Abstract
Economic and social transitions in the era of globalization warrant a fresh look at the neurological risks associated with environmental change. These are driven by industrial expansion, transfer and mobility of goods, climate change and population growth. In these contexts, risk of both infectious and non-infectious diseases are shared across geographical boundaries. In low- and middle-income countries, the risk of environmentally mediated brain disease is augmented several-fold by lack of infrastructure, poor health and safety regulations, and limited measures for environmental protection. Neurological disorders may occur as a result of direct exposure to chemical and/or non-chemical stressors such as ultrafine particulate matters. Individual susceptibilities to exposure-related diseases are modified by genetic, epigenetic and metagenomic factors. The existence of several uniquely exposed populations, including those in the areas surrounding the Niger Delta or north western Amazon oil operations; those working in poorly regulated environments, such as artisanal mining industries; or those, mostly in sub-Saharan Africa, relying on cassava as a staple food, offers invaluable opportunities to advance the current understanding of brain responses to environmental challenges. Increased awareness of the brain disorders that are prevalent in low- and middle-income countries and investments in capacity for further environmental health-related research are positive steps towards improving human health.
Highlights
R eports from the World Health Organization (WHO) indicate that the global burden of disease is determined by patterns of disease and disability in low- and middle-income countries (LMICs), which, predictably, have their own environmental signatures
As for high-income countries, environmental health research programmes in LMICs must primarily focus on elucidating the entire range and source of exposures to define the human ‘exposome’ relevant to brain health in LMICs
The research agenda should include mechanistic and translational research, as well as capacity building to foster a new generation of environmental health scientists. In this Review, we focus on environmental risk factors for brain diseases and conditions in LMICs
Summary
A global perspective on the influence of environmental exposures on the nervous system Desire Tshala-Katumbay[1,2,3], Jean-Claude Mwanza[4], Diane S. Economic transitions in the era of globalization warrant a fresh look at the neurological risks associated with environmental change These are driven by industrial expansion, transfer and mobility of goods, climate change and population growth. The research agenda should include mechanistic and translational research, as well as capacity building to foster a new generation of environmental health scientists In this Review, we focus on environmental risk factors for brain diseases and conditions in LMICs (http://data.worldbank.org/about/countryand-lending-groups). An iterative search of the literature was conducted using PubMed to retrieve information related to environmental determinants and mechanisms of brain disease in LMICs. Additional opinion was obtained from interviews with leading environmental scientists and neuroscientists, as well as programme officers at the US National Institutes of Health and US National Institute of Environmental Health Sciences (NIEHS), and Fogarty International Center. This Review integrates the goals and approaches to environmental health research as per the NIEHS 2012–2017 strategic plan (https://www. niehs.nih.gov/about/strategicplan/)
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