Green Housing Study: Boston Followup

描述(由申请人提供)：哮喘目前在美国影响着近2200万成人和儿童，导致直接和间接成本超过180亿美元/年(CDC，2012，AAFA，2012)。不同经济和种族的哮喘患病率和发病率差异很大，在一些低收入城市地区的患病率超过25%(Nicholas等人，2005年)。改善医疗保健和减少这些社区内的环境暴露的干预措施的必要性很大。为了研究“绿色”改善家庭环境的可能性，以减少家中化学物质和其他哮喘诱因的暴露，疾病控制和预防中心(CDC)发起了绿色住房研究(GHS)。正如《建议书》所述，《全球统一制度》的具体目标如下：具体目标1，对绿色住房和对照住房中的化学和生物污染物、杀虫剂、挥发性有机化合物、真菌、室内过敏原(就种类和浓度而言)进行暴露评估。A.测量表面擦拭样品中的室内农药水平；粉尘样品中的真菌和室内过敏原；以及空气样品中的挥发性有机化合物。B.比较绿色住房和对照住房居民的挥发性有机化合物和杀虫剂的生物标志物水平(就种类和浓度而言)。具体目标2研究居住在绿色住房和对比住房与哮喘发病率(例如，症状、急诊科就诊、药物使用、失去上学/工作日)之间的关系，这些儿童被医生诊断为哮喘(7-12岁)。将对过敏反应和环境烟草烟雾(ETS)进行调整。2011年，两个研究地点相继设立：波士顿和辛辛那提。实地调查工作于2011年夏天开始，目前正在进行基线评估。申请的资金将支持对参加全球保健系统的儿童的暴露和呼吸健康结果的后续测量。我们的项目团队是一个建立在哈佛公共卫生学院(HSPH)、塔夫茨医学院、波士顿医学中心和马萨诸塞大学洛厄尔分校同事重要专业知识和资源基础上的合作。到目前为止，我们的团队在所有外地程序方面都积累了大量的专门知识，并成功地开展了所有类别的主要研究活动。我们建议在2013年6月之前完成所有为期6个月和12个月的后续实地考察工作。 公共卫生相关性：居民暴露在过敏原和污染物中会导致哮喘发病率。绿色建筑和翻新方法提供了减少这些暴露的机会，从而改善健康。该项目为疾控中心领导的一项研究提供后续测量，研究绿色翻修对低收入社区中被诊断患有哮喘的儿童的环境暴露和健康的影响。

DESCRIPTION (provided by applicant): Asthma currently affects nearly 22 million adults and children in the U.S., and results in direct and indirect costs exceeding $18 billion/year (CDC, 2012, AAFA, 2012). Disparities in asthma prevalence and morbidity across economic and racial lines are striking, with prevalence rates exceeding 25% in some low-income urban areas (Nicholas et al., 2005). The need for improvements in healthcare and for interventions which mitigate environmental exposures within these communities are significant. In order to examine the potential for "green" improvements to the home environment to reduce exposures to chemicals and other asthma triggers within the home, the Centers for Disease Control and Prevention (CDC) initiated the Green Housing Study (GHS). As stated in the RFP, the specific aims of the GHS are as follows: Specific Aim 1 To conduct an exposure assessment of chemical and biological contaminants, pesticides, volatile organic compounds (VOCs), fungi, indoor allergens (in terms of variety and concentration) in green vs. comparison housing. a. Measure interior levels of pesticides in surface wipe samples; fungi and indoor allergens in dust samples; and VOCs in air samples. b. Compare levels of biomarkers of VOCs and pesticides (in terms of variety and concentration) from the participating residents of green and comparison housing. Specific Aim 2 To examine the relationship between living in green vs. comparison housing and asthma morbidity (e.g., symptoms, emergency department visits, use of medications, lost school/work days) of children with doctor-diagnosed asthma (ages 7-12 years). Adjustments for allergic sensitization and environmental tobacco smoke (ETS) will be made. In 2011, two study sites were established: Boston and Cincinnati. Fieldwork began in the summer of 2011 and baseline assessments are being conduction currently. The requested funding will provide support for follow-up measurements of exposures and respiratory health outcomes of children who are enrolled in GHS. Our project team is a collaboration that builds upon the significant expertise and resources of colleagues from the Harvard School of Public Health (HSPH), Tufts School of Medicine, the Boston Medical Center and the University of Massachusetts, Lowell. To date, our team has developed significant expertise in all field procedures and has successfully implemented all categories of principal study activities. We propose to complete all 6- and 12-month follow-up fieldwork by June 2013. PUBLIC HEALTH RELEVANCE: Residential exposures to allergens and pollutants contribute to asthma morbidity. Green building and renovation methods provide opportunities to reduce these exposures and thus, improve health. This project provides follow-up measurements for a CDC-led study of the effects of green renovations on environmental exposures and health for children diagnosed with asthma living in low-income communities.