The Impact of Unconventional Natural Gas Development on Maternal, Perinatal, and Childhood Health: an Electronic Health Record Approach

非常规天然气开发对孕产妇、围产期和儿童健康的影响：电子健康记录方法

• 批准号: 10200037
• 负责人: Joan A Casey
• 金额: $ 24.9万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-15 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10200037
• 关键词: Acute respiratory infection; Address; Affect; Age; Air; Air Pollutants; Air Pollution; Anxiety; Asthma; Award; Biological Models; Birth; Birth Weight; Caring; Catchment Area; Chemicals; Child; Child Care; Child Health; Childhood; Childhood Asthma; Chronic; Code; Cohort Studies; Complex; Data; Data Collection; Development; Diagnosis; Electronic Health Record; Environment; Environmental Epidemiology; Environmental Exposure; Environmental Health; Environmental Policy; Environmental Risk Factor; Exposure to; Geographic Information Systems; Geography; Gestational Diabetes; Goals; Health; Health system; Healthcare Systems; Hospitals; Hypertension; Infant Care; Inflammation; Injury; Institution; Interdisciplinary Study; Irritants; Joints; Link; Logistics; Longevity; Maternal Health; Maternal and Child Health; Measures; Mediating; Mediation; Mediator of activation protein; Mental Depression; Methods; Mission; Modeling; Mothers; National Institute of Environmental Health Sciences; Natural Gas; Nature; Neonatal; Outcome; Outcome Study; Particulate Matter; Pathway interactions; Pennsylvania; Perinatal; Phase; Policies; Policy Making; Population Heterogeneity; Poverty; Pregnancy; Premature Birth; Primary Health Care; Production; Psychological Stress; Public Health; Questionnaires; Race; Reading; Reporting; Research; Respiratory System; Risk Factors; Sleep Disorders; Socioeconomic Status; Stress; Technology; Term Birth; Time; Training; Work; adverse birth outcomes; air monitoring; air sampling; apprenticeship; asthma exacerbation; base; bioinformatics tool; career; data mining; design; early childhood; electronic data; elementary school; environmental stressor; epidemiology study; experience; experimental study; health data; improved; in utero; neonatal health; pediatric patients; population health; psychosocial; respiratory; respiratory health; skills; social; social determinants; social factors; social stress; social stressor; stressor; study population; text searching; volatile organic compound

PROJECT SUMMARY/ABSTRACT Recent studies have linked unconventional natural gas development (UNGD) to adverse birth outcomes. The relative contributions of specific risk factors, such as related air pollutants, socioeconomic status, and maternal health during pregnancy, however, remain unclear, as do the consequences of UNGD for childhood health. The objective of this K99/R00 application is to use UNGD in Pennsylvania as a model system–because it repre- sents a rapid, widespread social experiment with chemical and psychosocial exposures and as well as communi- ty changes–to disentangle the effects of environmental and social co-exposures on maternal, neonatal, and child health. The proposed project will link UNGD activity to mothers' electronic health records (EHRs) in combination with primary data collected by questionnaires, passive air samplers, and geographic information systems. EHR data are particularly well suited for environmental health research because they provide inexpensive access to longitudinal health data on large and diverse populations (i.e., in terms of age, socioeconomic status, race, and geography). Considerable logistical and analytic skills are required to optimize use of EHR data, supplement it with primary data collection, and complete causal analyses. The K99 is designed to augment the candidate's prior research experience through coursework, apprenticeships in environmental epidemiology, and directed readings, with specific training in: (1) maternal and child health; (2) EHR text mining; (3) causal mediation analysis; (4) primary data collection; and (5) analysis of co-exposures. The skills gained during this award are critical to the long-term goal to use EHR data from multiple healthcare systems to conduct environmental epi- demiology studies across the lifecourse, in order to inform environmental policy-making. The proposed research will utilize Geisinger Health System's EHR data, which provides access to >15,000 births that have spatial and temporal overlap with UNGD in Pennsylvania. Aim 1 (K99 phase) combines text mining strategies and diagnosis codes to extract mothers' pregnancy-related health conditions from EHR data and then applies causal inference methods to evaluate pregnancy-related hypertension, gestational diabetes, sleep disorders, depression, and anx- iety as mediators of the observed associations between UNGD and term birth weight and preterm birth. Aim 2 (K99 phase) pilots primary data collection of chronic social stressors via questionnaires and ambient air samples near elementary schools attended by Geisinger pediatric patients. The R00 phase builds upon K99 data collec- tion and follows the primary care infants until 2021 (ages 8-15 years) to evaluate associations of types and timing of UNGD activity in relation to asthma diagnosis and acute respiratory infection. Aims 3-4 (R00 phase) begin to disentangle the environmental and social determinants of childhood respiratory outcomes. The proposal ad- dresses logistical and analytic challenges in environmental epidemiology and will prepare the applicant for an independent research career. This work will evaluate joint effects of environmental and social stressors on health across the lifespan and advance use of EHR data in environmental epidemiology.

