Urban Diesel Exposure and Inner City Asthma

描述（由申请人提供）：居住在机动车流量大的地区与儿童呼吸道症状和肺功能衰竭有关。根据这些流行病学调查结果和支持性实验数据，暴露于与柴油有关的空气污染有可能引起健康问题，包括哮喘和过敏。然而，尽管我们对可能由柴油引起的哮喘或过敏症状的认识取得了实质性进展，但暴露于与柴油有关的空气污染与幼儿特应性和哮喘发病之间的直接联系尚未得到证实。柴油暴露与其他城市暴露对呼吸系统健康的相互作用也不清楚。我们假设，暴露在曼哈顿北部和南布朗克斯的柴油排放与过敏原特异性致敏、肺功能下降和5至6岁儿童哮喘发作有关。我们的策略是利用一个已建立的城市内出生队列，其中多种环境暴露和健康结果已经被测量，以评估是否暴露于柴油相关的空气污染单独，或与其他普遍的城市环境暴露（过敏原，环境烟草烟雾[ETS]），增加特应性或哮喘发作的风险。具体来说，我们建议使用我们已建立的队列来：

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.