Aeroallergens, Air Pollution and Respiratory Health in the Chickasaw Nation A1

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Project Summary/Abstract American Indians are disproportionately impacted by asthma. The Chickasaw Nation, located in southcentral Oklahoma, reports clinic visits for asthma as one of the top diagnoses, accounting for 7% of patients at Chickasaw Nation Department of Health. Due to the high patient burden for asthma in Chickasaw Nation, the Tribe has identified a need to better understand risk factors for asthma-related morbidity. The long-term goal of this research is to understand the impact of aeroallergens and anthropogenic air pollution on asthma morbidity in Chickasaw Nation and to investigate more efficient ways to monitor, control, and ultimately prevent asthma morbidity among this highly-susceptible population. The Chickasaw Nation provides clinical and public health services for the majority of American Indians residing within their jurisdictional area in southcentral Oklahoma; thus, improving the health of the Tribe promotes the health of the overall community. This study provides a unique opportunity to evaluate the effect of ambient aeroallergens (pollen) and anthropogenic air pollution (particulate matter, ozone) on asthma-related morbidity using a novel device to measure the time and location of metered-dose inhaler (MDI) use in a rural, American Indian population. This in-depth study will allow researchers and the Tribe to: 1) evaluate the association of spatially- and temporally-resolved aeroallergens and anthropogenic pollutants with Global Positioning System (GPS)-enabled MDIs among Chickasaw Nation community members with asthma, and 2) compare the participants' perceived individual and neighborhood asthma triggers to the spatial and temporal data collected through the MDIs using sketch maps and interviews. We are partnering with Propeller Health to use GPS-enabled MDIs to measure asthma exacerbations, which will allow us to collect the exact time and location of the MDI actuation. We will evaluate whether the measured exposures are associated with MDI actuation using a time-series model accounting for lag times up to one week. At the end of the study, the participants will develop sketch maps that describe the perceived geographic locations of their asthma triggers. Our central hypothesis is that aeroallergen and air pollution levels in Chickasaw Nation interact synergistically to increase the prevalence of asthma-related morbidity. Longitudinal data on aeroallergens and asthma are sparse in American Indian populations and awareness of triggers will help improve asthma management in Chickasaw Nation. This study provides a unique opportunity to evaluate the effect of aeroallergens and anthropogenic air pollution on asthma morbidity using a novel device to measure the time, frequency, and location of MDI use in this population.