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: 8925235
• 负责人: MATTHEW S PERZANOWSKI
• 金额: $ 0.21万
• 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/8925235
• 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，也是桑迪飓风过后居民最常见的投诉之一。一般来说，霉菌问题在城市家庭中很常见，并且对低收入家庭的影响尤为严重，因为他们对有利于霉菌生长的条件的控制能力较差。在城市环境中，患有哮喘的儿童可能特别容易受到与灾难性水灾后真菌暴露相关的不良健康影响。 2004 年医学研究所的一份报告和多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，大部分证据是基于潮湿或可见霉菌的报告，而不是基于测量的真菌暴露，这限制了这些研究证明 1) 真菌暴露是致病因素，2) 哪些真菌种类与健康结果相关，以及 3) 特定过敏致敏是否是哮喘相关发病的病因学途径。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局限性的阻碍，包括形态上难以辨别的孢子的微观鉴定和霉菌培养所需的物种特异性生长条件以及生物测定缺乏霉菌特异性。最近，聚合酶链反应方法学的进展将允许对与水损害相关的真菌特征进行表征，能够监测修复工作的效果和国内真菌特征的长期变化，并可能有助于阐明真菌暴露与呼吸系统健康不良之间的关联。该提案将测试以下假设：与未受影响的纽约市家庭相比，遭受桑迪飓风相关水损害的纽约市家庭在修复前和修复后具有不同的真菌物种特征，并且家庭中的真菌浓度与哮喘儿童的哮喘症状、气流阻塞和气道炎症有关。居住在纽约市因桑迪飓风受损的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，该合作伙伴关系为 2,000 栋房屋提供免费霉菌修复服务。居住在纽约市未受影响家庭中的 71 岁哮喘儿童的既定队列将用于比较受影响家庭和居住在这些家庭中的哮喘儿童的暴露和呼吸结果。该提案将在纽约市健康和心理卫生部 (DOHMH)、哥伦比亚大学、NIOSH 和私营企业的研究人员和公共卫生从业人员之间建立合作，提供互补的专业知识和技能，以回答重要的公共卫生研究问题，以应对这场毁灭性的自然灾害。如果成功，该提案将带来有关城市社区桑迪飓风等自然灾害后家庭真菌暴露以及儿童哮喘发病率相关增加的重要知识。纽约市卫生部和其他机构将利用这些知识来指导应对未来自然灾害，特别是澄清哮喘儿童面临的风险。