7. Project Summary/Abstract The Middle East and North Africa (MENA) region, especially its LMIC countries, faces a myriad of environmental and occupational health (EOH) challenges in a context of dynamic political changes, multiple concurrent humanitarian crises, weak regulations, and limited investment in EOH research and research capacity building. The American University of Beirut (AUB) in Lebanon (U01 application) is partnering with Yale University (U2R application) in collaboration with the University of Iowa in the US to establish a Global Environmental and Occupational Health Research and Training Hub for the MENA region (GEOHealth MENA), where AUB serves as the Hub Institution and one university in each of Egypt and Sudan will serve as Spoke Institutions. The aim of GEOHealth MENA is to build and strengthen EOH research capacity in the context of disadvantaged populations, at AUB, sister institutions, and relevant NGOs in Lebanon and the MENA region. The focus of the current project will be agricultural health and safety with an emphasis on exposure to pesticide among refugee populations. The MENA region hosts more than 50% of the world's total population of internally displaced persons and refugees. The U01 application proposes to evaluate the pathways of pesticide exposure among Syrian refugee agricultural workers, investigate the association of such exposure with neurobehavioral outcomes, and explore the role of social factors in this association. Findings will inform policy and practice guidelines that can improve the health of all agricultural workers. The multidisciplinary research team at AUB will build on a strong track record of studying refugee and migrant populations and translating evidence into policy. Yale and the University of Iowa will provide support to the AUB team in exposure assessment and the assessment of neurobehavioral performance. The U2R will provide full scholarships to 3 highly qualified and committed applicants (one from each of Egypt, Lebanon, and Sudan) to pursue a PhD in Epidemiology at AUB's Faculty of Health Sciences (FHS) focusing on EOH issues. The U2R will also provide full scholarships to 4 highly qualified and committed MDs (two from Lebanon and one from each of Egypt and Sudan) to pursue an MPH at AUB's FHS and a fellowship in Occupational Medicine at AUB's Faculty of Medicine. The 7 trainees will spend 3 months (MD/MPH) or 6 months (PhD) during their study period at Yale and Iowa for advanced and relevant research training and training on agricultural safety and health (AgS&H). Additionally, the U01/U2R applications will offer short-term research and AgS&H training to the community.

Public Health Relevance Statement The Middle East and North Africa (MENA) region faces a myriad of environmental and occupational health (EOH) challenges in a context of dynamic political changes and multiple concurrent humanitarian crises. The proposed collaborative U01 (led by the American University of Beirut, Lebanon) and U2R (led by Yale University in collaboration with the University of Iowa in the US) applications aim to establish a Global Environmental and Occupational Health Research and Training Hub for the MENA region (GEOHealth MENA) with the goal to build and strengthen EOH research capacity at academic/research institutions and relevant NGOs in the region. With the purpose of informing policy and practice guidelines, the U01 research project will evaluate pathways of pesticide exposure among Syrian refugee agricultural workers, investigate its association with neurobehavioral performance, and explore the role of social factors in this association, while providing a platform for short-term (workshops, courses) and long-term training (MPH, PhD) to health professionals from the MENA region supported by the U2R.