Fungal Exposure in NYC Homes Damaged by Hurricane Sandy and Respiratory Outcomes

纽约市受飓风桑迪损坏的房屋中的真菌暴露和呼吸系统后果

• 批准号: 8694846
• 负责人: MATTHEW S PERZANOWSKI
• 金额: $ 99.05万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2015-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8694846
• 关键词: Fungal; Exposure; NYC; Homes; Damaged

DESCRIPTION (provided by applicant): Project summary In New York City (NYC), domestic mold contamination has been one of the greatest concerns for public health officials and most common complaints of residents in the aftermath of Hurricane Sandy. Mold problems are common in urban homes in general and disproportionately affect lower-income families who have less control over conditions conducive to mold growth. In urban settings, asthmatic children could be particularly susceptible to adverse health effects related to fungal exposures following catastrophic water damage. A 2004 Institute of Medicine report and several meta-analyses have concluded that mold and home dampness factors are associated with asthma symptoms. However, a majority of this evidence is based on report of dampness or visible mold and not on measured fungal exposure, limiting these studies from demonstrating 1) that fungal exposure was the causative agent, 2) which species of fungi were associated with the health outcomes and 3) whether specific allergic sensitization is an etiological pathway to the asthma-related morbidity. Historically, making these connections was impeded by limitations of traditional methods for assessing domestic mold exposure, including the microscopic identification of morphologically indiscernible spores and species-specific growth conditions required for mold culture and a lack of specificity for mold with bioassays. Recently, advances in polymerase chain reaction methodologies will allow for characterization of fungal profiles associated with water damage, enable monitoring the efficacy of remediation efforts and long-term changes in domestic fungal profiles, and may aid in elucidating the association between fungal exposure and poor respiratory health. This proposal will test the hypotheses that NYC homes with Hurricane Sandy-related water damage will have different fungal species profiles both pre- and post- remediation as compared with NYC homes that were not impacted and that fungal concentrations in homes will be associated with asthma symptoms, airflow obstruction and airway inflammation among asthmatic children. Participants living in NYC homes damaged by Hurricane Sandy will be recruited from a unique public-private partnership that is providing services for free mold remediation for 2,000 houses. An established cohort of seven-eleven year-old asthmatic children living throughout NYC in non-impacted homes will be used to compare exposures and respiratory outcomes with impacted homes and the asthmatics children living in those homes. This proposal will establish collaboration between researchers and public health practitioners at the NYC Department of Health and Mental Hygiene (DOHMH), Columbia University, NIOSH and private industry with complementary expertise and skills to answer important public health research questions in response to this devastating natural disaster. If successful, this proposal will lead to important knowledge about domestic fungal exposure following a natural disaster like Hurricane Sandy in urban communities and the associated increase in asthma morbidity in children. This knowledge will be used by the NYC DOHMH and others to inform the response to future natural disasters, particular to clarify the risks to asthmatic children.

描述(由申请人提供)：项目摘要在纽约市(NYC)，家庭霉菌污染一直是公共卫生官员最关心的问题之一，也是飓风桑迪过后居民最常见的投诉之一。霉菌问题在城市家庭中普遍存在，对低收入家庭的影响更大，他们对有利于霉菌生长的条件控制较少。在城市环境中，哮喘儿童可能特别容易受到与灾难性水破坏后的真菌暴露有关的不良健康影响。2004年医学研究所的一份报告和几项荟萃分析得出结论，霉菌和家庭潮湿因素与哮喘症状有关。然而，这些证据大多基于潮湿或可见霉菌的报告，而不是测量的真菌暴露，限制了这些研究证明1)真菌暴露是致病因素，2)哪种真菌与健康结局有关，3)特异性过敏致敏是否是哮喘相关发病率的病因途径。从历史上看，建立这些联系受到了评估国内霉菌暴露的传统方法的限制，包括对霉菌培养所需的形态难以分辨的孢子和特定物种的生长条件进行显微鉴定，以及利用生物测定缺乏霉菌的特异性。最近，聚合酶链式反应方法的进展将有助于表征与水损害有关的真菌谱，能够监测补救努力的效力和国内真菌谱的长期变化，并可能有助于阐明真菌暴露与不良呼吸道健康之间的联系。这项提案将检验这样的假设：与未受影响的纽约市家庭相比，飓风桑迪相关的水损害家庭在修复前后的真菌种类分布将不同，家庭中的真菌浓度将与哮喘症状、气流阻塞和哮喘儿童的呼吸道炎症有关。居住在被飓风桑迪破坏的纽约市房屋中的参与者将从一个独特的公私合作伙伴关系中招募，该伙伴关系将为2000所房屋提供免费霉菌补救服务。居住在纽约市各地非受影响家庭的7-11岁哮喘儿童的既定队列将用于比较受影响家庭和生活在这些家庭中的哮喘儿童的暴露情况和呼吸结果。这项提议将在纽约市卫生和精神卫生部门(DOHMH)、哥伦比亚大学、NIOSH和私营行业的研究人员和公共卫生从业人员之间建立合作，他们拥有互补的专业知识和技能，以回答这场毁灭性自然灾害的重要公共卫生研究问题。如果成功，这项提议将带来关于城市社区发生飓风桑迪等自然灾害后家庭真菌暴露以及相关儿童哮喘发病率增加的重要知识。这些知识将被纽约卫生部和其他机构用来为未来自然灾害的应对提供信息，特别是用来澄清哮喘儿童的风险。