The Home Environment and Re-hospitalization in COPD study (HEAR COPD)

慢性阻塞性肺病研究中的家庭环境和再住院 (HEAR COPD)

• 批准号: 10331367
• 负责人: Nirupama Putcha
• 金额: $ 1.01万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10331367
• 关键词: Accounting; Address; Adult; Attention; Back; Baltimore; Biology; Biometry; COVID-19 pandemic; Cause of Death; Chemicals; Chronic Disease; Chronic Obstructive Airway Disease; Chronic lung disease; Clinical; Clinical Research; Data Analyses; Data Collection; Development; Diet; Disease Outcome; Dose; Dyspnea; Endocrine; Enrollment; Environment; Environmental Exposure; Environmental Health; Epidemiology; Equipment; Exposure to; Food; Future; Health; Home; Home environment; Individual; Industrialization; Inhalation; Knowledge; Link; Low income; Lung; Measurement; Medical; Metabolism; Morbidity - disease rate; National Institute of Environmental Health Sciences; Occupational Asthma; Outcome; Oxidative Stress; Parents; Participant; Patients; Pharmaceutical Preparations; Pilot Projects; Plastics; Pollution; Polyvinyl Chloride; Population; Population Group; Predisposition; Process; Production; Protocols documentation; Pulmonology; Quality of life; Questionnaires; Research; Research Infrastructure; Research Personnel; Respiratory Signs and Symptoms; Risk; Risk Factors; Severities; Source; Students; Training; United States; airway obstruction; building materials; cohort; consumer product; data management; eleventh grade; ethnic minority population; experience; health care service utilization; high school; hospital readmission; interest; non-smoker; patient oriented; personal care products; phthalates; pollutant; pulmonary function; respiratory; respiratory health; skills; tobacco smoke exposure; urinary

Project Summary Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the United States and a cause of substantial healthcare utilization. Although tobacco smoke exposure is a key risk factor for COPD, increasing attention has been paid to environmental contributors to the development and severity of COPD. Our research team has shown that numerous environmental exposures, including ambient pollutants, are linked to worse COPD morbidity. Among other common environmental exposures, compounds known as phthalates are of growing concern due to their possible adverse health effects on endocrine and respiratory health. Phthalates are a group of synthetic industrial chemicals with ubiquitous exposure among adults in the United States. Phthalate fumes have been established as a cause of occupational asthma and metabolism of phthalates has been shown to increase oxidative stress, which can worsen airway obstruction and heighten susceptibility to the effects of ambient pollution. Increased exposure to phthalates has been associated with small but significant decreases in lung function among healthy non-smokers and findings from our research team show an associa- tion between increased urinary levels of several phthalates and worse COPD outcomes, including worse respir- atory-specific quality of life, dyspnea, and rates of exacerbation. Studies indicate that exposure to phthalates is higher in low-income and ethnic minority populations – groups that also have worse outcomes in COPD. The majority of exposure to phthalates results from processed foods and food storage containers, personal care products, medical equipment, and building materials, but the source of pththalate exposure in a recently hospi- talized cohort of patients with chronic lung disease remains unclear. Given that phthalates have short half-lives and multiple sources of exposure, identifying their predominant sources is necessary to understand their effect on a chronic disease such as COPD and to inform future exposure mitigation strategies. To investigate this, we propose questionnaire assessment of possible sources of exposure among 20 participants enrolled in the ongo- ing Home Environment and Re-hospitalization in COPD study (HEAR COPD, NIEHS R01ES029999) with sim- ultaneous measurement of urinary phthalate concentrations. We will collect information on diet, use of personal care products, medications, and medical equipment to examine what factors are associated with higher urinary phthalate metabolite concentrations. The proposed research seeks to conduct a pilot study to assess determi- nants of phthalate exposure among adults with COPD in the HEAR COPD study. This proposal represents a feasible summer project of data collection for 20 participants of an ongoing parent study. It provides an excellent training vehicle, allowing Ms. Diaz (a rising high school 11th grade student) to gain skills in the acquisition and analysis of data on environmental exposures, with hands on experience conducting patient-oriented clinical re- search. Ms Diaz will have access to the data management and clinical research infrastructure of the Baltimore BREATHE (Bridging Research, Lung Health and the Environment) Center.

项目摘要 慢性阻塞性肺疾病（COPD）是美国的第四大死亡原因，A 大量医疗保健利用原因。尽管烟草烟雾暴露是COPD的关键危险因素，但 越来越多的关注对环境的发展和严重性的贡献者。我们的 研究小组表明，包括环境污染物在内的许多环境暴露与 COPD发病率更低。除其他常见的环境暴露外，称为邻苯二甲酸盐的化合物是 由于健康对内分泌和呼吸健康的不利影响而越来越关注。邻苯二甲酸盐 是一组合成工业化学物质，在美国成年人中无处不在。 邻苯二甲酸酯烟是占有疾病的原因，邻苯二甲酸盐的代谢具有 被证明会增加氧化应激，这可能会担心气道异议并提高对 环境污染的影响。邻苯二甲酸盐的接触增加与小但显着相关 健康的非吸烟者中肺功能的降低，我们的研究团队的发现表明， 几个邻苯二甲酸盐和COPD结局较差的尿液水平增加之间的影响，包括呼吸较差 特定于元素的生活质量，呼吸困难和加重率。研究表明，暴露于邻苯二甲酸盐是 低收入和少数民族人口的较高 - 在COPD中的结果也较差。这 大多数接触邻苯二甲酸盐的接触来自加工食品和食品存储容器，个人护理 产品，医疗设备和建筑材料，但最近医院的pththalate暴露来源 患有慢性肺部疾病的患者的病态队列尚不清楚。鉴于邻苯二甲酸盐的半衰期很短 和多种暴露源，确定其主要来源是必须了解其效果的必要来源 关于COPD等慢性疾病，并为未来的减轻暴露策略提供信息。为了调查这一点，我们 提案问卷调查对20名参与者的可能暴露来源评估 COPD研究中的家庭环境和重新住院（HEAL COPD，NIEHS R01ES029999） 尿邻苯二甲酸盐浓度的最终测量。我们将收集有关饮食的信息，使用个人 护理产品，药物和医疗设备以检查哪些因素与较高的尿液有关 邻苯二甲酸盐代谢物浓度。拟议的研究旨在进行一项试点研究，以评估确定 在HER COPD研究中，成年人患有COPD的邻苯二甲酸酯暴露。该建议代表 可行的夏季数据收集计划，用于正在进行的父母研究的20名参与者。它提供了极好的 训练车辆，允许迪亚兹女士（一名高中11年级的学生）获得收购和 分析有关环境暴露的数据，并具有进行以患者为导向的临床重新进行的经验 搜索。迪亚兹女士将可以访问巴尔的摩的数据管理和临床研究基础设施 呼吸（桥接研究，肺部健康与环境）中心。