Indoor and Outdoor NO2 and Asthma Severity in Children

室内和室外二氧化氮与儿童哮喘严重程度

• 批准号: 7629628
• 负责人: Brian P Leaderer
• 金额: $ 123.63万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-09-29 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7629628
• 关键词: 10 year old; Address; African American; Age; Air; Allergens; Allergic; Antibiotics; Antigens; Area; Asthma; Blood specimen; Breast Feeding; Calendar; Candidate Disease Gene; Canis familiaris; Censuses; Characteristics; Child; Connecticut; Control Animal; DNA; Data; Day Care; Dermatophagoides farinae antigen f 1; Dermatophagoides pteronyssinus antigen p 1; Dictyoptera; Dust; Education; Environment; Environmental Exposure; Environmental Tobacco Smoke; Epidemiologic Studies; Ethnic Origin; Exposure to; Family history of; Felis catus; Frequencies; Gases; Gender; Genes; Genotype; Guidelines; Hispanics; Home environment; Home visitation; House Call; House Dust; Household; Human; Hypersensitivity; IgE; Income; Infant; Infection; Information Systems; Interview; Length; Life; Literature; Low Birth Weight Infant; Measures; Molds; Monitor; Morbidity - disease rate; Mothers; Motor Vehicles; Nitrogen Dioxide; Perinatal; Pharmaceutical Preparations; Phase; Pollution; Population Study; Premature Birth; Prevalence; Puerto Rican; Questionnaires; Research; Research Personnel; Respiratory physiology; Risk; Risk Factors; Sampling; School-Age Population; Schools; Severities; Source; Spirometry; Symptoms; Telephone Interviews; Testing; Time; Treatment Protocols; United States; Vehicle Emissions; Visit; air contaminant; airborne allergen; allergen Bla g 1; cohort; density; design; effective intervention; elementary school; experience; follow-up; fungus; gene interaction; health care service utilization; infancy; mortality; novel; particle; pet animal; primary outcome; programs; prospective; pyroglyphid; residence; respiratory; trafficking

DESCRIPTION (provided by applicant): Exposure to aeroallergens and air contaminants is hypothesized to be a major factor in the exacerbation of asthma. Results of our ongoing studies suggest that nitrogen dioxide (NO2) associated indoors with gas appliance use and outdoors with motor vehicle emissions, at levels well below the EPA Air Quality Standard, may be associated with respiratory symptoms in children at risk for developing asthma and with the exacerbation of asthma in asthmatic children. Our data are also suggestive of an interaction between indoor aeroallergens and NO2 concentrations in enhancing respiratory symptoms in infants and asthmatic children. The potential impact is great since 57% of homes in the US use natural or LP gas, traffic volume is increasing and virtually all homes have significant dust allergen levels. We propose a prospective epidemiologic study of 1,533 children with active asthma (5 to 10 years of age), to test the hypothesis that carefully quantified NO2 concentrations associated with indoor sources and vehicle traffic on state and interstate roads are associated with asthma severity. In addition, we will determine if home levels of NO2, in the presence of common indoor dust allergens (Der p 1, Der f 1, Bla g 1, Pel d 1, Can f 1 and fungi), are associated with an increased risk of asthma severity in children sensitized to those allergens. The above hypotheses will be evaluated while adjusting for factors known or suspected to increase risk of more severe asthma, including household and school characteristics. The study population will be drawn from elementary schools in 16 Connecticut towns using a modified version of the ISAAC questionnaire to identify children with active asthma. Initial risk factors will be assessed in a home interview, and asthma severity (symptoms, frequency of ER visits, medication use, lung function.) will be assessed prospectively for one year using telephone interviews administered quarterly. At the home visit, dust samples will be collected for allergen and fungi determinations and blood samples collected for antigen specific IgE determinations. Indoor and outdoor NO2 levels will be obtained quarterly for each home. Global Information Systems in combination with road vehicle density data will be used to assess the impact of traffic on asthma severity and outdoor NO2 concentrations at the home. Household gas appliances and traffic-related pollution may represent important environmental exposures for asthmatic children, for which effective interventions can be developed to reduce asthma morbidity.

描述（由申请人提供）：暴露于空气过敏原和空气污染物被假设为哮喘恶化的主要因素。我们正在进行的研究结果表明，与室内燃气器具使用和室外机动车排放相关的二氧化氮（NO2）水平远低于EPA空气质量标准，可能与患哮喘风险儿童的呼吸道症状有关，并与哮喘儿童的哮喘加重有关。我们的数据也提示了室内空气过敏原和二氧化氮浓度之间的相互作用，可增强婴儿和哮喘儿童的呼吸道症状。潜在的影响是巨大的，因为美国57%的家庭使用天然气或液化石油气，交通量正在增加，几乎所有家庭都有显著的粉尘过敏原水平。我们提出了一项前瞻性流行病学研究，研究对象为1533名患有活动性哮喘的儿童（5至10岁），以验证仔细量化的NO2浓度与室内源和州际公路和州际公路上的车辆交通有关的假设。此外，我们将确定在常见室内粉尘过敏原（Der p1, Der f1, blag1, Pel d1， Can f1和真菌）存在的情况下，家庭二氧化氮水平是否与对这些过敏原敏感的儿童哮喘严重程度的风险增加有关。将对上述假设进行评估，同时调整已知或怀疑会增加更严重哮喘风险的因素，包括家庭和学校特征。研究人群将从康涅狄格州16个城镇的小学中抽取，使用ISAAC问卷的修改版本来识别患有活动性哮喘的儿童。最初的危险因素将在家庭访谈中评估，哮喘严重程度（症状、急诊室就诊频率、药物使用、肺功能）将通过季度进行的电话访谈进行前瞻性评估，为期一年。在家访时，将收集灰尘样本进行过敏原和真菌检测，收集血液样本进行抗原特异性IgE检测。每户每户的室内和室外二氧化氮水平将按季度获得。将使用全球信息系统结合道路车辆密度数据来评估交通对哮喘严重程度和家中室外二氧化氮浓度的影响。家用燃气器具和与交通有关的污染可能是哮喘儿童的重要环境暴露，因此可以制定有效的干预措施以减少哮喘发病率。