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差距，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资助，在过去5年中。这项研究的总体目标是确定患有哮喘的儿童是否对环境空气污染物和生物气溶胶浓度的短期每日增加产生不良反应，是否更有可能增加长期哮喘发病率，并降低肺功能发育。这项研究的具体目的如下：1)评估空气污染物/生物气溶胶暴露对症状、哮喘严重程度和肺功能发育的长期健康影响；2)评估交通相关污染物和生物气溶胶暴露之间的相互作用对短期和长期影响的影响；3)使用新的因果分析方法(边际结构模型)来处理第一类和第二类，比较因果分析和关联分析之间的定量推断；以及4)创建DNA标本库，用于未来研究潜在涉及确定哮喘个体对氧化性空气污染物和/或生物气溶胶暴露的短期和长期影响的易感性的基因的作用。总体设计是一系列镶嵌在纵向队列研究中的小组研究。为期14天的小组研究包括每天两次的肺活量测定和症状评估。年度外地办事处访问的纵向跟踪包括详细的问卷调查、哮喘严重程度的分类以及支气管扩张剂治疗前后的肺活量测定。小组研究的数据为每个受试者提供了对周围污染物的短期反应性的估计；每个小组的影响估计是哮喘严重程度和肺功能增长的纵向分析的主要“暴露”。这项研究产生了一系列独特的详细暴露和个人后续数据，否则目前无法获得这些数据。优势是使用统计方法，解决了以前研究的许多局限性。拟议研究的结果将有助于通过减少空气污染来控制哮喘负担的努力。

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.