Respiratory Effects in Workers From Post-Katrina Related Airborne Exposures

描述（由申请人提供）：本研究的目的是建立暴露于卡特里娜/洪水后的清理和恢复工作与工人呼吸系统疾病、症状和肺功能过度纵向下降的风险之间的联系，同时考虑可能的混杂变量的影响。我们假设卡特里娜飓风/洪水后的清理和恢复工作，预计将花费数年时间在新奥尔良的严重破坏和洪水地区，将需要大量和长期的空气暴露于有害颗粒和生物气溶胶中，这将对气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、超敏性肺炎的发病率增加，以及与这些疾病相关的症状，以及呼气流量和/或呼气量的年度异常下降，并且与测量的颗粒物和微生物污染标记物暴露有关。目标研究人口将包括大约1000名新奥尔良地区的工人，他们从事拆除工作、垃圾和碎片的清除和处置、污水和供水管道的维修、建筑工作、树木砍伐和景观恢复。将使用严格标准化的肺活量测定法，以及关于呼吸系统健康、吸烟史、以前和现在的职业暴露、[居住地]和卡特里娜飓风后特定工作/任务持续时间的问卷来收集基线信息，然后在五年内每年重复一次。大约[5,000]个个人监测样本（每年[1,000]个）将被收集和分析颗粒、内毒素和β -葡聚糖。暴露测量将用于描述特定的工作和活动暴露，当与研究期间个人参与者的工作/任务/持续时间概况（衍生的问卷）合并时，将用于估计个人累积和平均暴露，以供健康影响模型使用。呼吸道健康结局（肺功能和症状）的患病率和发生率将通过横断面和纵向分析确定，并将与使用一般的、基于人群的数据的预期率进行比较。肺活量测定的年度变化将评估对气道和实质的影响。[拟议的研究应提供有关此类暴露对呼吸系统影响的宝贵信息，包括在类似的洪水恢复行动中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.]