Spatio-temporal analyses of the role of environmental factors on cystic fibrosis severity, with a focus on fungal infections

空气污染是世界范围内的一个主要环境健康问题。患有囊性纤维化(CF)、慢性阻塞性肺疾病(COPD)和哮喘等肺部疾病的人特别容易受到空气污染的负面影响。世界卫生组织报告称，颗粒物(PM2.5和PM10)、NO2和O3被确定为对健康有重大影响的空气污染物。在英国，有超过12,000名CF患者。尽管越来越多的证据表明环境因素(例如，空气污染、接触二手烟)和社会经济状况对健康的影响，但英国关于环境因素在包括肺部恶化和其他并发症在内的CF严重程度中的作用的证据有限。真菌感染被认为与当地的环境特征密切相关，也与肺功能的迅速下降有关。我博士的目标是在美国和一些欧洲国家的研究成果的基础上，填补这一重要的研究空白。首先，我想评估空气质量、气候和房屋属性(特别是湿度、潮湿和霉菌)对CF疾病严重性的短期影响。其次，我想为更好地了解CF患者的居住地对真菌感染流行率的影响做出贡献。我的项目将使用英国CF注册中心(2007-2017)的数据，其中包括来自英国各地每个专业中心和诊所的数据，代表了超过99%的CF患者。我将侧重于使用基于小区域方法的时空分析来研究环境与健康之间的关联，并严格量化可能的因果关系。更好地了解这些相互作用和识别可能的环境风险因素可能会对CF个体产生直接的好处。该项目是在英国小区域健康统计单位(SAHU，https://www.sahsu.org)，)进行的，由UK CF Trust(https://www.cysticfibrosis.org.uk/)和帝国(https://www.imperial.ac.uk/mrc-dtp-studentships)，的MRC DTP资助与CF-EpiNet战略研究中心(https://www.cysticfibrosis.org.uk/the-work-we-do/research/research-we-are-funding/strategic-research-centres/src-4-bilton-data).合作

Air pollution is a major environmental health problem worldwide. Subjects with lung diseases such as cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD) and asthma are especially vulnerable to the negative effects of air pollution. Particulate matters (PM2.5 and PM10), NO2 and O3 have been identified as air pollutants which have a major impact on health reported by the World Health Organisation. There are over 12,000 people with CF in the UK. Despite growing evidence of the health impact of environmental factors (e.g. air pollution, exposure to second-hand smoke) and socio-economic status, there is limited evidence from the UK on the role of environmental factors in the severity of CF, including pulmonary exacerbations and other complications. Fungal infections, which are believed to be closely associated to local environmental characteristics, are also linked to a rapid decline in lung function. The aims of my Ph.D. are to fill in this important research gap, building on findings from the US and some European countries. First, I want to assess the short-term influence of air quality, climate, and housing properties (particularly humidity, dampness and molds) on disease severity in CF. Second, I would like to contribute to a better understanding of the influence of where individuals with CF live on the prevalence of fungal infections.My project will use data from the UK CF Registry (2007-2017), which includes data from every specialist centre and clinic across the UK, representing over 99% of people with CF. I will focus on using spatio-temporal analyses based on small-area methods to study environment-health associations and to rigorously quantify possible causative interactions. A better understanding of these interactions and the identification of possible environmental risk factors could have direct benefits for CF individuals.This project, conducted in the UK Small-Area Health Statistics Unit (SAHSU, https://www.sahsu.org), is funded by UK CF Trust (https://www.cysticfibrosis.org.uk/) and the MRC DTP at Imperial (https://www.imperial.ac.uk/mrc-dtp-studentships), in collaboration with the CF-EpiNet Strategic Research Centre (https://www.cysticfibrosis.org.uk/the-work-we-do/research/research-we-are-funding/strategic-research-centres/src-4-bilton-data).