The Effect of Phthalates on COPD Morbidity

邻苯二甲酸盐对慢性阻塞性肺病发病率的影响

• 批准号: 10469303
• 负责人: Daniel Carpenter Belz
• 金额: $ 3.26万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-07 至 2022-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10469303
• 关键词: Accounting; Address; Adult; Adverse effects; Airway Disease; Asthma; Attention; Baltimore; Biology; Biometry; Cause of Death; Chemical Exposure; Chemicals; Chronic Disease; Chronic Obstructive Airway Disease; Clinical; Clinical Research; Data; Data Analyses; Development; Diet; Diet Surveys; Disease Outcome; Dose; Dyspnea; Endocrine; Enrollment; Environment; Environmental Exposure; Environmental Health; Epidemiology; Equipment; Etiology; Evaluation; Exposure to; Follow-Up Studies; Food; Food Container; Future; Genetic Predisposition to Disease; Health; Home; Individual; Industrialization; Inhalation; Intervention; Investigation; Knowledge; Link; Low income; Lung; Measurement; Medical; Metabolism; Modification; Morbidity - disease rate; Occupational Asthma; Outcome; Oxidative Stress; Participant; Patients; Peat; Persons; Pharmaceutical Preparations; Phenotype; Plastics; Pollution; Polyvinyl Chloride; Population Group; Poverty; Predisposition; Process; Product Container; Production; Pulmonology; Quality of life; Research; Research Infrastructure; Research Personnel; Respiratory Signs and Symptoms; Risk; Risk Factors; Role; Rural; Sampling; Severities; Source; Training; United States; Urine; Visit; airway obstruction; allergic response; building materials; cohort; consumer product; data management; design; ethnic minority population; experience; health care service utilization; high risk population; improved; interest; non-smoker; novel; patient oriented; personal care products; phthalates; pollutant; pulmonary function; respiratory; respiratory health; respiratory morbidity; skills; study population; 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 morbidity and 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. Among common environmental exposures, compounds known as phthalates are of growing concern due to their possible adverse effects on endocrine and respiratory health. Phthalates are synthetic industrial chemicals used in plastics and numerous consumer products, with ubiquitous exposure among adults in the United States. Among the most widespread phthalates is Di-2-ethylhexyl phthalate (DEHP), a component of widely used plastics. Exposure to phthalates, including DEHP, has been linked with airway disease through mechanisms of oxidative stress and enhanced allergy responses. Increased exposure to DEHP and other phthalates has been associated with small but significant decreases in lung function among healthy non- smokers, with the strongest association in individuals with increased genetic susceptibility to oxidative stress. This oxidative stress can itself worsen airway obstruction as well as potentiate the effect of pollutant exposure. However, whether phthalate exposure is associated with poor outcomes in patients with COPD remains unknown. We hypothesize that exposure to DEHP is associated with respiratory morbidity among individuals with COPD. We have preliminary data showing a cross-sectional association with phthalate exposure and respiratory morbidity from a subset of an ongoing COPD study; however, causality cannot be established with this data, and intra-person variability in exposure to phthalates necessitates studies with longitudinal assessment of exposure. Further, sources of exposure and their relevance to COPD are unknown but are important to better design potential modification strategies. This proposal has two novel aims. First, to determine the association between 1a) individual and 1b) cumulative phthalate exposure on respiratory outcomes in individuals with COPD, we will conduct repeat measurement of urinary phthalate concentrations at a follow-up study visit paired with assessment of several respiratory outcomes. Second, to assess determinants of phthalate exposure among low-income individuals with COPD in order to identify modifiable factors and inform future exposure mitigation interventions, we will conduct home inspections and administer surveys of diet, personal care product use, and medical equipment use to determine the sources of exposure to phthalates in our study population. Results from this study will provide provocative evidence of the role of a chemical exposure (DEHP) not previously linked to COPD, and information on sources of exposure can be leveraged to develop mitigation strategies to improve COPD outcomes.

项目摘要 慢性阻塞性肺疾病（COPD）是美国第四大死亡原因 以及大量发病和医疗保健利用的原因。虽然烟草烟雾暴露是一个关键的风险， 由于COPD的因素，越来越多的关注环境因素对发展的影响， COPD的严重程度。在常见的环境暴露中，被称为邻苯二甲酸酯的化合物越来越多， 由于它们可能对内分泌和呼吸系统健康产生不利影响，因此令人担忧。邻苯二甲酸酯是人工合成的 塑料和许多消费品中使用的工业化学品，成人普遍接触 在美国邻苯二甲酸二（2-乙基己基）酯（DEHP）是最常见的邻苯二甲酸酯之一， 广泛使用的塑料。接触邻苯二甲酸盐，包括DEHP，与呼吸道疾病有关， 氧化应激和增强过敏反应的机制。增加接触DEHP和其他 邻苯二甲酸酯与健康非吸烟者的肺功能小但显著下降有关。 吸烟者，与个体对氧化应激的遗传易感性增加的最强关联。 这种氧化应激本身会加剧气道阻塞，并加剧污染物暴露的影响。 然而，邻苯二甲酸酯暴露是否与COPD患者的不良结局相关， 未知我们假设暴露于DEHP与个体的呼吸系统疾病有关 COPD。我们有初步数据显示邻苯二甲酸酯暴露与横截面相关， 来自正在进行的COPD研究子集的呼吸道发病率;但是，无法确定与 该数据以及邻苯二甲酸酯暴露的人内变异性需要进行纵向评估研究 暴露。此外，暴露来源及其与COPD的相关性尚不清楚，但对于更好地 设计潜在的修改策略。这项提议有两个新的目标。第一，确定关联 1a）个体和1b）累积邻苯二甲酸酯暴露对个体呼吸结局的影响 对于COPD患者，我们将在随访研究访视时重复测量尿邻苯二甲酸酯浓度 同时评估几种呼吸结果。第二，评估邻苯二甲酸酯的决定因素 低收入COPD患者的暴露水平，以确定可改变的因素并为未来提供信息。 暴露缓解干预措施，我们将进行家庭检查，并对饮食，个人 护理产品使用和医疗设备使用，以确定我们研究中邻苯二甲酸酯的暴露来源 人口本研究的结果将为化学品暴露（DEHP）的作用提供挑衅性证据 以前与COPD无关，并且可以利用暴露源信息制定缓解措施 改善COPD结局的策略。

项目成果

A cross sectional pilot study to assess the role of phthalates on respiratory morbidity among patients with chronic obstructive pulmonary disease.

• DOI: 10.1016/j.envres.2023.115622
• 发表时间: 2023-03
• 期刊: Environmental research
• 影响因子: 8.3
• 作者: L. Quirós-Alcalá;D. Belz;H. Woo;W. Lorizio;N. Putcha;K. Koehler;M. McCormack;N. Hansel