Air pollution, a warm bedroom and high levels of carbon dioxide and ambient noise all may adversely affect our ability to get a good night’s sleep, suggests a study from researchers with the Perelman School of Medicine at the University of Pennsylvania and the University of Louisville’s Christina Lee Brown Envirome Institute (CLBEI).

The study, published April 18 in Sleep Health, is one of the first to measure multiple environmental variables in the bedroom and analyze their associations with sleep efficiency—the time spent sleeping relative to the time available for sleep. The analysis found that in a group of 62 participants tracked for two weeks with activity monitors and sleep logs, higher bedroom levels of air pollution ( or PM_2.5), carbon dioxide, noise and temperature were all linked independently to lower sleep efficiency.

The study was a collaboration between Penn Medicine and UofL’s CLBEI which is led by Aruni Bhatnagar. The researchers recruited participants from the CLBEI’s National Institutes of Health-funded Green Heart Project that investigates the effects of planting 8,000 mature trees on the cardiovascular health of Louisville residents.

“These findings highlight the importance of the bedroom environment for high-quality sleep,” said study lead author Mathias Basner, professor and director of the division of Sleep and Chronobiology in the department of Psychiatry at Penn Medicine.

The researchers suggest that more research is needed now on interventions that could improve sleep efficiency by reducing exposures to these sleep-disrupting factors.

“This could be as simple as leaving a bedroom door open to lower carbon dioxide levels, and using triple-pane windows to reduce noise,” Bhatnagar said. “We also applied for (future) funding that will allow us to investigate whether planting trees can improve sleep and cardiovascular health through improving health behaviors and the bedroom environment.”

About the study

In addition to work and family obligations that , a quickly changing environment due to growing urbanization and climate change seems to have made it harder to get a good night’s sleep. Sleep that is of inadequate duration, or inadequate efficiency due to frequent disruption (“tossing and turning”), affects work productivity and quality of life. It also has been linked to a higher risk of chronic diseases including heart disease, type 2 diabetes, depression and dementia.

This research is among a limited number of studies that looked at associations between multiple objectively measured factors in the sleep environment—such as noise and temperature—and objectively measured sleep.

For each of the environmental variables measured, the researchers compared sleep efficiency during exposures to the highest 20 percent of levels versus lowest 20 percent of levels. Through this analysis, they found that high noise was associated with a 4.7 percent decline in sleep efficiency compared to low noise, high carbon dioxide with a 4.0 percent decline compared to low levels, high temperature with a 3.4 percent decline compared to low temperature, and high PM_2.5 with a 3.2 percent decline compared to low PM_2.5. Two other sleep environment variables, relative humidity and barometric pressure, appeared to have no significant association with sleep efficiency among the participants.

Interestingly, only bedroom humidity was associated with sleep outcomes assessed with questionnaires, such that higher humidity was associated with lower self-reported sleep quality and more daytime sleepiness. This suggests that studies based on questionnaires may miss important associations readily detected by objective measures of sleep. This is not surprising as humans are unconscious and unaware of themselves and their surroundings during large portions of their sleep period.

Also, most study participants rated humidity, temperature and noise levels in the bedroom as “just right” regardless of the actual exposure levels.

“We seem to habituate subjectively to our bedroom environment, and feel there is no need to improve it, when in fact our sleep may be disturbed night after night as evidenced by the objective measures of sleep we used in our study,” said Basner.

Supported by the University of Louisville, the Humana Foundation and the Health Equity Innovation Hub, the Air Justice website,, debuts at noon, March 28.

More than 50 UofL students have worked on the project since 2021 with a coalition that includes professors, community leaders and activists. The team conducted nearly 2,000 surveys around the Rubbertown area and also held workshops with residents to determine residents’ informational needs.

Rubbertown was named for the tire and synthetic rubber plants built there during World War II. Air quality in the area has suffered as a result. In west and southwest Louisville, the areas that border Rubbertown, residents are predominantly Black and other people of color, most of whom also experience poverty.

