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: 6374079
• 负责人: Alkis Togias
• 金额: $ 46.97万
• 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/6374079
• 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.

贫困城市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的重要预测因素。如果这是真的，那么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。 该项目的主要目的是提供额外的证据来支持蟑螂过敏与哮喘和哮喘严重程度之间存在因果关系的概念，并开始研究解决这一问题的主动方法。我们的跨学科团队涵盖临床调查、医学人类学、呼吸流行病学和医学昆虫学等领域，并与巴尔的摩市住房管理局建立了合作关系，在此基础上，我们建议开展一项研究，涉及将要搬迁到新住宅的公共住房中的现有居民，作为用新社区取代困境综合体的广泛计划的一部分。 在对公共住宅区的全部人口进行调查后，我们将识别患有哮喘的居民，并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蟑螂侵扰和抗原水平的广泛评估。使用病例对照方法，我们将评估接触蟑螂是否是哮喘的危险因素。 然后，在所有哮喘患者搬入新家时，对他们的哮喘发病率和蟑螂暴露情况进行纵向监测。我们的假设是，对蟑螂过敏的人搬迁到无蟑螂的环境后，他们的呼吸道疾病会得到显着改善。对蟑螂不敏感的哮喘患者将作为阴性对照。在第二批公共住房人口中，我们将测试积极主动的早期教育/行为改变计划的有效性，并结合有针对性的早期缓解措施，以避免新的无蟑螂房屋受到侵扰。结合上述项目，我们建议使用多点灰尘采样和空间分析技术来开发和验证一种监测蟑螂暴露的新方法。 该项目可以回答有关蟑螂暴露在哮喘中的作用的关键问题，并可以影响美国城市人口的健康，这些人口患有这种疾病的发病率和死亡率不成比例。