Fresno Asthmatic Children's Environment Study (FACES)

描述（由申请人提供）：为了解决一个重要的数据缺口，我们建议继续进行一项纵向队列研究，弗雷斯诺哮喘儿童环境研究（FACES），由加州空气资源委员会在过去5年资助。本研究的总体目标是确定对环境空气污染物和生物气溶胶浓度的短期每日增加有不良反应的哮喘儿童是否更有可能增加长期哮喘发病率和降低肺功能发育。本研究的具体目的如下：1）评估暴露于空气污染物/生物气溶胶对症状、哮喘严重程度和肺功能发育的长期健康影响; 2）评估暴露于交通相关污染物和生物气溶胶之间的相互作用对短期和长期影响的影响;（3）运用新的因果分析方法（边际结构模型），以解决施舍1和2，与因果关系和关联分析之间的定量推理比较;和4）建立DNA样本库，用于未来研究基因的作用，这些基因可能参与确定哮喘个体对暴露于氧化剂空气污染物和/或生物气溶胶的短期和长期影响的易感性。总体设计是一系列嵌入纵向队列研究的面板研究。为期14天的小组研究包括每日两次肺量测定和症状评估。在每年的外地办事处访视中进行纵向随访，包括详细的问卷调查、哮喘严重程度分类以及使用支气管扩张剂前后的肺功能测定。来自小组研究的数据提供了每个受试者对环境污染物的短期反应性的估计值;每个小组的效应估计值是哮喘严重程度和肺功能增长纵向分析的主要“暴露”。这项研究产生了一套独特的详细暴露和个体随访数据，这些数据目前尚不可用。优势是使用统计方法，解决了以前研究的许多局限性。拟议研究的结果将为通过减少空气污染来控制哮喘负担的努力提供重要信息。

DESCRIPTION (provided by applicant): To address an important data gap, we propose to continue a longitudinal cohort study, the Fresno Asthmatic Children's Environment Study (FACES), funded by the California Air Resources Board for the last 5 years. The overall goal of the study is to determine if children with asthma who have adverse responses to short- term, daily increases in concentrations of ambient air pollutants and bioaerosols are more likely to have increased long-term asthma morbidity and decreased lung function growth. The specific aims of the study are the following: 1) to evaluate the long-term health effects of exposure to air pollutants/bioaerosols on symptoms, asthma severity, and growth of lung function; 2) to evaluate the effect of interactions between exposures to traffic-related pollutants and bioaerosols on both short-term and long-term effects; 3) to use new methods of causal analysis (marginal structural models) to address Alms 1 and 2, with comparison of quantitative inferences between causal and association analyses; and 4) to create a DNA specimen bank for future studies of the role of genes potentially involved in determining susceptibility of asthmatic individuals to short and long-term effects of exposures to oxidant air pollutants and/or bioaerosols. The overall design is a series of panel studies embedded within a longitudinal cohort study. The 14-day panel studies include twice- daily spirometry and symptom evaluation. Longitudinal follow-up at annual field office visits includes a detailed questionnaire, classification of asthma severity, and pre- and post-bronchodilator spirometry. Data from the panel studies provide estimates of short-term responsiveness to ambient pollutants for each subject; the effect estimates for each panel are the principal "exposure" for the longitudinal analysis of asthma severity and lung function growth. The study has generated a unique body of detailed exposure and individual follow-up data that are otherwise not currently available. Strength is the use of statistical methods that address many limitations of previous studies. The results of the proposed study will contribute important information to the effort to control the burden of asthma through reductions in air pollution.