Aeroallergens, Air Pollution and Respiratory Health in the Chickasaw Nation A1

项目总结/摘要 美国印第安人不成比例地受到哮喘的影响。Chickasaw Nation，位于中南部 俄克拉荷马州报告说，哮喘是最常见的诊断之一，占2010年患者的7%。 Chickasaw Nation Department of Health.由于Chickasaw Nation的哮喘患者负担很高， Tribe已经确定需要更好地了解哮喘相关发病率的风险因素。的长期目标 本研究旨在了解空气过敏原和人为空气污染对哮喘发病率的影响。 并研究更有效的方法来监测、控制并最终预防哮喘 这一高度易感人群的发病率。奇卡索国家提供临床和公共卫生 为居住在俄克拉荷马州中南部管辖区内的大多数美洲印第安人提供服务; 因此，改善部落的健康促进了整个社区的健康。这项研究提供了一个 评估环境空气过敏原（花粉）和人为空气污染影响的独特机会 （颗粒物，臭氧）对哮喘相关发病率的影响，使用一种新的设备来测量时间和位置， 美国印第安人农村人口使用计量吸入器的情况。这项深入的研究将使 研究人员和部落：1）评估空间和时间分辨的空气过敏原的关联， Chickasaw Nation中使用全球定位系统（GPS）的计量吸入器人为污染物 社区成员与哮喘，和2）比较参与者的个人和邻居的感知 哮喘触发器的空间和时间的数据收集通过使用草图和采访的MDI。 我们正在与Propeller Health合作，使用支持GPS的MDI来测量哮喘急性发作，这将 让我们能够收集到MDI启动的确切时间和位置。我们将评估所测量的 使用时间序列模型，考虑到长达一周的滞后时间，暴露与MDI驱动相关。 在研究结束时，参与者将绘制草图，描述感知的地理位置。 哮喘诱因的位置我们的中心假设是奇克索的空气过敏原和空气污染水平 国家之间的相互作用会增加哮喘相关发病率。纵向数据 在美洲印第安人中，空气过敏原和哮喘很少，对触发因素的认识将有助于改善 哮喘管理在奇克索国家。这项研究提供了一个独特的机会，以评估的影响， 空气过敏原和人为空气污染对哮喘发病率的影响， 在这一人群中使用MDI的频率和位置。

Project Summary/Abstract American Indians are disproportionately impacted by asthma. The Chickasaw Nation, located in southcentral Oklahoma, reports clinic visits for asthma as one of the top diagnoses, accounting for 7% of patients at Chickasaw Nation Department of Health. Due to the high patient burden for asthma in Chickasaw Nation, the Tribe has identified a need to better understand risk factors for asthma-related morbidity. The long-term goal of this research is to understand the impact of aeroallergens and anthropogenic air pollution on asthma morbidity in Chickasaw Nation and to investigate more efficient ways to monitor, control, and ultimately prevent asthma morbidity among this highly-susceptible population. The Chickasaw Nation provides clinical and public health services for the majority of American Indians residing within their jurisdictional area in southcentral Oklahoma; thus, improving the health of the Tribe promotes the health of the overall community. This study provides a unique opportunity to evaluate the effect of ambient aeroallergens (pollen) and anthropogenic air pollution (particulate matter, ozone) on asthma-related morbidity using a novel device to measure the time and location of metered-dose inhaler (MDI) use in a rural, American Indian population. This in-depth study will allow researchers and the Tribe to: 1) evaluate the association of spatially- and temporally-resolved aeroallergens and anthropogenic pollutants with Global Positioning System (GPS)-enabled MDIs among Chickasaw Nation community members with asthma, and 2) compare the participants' perceived individual and neighborhood asthma triggers to the spatial and temporal data collected through the MDIs using sketch maps and interviews. We are partnering with Propeller Health to use GPS-enabled MDIs to measure asthma exacerbations, which will allow us to collect the exact time and location of the MDI actuation. We will evaluate whether the measured exposures are associated with MDI actuation using a time-series model accounting for lag times up to one week. At the end of the study, the participants will develop sketch maps that describe the perceived geographic locations of their asthma triggers. Our central hypothesis is that aeroallergen and air pollution levels in Chickasaw Nation interact synergistically to increase the prevalence of asthma-related morbidity. Longitudinal data on aeroallergens and asthma are sparse in American Indian populations and awareness of triggers will help improve asthma management in Chickasaw Nation. This study provides a unique opportunity to evaluate the effect of aeroallergens and anthropogenic air pollution on asthma morbidity using a novel device to measure the time, frequency, and location of MDI use in this population.