Reduction of Exposures & Risk from Pesticides, Allergens, & Other Health Related

哥伦比亚儿童环境卫生中心（CCCEH）、纽约市卫生和心理卫生部（NYCDohMH）和纽约市住房管理局（NYCHA）计划继续开展合作研究，以评估公共住房中的全建筑综合虫害管理（IPM）计划是否是定期使用气雾剂杀虫剂的有效替代方案。在NYCHA的支持下，NYCHA雇用并培训了社区居民，使他们成为有执照的害虫控制操作员，以提供IPM干预措施。 租户协会、NYCDOHMH和CCCEH正在合作评估干预措施对害虫种群、过敏原水平和居民健康的影响。IPM试图通过消除食物来源和进入点以及使用低毒性农药（如诱饵、凝胶和硼酸）来控制害虫。CCCEH的研究结果表明，在CCCEH队列中，子宫内对蟑螂过敏原的敏感性和暴露于用于住宅害虫控制的杀虫剂的情况很普遍，这强调了低收入少数民族社区对有效低毒形式的害虫控制的需求。产前暴露于杀虫剂毒死蜱也与这些儿童的出生体重和身长减少有关。此外，住房相关的暴露是居民在社区委员会会议上表达的主要关切，我们参加了会议，以获得对中心研究的反馈。我们的两项研究计划 项目建立在我们目前与城市和社区的合作以及中心的研究成果之上。在第一阶段，我们将研究IPM的长期成功性、耐久性和成本效益，在第二阶段，我们将测试加强检查和补救过程的有效性，以改善广泛的健康相关住房 条件如果成功的话，这些干预措施可以在全市范围内推广，并可以作为美国其他城市公共住房机构的典范。 具体目标是： 目标1.通过测量（a）IPM使害虫水平降低的持续时间;（B）物理修理、密封和填缝在降解之前持续的时间;以及（c）维护IPM所需的维护时间表来确定IPM有效性的持续时间。目前对300套公寓（170套在东哈莱姆，另外130套将在布鲁克林布什威克招募）的研究将延长到干预后6个月至12个月。 目标2.确定NYCHA工作人员和建筑租户协会的合作干预是否可以改善NYCHA公寓中与健康相关的住房条件，方法是测量（a）居民对其总体健康、住房相关生活质量和对NYCHA维护程序的满意度的看法;（B）对广泛的与健康相关的住房条件的控制;以及（c）哮喘居民的发病率。其他NYCHA建筑物， 将对大约200套公寓进行研究。比较建筑将接受常规护理，干预建筑将接受干预，包括NYCHA维护人员的年度检查，并对与健康相关的住房条件进行补救，包括害虫，管道泄漏和霉菌，油漆剥落，烟雾探测系统，窗户防护和通风。 目标3：与社区外展，翻译和应用核心（COTAC）合作，评估社区与健康有关的住房问题，翻译研究结果，让社区成员理解和使用，并协助开展活动，帮助改善政策和做法，减少环境对儿童健康的风险。

The Columbia Center for Children's Environmental Health (CCCEH), the New York City Department of Health and Mental Hygiene (NYCDOHMH), and the New York City Housing Authority (NYCHA) plan to continue our collaborative research to assess whether a building-wide, integrated pest management (IPM) program in public housing is an effective alternative to the regular application of aerosol pesticides. NYCHA has hired and trained community residents to become licensed pest control operators to provide the IPM intervention, and with the support of NYCHA tenants' associations, NYCDOHMH and CCCEH are collaborating to evaluate the intervention's impact on pest populations, allergen levels, and residents' health. IPM attempts to control pests by eliminating sources of food and points of entry, and by using low-toxicity pesticides such as baits, gels and boric acid. The need for an effective, low-toxicity form of pest control in low-income minority neighborhoods has been underscored by CCCEH findings showing that in utero sensitization to cockroach allergens and exposure to pesticides used for residential pest control are widespread in the CCCEH cohort.Prenatal exposure to the pesticide chlorpyrifos has also been associated with reduced birth weight and length in these children. Further, housing-related exposures are the primary concern expressed by residents at community board meetings we attended to receive feedback on Center research. Our two proposed research projects build on our current collaboration with the city and the community and the Center's research findings. In Phase 1, we will examine the long-term success, durability, and cost-effectiveness of IPM, and in Phase 2, we will test the effectiveness of an enhanced inspection and remediation process to improve a broad range of health-related housing conditions. If successful, these interventions may be replicated citywide, and could serve as a model for other public housing agencies in cities across the United States. The specific aims are to: Aim 1. Determine the duration of lPM effectiveness by measuring (a) how long IPM keeps pest levels reduced; (b) how long the physical repairs, sealing and caulking last before degrading; and (c) the maintenance schedule needed to maintain IPM. The current study of 300 apartments (170 in East Harlem, and an additional 130 to be recruited in Bushwick, Brooklyn) will be extended past the current 6 months to 12 months post intervention. Aim 2. Determine whether a collaborative intervention by NYCHA staff and building tenants' associations can improve health-related housing conditions in NYCHA apartments by measuring (a) residents' perceptions of their overall health, housing-related quality of life, and satisfaction with NYCHA maintenance procedures; (b) control of a broad spectrum of health-related housing conditions; and (c) morbidity in residents with asthma. Additional NYCHA buildings with approximately 200 apartments will be studied. Comparison buildings will receive usual care, and intervention buildings will receive an intervention that includes annual inspection by NYCHA maintenance staff with remediation of health-related housing conditions, including pests, plumbing leaks and mold, peeling paint, smoke detection systems, window guards, and ventilation. Aim 3: Collaborate with the Community Outreach, Translation, and Application Core (COTAC) to assess health-related housing concerns of the community, translate research findings to be understood and used by community members, and assist in activities to help improve policies and practices to reduce environmental risks to children's health.