“The Air Justice team considers air quality an environmental health equity issue, one that has a lot to do with literacy or with how information about air quality is distributed in the city,” said Megan Poole, UofL assistant professor of English, College of Arts & Sciences. “The Air Justice website decodes the science and health effects of air pollution, uncovers the history of environmental injustice in West Louisville, amplifies residents’ stories related to air pollution, and directs residents to resources for reporting odors and pushing for increased air quality regulation.”��

In addition to Poole and the students, the��Environmental Health Literacy Coalition�����Գ����ܻ���:

• Shavonnie Carthens, assistant professor of law, Louis D. Brandeis School of Law;
• Keisha Dorsey, who formerly represented Louisville Metro Council District 3, an area bordering Rubbertown, and is now deputy chief of staff to Louisville Mayor Craig Greenberg, and
• the grassroots activist group Rubbertown Emergency Action (REACT).

Human health risks associated with the chemicals released in the Rubbertown area are over 10,000 times higher than the industry average.

“Even more pronounced is the inequity of this health issue,” Poole said. “Over 60% of residents identify as ‘minority,’ over 50% identify as Black, and over 52% experience poverty.”

This website launch is only the beginning of Air Justice’s health equity work. “This website is a communal work in progress,” Carthens said. The project aims to co-create health equity solutions alongside residents and local communities.

Air Justice also launched on Instagram (@airjusticelou) and Facebook (Air Justice Louisville) to begin engaging community members prior to the public launch of the website.��

The project has received over $350,000 through support from The Gheens Foundation,��and the Humana Foundation.

The campus will be��both a world-class research center and a nexus for community engagement, spawning citizen scientists and making health equity everyone’s pursuit.��It will consist of two historic buildings on West Muhammad Ali Boulevard totaling 133,000 square feet and an adjacent garden space.

The launch of the New Vision of Health Campus is made possible by a commitment from health advocate Christina Lee Brown of Louisville valued at $47 million by the university. Brown is providing $30 million over 20 years to support the����and is giving rent-free use of the buildings to the university, equating to a $17-million in-kind donation. In a special meeting earlier today, the UofL Board of Trustees approved a lease granting UofL use of the property, which is owned by Brown. The university plans to seek additional partnerships and financial support for the campus and its mission.

“We are incredibly grateful to Mrs. Brown for this generous gift of support and this special space in the heart of the city,” said Lori Stewart Gonzalez, interim president of UofL. “On this new campus, UofL researchers will increase our understanding of the many aspects of our environment that contribute to optimum health for everyone, here and beyond. It embodies our commitment to health equity.”

“To grow from our past and promote long, fulfilling lives, we shouldn’t chase any single cause. We live in a complex, interdependent world where history is our shared legacy and health is our shared aspiration,” Brown said. “By honestly recognizing our common stories, we can frame a new vision of health which unifies us. It can inspire healthier lives, healthier communities and a healthier world.”

�ճ������will include specially designed laboratories and offices for the��that will engage researchers and community members to learn how natural, cultural and personal environments impact health. Institute researchers work with community partners to discover how to build healthier cities, creating insights and models to improve health in Louisville and around the world.

The research will be directed by Aruni Bhatnagar, director of the UofL Envirome Institute, professor of medicine and chief of the UofL Division of Environmental Medicine.

“Our quest is to pursue the new vision that health is a resource that needs to be cultivated through conducive physical and environmental conditions,” Bhatnagar said. “Health is more than the absence of disease. Health is a resilience that helps individuals withstand all forms of stress. We want to move the discussion of health away from disease and instead focus on actively promoting health before disease occurs.”

The UofL Christina Lee Brown Envirome Institute was created in 2018 with a $5-million gift from Brown that charged UofL researchers to take a holistic, multidisciplinary approach to understanding how the human-environment interrelationship affects peoples’ lives and to convert that knowledge to actionable steps to promote human health. This research and the new funding announced today support the university’s grand challenge strategic research priority of “,” an initiative to lead a transformative shift in how we understand, promote and recover health through all stages of life.

Research highlights from the Envirome Institute include the��, documenting the health impacts of living among greater levels of vegetation, the��, tracking the presence and spread of COVID-19 in the community through testing of individuals and wastewater, and research to document the effects of smoking and vaping on health. Bhatnagar is co-director of the American Heart Association’s Tobacco Center for Regulatory Science, and the center’s research was employed as key evidence for ending the sale of flavored vaping products in California. The institute also houses the only NIH Superfund Research Center devoted to studying the effects of superfund chemicals on cardiovascular health, diabetes and obesity.

