Urban Diesel Exposure and Inner City Asthma

描述(申请人提供)：居住在机动交通流量大的地区与儿童的呼吸道症状和肺功能死亡有关。根据这些流行病学发现和支持的实验数据，暴露在与柴油相关的空气污染中可能会引起包括哮喘和过敏在内的健康问题。然而，尽管我们在认识到柴油可能导致的哮喘或过敏症状方面取得了重大进展，但暴露于与柴油有关的空气污染与幼儿过敏和哮喘发病之间的直接联系尚未得到证实。柴油接触与其他城市接触对呼吸健康的影响也不清楚。我们假设，暴露在曼哈顿北部和南布朗克斯的柴油尾气排放与过敏原特异性致敏、肺功能下降以及5至6岁儿童哮喘的发病有关。我们的战略是利用已经建立的市中心出生队列，其中多种环境暴露和健康结果已经被测量，以评估单独暴露于与柴油相关的空气污染，或与其他普遍存在的城市环境暴露(过敏原、环境烟草烟雾[ETS])联合暴露是否会增加过敏或哮喘的发病风险。具体地说，我们建议利用我们的既定队列来： 目的1.确定暴露于柴油相关的空气污染是否与5至6岁儿童的过敏原特异性致敏、肺功能下降和/或哮喘的发病有关，以及 目的2.确定暴露于柴油相关的空气污染是否与a)过敏原和/或b)ETS暴露相互作用，在5-6岁时出现过敏原特异性致敏、肺功能下降和/或哮喘。 作为哥伦比亚儿童环境健康中心的一部分，居住在曼哈顿北部的300名多米尼加和非洲裔美国儿童自出生以来一直受到预期的跟踪，他们将在5岁到6岁之间被招募。将在家中进行为期两周的多环芳烃、黑碳、质量和痕量金属的空气监测。PM25和碳的重复测量将在6个月后重复。结果包括血清IgE、抗原特异性T细胞增殖、过敏皮肤试验、肺功能和哮喘诊断。主要目标是确定与柴油相关的暴露是否会导致过敏和/或哮喘的发展，并确定其相对于其他城市暴露的贡献。

DESCRIPTION (provided by applicant): Living in areas with high volumes of motorized traffic has been associated with respiratory symptoms and deceased lung function in children. Based on both these epidemiological findings and supporting experimental data, exposure to diesel-related air pollution has potential for health concerns that include asthma and allergy. However, despite substantial gains in our recognition of likely diesel-induced asthmatic or allergic symptoms, direct associations between exposure to diesel-related air pollution and the onset of atopy and asthma in young children have not yet been demonstrated. The interaction of diesel exposure with other urban exposures on respiratory health also is not clear. We hypothesize that exposure to diesel emissions in Northern Manhattan and the South Bronx is associated with allergen-specific sensitization, decreased lung function, and the onset of asthma in children at age 5 through 6 years. Our strategy is to take advantage of an established inner city birth cohort in which multiple environmental exposures and health outcomes already are being measured to evaluate whether exposure to diesel-related air pollution independently, or jointly with other prevalent urban environmental exposures (allergens, environmental tobacco smoke [ETS]), increase the risk for the onset of atopy or asthma. Specifically, we propose to use our established cohort to: Aim 1. Determine whether exposure to diesel-related air pollution is associated with the onset of allergen-specific sensitization, decreased lung function and/or asthma at age 5 through 6 years, and Aim 2. Determine whether exposure to diesel-related air pollution interacts with a) allergen, and/or b) ETS exposure, on the onset of allergen-specific sensitization, decreased lung function and/or asthma at age 5-6 years. 300 Dominican and African American children residing in Northern Manhattan that are being followed prospectively since birth as part of Columbia Center for Children's Environmental Health will be recruited at age 5 through 6 years. Two-week air monitoring at home for PAHs, black carbon, mass, and trace metals will be performed. Repeat measures of PM25 and carbon will be repeated 6 months later. Outcomes include sera IgE, antigen-specific T cell proliferation, allergy skin tests, lung function, and asthma diagnosis. The primary goals are to determine whether diesel-related exposure can induce the development of allergy and/or asthma, and to identify its contribution relative to other urban exposures.