Phthalate Exposure and Inner City Pediatric Asthma

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The proposed study will determine whether early childhood exposures to phthalates are associated with the development of current asthma and proallergic immunoglobulin (Ig) E production at ages 5-7and whether current exposures to phthalates are associated with augmented airway inflammation and diminished lung function at ages 5,-7. The research will confirm or refute recent epidemiologic findings of associations between phthalate exposures and childhood asthma, atopy and reduced lung function. This prior research is limited by incomplete exposure and outcome measures. However, results from a pilot undertaken for the proposed study also support the hypothesis that phthalate exposures are risk factors in the development of asthma. The proposed study will be conducted among a cohort of 400 children who reside in minority communities in New York City. These communities experience some of the highest childhood asthma rates in the world. Phthalate exposures are also widespread. The research will be performed within the ongoing longitudinal birth cohort study being conducted by the Columbia Center for Children's Environmental Health (CCCEH). The CCCEH is evaluating the contribution of prenatal and postnatal exposures in the development of asthma and other health outcomes. Children are followed from pregnancy through age 7 years. The proposed research is cost effective in that many of the required exposure and outcome measurements are already being gathered within the CCCEH cohort. These include detailed history of respiratory and allergic symptoms, asthma treatment and emergency room visits; lung function testing at age 6; allergen levels in house dust samples collected from pregnancy through age 5; and measurement of allergic sensitization (total and specific IgE measured at ages 2, 3, and 5 years). The phthalates will be measured in stored urine samples collected from the mother during pregnancy and from children at ages 3 and 5 years and in newly collected indoor air and urine samples at ages 5-7. Also at ages 5-7, exhaled nitric oxide will be measured as an indicator of airway inflammation and total and allergen-specific IgE levels will be determined. The case ascertainment of current asthma at ages 5-7 will be made by a designated board- certified pediatric pulmonologist at the Morgan Stanley Children's Hospital of New York Presbyterian Hospital. Hypothesesto be tested are: (1) that early childhood exposures to the phthalates, as measured by metabolite levels in urine samples collected during pregnancy and at ages 3 and 5 years, predict current asthma at ages 5-7 and production of IgE antibodies at age 7; and (2) after correcting for early phthalate exposure, current exposure as measured by levels of the parent compounds in indoor air samples and metabolites in urine samples collected at ages 5-7 years, will be associated inversely with lung function and positively with airway inflammation at ages 5-7 years.