“This is UofL research that could transform the way we promote well-being by revealing and decoding the factors that affect it,” said Kevin Gardner, UofL’s executive vice president for research and innovation. “We are proud to work with Christina Lee Brown and appreciate her continued support to further this important effort in advancing our health. Together, we will help people here in Louisville and around the world live lives that are not just longer, but healthier and more resilient.”

The gift announced today is the single largest philanthropic gift in the university’s history.

The launch of the New Vision of Health Campus is made possible by a commitment from health advocate Christina Lee Brown of Louisville valued at $47 million by the university. Brown is providing $30 million over 20 years to support the and is giving rent-free use of the buildings to the university, equating to a $17-million in-kind donation. In a special meeting earlier today, the UofL Board of Trustees approved a lease granting UofL use of the property, which is owned by Brown. The university plans to seek additional partnerships and financial support for the campus and its mission.

“We are incredibly grateful to Mrs. Brown for this generous gift of support and this special space in the heart of the city,” said Lori Stewart Gonzalez, interim president of UofL. “On this new campus, UofL researchers will increase our understanding of the many aspects of our environment that contribute to optimum health for everyone, here and beyond. It embodies our commitment to health equity.”

“To grow from our past and promote long, fulfilling lives, we shouldn’t chase any single cause. We live in a complex, interdependent world where history is our shared legacy and health is our shared aspiration,” Brown said. “By honestly recognizing our common stories, we can frame a new vision of health which unifies us. It can inspire healthier lives, healthier communities and a healthier world.”

The will include specially designed laboratories and offices for the that will engage researchers and community members to learn how natural, cultural and personal environments impact health. Institute researchers work with community partners to discover how to build healthier cities, creating insights and models to improve health in Louisville and around the world.

The research will be directed by Aruni Bhatnagar, director of the UofL Envirome Institute, professor of medicine and chief of the UofL Division of Environmental Medicine.

“Our quest is to pursue the new vision that health is a resource that needs to be cultivated through conducive physical and environmental conditions,” Bhatnagar said. “Health is more than the absence of disease. Health is a resilience that helps individuals withstand all forms of stress. We want to move the discussion of health away from disease and instead focus on actively promoting health before disease occurs.”

The UofL Christina Lee Brown Envirome Institute was created in 2018 with a $5-million gift from Brown that charged UofL researchers to take a holistic, multidisciplinary approach to understanding how the human-environment interrelationship affects peoples’ lives and to convert that knowledge to actionable steps to promote human health. This research and the new funding announced today support the university’s grand challenge strategic research priority of “,” an initiative to lead a transformative shift in how we understand, promote and recover health through all stages of life.

Research highlights from the Envirome Institute include the , documenting the health impacts of living among greater levels of vegetation, the , tracking the presence and spread of COVID-19 in the community through testing of individuals and wastewater, and research to document the effects of smoking and vaping on health. Bhatnagar is co-director of the American Heart Association’s Tobacco Center for Regulatory Science, and the center’s research was employed as key evidence for ending the sale of flavored vaping products in California. The institute also houses the only NIH Superfund Research Center devoted to studying the effects of superfund chemicals on cardiovascular health, diabetes and obesity.

“This is UofL research that could transform the way we promote well-being by revealing and decoding the factors that affect it,” said Kevin Gardner, UofL’s executive vice president for research and innovation. “We are proud to work with Christina Lee Brown and appreciate her continued support to further this important effort in advancing our health. Together, we will help people here in Louisville and around the world live lives that are not just longer, but healthier and more resilient.”

The gift announced today is the single largest philanthropic gift in the university’s history.

“We are pleased to be an official satellite mini-conference host site of the World Health Organization’s first global conference on air pollution and health,” said Ted Smith, PhD, Center for Healthy Air, Water and Soil Director. “This conference is a prime opportunity for Kentuckiana citizens who are interested in the impact air pollution has on health and well-being to share ideas and learn from experts around the globe as well as those in our own community.”

The mini conference will include video streams from the plenary session of the main conference in Geneva with an opportunity for discussions in Louisville to be shared with the main conference each day.

Tuesday’s session will open with remarks from Smith. A session will follow that examines the scientific evidence that exists showing the impact air pollution has on health with a discussion to follow mediated by Daniel Conklin, PhD, UofL professor of medicine.

Wednesday’s session will cover engaging the health sector as a leader of change in public policy, and communication, advocacy and partnerships to develop opportunities and remove barriers for promoting clean air policy.

