Identifying the role of short-term fine particulate matter air pollution in the heart and lung health outcomes of adolescent and young adult cancer survivors

确定短期细颗粒物空气污染对青少年和年轻成年癌症幸存者的心脏和肺部健康结果的作用

• 批准号: 10308109
• 负责人: Anne C Kirchhoff
• 金额: $ 7.63万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-01 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10308109
• 关键词: Accident and Emergency department; Address; Adolescent and Young Adult; Affect; Age; Air Pollution; Anthracycline; Bleomycin; Breast Lymphoma; Breathing; Cancer Survivor; Cardiac health; Cardiomyopathies; Cardiovascular system; Chemotherapy and/or radiation; Chest; Communities; Cross-Over Studies; Crossover Design; Data; Development; Diagnosis; Disease; Emergency department visit; Environmental Pollutants; Ethnic Origin; Event; Exposure to; General Population; Goals; Health; Health system; Heart; Hospitalization; Hospitals; Hour; Individual; Institutes; Knowledge; Link; Lung; Malignant Neoplasms; Measures; Medical History; Modification; Morbidity - disease rate; Myocardial Infarction; Outcome; Outpatients; Particulate Matter; Persons; Physiological; Pollution; Population; Population Database; Predisposition; Public Health; Quality of life; Race; Radiation; Radiation therapy; Records; Registries; Reporting; Research; Respiratory Disease; Risk; Role; SEER Program; Sampling; Smoking; Smoking Status; Socioeconomic Status; Stress; Stroke; Subgroup; Survivors; Thyroid Gland; Time; Time trend; Tissues; Toxic effect; Treatment Protocols; United States; Utah; Wildfire; Withholding Treatment; adolescent health outcomes; anticancer research; cancer therapy; cardiovascular health; cardiovascular risk factor; chemotherapy; cohort; data resource; experience; fine particles; follow-up; health care service utilization; high risk; improved; insight; interest; lung health; lung injury; melanoma; mortality; neoplasm registry; physiologic stressor; prevent; respiratory; respiratory health; sex; survivorship; young cancer survivor

PROJECT SUMMARY ABSTRACT Cardiovascular (CV) and respiratory toxicity from cancer treatments are a major causes of morbidity among adolescent and young adult (AYA) cancer survivors. This toxicity may reduce a survivor’s ability to neutralize the added physiologic stress from short-term air pollution exposure, leading to a higher risk for cardiovascular and respiratory problems. However, the health effects of exposure to air pollution on AYA cancer survivors are largely unknown. To fill this knowledge gap, we will examine how fine particulate matter (PM2.5) is associated with CV and respiratory health events among survivors diagnosed with the five most common AYA cancers in the state of Utah (thyroid, melanoma, breast, lymphoma, testicular) between 1997 and 2016 (N=9,382). We will employ a case-crossover design nested in this preexisting cohort to examine the effects of short-term PM2.5 on the risk for cardiovascular and respiratory health events defined from statewide hospital discharge and emergency department data, and outpatient records from Utah’s two largest health systems serving >85% of Utah. Using data from the Utah Population Database, we can measure residential PM2.5 exposure at the address level for our sample. We will: 1) Investigate the association between short-term PM2.5 and CV and respiratory health events among AYA cancer survivors, and compare survivors’ risk of PM2.5-associated health events to a cancer-free sample, and 2) Determine whether treatments with known toxicities modify the association between short-term PM2.5 and CV and respiratory health events among AYA cancer survivors. We will identify temporal trends in these associations among survivors from diagnosis to the end of follow-up. Subgroups of survivors will be investigated to determine differences by smoking, race/ethnicity, and other relevant factors. Utah has severe PM2.5 pollution due to winter inversions and summer wildfires. Because of the pervasiveness of air pollution in United States and the lack of data on how environmental pollutants affect cancer survivors, this project represents a unique opportunity to determine whether air pollution is a risk factor for cardiovascular and respiratory health problems among AYA cancer survivors. Our study will provide a deep examination of cancer treatment, health care utilization, and PM2.5 exposure, and expand upon the established perspective of survivorship research by adding information the role air pollution on the risk for health events among cancer survivors.

项目摘要