Indoor Air Quality and Respiratory Morbidity in School-Aged Children with Bronchopulmonary Dysplasia

项目摘要/摘要 虽然对早产儿的护理继续提高出生在越来越矮的婴儿的存活率 在胎龄方面，没有证据表明支气管肺发育不良(BPD)的发生率最高 早产儿慢性肺部疾病的发病率正在显著下降，导致儿童人口总体上不断增长 有严重的呼吸道健康损害。几乎一半患有BPD的学龄儿童患有哮喘或 哮喘样症状和更多的人遭受长期的肺功能异常，这使他们处于 成年期肺功能较差。很少有研究评估长期呼吸困难的影响因素。 发病率，而且，除了吸烟，没有关于新生儿重症监护病房(NICU)的数据 环境影响。众所周知，空气污染和室内呼吸系统刺激物会引起呼吸道症状。 TOM，肺功能下降，并与几个高危人群的医疗保健利用有关 有慢性呼吸道疾病的儿童，以及健康的儿童群体。因此，识别 这些潜在的可修改的暴露对高症状发生率和肺功能的影响- 这一群体中的男性对于制定未来的干预措施以改善儿童的健康至关重要 与BPD。 这项研究的总体目标是确定室内空气质量和环境的贡献- 有BPD病史的儿童在家庭环境中暴露于TAL对呼吸道疾病发病率的影响，这是第一步 朝着实现产生有针对性的干预措施以改善呼吸健康的长期研究目标 在患有慢性肺部疾病的儿童中。中心假设是患有BPD的儿童患有更多的呼吸疾病- 暴露于家庭环境中的空气污染物所致的疾病，与过敏原和 其他因素。 该提案详细介绍了一项为期五年的项目，该项目旨在调查室内环境暴露对 BPD学龄儿童的呼吸系统症状和肺功能缺陷。最新情况- 室内空气质量成分的ART测量将评估二氧化氮(NO2)、颗粒物 物质(PM2.5)，以及过敏原(霉菌、老鼠、蟑螂、宠物)、内毒素、空气温度- 真实湿度与同时测量的呼吸道症状和肺功能有良好的特征 患有BPD的儿童队列。这项研究将确定室内环境的特定有害成分 独立于新生儿的BPD儿童与呼吸道并发症和肺功能低下相关 BPD严重程度和其他已知的流行病学危险因素。这些发现的影响将是确定莫迪- 可预见的风险因素，并确定未来的机会，以测试可能改善实质性呼吸的干预措施- 保守党的健康负担在这一日益增长的患有BPD的高危儿童群体中终生遭受。

Project Summary/Abstract While the care of premature infants continues to improve survival for infants born at increasingly shorter gestational ages, there is no evidence that the rate of bronchopulmonary dysplasia (BPD), the most common chronic lung disease of prematurity, is significantly declining, leaving an overall growing population of children with substantial respiratory health impairment. Almost half of all school-aged children with BPD have asthma or asthma-like symptoms and more suffer long-term lung function abnormalities that put them on a trajectory of poor lung function in adulthood. Few studies have evaluated contributing factors to long-term respiratory mor- bidity, and, except smoking, there is an absence of data regarding post-neonatal intensive care unit (NICU) environmental influences. Air pollution and indoor respiratory irritants are known to cause respiratory symp- toms, decline in lung function, and are associated with healthcare utilization in several at-risk populations of children with chronic respiratory conditions, as well as, populations of healthy children. Therefore, identifying the impact these potentially-modifiable exposures have on the high rate of symptoms and lung function abnor- malities in this group is critically important to developing future interventions to improve the health of children with BPD. The overall objective of this study is to determine the contribution of indoor air quality and environmen- tal exposures in the home environment to respiratory morbidity in children with a history of BPD, the first step toward achieving the long-term research goal of producing targeted interventions to improve respiratory health in children with chronic lung diseases. The central hypothesis is that children with BPD suffer respiratory mor- bidity by exposure to air pollutants encountered inside the home environment, independent of allergens and other factors. This proposal details a five-year project to investigate the role of indoor environmental exposures on respiratory symptoms, and, separately, on lung function deficits in school-aged children with BPD. State-of-the- art measures of indoor air quality constituents will assess the relationship of nitrogen dioxide (NO2), particulate matter (PM2.5), as well as, concentrations of allergens (mold, mouse, cockroach, pet), endotoxin, air tempera- ture and humidity with concurrently measured respiratory symptoms and lung function in a well-characterized cohort of children with BPD. This research will identify specific harmful components of the indoor environment associated with respiratory morbidity and poor lung function in children with BPD, independent of neonatal BPD severity and other known epidemiologic risk factors. The impact of these findings will be to identify modi- fiable risk factors and identify future opportunities to test interventions that may improve the substantial respira- tory health burden suffered by this growing high-risk group of children with BPD throughout life.