Exposure Intervention in a Rural Pediatric Asthma Cohort

农村小儿哮喘队列的暴露干预

• 批准号: 6655694
• 负责人: Peter S Thorne
• 金额: $ 38.38万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2006-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6655694
• 关键词: air pollution control; air sampling /monitoring; airborne allergen; asthma; clinical trials; dust; endotoxins; environmental exposure; enzyme linked immunosorbent assay; fungal antigens; health behavior; health education; human subject; human therapy evaluation; medically underserved population; patient oriented research; pediatrics; polymerase chain reaction; quality of life; questionnaires; respiratory disease /disorder therapy; respiratory disorder epidemiology; rural area; spirometry; statistics /biometry; technology /technique development

DESCRIPTION (provided by applicant): Recent studies have provided evidence to support a causal relationship between asthma exacerbations and exposure to inflammatory agents such as endotoxin and fungal glucans. Investigators have also begun to assess what changes to the environment can reduce the severity of asthma. This project is a community- based, participatory, environmental intervention study in an established cohort of asthmatic children who reside in a rural, medically underserved, and ethnically diverse Iowa county. The cohort is currently serving as the control group for a medical intervention in the adjacent county. This project recognizes that interventions that are effective for urban residents may not apply to children living on farms and in rura1 communities. Thus, this project will test the efficacy of an intervention that includes a household hygiene educational intervention, professional super cleaning, booster cleaning, and integrated pest control against a minimal intervention in the control group. This randomized controlled study with repeated measures has the following specific aims: Aim 1. Develop and validate reproducible, quantitative methods for assessing airborne and settled dust exposures to inflammatory agents and rural allergens in homes and schools. Aim 2. Perform a pilot study to establish the time course for changes in environmental concentrations of etiologic agents before and at various times after an extensive "Super Cleaning." Aim 3. Perform a controlled, targeted environmental intervention in homes and schools of 132 rural child asthmatics and determine the effectiveness of these measures for reducing exposures to etiologic agents for asthma. Aim 4. Determine the effectiveness of the asthma intervention measures for reducing asthma symptoms, school absenteeism, and utilization of medical services; and improving pulmonary function and quality of life. Aim 5. Through analysis of pre-intervention and post-intervention exposure data and health status data, examine exposure-response relationships between endotoxins, glucans, and other exposure and indicators of health status. Environmental sampling in the homes will occur at baseline and 6, 14, and 26 weeks. Home hygiene education will occur at 2 weeks, the professional super cleaning will take the place at 4 weeks, follow-up home hygiene educations at 6 and 14 weeks, and the booster cleaning at 16 weeks. Detailed health and home hygiene questionnaires and home inspections will be conducted at baseline and one year later, as will child spirometry.

描述（由申请人提供）： 最近的研究提供了支持因果关系的证据 哮喘恶化和暴露于炎症剂，例如内毒素和 真菌葡萄糖。 调查人员还开始评估对 环境可以减少哮喘的严重程度。 这个项目是一个社区 - 基于既定的，参与性的环境干预研究 居住在乡村，医学上贫乏的哮喘儿童的队列，以及 爱荷华县种族多样化。 该队列目前正在担任 在邻近县进行医疗干预的对照组。 这个项目 认识到对城市居民有效的干预措施可能不会 适用于居住在农场和RURA1社区的儿童。 因此，这个 项目将测试包括家庭在内的干预措施的功效 卫生教育干预，专业超级清洁，助推器 清洁和整合害虫控制，以最少干预 对照组。 这项通过重复测量的随机对照研究具有 以下具体目的：目标1。发展和验证可重复的， 评估空气传播和沉降尘埃的定量方法 房屋和学校中的炎症剂和农村过敏原。 目标2。执行 一项试点研究，以建立改变环境的时间课程 病原体的浓度 广泛的“超级清洁”。 AIM 3。执行受控的，有针对性的 环境干预132名农村儿童哮喘患者的房屋和学校 并确定这些措施的有效性，以减少暴露 哮喘的病因学剂。 目标4。确定哮喘的有效性 减轻哮喘症状，学校缺勤和 利用医疗服务；并改善肺功能和质量 生活。目标5。通过干预前和干预后分析 暴露数据和健康状况数据，检查暴露响应关系 内毒素，葡萄糖和其他暴露和健康指标之间 地位。 房屋中的环境采样将在基线和6、14中进行 和26周。 家庭卫生教育将在2周内进行，专业人士 超级清洁将在4周内占有一席之地，后续卫生 在6周和14周的教育，以及16周的助推器清洁。 详细的 将进行健康和家庭卫生问卷和房屋检查 在基线和一年后，儿童肺活量测定法也会。