Psychosocial stressors, air pollution and childhood respiratory health in LAFANS

 描述(申请人提供)：2008年，9.3%的美国儿童患有哮喘。由于对医疗保健的利用以及哮喘往往持续终生，它被认为是代价最高的慢性病之一(1)，对少数群体和穷人的影响不成比例(2)。与环境和交通有关的空气污染增加了儿童哮喘的发病率，在社会经济上处于不利地位的人群中风险更大(3)。该项目的目的是在加利福尼亚州洛杉矶的一个人群队列中，确定儿童自我报告的心理社会应激源是否改变了空气污染与儿童哮喘症状和肺功能之间的关系。该项目将首次使用洛杉矶家庭和邻里调查(L.A.FANS1-2)的数据，该调查从儿童及其主要照顾者那里收集了自我报告的心理社会压力源。重要的是，这个多样化的样本中有很大比例的西班牙裔(55%)，并过度抽样贫困家庭。研究人员假设，社会经济地位较低的人的心理社会应激源往往更高，这可能解释了社会经济地位所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)，或孩子接触暴力行为(5)。然而，这些措施可能会歪曲儿童所感知的心理社会压力，如父母和孩子之间的关系，孩子的年龄，孩子的同伴网络， 而孩子自己的应对机制可能会保护孩子免受父母自己感受到的压力。使用儿童自我报告的心理社会应激源，根据洛杉矶联邦储备银行的数据构建他们感知到的压力的整体测量，该项目的目的有两个；确定儿童感知到的压力水平是否会改变空气污染对(1)9-17岁儿童的哮喘症状和(2)5-17岁儿童的肺功能的影响。下一个目标是确定幼儿(0-8岁)亲子关系差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)的空间高度精细化的土地利用回归模型(LUR)。这项研究将通过构建儿童感知到的压力的更全面的测量来补充之前的文献，并使用该测量来确定儿童感知到的压力是否会改变他们患哮喘的风险或空气污染导致的肺功能下降。通过确定可能导致儿童哮喘的风险因素，特别是在诸如低SES的弱势人群中，我们努力减少儿童哮喘对儿童及其家庭造成的巨大损失。

 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.