Respiratory Effects in Workers From Post-Katrina Related Airborne Exposures

说明(申请人提供)：这项研究的目的是建立暴露于卡特里娜/洪灾后清理和修复工作与呼吸系统疾病、症状和工人肺功能过度纵向下降之间的联系，同时考虑到可能的混杂变量的影响。]我们推测，卡特里娜飓风/洪灾后的清理和修复工作预计将在新奥尔良严重受损和洪水泛滥的地区持续数年，这将导致大量和长期的空气中有害颗粒物和生物气溶胶的暴露，这将对呼吸道和实质产生不利影响。这些影响可能表现为哮喘、支气管炎、肺炎、过敏性肺炎的发生率增加，以及与这些情况相关的症状，以及呼气流速和/或呼气量每年异常下降，并将与测量到的颗粒物和微生物污染标志物的暴露有关。目标研究人群将包括大约1000名新奥尔良地区的工人，他们从事拆迁工作、垃圾和瓦砾的清除和处置、排污和水管修复、建筑工作、树木砍伐和景观恢复。将采用严格标准化的肺活量测定法，并对呼吸健康、吸烟史、以前和现在的职业接触、[居住地点]和卡特里娜飓风后特定工作/任务持续时间进行问卷调查，以收集基线信息，然后在五年期间每年重复一次。将收集大约[5,000]个个人监测样本(每年[1,000]个)，并对其进行颗粒物、内毒素和β-葡聚糖的分析。暴露测量将被用来描述特定的工作和活动暴露的特征，当与研究中个体参与者的工作/任务/持续时间概况(来自调查问卷)合并时，将被用来估计用于健康影响模型的个人累积和平均暴露。呼吸健康结果(肺功能和症状)的患病率和发生率将使用横断面和纵向分析来确定，并将使用一般的基于人群的数据与预期的比率进行比较。肺活量测试的年度变化将评估对呼吸道和实质的影响。[拟议的研究应提供关于这种暴露对呼吸的影响的宝贵信息，包括类似洪灾恢复行动所需的呼吸保护水平。]

DESCRIPTION (provided by applicant): The objective of the study is to establish associations between exposure to post- Katrina/flooding cleanup and restoration work and the risk of respiratory illness, symptoms, and excessive longitudinal decline in lung function in workers, while accounting for the effects of possible confounding variables.] We postulate that post-Katrina/flooding cleanup and restoration work, expected to take several years in heavily damaged and flooded areas of New Orleans, will entail large and protracted airborne exposures to noxious particulates and bioaerosols that will have adverse airways and parenchymal effects. These effects may be manifested as increased incidences of asthma, bronchitis, pneumonia, hypersensitivity pneumonia, and symptoms associated with those conditions, as well as abnormal annual declines in expiratory flowrates and/or exhaled volumes, and will be relatable to measured exposures of particulates and markers of microbial contamination. The target study population will consist of approximately 1,000 New Orleans area workers performing demolition work, trash and debris removal and disposal, sewerage and water line repair, construction work, tree cutting, and landscape restoration. Rigorously standardized spirometry, and questionnaires on respiratory health, smoking history, previous and current occupational exposure, [location of residence] and post-Katrina-specific jobs/tasks durations will be administered to gather baseline information, then repeated annually over a five year period. Approximately [5,000] personal monitoring samples ([1,000] per year) will be collected and analyzed for particulates, endotoxins and beta glucans. The exposure measurements will be used to characterize specific job and activity exposures that, when merged with individual participant's jobs/tasks/durations profile over the study (questionnaire derived), will be used to estimate individual cumulative and average exposures for use in the health effects models. The prevalence and incidence of respiratory health outcomes (lung function and symptoms) will be determined using both cross-sectional and longitudinal analyses, and will be compared to expected rates using general, population-based data. Annual change in spirometric tests will assess effects on both airways and parenchyma. [The proposed research should provide valuable information on the respiratory impact of such exposures, including the level of respiratory protection required in similar flood recovery operations.]