Enhancing Environmental data Resources In Cohort studies: ALSPAC exemplar (ERICA)

关键词：空气污染；队列研究；二氧化氮；哮喘；肺功能；信息治理；环境健康空气污染对人类健康有重大影响。英国皇家医师学会在其题为《我们呼吸的每一口气：空气污染的终生影响》的报告中估计，空气污染每年导致英国4万人过早死亡。该报告描述了空气污染如何影响生命的健康，从母亲子宫中的婴儿到儿童再到成年。道路交通是英国空气污染的主要来源。这会产生细污染颗粒(PM)和二氧化氮(NO2)等气体。我们知道很多关于PM呼吸对健康造成的损害，但对呼吸NO2的影响知之甚少。英国政府和卫生专业人士都呼吁在这一领域进行更多的研究。“在队列研究中增强环境数据资源：ALSPAC样本”(ERICA)项目旨在通过出生队列研究来提高我们对呼吸NO2对健康影响的理解。出生队列研究招募了大量孕妇参与长期研究项目。这些妇女--及其未出生的孩子(REN)--的健康状况在怀孕、分娩和童年期间受到监测。健康信息可以与儿童一生中暴露在空气污染中的信息联系起来，以调查重要问题，例如，生活在高NO2污染地区的儿童是否更有可能患哮喘？这些研究的证据帮助公众、卫生专业人员和政客了解空气污染对健康的影响，以及应该花费多少精力和资金来降低污染水平。然而，进行这一重要类型研究的能力可能会受到一系列问题和担忧的阻碍。首先，研究需要找到有关空气污染的历史信息，并了解这些记录是如何长期收集的。其次，估计一座城市及其周边地区的空气污染暴露，并将其与儿童在哪里居住和上学的信息联系起来，需要专业技能。第三，关于一个人住在哪里的信息是私人的，需要保密。有关如何做到这一点以及个人数据的使用的法律法规正在迅速变化。ERICA旨在通过使用雅芳父母和儿童纵向研究(ALSPAC)出生队列研究来调查NO2污染对健康的影响，从而找到解决这些问题的方法。这项研究的第一部分将提供有关空气污染暴露的信息。Erica将与布里斯托尔市议会(许多ALSPAC参与者在怀孕期间住在那里)和环境科学家合作，收集有关当地空气污染暴露的历史信息。他们将使用这些和其他数据来估计参与者家庭和学校地点的NO2暴露，以提供儿童一生中NO2暴露的照片。数据安全和隐私专家将在与ALSPAC研究参与者的讨论中，就保护数据的最佳方式提供建议。然后，Erica将进行一项健康研究，调查暴露在较高水平的NO2是否与哮喘的发生有关，以及它们是否会影响肺生长。我们将向科学家、卫生专业人员和政界人士宣传这项研究的成果，帮助他们进一步了解NO2污染的影响。ALSPAC还将作为一个资源被推广，以调查儿童时期空气污染对一系列疾病和健康措施的影响。最后，我们将与其他队列研究的数据经理分享我们开发的方法。Erica将帮助展示使用出生队列研究来进行环境对健康影响的研究是多么可行，并形成一个模型，可以用于其他队列中的环境健康研究，并扩展到其他环境暴露和空气污染。

Keywords: air pollution; cohort studies; NO2; asthma; lung function; information governance; environmental healthAir pollution has a major impact on human health. The Royal College of Physicians - in their 'Every breath we take: the lifelong impact of air pollution' report - estimated that air pollution contributes to 40,000 premature deaths in the UK every year. The report describes how air pollution affects health through life, from babies in their mother's womb, to children and into adulthood. Road traffic is a major source of air pollution in the UK. This produces fine pollution particles (PM), and gases such as Nitrogen Dioxide (NO2). We know a lot about the health damage caused by breathing in PMs, but less about the effects of breathing in NO2. Both the UK Government and health professionals have called for more research in this area.The 'Enhancing Environmental data Resources In Cohort studies: ALSPAC exemplar' (ERICA) project aims to improve our understanding of the health effects of breathing in NO2 through using a birth cohort study. Birth cohort studies recruit large numbers of pregnant women into long-term research projects. Health of these women - and their unborn child(ren) - are monitored through pregnancy, birth and childhood. Health information can be linked with information on air pollution exposure during a child's lifetime to investigate important questions, e.g. are children living in high NO2 pollution areas more likely to develop asthma? Evidence from such studies helps the public, health professionals, and politicians understand the impact of air pollution on health, and how much effort and money should be spent on reducing levels of pollution. However, the ability to do this important type of research may be held back by a range of issues and concerns. Firstly, studies need to find historical information on air pollution, and to understand how the records were collected over long periods of time. Secondly, estimating air pollution exposures across a city and surrounding areas and linking this to information on where children live and go to school requires specialist skills. Thirdly, information on where a person lives is private and needs to be kept confidential. The laws and regulations governing how to do this and the use of personal data are changing rapidly. ERICA aims to find solutions to these issues by using the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort study to investigate the health impacts of NO2 pollution. The first part of the study will source information on air pollution exposure. ERICA will work with Bristol City Council (where many ALSPAC participants lived in pregnancy) and environmental scientists to collect historical information about local air pollution exposures. They will use these and other data to estimate NO2 exposures at participants' home and school locations, to provide a picture of NO2 exposure over a child's lifetime. Data security and privacy experts will advise on the best way to keep data confidential, in discussion with ALSPAC study participants. ERICA will then conduct a health study to investigate whether higher levels of NO2 exposure are associated with development of asthma and if they affect lung growth. We will promote the findings of this research to scientists, health professionals and politicians to help them further understand the impact of NO2 pollution. ALSPAC will also be promoted as a resource to investigate the impact of air pollution in childhood on a range of diseases and measures of health.Finally, we will share the methods we have developed with the data managers in other cohort studies. ERICA will help show how feasible it is to use a birth cohort study to conduct research on the impact of the environment on health, and to form a model that could be used to benefit environmental health research in other cohorts and expanded to other environmental exposures as well as air pollution.