Occupational and Environmental Exposures to Xenobiotic Compounds in Indigenous Guatemalan Communities: Impact on Health Outcomes and Intergenerational Effects

Indigenous populations remain strongly underrepresented in environmental epidemiology. No studies have examined combined exposures from multiple chemical sources in the Maya communities of Guatemala. My PhD addresses this gap within the Lake Atitlán Respiratory Health Study, a family-based study of 253 Tz'utujil Maya families in San Juan La Laguna and San Pablo La Laguna.

Families in these communities live with several overlapping exposures: pesticides from subsistence and commercial agriculture, synthetic dyes and chemicals from traditional textile production, smoke from cooking with wood, cleaning products, and waste burning. The project measures these exposures with urinary biomarkers of pesticides, combustion products, volatile organic compounds and plastic-related chemicals, together with household air and surface sampling and detailed questionnaires. Respiratory health is assessed with the ECRHS questionnaire, spirometry following ATS/ERS standards, and anthropometry.

The PhD has three objectives, each leading to a paper:

1. To describe the prevalence of respiratory symptoms, lung function and treatment use in Maya families.
2. To examine associations between exposure biomarkers and respiratory outcomes.
3. To analyse whether parents' exposures are associated with their children's respiratory health, using family-based models.

The project is supervised by Cecilie Svanes (Centre for International Health, UiB), with co-supervisors Randi Jacobsen Bertelsen (Haukeland University Hospital) and Manuel Ramírez-Zea (INCAP, Guatemala). It is carried out in collaboration with INCAP, the Centre for the Study of Equity and Governance in Health Systems (CEGSS) and the RHINESSA network.

Before my PhD, I coordinated field operations for UiB-led epidemiological studies in Guatemala from 2020. I hold an MSc in Global Health from UiB (2024) and have nearly two decades of experience in public health research, civil society and international development in Guatemala, including work with CEGSS, UNICEF, Open Society Foundations and Universidad Rafael Landívar.

This project is designed to produce usable knowledge, not only academic publications. It is carried out in partnership with the Centre for the Study of Equity and Governance in Health Systems (CEGSS) and the Network of Community Defenders for the Right to Health (REDC-Salud), a network of Indigenous community leaders who monitor public health services and advocate for the right to health in their territories. Community authorities and local health workers in San Juan La Laguna and San Pablo La Laguna take part through traditional Maya decision-making, and this collaboration shapes how results are interpreted and used.

Findings will be returned to participating communities in Spanish and Tz'utujil, in formats that community defenders can use in their own dialogue with health authorities. At the policy level, results will inform policy briefs and stakeholder workshops with Guatemala's Ministry of Health and Indigenous organisations, focusing on the detection and treatment of respiratory disease and on reducing harmful exposures in homes and workplaces. The longer-term aim is to strengthen environmental health research with and for Indigenous communities in Latin America.

I am a teaching assistant in the Observational Epidemiology course at the Centre for International Health, University of Bergen, led by Professor Cecilie Svanes.

Before my PhD, I designed and delivered training in qualitative research methods, health rights and advocacy for research teams and community leaders in Guatemala, adapting materials to diverse cultural and linguistic contexts.