项目摘要/摘要 最近的研究表明，非常规天然气开发(UNGD)与不良生育结局有关。这个 特定风险因素的相对贡献，如相关的空气污染物、社会经济地位和孕产妇 然而，怀孕期间的健康仍然不清楚，UNGD对儿童健康的影响也是如此。 这个K99/R00应用程序的目标是使用宾夕法尼亚州的UNGD作为一个模型系统-因为它代表- 发送一项快速、广泛的社会实验，涉及化学和心理社会暴露以及社区- TY变化--理清环境和社会共同暴露对母亲、新生儿和儿童的影响 健康。拟议的项目将把联合国非政府组织的活动与母亲的电子健康记录结合起来。 通过问卷、被动空气采样器和地理信息系统收集的主要数据。电子病历 数据特别适合于环境健康研究，因为它们提供了廉价的访问途径 关于大量和不同人群的纵向健康数据(即年龄、社会经济地位、种族和 地理位置)。需要相当多的后勤和分析技能来优化电子病历数据的使用，补充它 主要的数据收集和完整的因果分析。K99的设计目的是增强候选人的 以前的研究经验，通过课程学习，在环境流行病学的学徒，并指导 阅读材料，并在以下方面进行具体培训：(1)妇幼保健；(2)EHR文本挖掘；(3)因果调解 分析；(4)初级数据收集；(5)联合曝光分析。在该奖项中获得的技能包括 对于使用来自多个医疗保健系统的EHR数据来进行环境环境保护的长期目标至关重要- 人口学研究贯穿整个生命周期，以便为环境政策制定提供信息。拟议的研究 将利用盖辛格健康系统的EHR数据，该数据提供了对15,000名出生在空间和 与宾夕法尼亚州UNGD的时间重叠。目标1(K99阶段)结合了文本挖掘策略和诊断 从EHR数据中提取母亲与怀孕相关的健康状况的代码，然后应用因果推理 方法评估妊娠期高血压、妊娠期糖尿病、睡眠障碍、抑郁和臀部疼痛。 作为观察到的UNGD与足月出生体重和早产之间关联的中介变量。目标2 (K99阶段)飞行员通过问卷和环境空气样本收集慢性社会压力源的初步数据 附近有盖辛格儿科病人就读的小学。R00阶段基于K99数据收集- 并跟踪初级保健婴儿直到2021年(8-15岁)，以评估类型和时间的相关性 UNGD活动与哮喘诊断和急性呼吸道感染的关系。目标3-4(R00阶段)开始 理清儿童呼吸结果的环境和社会决定因素。该建议书广告- 介绍环境流行病学方面的后勤和分析挑战，并将为申请者准备参加 独立研究生涯。这项工作将评估环境和社会应激源对健康的联合影响 在整个生命周期内，并在环境流行病学中推进EHR数据的使用。

项目成果

Naming Civic Health in Environmental Justice Discourse: The Jackson Water Crisis.

在环境正义话语中命名公民健康：杰克逊水危机。

• DOI: 10.1016/j.lana.2022.100378
• 发表时间: 2022
• 期刊: Lancet regional health. Americas
• 作者: Nwanaji-Enwerem,JamajiC;Casey,JoanA
• 通讯作者: Casey,JoanA

Historic redlining and the siting of oil and gas wells in the United States.

• DOI: 10.1038/s41370-022-00434-9
• 发表时间: 2023-01
• 期刊: JOURNAL OF EXPOSURE SCIENCE AND ENVIRONMENTAL EPIDEMIOLOGY
• 影响因子: 4.5
• 作者: Gonzalez, David J. X.;Nardone, Anthony;Nguyen, Andrew, V;Morello-Frosch, Rachel;Casey, Joan A.
• 通讯作者: Casey, Joan A.