AIM to Improve Asthma: Airflow Improvements during Meal-prep

哮喘是儿童时期最常见的慢性病之一。因为孩子们花了很多时间 在家中，减少哮喘的干预措施--加剧家中的暴露--可能会产生深远的影响 影响。此外，许多污染物，如细颗粒物(PM2.5)和二氧化氮(NO2) 室内的水平比室外高，即使在发达国家也是如此。空气污染物可能会加重哮喘 症状通过多种机制，包括通过直接增加呼吸道炎症。其中一个 美国室内污染物的主要来源是用煤气炉做饭，以及与做饭有关的 污染物已被证明与哮喘症状的增加有关。在一个具有全国代表性的 在样本中，生活在没有使用烹饪通风设备的家庭的儿童患哮喘和 其他呼吸道疾病。这项研究将在有两个孩子的家庭中进行试点阶梯楔形随机试验 哮喘和煤气炉，评估密集的烹饪通风干预。长期目标是 为易于实施的家庭空气污染干预提供科学依据。初级阶段 该项目的目的是评估烹饪通风干预对家庭PM2.5和 NO2水平，次要目标是评估烹饪通风对短期措施的影响 儿童哮喘控制，因为PM2.5和NO2的变化或变化可能导致改善 在其他化学品中。作为一项青年参与性行动研究项目，第三个目标将是发展科学 社区青年的领导能力。这将是第一次尝试同时更换炉罩以改进 对哮喘儿童家庭的烹饪通风情况进行评估，并客观测量炉灶和引擎盖风扇的使用情况。 此外，阶梯式楔形设计将允许以两种方式进行分析：第一，作为随机对照试验 (以最大限度地减少混淆)，其次作为前后试验(以最大限度地增加样本容量)。所有家庭都将 接受通过抽油烟机的空气流量的测量，并由两部分组成：(1)更换 抽油烟机，如果空气流量低于加州建筑法规规定的每分钟100立方英尺(CFM)或 噪音高得令人无法忍受(2)在所有烹饪活动中使用抽油烟机的强化教育和 清洗油网。一家制造商(Broan)，没有参与研究的设计，计划 如果气流不足，请提供更换罩。炉灶和抽油烟机传感器也将安装在 在整个为期3周的数据收集期间，参与者的家，印心时和每周都有学习访问 此后，在为期三周的数据收集期间总共进行了四次访问。随机分为1组(30人 家庭)将在一周的基线数据收集后接受干预，第二组(30个家庭)将接受干预 两周后收到。测量的变量将包括炉灶使用、抽油烟机使用、PM2.5和NO2 家庭和儿童哮喘控制的多项措施(肺活量测定、部分呼出的硝酸盐 氧化物、哮喘控制问卷、艾萨克哮喘和环境问卷)。

Asthma is one of the most prevalent chronic diseases of childhood. Because children spend many hours indoors at home, interventions to decrease asthma-exacerbating exposures in the home could have profound impacts. In addition, many pollutants, such as fine particulate matter (PM2.5) and Nitrogen dioxide (NO2) have higher levels indoors than outdoors, even in the developed world. Air pollutants may worsen asthma symptoms through multiple mechanisms, including by directly increasing airways inflammation. One of the primary sources of indoor pollutants in the United States is cooking with gas stoves, and cooking-related pollutants have been shown to be related to increases in asthma symptoms. In a nationally representative sample, children who live in homes where cooking ventilation is not used have higher rates of asthma and other respiratory diseases. This study will be a pilot stepped-wedge randomized trial in homes with both a child with asthma and a gas stove, assessing an intensive cooking ventilation intervention. The long-term goal is to provide the scientific rationale for an easily implementable household air pollution intervention. The primary aim of this project will be to assess the effect of the cooking ventilation intervention on household PM2.5 and NO2 levels, and a secondary aim is to assess the effect of the cooking ventilation on short-term measures of pediatric asthma control, as improvements could result either from changes in PM2.5 and NO2 or from changes in other chemicals. As a youth participatory action research project, a third aim will be to develop scientific leadership capacity in community youth. This will be the first trial to both replace stove hoods for improved cooking ventilation in the homes of children with asthma and objectively measure both stove and hood fan use. Moreover, the stepped wedge design will allow for analysis in two ways: first as a randomized controlled trial (to minimize confounding) and secondly as a before-after trial (to maximize sample size). All homes will receive measurement of air flow through the range hood, and an intervention with two parts: (1) replacement of the range hood if air flow is less than the California building code level of 100 cubic feet per minute (cfm) or intolerably noisy and (2) intensive education regarding the use of the range hood during all cooking events and cleaning of the grease screen. A manufacturer (Broan), which has no role in the design of the study, plans to provide replacement hoods if the airflow is inadequate. Stove and Range hood sensors will also be installed in participant homes for the entire 3-week data collection period, with study visits at initiation and every week thereafter, for a total of four visits spanning three weeks of data collection. Those randomized to group 1 (30 homes) will receive the intervention after one week of baseline data collection and group 2 (30 homes) will receive it after two weeks. Measured variables will include stove use, range hood use, PM2.5 and NO2 in the household, and multiple measures of asthma control in the children (spirometry, Fractional exhaled Nitric Oxide, asthma control questionnaire, ISAAC Asthma and Environmental Questionnaires).