Airway Disease and Cockroach Exposure in Public Housing

公共房屋中的气道疾病和蟑螂暴露

• 批准号: 6944236
• 负责人: Alkis Togias
• 金额: $ 52.8万
• 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 2009-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6944236
• 关键词: air sampling /monitoring; airborne allergen; asthma; behavioral /social science research tag; clinical research; cockroach; disease /disorder proneness /risk; environmental contamination; environmental exposure; hay fever; health behavior; health disparity; health education; health service demonstration project; health services research tag; housing; human morbidity; human subject; longitudinal human study; respiratory disorder epidemiology; spirometry; urban poverty area

DESCRIPTION (provided by applicant): Asthma morbidity and mortality in poor, urban populations is unacceptably high. We and others have proposed that allergic sensitization to cockroaches may contribute to this problem. New analysis of our previously completed study of asthmatic adolescents shows even stronger association between indices of asthma severity and cockroach allergy. However, further in-depth assessment is required for the development of environmental policies and urban housing planning that address cockroach infestation in the context of respiratory health. The current grant was designed to provide additional evidence supporting the causal relationship between asthma morbidity and cockroach allergy/exposure. In the first period of this project, the data we have generated through a complete survey of the Claremont public housing complex in Baltimore City indicate that the prevalence of asthma in this population is much higher than the national average. In addition, we find that 60% of asthmatics in this population are sensitized to cockroaches. We continue our strong collaboration with the Housing Authority of Baltimore City and we are in the process of beginning our work in the O'Donnell Heights complex. This development is scheduled for demolition by the end of 2005, with new units available in 2007. We request renewal of this grant with the following aims. In Aim 1, we will survey the entire O'Donnell population so that we have full asthma prevalence data of a representative sample of public housing residents. Survey results will be validated with determination of airways responsiveness. Within the O'Donnell population, we will perform a cross-sectional study in individuals with asthma evaluating risk factors for asthma morbidity with focus on cockroach and other allergen exposure, endotoxin exposure, exposure to indoor air pollutants (PM2.5 and PM10) and obesity. To ascertain the relationship between the above risk factors and the presence of asthma, we will perform a case-control study involving the O'Donnell residents with asthma vs. a group of residents with lone rhinitis and a healthy group. In Aim 2, we will monitor asthma morbidity longitudinally in all asthmatic residents of O'Donnell Heights, while they are relocated into new homes. It is our hypothesis that those with cockroach allergy who will be relocated to cockroach-free environment will experience improvement in airway disease. Aim 3, consists of a randomized, parallel study utilizing individuals relocating into the new units that are replacing the Claremont complex. This study will test the effectiveness of an education/behavioral modification program, combined with precision-targeted early mitigation, against no intervention, in avoiding cockroach infestation of new homes. We hope that with the data to be generated, we will positively impact the health of urban US populations who are disproportionally suffering from asthma morbidity and mortality.

描述（由申请人提供）：贫困城市人群的哮喘发病率和死亡率高得令人无法接受。 我们和其他人提出，对蟑螂的过敏可能导致这个问题。 对我们先前完成的青少年哮喘研究的新分析显示，哮喘严重程度指数与蟑螂过敏之间存在更强的关联。 然而，需要进一步深入评估，以制定环境政策和城市住房规划，从呼吸系统健康的角度解决蟑螂侵扰问题。 目前的赠款旨在提供更多的证据支持哮喘发病率和蟑螂过敏/暴露之间的因果关系。 在本项目的第一阶段，我们通过对巴尔的摩市克莱蒙公共住房综合体的全面调查所产生的数据表明，该人群中哮喘的患病率远高于全国平均水平。 此外，我们发现，60%的哮喘患者在这一人群中是敏感的蟑螂。 我们继续与巴尔的摩市住房管理局密切合作，我们正在开始我们在奥唐纳高地综合体的工作。 这一发展计划定于2005年底拆除，2007年可提供新的单位。 我们请求延长这一赠款，目的如下。在目标1中，我们会对整个奥唐纳人口进行调查，以便我们能从一个有代表性的公共屋居民样本中，取得全面的哮喘患病率数据。 将通过确定气道反应性来验证调查结果。 在奥唐纳人群中，我们将对哮喘患者进行横断面研究，评估哮喘发病的风险因素，重点是蟑螂和其他过敏原暴露、内毒素暴露、室内空气污染物（PM2.5和PM10）暴露和肥胖。 为了确定上述危险因素与哮喘发生之间的关系，我们将进行一项病例对照研究，研究对象包括患有哮喘的奥唐纳居民、患有孤立性鼻炎的居民和健康人群。 在目标2中，我们将纵向监测奥唐纳高地所有哮喘居民的哮喘发病率，而他们被重新安置到新的家园。 我们的假设是，那些对蟑螂过敏的人将被重新安置到无蟑螂的环境中，呼吸道疾病将得到改善。 目标3，包括一项随机、平行研究，利用搬迁到新单位的个人，取代克莱蒙复杂。 这项研究将测试教育/行为矫正计划的有效性，结合精确的有针对性的早期缓解，对没有干预，在避免蟑螂侵扰的新家园。我们希望通过这些数据，我们将对美国城市人口的健康产生积极的影响，这些人口因哮喘发病率和死亡率而遭受痛苦。