risk of ill-health among adult and older adults, including a local multi-ethnic community in South London.
Trials of smoking cessation interventions, including evaluations of financial incentives (CPITT), text messaging (MiQuit) and e-cigarettes (PREP) in pregnancy, as well as smoking reduction using physical activity (TARS), form part of a broader programme addressing addictive behaviours, in collaboration with the UK Centre for Tobacco and Alcohol Studies (UKCTAS).
Links between physical activity and the urban environment, and their implications for town planning, are being explored by the ENABLE study of East London residents who are being rehoused into the former Olympic Athletes Village.