Admission is free but reservations are required to receive a box lunch. To register, go to the ��

The event is organized in collaboration with the United National Environment Programme, World Meteorological Organization, Climate and Clean Air Coalition, the secretariat of the UN Framework Convention on Climate Change, UN Economic Commission for Europe and The World Bank.

Today, UofL announced a five-year, $3 million grant from the National Institutes of Health to help fund the Green Heart project. The university also announced a $2 million grant from The Nature Conservancy to support the endeavor.

The Green Heart study will look at the connections between a green environment and human health. The institute will study air quality, innovative landscape design, the qualities of a friendly, healthy neighborhood and human health.

“The Green Heart project is the epitome of collaboration,” said UofL President Neeli Bendapudi, PhD. “Dr. Aruni Bhatnagar and his team are bringing together people from not only all of the university, but throughout Louisville and beyond to create a new paradigm for population research that truly has international implications.

“His creative thinking is leading to innovative public-private partnerships that eventually will lead to healthier communities.”

“People appreciate trees and they’re good and they’re aesthetically pleasing, but whether they actually have specific quantifiable health-promoting effects by removing pollutants from air has never been rigorously tested,” said Bhatnagar, director of the Envirome Institute and the Smith and Lucille Gibson Chair in Medicine. “Through the Green Heart project, we are changing that.”

More than half the world’s population resides in urban areas, which have higher than average levels of air pollution. Air pollution is a significant contributor to cardiovascular disease and is linked to 7 million premature deaths worldwide annually, 200,000 in the United States alone.

Bhatnagar and his team will include 16 low-vegetation neighborhood clusters in Louisville to examine the impact of urban greenery on their health. The researchers are recruiting 700 community participants within these 16 clusters for the study. The team will examine blood, urine and hair samples to assess cardiovascular health.

In eight of the clusters, the team and their partners will plant as many as 8,000 native trees of all sizes. Additionally, they will plant shrubbery and grasses to further optimize the ability to filter pollutants from the air.

Two years later, the researchers again will collect samples from the volunteers and analyze the differences. They also will compare the results to those from the participants in the eight neighborhood clusters that did not live in the areas that had the plantings.

“We believe that the greening of the neighborhoods will positively impact not only the air quality, but also the health of the people who live in those areas,” Bhatnagar said. “If we are correct, we may be able to create new strategies for the prevention of cardiovascular disease.

“The results of this project also will provide new insights into the effects of urban vegetation on community environment. These findings will be relevant to the development of new public health polices and the optimization of ongoing planting efforts in cities around the world to enhance public health.

The Green Heart Project is a collaborative initiative of the University of Louisville with Washington University in St. Louis; Cornell University, The Nature Conservancy, Hyphae Design Laboratory, the United States Forest Service and other partners. The grant from the National Institutes supports health evaluation of community participants, whereas the greening efforts are supported by the grant from The Nature Conservancy.

Check out highlights from today’s announcement:��

The UofL Cancer ����ֱ�� Program is an intensive summer research and professional development program for outstanding undergraduate and health professional students, supporting their pursuit of careers in cancer research.

The , funded by an R25 grant from the National Cancer Institute of the National Institutes of Health, accepts about 30 trainees each summer. The students engage in a 10-week research project under the guidance of UofL cancer researchers and lab mentors in basic, clinical, translational, behavioral and population-based cancer research. The mentors are research-intensive UofL faculty, most of whom are affiliated with the James Graham Brown Cancer Center.

This spring, the program was renewed for five years with the leadership addition of director LaCreis Kidd, PhD, MPH, associate professor and Our Highest Potential Endowed Chair in Cancer Research in the UofL Department of Pharmacology and Toxicology. David Hein, PhD, chair of the department, established the program and continues as director along with Kidd.��More than 60 UofL faculty members serve as mentors and key contributors to the program.

“The renewal of this program is a clear indication that the trainees are excelling in cancer research during and after completion of the program. In addition, UofL and the James Graham Brown Cancer Center are providing cutting edge research, professional development and networking opportunities for the next generation of cancer research scientists,” Kidd said.

Since it began in 2012, the program has trained more than 150 students, including college undergraduates and medical, public health, dental and nursing students from more than 25 universities across the United States. More than one-third of the trainees have continued their studies as medical, doctoral and MD/PhD students at UofL. Others have continued their cancer research training at institutions such as Johns Hopkins University and Columbia. The five-year award of $1,593,000 supports the students’ research activities, subsistence payments, travel and housing.

