News & Views
Busselton Releads the Way What started out as a rural GP’s vision to improve the health of his community has developed into a global treasure trove for researchers at the edge of science. The Busselton Population Health Studies celebrates 50 years next month and there would be few doctors who have not been touched by its work in some way – be it personal involvement or having used some of its research findings at medical school or in their practice. It’s like a faithful friend who’s always there but, at times, can be taken for granted. So in the golden glow of such a significant anniversary, it is fitting to remind ourselves what it has achieved and what it means to WA to have such a substantial and distinguished longitudinal population health study in our midst.
Among the discoveries are: så 4HEåDISCOVERYåOFåTHEålRSTåGENETICå association with asthma så $ElNINGåTHEåCLINICALåRELEVANCEåOFåGENETICå testing in haemochomatosis så .EWåGENEåDISCOVERYåANDåCONlRMATIONåOFå KNOWNåGENETICåASSOCIATIONSåWITHå#6$ å respiratory disease, lung function, obesity, sleep apnoea, diabetes, iron metabolism and thyroid disease And the list goes on but at the heart of it all is Kevin Cullen’s prime motivation – to demonstrate the health effects of the survey, or as Prof Welborn said in an oral history about the project: “No survey without Service”. The health care of the Busselton participants would be enhanced by their involvement. After a period in the 1980s and 1990s when there were some widening survey gaps, the past decade has seen renewed and reinvigorated work on the longitudinal study owing in part to a permanent presence in the town.
Dr Kevin Cullen and Prof Tim Welborn
It’s certainly come a long way since Busselton GP Kevin Cullen pushed the idea in 1966 for a cross-disciplinary study of community health that would not only help to improve care but also provide research opportunities for undergraduates and post-graduates in the social sciences and medicine. His ideas were music to the ears of young Perth-based researchers, endocrinologist Prof Tim Welborn, epidemiologist Dr Michael McCall, biochemist Dr David Curnow and CSIRO biostatistician Dr Norman Stenhouse. And with a lot of hard work and forthright exchanges of opinion, the first health survey of 3394 Busselton adults took place in November 1966 with 1614 Busselton children surveyed the following year. The surveys have changed shape as the population of Busselton has grown and become more mobile – from 6000 in 1966 to 36,000 in 2016 – and research focuses have changed reflecting worldwide clinical demand. Data and biosamples from the 20,368 Busseltonians who have participated have contributed to more than 400 local and international scientific papers across a broad range of chronic diseases.
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The Busselton Population Medical Research Institute (BPMRI) has been established with survey centre director Dr Michael Hunter leading a core staff and overseeing the annual collection Dr Michael Hunter of data. Between 2005 and 2008, surveys have been conducted into the respiratory health of 4268 adults and children, sleep studies for 793 and obstructive lung disease. In 2008-09 the focus was diabetes and from 2010 the surveys have looked into healthy ageing and currently until 2020, the health of Baby Boomers. The eyes of the world are on Busselton. “A lot of our research is presented to international conferences and the conversation and topic is Busselton. Particularly over the past 10 years, the data set has allowed us to be a part of large international collaborations exploring genetic causes for a range of diseases,” Michael said. “Busselton is the first stop for many researchers because the data is here. The Busselton studies have really put WA medical
research on the map. Local researchers such as Prof Fiona Stanley, who was involved in the study as a student collecting samples, to Nobel Laureate Prof Barry Marshall, who used data collected in Busselton to study the transmission rates of helicobactor pylori, have mined what Prof Stanley describes as a treasure trove. “It is a unique resource and as technology and scientific knowledge expands, the importance of the results from the past 50 years has become invaluable,” Michael said. “The explosion of genetic technology over the past 10 years has seen researchers all over the world use DNA samples that were collected 30 years ago in the 1994-95 survey as they have moved from genome association studies to genomic location of a disease to genome sequencing.” “The only way you can do these types of studies is to have a really well phenotyped population like Busselton with DNA samples available and the willingness of the community to take part. This is an irreplaceable resource.” Research funding is tricky at the best of times, in fiscally constrained times even harder and Michael said the challenge is to keep the study and the work of the institute at the fore of public consciousness. But like many other research institutes, the competition for NHMRC grants is intense. The BPMRI’s activities are partly supported by State Government grants and custodial arrangements of the database and the biospecimen collection exist with UWA and Pathwest. However, to maintain this 50year resource and fund ongoing surveys a relatively modest $750,000 a year secured funding would ensure its future. “With the permanent presence of the study in Busselton, the past 10 years have seen the community re-engage and we are starting to achieve exceptional participation rates that match the earlier surveys. We are building momentum. Staff are trained and the people of Busselton are enthused. To lose that headway, or shut down survey activity would take a lot of time, resources and money to build back up again.” ED: As part of the 50th anniversary an online publication and a hard copy history of the work of the Busselton Population Health Study is at http:// bpmri.org.au.
MEDICAL FORUM