Asthma Severity in Children & Fine Particle Composition

儿童哮喘严重程度

• 批准号: 7909501
• 负责人: Brian P Leaderer
• 金额: $ 45.8万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-06 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7909501
• 关键词: Accounting; Admission activity; Aerosols; African American; Air; Air Pollution; Allergens; Allergic; Applications Grants; Area; Asthma; Caliber; Carbon; Carbon Black; Characteristics; Chemicals; Chest; Child; Childhood Asthma; Collection; Complex; Connecticut; Coughing; Data; Data Set; Development; Diagnosis; Elements; Environmental Protection; Epidemiologic Studies; Equation; Evaluation; Exposure to; Factor Analysis; Fluorescence; Follow-Up Studies; Generations; Guidelines; Health; Heating; Hispanics; Home environment; Hospitals; Hour; Household; IgE; Individual; Intervention; Ions; Iron; Lead; Massachusetts; Measurement; Measures; Metals; Meteorology; Methods; Modification; Monitor; Mothers; Motor Vehicles; New England; Nitrogen Dioxide; Outcome; Ozone; Particulate; Particulate Matter; Pharmaceutical Preparations; Physicians; Pollen; Process; Public Health; Reaction; Recording of previous events; Regression Analysis; Reporting; Research Personnel; Respiratory physiology; Roentgen Rays; Seasons; Severities; Shortness of Breath; Site; Source; Subgroup; Sulfur; Sulfur Dioxide; Symptoms; Techniques; Temperature; Testing; Time; Trace Elements; Tracer; United States Environmental Protection Agency; Vanadium; Variant; Wheezing; anthropogenesis; cost; density; design; exhaust; particle; particle exposure; pollutant; programs; prospective; respiratory; trafficking

DESCRIPTION (provided by applicant): Ambient fine particle matter (< 2.5 |j,m in diameter [PM2.s]) is hypothesized to be a factor in the exacerbation of asthma. The current US EPA standard for fine particles may not protect a sensitive sub-group-children with asthma. Limitations in the few cross-sectional and panel studies of the health effects of particle exposure are numerous and include: small subject numbers, narrow range of asthma severity, narrow time frame of observation, no control for household characteristics and allergic status, limited information on particles (chemical speciation and sources), and poor control of gaseous co-pollutants. We recently completed a prospective, 1-year follow-up study of 466 physician-diagnosed asthmatic children residing in southern New England, a region that includes an area of non-attainment of the EPA standard. Preliminary analysis using data from our Childhood Asthma Study and using limited, publicly available data on chemical constituents of PM2.5, suggests that daily respiratory health is compromised by exposure to particular components of PM2.s. In this grant application, we propose to acquire and analyze the stored, fine-particle collection filters from EPA monitoring sites in our region for trace elements and elemental carbon. We further propose to take advantage of the 158,000 subject-days of symptom and medication use data from our Childhood Asthma Study to examine the impact of exposure to PM2.5 and PM2.5 constituents on respiratory health. The primary health outcomes are: mother-reported daily respiratory symptoms (wheeze, persistent cough, chest tightness and shortness of breath) and medication use; and monthly asthma severity, assessed using the Global Initiative for Asthma (GINA) guidelines. Associations will be assessed with longitudinal repeated measures analyses using generalized estimating equations as well as empirical Bayes methods that will take into account sources of variability of exposures. Gaseous co-pollutants, meteorological variables and potential confounders (season of the year, atopic status of the child, local traffic density) will also be included in the evaluation. Relevance: Results of this study will provide important information necessary to assess the adequacy of the EPA PM2.5 standard, could identify the component(s) of PM2.s having the strongest impact on respiratory health, and could lead to more cost-effective strategies for source-targeted air-pollution interventions.

描述（申请人提供）：环境细颗粒物（< 2.5| j，m直径[PM2.s]）被假设为哮喘恶化的一个因素。目前美国环保署的细颗粒物标准可能无法保护一个敏感的亚组-哮喘儿童。颗粒物暴露对健康影响的少数横断面和小组研究的局限性很多，包括：受试者人数少，哮喘严重程度范围窄，观察时间范围窄，没有控制家庭特征和过敏状态，颗粒物（化学形态和来源）信息有限，以及对气态共污染物的控制不佳。我们最近完成了一项前瞻性的，为期1年的随访研究，466名医生诊断的哮喘儿童居住在南部新英格兰，该地区，包括一个地区的未达到环保署的标准。使用我们的儿童哮喘研究的数据和使用有限的公开可用的PM2.5化学成分数据进行的初步分析表明，暴露于PM2.5的特定成分会损害日常呼吸系统健康。在这项拨款申请中，我们建议从我们地区的EPA监测点获取和分析储存的细颗粒物收集过滤器的微量元素和元素碳。我们进一步建议利用我们儿童哮喘研究中158，000受试者-日的症状和药物使用数据，研究暴露于PM2.5和PM2.5成分对呼吸系统健康的影响。主要健康结果是：母亲报告的每日呼吸道症状（喘息，持续咳嗽，胸闷和呼吸急促）和药物使用情况;以及每月哮喘严重程度，使用全球哮喘倡议（GINA）指南进行评估。将使用广义估计方程和经验贝叶斯方法（考虑暴露变异性来源），通过纵向重复测量分析评估相关性。评价中还将包括气体共污染物、气象变量和潜在混杂因素（一年中的季节、儿童的特应性状态、当地交通密度）。相关性：这项研究的结果将提供评估EPA PM2.5标准的充分性所需的重要信息，可以确定对呼吸系统健康影响最大的PM2.5成分，并可能导致更具有成本效益的针对源的空气污染干预策略。