Child Health in South Africa

Impact of genetics, epigenetics and environmental risk factors

Collaboration with Heather Zar, Dan Stein, Aneesa Vanker and many other wonderful colleagues at the University of Cape Town &

Michael Kobor and his lab at the University of British Columbia

Link to our recent preprint on neonatal biomarkers for neurodevelopmental delay.

Link to our recent publication on indoor air pollution, genetics and lung function.

More information about the Drakenstein Child Health Study can be found here.

With the Drakenstein Child Health Study we are also part of the Pregnancy And Childhood Epigenetics (PACE) consortium, which is comprised of researchers at NIEHS and around the world who are interested in studying the early life environmental impacts on human disease using epigenetics. 

Students and research assistants involved in on-going projects:

  • Sarina Abrishamcar (MPH Student in Epidemiology)

  • Emily Drzymalla (MPH Student in Epidemiology)

  • Claire Rowcliffe (MPH Student in Epidemiology)

  • Yining Zhang (MPH Student in Epidemiology)

Child Development in Europe

Impact of genetics and sociodemographic and environmental risk factors

Collaboration with the Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany and the IDEFICS/I.Family consortia.

Link to our recent publication.

Dementia and Late-Life Depression

Impact of genetics and epigenetics

Collaboration with Michael Epstein, Aliza Wingo, Thomas Wingo and Karen Conneely from the School of Medicine at Emory University

Link to our recent publication on DNA methylation and cognitive decline.

Link to our recent publication on DNA methylation and late-life depression.

Air Pollution and Cognitive Function

Two on-going projects that aim to understand the effects of air pollution on our brain.

HERCULES Pilot Project

Outdoor air pollution from traffic, power plants, and other industry is the largest environmental cause of disease and premature death in the world. Recent studies have shown that some particular air pollutants can also affect our brain and increase the risk for dementia, a cognitive decline that affects behavior and thought processes. However, in real life, we inhale more than one air pollutant at a time and the interaction between many pollutants might be particularly dangerous. Our study will use data from the Emory Healthy Aging Study (EHAS), which is the largest research study on aging in Atlanta. We will link EHAS questionnaire data with data on traffic-related air pollution for each participant based on their residential location. Using the linked database, we will estimate relationships between air pollutant mixtures and different stages of cognitive decline. The results of this study will promote awareness about the harmful effects of air pollution mixtures on the human brain.


Collaboration with Stefanie Ebelt and Lance Waller from the RSPH at Emory University

Research assistants:

Zhenjiang Li (PhD student in Environmental Health Sciences, RSPH) and Grace Christensen (PhD student in Epidemiology)

More details about the project can be found here.

Dean's Pilot Project

This study will analyze associations of air pollution exposure with neuropathology and epigenetic markers (DNA methylation) in human postmortem brains from the Emory University Goizueta Alzheimer’s Disease Research Center Neuropathology Core Brain Bank. The results of this study will provide data on the consequences of air pollution on neuropathology – a biological pathway that has been hypothesized for over a decade, but for which only very little data has been generated.

Collaboration with Aliza and Thomas Wingo from the School of Medicine at Emory University

Research assistant: Zhenjiang Li (PhD student in Environmental Health Sciences, RSPH)

More details about the project can be found here.

COVID-19 in Individuals with Down Syndrome

T21RS COVID-19 initiative

International initiative to better understand the risk and to formulate appropriate recommendations to protect individuals with Down syndrome against COVID-19.


Our results, which are based on more than 1,000 COVID-19 patients with Down syndrome, show that individuals with Down syndrome often have more severe symptoms at hospitalization and experience high rates of lung complications associated with increased mortality. These results have implications for preventive and clinical management of COVID-19 patients with Down syndrome and emphasize the need to prioritize individuals with Down syndrome for vaccination. 

More details about the project can be found here.

Link to our recent publication in The Lancet's EClinical Medicine.

Selected interviews and media coverage:

  • Hüls A interviewed by Science Magazine (Dec. 15, 2020, based on our medRxiv Preprint)​

  • Hüls A interviewed by 11Alive (Feb. 23, 2021, NBC-affiliated television station in Georgia, USA)​

  • Hüls A cited in Mint (Feb. 27, 2021, Indian daily newspaper)​

  • Hüls A interviewed by USA Today (Mar. 8, 2021, most read daily newspaper in the USA)

  • Hüls A interviewed by Verywell (Mar. 18, 2021, ranked in the top 10 health information sites, reaching 17 million US unique users each month)

Impact: Partly based on our findings, individuals with Down syndrome have been prioritized for vaccination in many countries all over the world. We have published a tracker, which countries and US states and territories are already vaccinating individuals with Down syndrome against COVID-19: 

Research assistant: Lauren Russell (MPH Student in Epidemiology)