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: 6511101
• 负责人: Alkis Togias
• 金额: $ 48.38万
• 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/6511101
• 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.

贫穷的城市人口的哮喘发病率和死亡率仍然高得令人无法接受。健康科学家并不了解这一现象背后的原因。最近，我们和其他人提出，对蟑螂的过敏反应是低收入患者哮喘发病率的重要预测因素。如果这是真的，防止蟑螂肆虐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之间存在因果关系的概念，并开始研究主动抗击这一问题的方法。我们的多学科团队涵盖临床调查、医学人类学、呼吸道流行病学和医学昆虫学等领域，与巴尔的摩市住房委员会建立了合作关系，在此基础上，我们提议进行一项研究，涉及即将搬迁到新住所的公共住房的现有居民，作为用新社区取代陷入困境的综合体的广泛计划的一部分。在调查了整个公共房屋建筑群的人口后，我们将确定患有哮喘的居民，并根据特应性状态和哮喘严重程度对他们进行全面的特征描述。此外，我们会就蟑螂滋生情况和抗原水平，对它们原来的住所进行广泛的评估。使用病例对照方法，我们将评估蟑螂暴露是否为哮喘的风险因素。然后，在所有哮喘患者被重新安置到新家期间，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，蟑螂过敏的个体将被重新安置到没有蟑螂的环境中，他们的呼吸道疾病将经历显着的改善。非蟑螂敏感型哮喘患者作为阴性对照。在公共住房人口的第二个队列中，我们将测试一个积极的、早期教育/行为矫正计划的有效性，结合精确定向的早期缓解，以避免侵扰新的、没有蟑螂的房屋。结合上述项目，我们建议开发和验证一种新的监测蟑螂暴露的方法，使用多个地点的粉尘采样和空间分析技术。该项目可以为有关蟑螂暴露在哮喘中的作用的关键问题提供答案，并可能影响美国城市人口的健康，这些人已经不成比例地受到这种疾病的发病率和死亡率的影响。