Sleep Disordered Breathing and Asthma Morbidity in Inner City School Children

描述（由申请人提供）：哮喘对市中心儿童的影响尤为严重。市中心哮喘发病率可能是多因素的，其中环境暴露起着关键作用。市中心人口容易受到睡眠障碍的影响；然而，睡眠呼吸障碍（SDB）与哮喘发病率之间的关系尚未深入研究。本研究的主要目的是探讨SDB对哮喘发病率的影响。我们假设SDB将与哮喘发病率增加独立相关。本研究的次要目的是确定家庭和学校环境暴露（包括常见的空气过敏原[尘螨、猫、狗、老鼠、蟑螂和霉菌]、内毒素和空气污染[黑碳和二氧化氮]）对SDB和哮喘发病率的差异影响。关于环境暴露在SDB和哮喘发病率的复杂关联中的作用的研究很少。我们假设以学校为基础的暴露将独立地促进SDB和哮喘发病率。这项研究是独一无二的，因为我们将是第一个研究学校/教室特定环境暴露对SDB和哮喘发病率影响的研究。为了验证这些假设，我们将评估纳入已建立队列的儿童，即市中心学校过敏原和儿童哮喘（Wanda Phipatanakul博士，PI, NIAID R-01-AI-073964）的SDB（使用手腕活动仪和脉搏血氧仪）。该提案详细介绍了一个为期一年的项目，为Wright博士提供环境暴露评估及其对SDB和哮喘发病率的影响的培训和专业知识，特别关注市中心哮喘患者的学校环境。Wright博士将在哮喘和环境流行病学专家Phipatanakul博士的指导下工作，此外还有一个非凡的研究团队，包括dr。Joshua Boyce（哮喘专家），Susan Redline（睡眠医学专家）和Brent Coull（环境统计建模专家），他们投入了自己的时间和资源来促进Wright博士的职业发展和成功完成拟议的项目。作为研究培训计划的一部分，赖特博士将完成公共卫生硕士学位，主修环境卫生，以获得必要的流行病学和生物统计技能，成为一名成功的独立初级调查员。

DESCRIPTION (provided by applicant): Asthma disproportionately affects inner-city children. Asthma morbidity in the inner-city is likely multifactorial with environmental exposures playing a critical role. Inner city populations are vulnerable to sleep disturbances; however, the relationship between sleep disordered breathing (SDB) and asthma morbidity has not been thoroughly investigated in inner city asthmatics. The primary objective of this study is to investigate the effect of SDB on asthma morbidity. We hypothesize that SDB will be independently related to increased asthma morbidity. The secondary objective of this study is to determine the differential effect of home and school environmental exposures (including common aeroallergens [dust mite, cat, dog, mouse, cockroach, and mold], endotoxin, and air pollution [black carbon and nitrogen dioxide]) on SDB and asthma morbidity. There is a paucity of studies that have examined the role of environmental exposures on the complex associations of SDB and asthma morbidity. We hypothesize that school based exposures will independently contribute to SDB and asthma morbidity. This study is unique because we will be among the first to examine the effect of school/classroom specific environmental exposures on SDB and asthma morbidity. To test these hypotheses, we will evaluate the children enrolled in an established cohort, the Allergens in Inner-City Schools and Childhood Asthma (Dr. Wanda Phipatanakul, PI, NIAID R-01-AI-073964), for SDB (using wrist actigraphy and pulse oximetry). This proposal details a one year project to provide Dr. Wright with training and expertise in the assessment of environmental exposures and its effects on SDB and asthma morbidity with a specific focus on the school environment of inner city asthmatics. Dr. Wright will work under the mentorship of Dr. Phipatanakul, an expert in asthma and environmental epidemiology, in addition to an extraordinary team of researchers, including Drs. Joshua Boyce (with expertise in asthma), Susan Redline (with expertise in sleep medicine), and Brent Coull (with expertise in environmental statistical modeling), who have committed their time and resources to facilitate Dr. Wright's career development and the successful completion of the proposed project. As part of the research training program, Dr. Wright will complete a Master of Public Health with a concentration in environmental health in order to acquire the necessary epidemiologic and bio-statistical skills to become a successful independent junior investigator.