AIRWAY DISEASE AND COCKROACH EXPOSURE IN PUBLIC HOUSING

公共住房中的呼吸道疾病和蟑螂接触

• 批准号: 6170936
• 负责人: Alkis Togias
• 金额: $ 48.03万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-07-13 至 2004-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6170936
• 关键词: air sampling /monitoring; airborne allergen; asthma; clinical research; cockroach; disease /disorder proneness /risk; environmental contamination; health behavior; health education; human morbidity; human subject; longitudinal human study; spirometry; urban poverty area

Asthma morbidity and mortality in poor, urban populations continues to be unacceptably high. Health scientists have no understanding of the reasons behind this phenomenon. Recently, we and others have suggested that allergic sensitization to cockroaches constitutes an important predictor of asthma morbidity in low income patients. If this is true, measures against cockroach infestation should become central in environmental policy planning with respect to urban housing. The main purpose of this project is to provide additional evidence supporting the concept that cockroach allergy has a causal relationship to asthma and to asthma severity and to begin examining proactive methods to combat this problem. Our multi- disciplinary team which covers the fields of clinical investigation, medical anthropology, respiratory epidemiology and medical entomology, has built a collaboration with the Housing Authority of Baltimore City, based on which we propose to perform a study involving the current residents of public housing that are to be relocated to new dwellings as part of an extensive plan to replace distressed complexes with new communities. After surveying entire populations of public housing complexes, we will identify residents with asthma and will fully characterize them with respect to atopic status and asthma severity. In addition, we will perform extensive evaluation of their original dwellings with respect to cockroach infestation and antigen levels. Using a case-control approach, we will assess whether cockroach exposure is a risk factor for asthma. Asthma morbidity and cockroach exposure will be then monitored longitudinally, in all asthmatics, while they are relocated into new homes. It is our hypothesis that the individuals with cockroach allergy who will be relocated to cockroach-free environments will experience significant improvement in their airway disease. Asthmatics without cockroach sensitivity will serve as negative controls. In a second cohort from the public housing population, we will test the effectiveness of a pro-active, early educational/behavioral modification program, combined with precision-targeted early mitigation, to avoid infestation of the new, cockroach-free homes. In conjunction with the above projects, we propose to develop and validate a new methodology for monitoring cockroach exposure, using multiple site dust sampling and spatial analysis techniques. This project can provide answers to crucial questions regarding the role of cockroach exposure in asthma and can impact the health of urban US populations who have disproportionally suffered from the morbidity and mortality of this disease.

城市贫困人口的哮喘发病率和死亡率仍然高得令人无法接受。健康科学家不了解这种现象背后的原因。最近，我们和其他人提出，对蟑螂过敏是低收入患者哮喘发病率的一个重要预测因素。如果这是真的，防治蟑螂侵扰的措施应该成为城市住房环境政策规划的核心。 这个项目的主要目的是提供更多的证据支持蟑螂过敏与哮喘和哮喘严重程度有因果关系的概念，并开始研究积极主动的方法来解决这个问题。我们的多学科团队涵盖了临床调查、医学人类学、呼吸流行病学和医学昆虫学等领域，他们与巴尔的摩市住房管理局建立了合作关系，在此基础上，我们建议进行一项研究，涉及将搬迁到新住宅的公共住房现有居民，作为用新社区取代破旧建筑群的广泛计划的一部分。 在调查了整个公共住宅区的人口后，我们将确定患有哮喘的居民，并将充分描述他们的特应性状态和哮喘严重程度。此外，我们还将对他们原来的住所进行广泛的蟑螂感染和抗原水平评估。使用病例对照方法，我们将评估蟑螂暴露是否是哮喘的危险因素。 在所有哮喘患者被重新安置到新的家园时，将对他们的哮喘发病率和蟑螂暴露进行纵向监测。我们的假设是，对蟑螂过敏的个体将被重新安置到无蟑螂的环境中，他们的气道疾病将得到显着改善。无蟑螂敏感性的哮喘患者将作为阴性对照。在来自公共住房人口的第二个队列中，我们将测试积极的早期教育/行为矫正计划的有效性，并结合精确的早期缓解措施，以避免新的无蟑螂房屋的侵扰。结合上述项目，我们建议开发和验证一种新的方法来监测蟑螂接触，使用多个站点的灰尘采样和空间分析技术。 这个项目可以提供答案的关键问题，蟑螂暴露在哮喘中的作用，可以影响美国城市人口的健康，谁曾遭受这种疾病的发病率和死亡率。