Psychosocial stressors, air pollution and childhood respiratory health in LAFANS

 描述（由申请人提供）：2008年，美国9.3%的儿童患有哮喘。由于哮喘的医疗保健利用和通常的终身持续时间，它被认为是最昂贵的慢性疾病之一（1），并严重影响少数民族和穷人（2）。环境和交通相关的空气污染增加了儿童哮喘的发病率，在社会经济弱势群体中风险更大（3）。本项目的目的是确定是否心理社会压力自我报告的儿童修改空气污染和儿童哮喘症状和肺功能之间的关系，在人口为基础的队列洛杉矶，CA。该项目将首次使用来自洛杉矶家庭和邻里调查（L.A.FANS1-2）的数据，该调查收集了儿童及其主要照顾者自我报告的心理社会压力因素。重要的是，这个多样化的样本有很大比例的西班牙裔（55%），和过度抽样的贫困家庭。 研究人员假设，社会心理压力源在社会经济地位较低的人中往往更高，这可能解释了社会经济地位观察到的对空气污染的不同脆弱性（4-8）。以前关于压力和儿童哮喘的研究主要依赖于父母报告他们自己的压力水平（7-10），父母报告的邻里凝聚力措施（6，11），或儿童暴露于暴力行为（5）。然而，这些措施可能会歪曲儿童感知的心理社会压力，例如父母与儿童之间的关系、儿童的年龄、儿童的同伴网络， 孩子自己的应对机制可以保护孩子免受父母自己感知的压力。使用儿童自我报告的心理社会压力源，从L.A.FANS数据中构建他们感知压力的整体测量，该项目的目的有两个：确定儿童感知压力水平是否会改变空气污染对（1）9-17岁儿童哮喘症状和（2）5-17岁儿童肺功能的影响。子目标是确定幼儿（0-8岁）中的亲子关系是否会改变空气污染对哮喘症状的影响。该项目将利用我们为样本构建的与交通相关的空气污染物（NO，NO2，NOX）的空间高度精细化土地利用回归模型（LUR）。 这项研究将通过构建一个更全面的衡量儿童感知的压力的方法来补充以前的文献，并使用该方法来确定儿童感知的压力是否会改变他们患哮喘或因空气污染而降低肺功能的风险。通过识别可能导致儿童哮喘的风险因素，特别是在弱势人群中，如SES低的人群，我们努力减少儿童哮喘对儿童及其家庭的巨大影响。

 DESCRIPTION (provided by applicant): In 2008, 9.3% of children in the US had asthma. Due to the healthcare utilization and often lifetime duration of asthma, it is considered to be one of the costliest of chronic diseases (1), and disproportionally affects minorities and the poor (2). Ambient and traffic related air pollution increases the morbidity of childhood asthma, with greater risk among the socioeconomically disadvantaged (3). The objective of this project is to determine whether psychosocial stressors self-reported by a child modify the relationship between air pollution and childhood asthmatic symptoms and lung function in a population based cohort in Los Angeles, CA. This project will for the first time use data from the Los Angeles Family and Neighborhood Survey (L.A.FANS1-2), which collected self-reported psychosocial stressors from both the children and their primary caregivers. Importantly, this diverse sample has a large proportion of Hispanics (55%), and oversampled poor households. Researchers have hypothesized that psychosocial stressors, which tend to be higher in those with lower socioeconomic status, may explain some of the differential vulnerability to air pollution observed by socioeconomic status (4-8). Previous studies of stress and childhood asthma have primarily relied upon parents reporting their own stress levels (7-10), parent-reported neighborhood cohesion measures (6,11), or the child's exposure to violent acts (5). These measures, however, may misrepresent the psychosocial stress that a child perceives, as the relationship between the parent and child, the age of the child, the peer network of the child, and the child's own coping mechanisms may protect the child from the parent's own perceived stress. Using the child's self-reported psychosocial stressors to construct a holistic measure of their perceived stress from L.A.FANS data, the aims of the project are twofold; to determine whether a child's perceived stress level modifies the effect of air pollution on (1) asthmatic symptoms in children ages 9-17 and (2) lung function in children ages 5-17. The sub-aim is to determine if poor parent-child bonding in young children (ages 0-8) modifies the effect of air pollution on asthmatic symptoms. The project will utilize spatially highly refined land use regression models (LUR) for traffic related air pollutants (NO, NO2, NOX) that we constructed for the sample. This study will add to the previous literature by constructing a more holistic measure of the stress perceived by the child, and use that measure to determine if a child's perceived stress modifies their risk of asthma or reduced lung function from air pollution. By identifying risk factors that may contribute to childhood asthma, particularly in vulnerable populations such as those with low SES, we strive to reduce the enormous toll that childhood asthma has on children and their families.