To sharpen their professional skills, the trainees participate in engaging professional development activities. The activities include a 90-second elevator pitch contest, speed networking and public speaking activities that allow trainees to connect with their audience and deliver engaging oral presentations.

At the conclusion of the program, the students deliver their work in the form of research posters and oral presentations to faculty, judges and fellow students. Many of the students also present their research at as well as at regional, national and international scientific meetings. Research conducted in the program is frequently published with a student as first author.

“The NCI R25 Cancer ����ֱ�� Program is well poised to prepare the next generation of young investigators in the field of cancer research or clinical oncology,” Kidd said.

One goal of the UofL NCI Cancer ����ֱ�� Program is to reach underrepresented minorities for participation. Of the 156 students who have completed the program, 53 are underrepresented minority students.

The Cancer ����ֱ�� Program is integrated with other summer research activities on UofL’s Health Sciences Center campus, including the Summer Research Scholar Program for students in the School of Medicine and the School of Dentistry’s Summer Research Program.

UofL Training Program in Environmental Health Sciences renewed

Another training program at UofL, the Training Program in Environmental Health Sciences, was renewed for a 5-year term with a $2.4 million T32 grant in late 2016 by the National Institute of Environmental Health Sciences. The program funds predoctoral and post-doctoral students on a full-time basis, incorporating numerous centers, institutes, schools and more than 50 faculty mentors��to provide cutting edge basic, clinical, computational and population-based research.

Hein established this program in 2004 and served as principal director until 2016. With the program’s renewal, Gavin Arteel, PhD, professor and Distinguished University Scholar in the Department of Pharmacology and Toxicology, took over as director. The Training Program in Environmental Health Sciences supports six predoctoral and three postdoctoral trainees. Graduates of the program have gone on to positions in the Environmental Protection Agency, the Food and Drug Administration, the pharmaceutical industry, and as faculty members at UofL and other prestigious universities. Kevyn Merten, PhD, assistant vice president for research and innovation at UofL, was among the first graduates, completing the program in 2006.

“The grant renewal recognizes that the university supports a critical mass of research to support the training of students and postdoctoral associates in this area,” Arteel said. “Two very strong programs that we have are the Diabetes and Obesity Center and the Hepatobiology and Toxicology Program.”

Aruni Bhatnagar, Ph.D., Matthew Cave, M.D., and Hein serve as co-directors for the program.

Sullivan is the chief and medical director of the Kosair Charities Pediatric Clinical Research Unit in UofL’s Department of Pediatrics. The UofL award totals $1,673,259 to fund a multiple investigator team program titled “The Kentucky Pediatric Clinical Trials Rural/Urban Partnership.”

“Our team of experienced pediatric clinician-investigators and clinical trial specialists is excited to expand our participation in collaborative multicenter studies that can identify the environmental origins of pediatric diseases and test therapies to treat and prevent disease,” said Department of Pediatrics Vice Chair for Research Brad Keller, MD. “The research funding announced today will help us continue to find the cures of tomorrow, enabling children in Kentucky, Southern Indiana and beyond to live longer, healthier lives.”

The ECHO program will investigate environmental exposures from conception through early childhood. Experiences during sensitive developmental windows – around the time of conception, later in pregnancy and during infancy and early childhood – can have long-lasting effects on the health of children. These experiences encompass a broad range of exposures, from air pollution and chemicals found in neighborhoods, to societal factors such as stress, to individual behaviors like sleep and diet. They may act through any number of biological processes, for example changes in the expression of genes or development of the immune system.

A critical component of ECHO will be to use the NIH-funded to build state-of-the art pediatric clinical research networks in rural and medically-underserved areas so that children from these communities can participate in clinical trials. Sullivan’s award falls in this category.

The awards announced will build the infrastructure and capacity for the ECHO program to support multiple, synergistic longitudinal studies that extend and expand existing cohort studies of mothers and their children. ECHO research will focus on factors that may influence health outcomes around the time of birth as well as into later childhood and adolescence, including upper and lower airway health and development, obesity and brain and nervous system development.

“Every baby should have the best opportunity to remain healthy and thrive throughout childhood,” said NIH Director Francis S. Collins, MD, PhD. “ECHO will help us better understand the factors that contribute to optimal health in children.”

For complete details about the ECHO program, see the .