Indoor Air Quality and Respiratory Morbidity in School-Aged Children with Bronchopulmonary Dysplasia

患有支气管肺发育不良的学龄儿童的室内空气质量和呼吸系统发病率

• 批准号: 10321588
• 负责人: JONATHAN MARK GAFFIN
• 金额: $ 72.5万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-01-15 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10321588
• 关键词: Acute; Adult; Affect; Air; Air Pollutants; Air Pollution; Allergens; Asthma; Bronchiolitis; Bronchopulmonary Dysplasia; Caring; Child; Child Health; Childhood; Childhood Asthma; Chronic; Chronic lung disease; Clinical; Clinical Research; Data; Development; Dictyoptera; Disease; Endotoxins; Environmental Exposure; Environmental Health; Epidemiology; Exposure to; Force of Gravity; Future; General Population; Gestational Age; Goals; Health; Home; Home environment; Humidity; Hypersensitivity; Impaired health; Impairment; Individual; Indoor Air Pollution; Indoor Air Quality; Indoor environment; Infant; Intensive Care Units; Intervention; Intervention Studies; Irritants; Life; Literature; Lung diseases; Measures; Molds; Morbidity - disease rate; Mus; Neonatal; Nitrogen Dioxide; Outcome; Outcomes Research; Particulate Matter; Patients; Policy Maker; Pollution; Population; Populations at Risk; Predisposing Factor; Premature Infant; Prevalence; Pulmonary Function Test/Forced Expiratory Volume 1; Recording of previous events; Research; Respiratory Disease; Respiratory Signs and Symptoms; Risk; Risk Factors; Role; Sampling; School-Age Population; Schools; Seasonal Variations; Severities; Smoking; Source; Subgroup; Symptoms; Temperature; Testing; Time; Vulnerable Populations; asthmatic; base; cohort; comorbidity; design; disability; epidemiology study; experience; health care service utilization; high risk population; household environmental exposure; improved; indoor concentrations; indoor pollutant; modifiable risk; negative affect; pollutant; premature; prevent; pulmonary function; respiratory; respiratory health; respiratory morbidity; response

Project Summary/Abstract While the care of premature infants continues to improve survival for infants born at increasingly shorter gestational ages, there is no evidence that the rate of bronchopulmonary dysplasia (BPD), the most common chronic lung disease of prematurity, is significantly declining, leaving an overall growing population of children with substantial respiratory health impairment. Almost half of all school-aged children with BPD have asthma or asthma-like symptoms and more suffer long-term lung function abnormalities that put them on a trajectory of poor lung function in adulthood. Few studies have evaluated contributing factors to long-term respiratory mor- bidity, and, except smoking, there is an absence of data regarding post-neonatal intensive care unit (NICU) environmental influences. Air pollution and indoor respiratory irritants are known to cause respiratory symp- toms, decline in lung function, and are associated with healthcare utilization in several at-risk populations of children with chronic respiratory conditions, as well as, populations of healthy children. Therefore, identifying the impact these potentially-modifiable exposures have on the high rate of symptoms and lung function abnor- malities in this group is critically important to developing future interventions to improve the health of children with BPD. The overall objective of this study is to determine the contribution of indoor air quality and environmen- tal exposures in the home environment to respiratory morbidity in children with a history of BPD, the first step toward achieving the long-term research goal of producing targeted interventions to improve respiratory health in children with chronic lung diseases. The central hypothesis is that children with BPD suffer respiratory mor- bidity by exposure to air pollutants encountered inside the home environment, independent of allergens and other factors. This proposal details a five-year project to investigate the role of indoor environmental exposures on respiratory symptoms, and, separately, on lung function deficits in school-aged children with BPD. State-of-the- art measures of indoor air quality constituents will assess the relationship of nitrogen dioxide (NO2), particulate matter (PM2.5), as well as, concentrations of allergens (mold, mouse, cockroach, pet), endotoxin, air tempera- ture and humidity with concurrently measured respiratory symptoms and lung function in a well-characterized cohort of children with BPD. This research will identify specific harmful components of the indoor environment associated with respiratory morbidity and poor lung function in children with BPD, independent of neonatal BPD severity and other known epidemiologic risk factors. The impact of these findings will be to identify modi- fiable risk factors and identify future opportunities to test interventions that may improve the substantial respira- tory health burden suffered by this growing high-risk group of children with BPD throughout life.

项目概要/摘要 虽然早产儿的护理不断提高出生时间越来越短的婴儿的生存率 妊娠年龄，没有证据表明最常见的支气管肺发育不良（BPD）的发生率 早产儿慢性肺病的发病率正在显着下降，导致儿童人口总体不断增长 患有严重的呼吸系统健康损害。几乎一半患有 BPD 的学龄儿童患有哮喘或 哮喘样症状，更多人患有长期肺功能异常，这使他们陷入了 成年后肺功能较差。很少有研究评估长期呼吸死亡的影响因素。 除吸烟外，缺乏有关新生儿重症监护病房 (NICU) 的数据 环境影响。众所周知，空气污染和室内呼吸道刺激物会引起呼吸道症状 汤姆斯，肺功能下降，并与几个高危人群的医疗保健利用有关 患有慢性呼吸道疾病的儿童以及健康儿童群体。因此，识别 这些潜在可改变的暴露对症状和肺功能异常的高发生率的影响 该群体的疾病对于制定未来改善儿童健康的干预措施至关重要 与边缘性人格障碍。 本研究的总体目标是确定室内空气质量和环境的贡献 有 BPD 病史的儿童在家庭环境中的呼吸道疾病总暴露量，第一步 实现制定有针对性的干预措施以改善呼吸系统健康的长期研究目标 患有慢性肺部疾病的儿童。核心假设是，患有 BPD 的儿童会出现呼吸系统疾病。 通过接触家庭环境中遇到的空气污染物而产生的抗体，与过敏原无关 其他因素。 该提案详细介绍了一个为期五年的项目，旨在调查室内环境暴露对健康的影响。 呼吸道症状，以及患有 BPD 的学龄儿童的肺功能缺陷。现状- 室内空气质量成分的艺术测量将评估二氧化氮 (NO2)、颗粒物的关系 物质（PM2.5），以及过敏原（霉菌、老鼠、蟑螂、宠物）、内毒素、空气温度的浓度 温度和湿度，同时测量呼吸道症状和肺功能 患有 BPD 的儿童队列。这项研究将识别室内环境中的特定有害成分 与 BPD 儿童的呼吸系统疾病和肺功能不良相关，与新生儿无关 BPD 严重程度和其他已知的流行病学危险因素。这些发现的影响将是确定修改 可行的风险因素，并确定未来测试可能改善显着呼吸的干预措施的机会 患有边缘性人格障碍的儿童这一不断增长的高危群体终生承受着巨大的健康负担。