Relationships between air pollutants and asthma exacerbations in a birth cohort

描述(由申请人提供)：在宫内和早期生活经历会影响生理发育，并会影响一生中对环境因素的敏感性。然而，研究环境空气污染物浓度与儿童哮喘恶化之间关系的研究人员通常无法获得有关早期生活风险因素的数据。在乔治亚州，出生记录(1994-2007年)与佐治亚州人力资源部工作人员的儿科急诊科就诊(2002-2007年)有关。这种180万出生记录和550万儿科急诊科就诊之间的新联系将被用来调查早产或低出生体重的儿童是否比他们的同龄人对环境空气污染物浓度更敏感。如果观察到按胎龄或出生体重进行效果调整，那么这些发现将有助于为公共卫生政策决策提供信息，因为保护敏感亚群是环境保护局作为监管机构的使命的核心。此外，在大都会亚特兰大，一个研究空气质量监测站提供直径小于2.5微米的一整套颗粒物成分的每日浓度，这一资源通常也不向调查人员提供。这些测量可以用来区分由直径小于2.5微米的颗粒物组成的各种化合物，拟议中的研究将首次在出生队列中调查这些化合物与儿科急诊科就诊之间的关联。在广义加性模型的框架下，将使用基于二维黄土平滑器的创新建模方法来研究环境空气污染物与空气中花粉之间的复杂相互作用对儿童哮喘恶化的影响。 众所周知，环境空气污染物会导致儿童哮喘加重。要为公共卫生政策决策提供信息，重要的是要知道哮喘儿童的某些亚群是否增加了对空气污染物的易感性，拟议中的研究将首次调查早产或低出生体重的儿童是否对空气污染增加易感性。

DESCRIPTION (provided by applicant): In utero and early life experiences affect physiological development and can influence sensitivity to environmental factors throughout life. Data on early life risk factors, however, are typically not available to investigators who study associations between ambient air pollutant concentrations and pediatric asthma exacerbations. In the state of Georgia, birth records (1994-2007) have been linked with pediatric emergency department visits (2002-2007) by staff at the Georgia Department of Human Resources. This novel linkage between 1.8 million birth records and 5.5 million pediatric emergency department visits will be used to investigate whether children who were born premature or low birth weight are more sensitive to ambient air pollutant concentrations than their counterparts. If effect modification by gestational age or birth weight is observed, then these findings will help inform public health policy decisions, since protection of sensitive subgroups is central to EPA's mission as a regulatory agency. Further, within Metropolitan Atlanta, a research air quality monitoring station provides daily concentrations for a comprehensive suite of components of particulate matter less than 2.5 microns in diameter, a resource also not typically available to investigators. These measurements can be used to distinguish among the various compounds that comprise particulate matter less than 2.5 microns in diameter, and the proposed study will be the first to investigate associations between these compounds and pediatric emergency department visits in a birth cohort. Complex interactions between ambient air pollutants and airborne pollens on pediatric asthma exacerbations will be investigated using an innovative modeling approach based on two- dimensional loess smoothers in the framework of generalized additive models. Ambient air pollutants are known to cause asthma exacerbations in children. To inform public health policy decisions it is important to know whether certain subgroups of asthmatic children have increased susceptibility to air pollutants, and the proposed study will be the first to investigate whether children who were born premature or low birth weight have an increased susceptibility to air pollution.