AIR POLLUTION, RACE, SES & ASTHMA HOSPITALIZATION RISK

描述(改编自申请人摘要)：我们建议进行 估计这种关联如何因种族/民族、社会经济状况而改变 职位、严重程度、年龄和性别。我们的假设是亚群和/或 弱势群体将更容易受到环境空气的影响 污染。 研究背景为南部和北部的Kaiser Permanente(KP) 加利福尼亚州，一家大型管理型医疗组织，基础人口超过 520万人。病例将被定义为金伯利进程的成员 1997至2000年间因哮喘(ICD-9 493)住院 (n=11,800)。种族/民族、年龄和性别将从Kaiser处获得 永久性数据库，而社会经济数据将通过地理编码获得 并链接到美国人口普查信息。严重程度将源自利用率 金伯利进程的数据库。环境空气污染和气象数据将 从环境监测站确定的。暴露量与气象因素 将映射到分配给每个人的地理区域和曝光量 根据他或她的住址。 与每个人的事件相关的暴露将与暴露进行比较 用条件Logistic回归估计参考天数的风险 与周围空气污染有关的哮喘住院治疗。 在对潜在的混杂因素进行调整后，如气象学和相互作用 种族/民族、年龄、性别、疾病严重程度和社会经济地位 将会被检查。这将是第一次看到这样的流行病学研究。 这些因素中的大多数都是以全人口为基础的。 这项研究将解决一个以前未被研究的问题，如果结果 证明少数族裔和/或生活在较低SES地区的人处于 环境空气污染对健康造成急性影响的风险更高， 研究和政策影响。

DESCRIPTION (Adapted from applicant's abstract): We propose to conduct estimate how this association is modified by race/ethnicity, socioeconomic position, severity, age, and gender. Our hypothesis is that subgroups and/or disadvantaged populations will be more vulnerable to the effects of ambient air pollution. The study setting is Kaiser Permanente (KP) in Northern and Southern California, a large managed care organization with a base population of over 5.2 million people. Cases will be defined as members of KP who were hospitalized with a diagnosis of asthma (ICD-9 493) between 1997 and 2000 (n=11,800). Race/ethnicity, age and gender will be obtained from Kaiser Permanente databases, while socioeconomic data will be obtained by geocoding and linking to US census information. Severity will be derived from utilization databases in KP. Ambient air pollution and meteorologic data will be ascertained from ambient monitoring stations. Exposure and meteorologic factors will be mapped to the geographic areas and exposure assigned to each individual based on his or her residential address. Exposure related to the event for each individual will be compared to exposures on reference days using conditional logistic regression to estimate the risk of an asthma hospitalization associated with exposure to ambient air pollution. After adjusted for potential confounders, such as meteorology, and interactions with race/ethnicity, age, gender, disease severity, and socioeconomic position will be examined. This will be the first such epidemiologic study to look at most of these factors on a population-wide basis. This study will address a previously understudied question and if the results demonstrate that minorities and/or people living in lower SES areas are at higher risk for acute health effects from ambient air pollution, there will be research and policy implications.