Project 1: Wildfire impacts on birth and developmental outcomes in a rural state

项目 1：野火对农村地区出生和发育结果的影响

• 批准号: 10362584
• 负责人: Erin O'Brien Semmens
• 金额: $ 23.13万
• 依托单位: UNIVERSITY OF MONTANA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10362584
• 关键词: Accounting; Achievement; Acute; Address; Admission activity; Age-Months; Air Pollutants; Air Pollution; American; Area; Birth; Birth Certificates; Birth Weight; Cardiovascular system; Centers for Population Health; Child; Child Health; Childhood; Chronic; Clinic; Collaborations; Communication; Communities; Computerized Medical Record; Cookstove; Country; Data; Data Sources; Death Certificates; Development; Education; Electronic Health Record; Ensure; Environmental Exposure; Environmental Impact; Event; Exposure to; Federally Qualified Health Center; Fetal Death; Fetal Mortality Statistics; Fire - disasters; Frequencies; Future; Gestational Age; Health; Health system; Healthcare Systems; Heating; Hospitals; Household; Human; Impairment; Income; Individual; Industry; Infant; Infant Development; Infant Mortality; Intervention; Investigation; Knowledge; Link; Literature; Low Birth Weight Infant; Measures; Medical center; Modeling; Modification; Montana; Mothers; Neighborhoods; Neonatal Intensive Care Units; Outcome; Participant; Particulate; Particulate Matter; Population; Pregnancy; Premature Birth; Public Health; Records; Research; Resource Development; Resources; Risk; Rural; Rural Community; Science; Seasons; Services; Severities; Small for Gestational Age Infant; Socioeconomic Status; Source; Spontaneous abortion; Surveys; Testing; Time; Wildfire; Wood stove; Work; autism spectrum disorder; climate change; early childhood; epidemiology study; experience; fine particles; fire fighter; forest; health care service organization; improved; interest; mortality; neurodevelopment; novel; predictive modeling; premature; residence; resilience; respiratory health; rural area; social capital; spatiotemporal; therapy design; trend; urban area

Project Summary/Abstract Wildfires are increasing in frequency, severity, and duration. Climate change and readily-available fuel sources ensure the trend toward increased fire frequency and severity will persist. Moreover, wildfires are not simply a short-term phenomenon; the duration of fire seasons has increased dramatically over the last three decades.  Research on the health impacts of wildfires has to date emphasized respiratory health and, to a lesser degree, cardiovascular endpoints. Although a growing body of literature has demonstrated that urban air pollution, specifically PM2.5, is linked to increased risk of miscarriage, lower birth weight, prematurity, being small for gestational age, and developmental conditions such as autism, little research has evaluated influence of wildfires on birth and development in the U.S. Of note, none of this work has been performed in rural areas, which have a unique profile of exposures throughout the year. An urgent need exists to understand impacts to inform strategies for community- and individual-level interventions. We will combine state-of-the-art air pollutant exposure assessment, birth certificate and fetal and infant mortality data, and electronic health records (EHR) to quantify the risk to infants associated with wildfire exposures during pregnancy and identify factors that promote resilience. The association between participant residence-specific estimates of wildfire exposure, overall and by trimester, and birth outcomes in Montana between 2000 and 2017, accounting for exposures occurring throughout the year, will be investigated. Specific outcomes include birth weight, low birth weight status, and small for gestational age status; gestational age at birth and preterm birth status; neonatal intensive care unit admission; fetal death; and infant mortality. EHR will be used to evaluate the impact of wildfire exposures on development in infants born in western Montana in the Providence and Community Medical Center health care organizations between 2012 and 2017. Specifically, we will investigate the effect of wildfire- related PM2.5 exposures on developmental milestone achievement at 2, 4, and 6 months of age. To inform the development of efficacious, practical, and sustainable interventions, we will examine potential effect modification by: individual-level factors, such as maternal education and household income, and community resilience promoting resources, including neighborhood socioeconomic status, social capital, and information and communication capacity. The successful conduct of the proposed research will build capacity for sophisticated spatio-temporal modeling of wildfire-associated air pollutant exposure and expanded and more comprehensive studies of neurodevelopmental impacts of environmental exposures. The proposed project will, for the first time, quantify the impacts of wildfires on birth and development in rural areas and determine resources that confer resilience to these effects. Most importantly, it will inform future interventions designed to mitigate the impacts of this ever-growing threat to public health.

项目概要/摘要 野火的频率、严重程度和持续时间都在增加。气候变化和现成的燃料来源 确保火灾频率和严重程度增加的趋势将持续下去。此外，山火不仅仅是一场 短期现象；过去三十年来，火灾季节的持续时间急剧增加。  迄今为止，关于野火对健康影响的研究一直强调呼吸系统健康，并且在较小程度上强调了 心血管终点。尽管越来越多的文献表明城市空气污染 特别是 PM2.5，与流产、低出生体重、早产、身材矮小的风险增加有关 胎龄和自闭症等发育状况的影响，很少有研究评估 野火对美国出生和发展的影响值得注意的是，这些工作都没有在农村地区进行过， 全年都有独特的风险敞口。迫切需要了解对 为社区和个人层面的干预策略提供信息。我们将结合最先进的空气污染物 暴露评估、出生证明、胎儿和婴儿死亡率数据以及电子健康记录 (EHR) 量化怀孕期间与野火暴露相关的婴儿风险，并确定影响因素 促进复原力。参与者对野火暴露的特定居住地估计之间的关联， 蒙大拿州 2000 年至 2017 年间的整体情况和按三个月计算的出生结果（考虑了暴露情况） 全年发生的情况，将受到调查。具体结果包括出生体重、低出生体重 状况和小于胎龄状况；出生胎龄和早产状况；新生儿强化 入住护理单位；胎儿死亡；和婴儿死亡率。 EHR将用于评估野火的影响 普罗维登斯和社区医疗中心蒙大拿州西部出生的婴儿发育暴露情况 2012 年至 2017 年间中心医疗机构。具体来说，我们将调查野火的影响- 相关 PM2.5 暴露对 2、4 和 6 个月龄发育里程碑成就的影响。通知 制定有效、实用和可持续的干预措施，我们将研究潜在的效果 修改依据：个人层面的因素，例如孕产妇教育和家庭收入以及社区 复原力促进资源，包括社区社会经济地位、社会资本和信息 和通讯能力。拟议研究的成功进行将建设能力 与野火相关的空气污染物暴露的复杂时空模型以及扩展等 环境暴露对神经发育影响的综合研究。拟议的项目将， 首次量化野火对农村地区出生和发展的影响，并确定 赋予抵御这些影响的资源。最重要的是，它将为未来的干预措施提供信息 减轻这一日益严重的公共卫生威胁的影响。