Early Identification of World Trade Center Conditions in Adolescents

描述（由申请人提供）：纽约大学医学院和辛辛那提儿童医院医学中心对PAR-12 - 126做出回应，建议评估早期暴露于世界贸易中心（WTC）灾难的潜在长期潜伏期心脏代谢和肺部影响，并确定早期识别WTC相关健康后果的机会。来自定期为在世贸中心附近居住/上学的儿童提供临床护理的唯一调查人员的初步数据确定了与尘云暴露相关的肺功能下降，以及心脏代谢危险因素的频率非常高。从这个临床上，自我选择的人群的结果不能外推到整个人口的儿童谁是暴露于灾难，但尽管如此，表明进一步的研究是必要的可能的代谢和心血管后果的WTC暴露。如果与WTC暴露在一个更大的，更有代表性的样本，两个新的和创新的技术，测量和脉搏波速度评估，持有WTC相关的肺部和心脏代谢疾病的早期检测，为他们的饮食，环境和药物干预可能会防止疾病在以后的生活中进展的巨大希望。因此，合作者建议招募225名对WTC健康登记处（WTCHR）有反应的青少年，这是最具代表性的儿科人群，并且从环境暴露的角度来看最具特征。将该研究与WTTRUNK相关联还显示了联邦资源利用的效率，提供了更客观的临床数据，以支持WTTRUNK捕获的持续性呼吸道症状增加的自我报告结果，从而提高了登记数据的可靠性。我们将比较肺和心脏代谢结局与来自纽约大学医学院附属初级保健（私人和公共诊所）的仔细匹配（年龄、种族/民族、性别、当前居住区和社会经济地位）和未暴露对照（2001年9月11日不在休斯顿街以南居住/上学）人群。研究小组得益于与社区组织的强有力伙伴关系，这些组织自2001年以来一直向受影响社区提供外联和支助，这将加强征聘和成果交流。总之，研究人员对暴露于世贸中心破坏的成年人有着杰出的经验，在呼吸健康和精神健康的流行病学研究方面也有相当丰富的经验。除了对与WTC接触有关的心脏代谢和呼吸系统疾病进行饮食、环境和医疗干预的机会外，如果暴露于世贸中心袭击的心理后遗症被发现与（可能作为调解人或主持人）由于早期生活暴露于世贸中心灾难对心脏代谢和肺部的影响，这将表明平行筛查心理后遗症的重要性，以保护那些年轻时暴露的人。

DESCRIPTION (provided by applicant): NYU School of Medicine and Cincinnati Children's Hospital Medical Center respond to PAR-12-126, proposing to assess the potential for longer-latency cardiometabolic and pulmonary effects of early life exposure to the World Trade Center (WTC) disaster, and to identify opportunities for early identification of WTC-related health consequences. Preliminary data from the only investigators who regularly provide clinical care to children who lived/attended school near the WTC site identified decrements in spirometry associated with dust cloud exposure, and a remarkably high frequency of cardiometabolic risk factors. Findings from this clinically, self- selected population cannot be extrapolated to the entire population of children who were exposed to the disaster but nonetheless suggest that further study is warranted of the possible metabolic and cardiovascular consequences of WTC exposures. If associated with WTC exposures in a larger, more representative sample, two new and innovative techniques, oscillometry and pulse wave velocity assessment, hold great promise for earlier detection of WTC-related pulmonary and cardiometabolic disease, for whom dietary, environmental and medication interventions may prevent disease progression in later life. The collaborators therefore propose to recruit 225 adolescents who respond to the WTC Health Registry (WTCHR), the most representative pediatric population and best-characterized from an environmental exposure standpoint. Connecting the study to the WTCHR also presents efficiency of federal resource utilization, providing more objective clinical data to support self-reported findings of increased persistent respiratory symptoms captured by the WTCHR, thereby improving reliability of the registry data. We will compare pulmonary and cardiometabolic outcomes to carefully matched (age, race/ethnicity, gender, current borough of residence and socioeconomic status) and unexposed control (not resident/attending school south of Houston Street on September 11, 2001) populations from NYU School of Medicine affiliated primary care (private and public clinics). The research team benefits from strong partnerships with community-based organizations which have provided outreach and support to affected communities since 2001, which will enhance recruitment and communication of results. Together, the investigators have outstanding experience with adults exposed to the WTC destruction and considerable experience in the conduct of epidemiologic research on respiratory health and mental health. Besides the opportunities for dietary, environmental and medical interventions for cardiometabolic and respiratory conditions related to WTC exposure, if the psychological sequelae of exposure to the WTC attacks are found to be associated (perhaps as mediators or moderators) with cardiometabolic and pulmonary effects of early life exposure to the WTC disaster this would suggest the importance of parallel screening for psychological sequelae as part of an assertive response to protect those exposed when young.