Environmental Determinants of Pulmonary Disease: A new approach to an old problem

描述（由申请人提供）：我的长期职业目标是研究肺部疾病（如哮喘，反应性气道功能障碍综合征，纤维化肺病，过敏性肺炎等）的环境决定因素。南卡罗来纳州的社区受到了不成比例的影响。为了实现这一目标，我的研究策略是利用我目前的联合职位，在肺部健康结果存在差异的南卡罗来纳州社区内利用协作和多学科社区参与性研究（CBPR）的能力。我有三个短期目标：1。以更好地确定其他社区与肺部疾病的差异2.建立更好的机制，在肺部疾病差异较大的南卡罗来纳州社区内建立伙伴关系和联盟。将我的研究策略整合到一个现有的社区，作为一个示范性的社区（研究项目）。几位导师已经同意帮助我实施我的战略，并完成我的目标，包括强大的建立研究人员与成功的门徒的历史。目标1和2在我的职业发展计划中得到了解决，并将主要在卫生部门内实施，目标是将这些活动与CBPR与学术界的伙伴关系联系起来。为了完成我的研究项目，我编制了一个登记队列，其中包括950多名在社区环境灾难期间急性暴露于氯气的受害者。该研究项目的目标是完成必要的初步研究，以获得纵向队列研究的R 01资金。我们将检验以下关于急性氯气暴露的假设：（1）儿童和成人肺功能降低，气道反应性和炎症随着暴露/急性肺损伤的增加而增加（2）用皮质类固醇治疗的患者不太可能具有更严重的长期肺部发病率（3）吸烟、特应性、职业暴露于肺刺激物的历史，和肥胖是长期肺部预后不良的危险因素。这项拟议的计划具有重大的公共卫生意义，因为它解决了疾病预防控制中心的目标（健康的人在健康的地方;人们准备为新出现的健康威胁）和启动目标（健康社区：36;新出现的健康威胁;化学/放射。目标：提高公众和专业人员对化学/放射性灾害的防备能力。

DESCRIPTION (provided by applicant): My long-term career goal is to research the environmental determinants of pulmonary diseases (e.g. asthma, reactive airways dysfunction syndrome, fibrotic lung disease, hypersensitivity pneumonitis, etc.) within South Carolina communities disproportionately affected by them. To accomplish this goal, my research strategy is to leverage my current joint position to harness the capabilities for collaborative and multidisciplinary community-based participatory research (CBPR) within South Carolina communities with disparities in pulmonary health outcomes. I have three short-term objectives: 1. to better identify additional communities with disparities in pulmonary disease 2. to establish better mechanisms for building partnerships and coalitions within South Carolina communities with disparities in pulmonary disease 3. to integrate my research strategy into an existing community with disparities in pulmonary health as an exemplary community (Research Project). Several mentors have agreed to assist me with the implementation of my strategy and towards completion of my objectives, including strong established researchers with a history of successful proteges. Objectives 1 & 2 are addressed in my career development plan, and will be implemented primarily within the health department with the goal of linking those activities to CBPR with the partnership of academia. To accomplish my research project, I have compiled a registry cohort of over 950 victims acutely exposed to chlorine gas during a community environmental disaster. The goal of the research project is to complete the preliminary research necessary to procure R01 funding for a longitudinal cohort study. We will test the following hypotheses regarding acute exposure to chlorine gas: (1) children and adults have reduced lung function and increased airway reactivity and inflammation with increasing exposure/acute lung injury (2) patients treated with corticosteroids are less likely to have more severe long-term lung morbidity (3) cigarette smoking, atopy, history of occupational exposures to lung irritants, and obesity are risk factors for poor long-term lung prognosis. This proposed program is of great public health significance, since it addresses CDC goals (Healthy People in Healthy Places; People Prepared for Emerging Health Threats) and Starter Objectives (Healthy Communities: 36; Emerging Health Threats; Chem/Rad. Objective: Increase public and professional preparedness for chemical/radiological disasters).