Environmental Determinants of Pulmonary Disease: A new approach to an old problem

简介(申请人提供)：我的长期职业目标是研究肺部疾病的环境决定因素(例如哮喘、反应性呼吸道功能障碍综合症、纤维性肺部疾病、过敏性肺炎等)。在南卡罗来纳州的社区中，他们受到的影响不成比例。为了实现这一目标，我的研究战略是利用我目前的联合职位，在南卡罗来纳州肺部健康结果存在差异的社区内利用协作和多学科社区参与性研究(CBPR)的能力。我有三个短期目标：1.更好地确定其他在肺部疾病方面存在差异的社区；2.建立更好的机制，以便在南卡罗来纳州有肺部疾病差异的社区内建立伙伴关系和联盟；3.将我的研究战略整合到一个在肺部健康方面存在差异的现有社区，作为一个模范社区(研究项目)。几位导师同意帮助我实施我的战略并实现我的目标，其中包括有成功门徒历史的强大的知名研究人员。目标1和目标2在我的职业发展计划中涉及，并将主要在卫生部内实施，目标是将这些活动与CBPR与学术界的伙伴关系联系起来。为了完成我的研究项目，我编制了一个登记队列，其中包括950多名在一次社区环境灾难中严重接触氯气的受害者。该研究项目的目标是完成为纵向队列研究获得R01资金所需的初步研究。我们将测试以下有关急性氯气暴露的假设：(1)儿童和成人肺功能下降，呼吸道反应性和炎症增加，暴露/急性肺损伤增加(2)接受皮质类固醇治疗的患者不太可能出现更严重的长期肺部疾病(3)吸烟、过敏、职业暴露于肺部刺激物和肥胖是导致不良长期肺部预后的危险因素。这项拟议的计划具有重大的公共卫生意义，因为它涉及疾控中心的目标(在健康的地方健康的人；为新出现的健康威胁做好准备的人)和启动目标(健康社区：36；新出现的健康威胁；化学/辐射)。目标：加强公众和专业人员对化学/辐射灾害的准备)。

DESCRIPTION (provided by applicant): My long-term career goal is to research the environmental determinants of pulmonary diseases (e.g. asthma, reactive airways dysfunction syndrome, fibrotic lung disease, hypersensitivity pneumonitis, etc.) within South Carolina communities disproportionately affected by them. To accomplish this goal, my research strategy is to leverage my current joint position to harness the capabilities for collaborative and multidisciplinary community-based participatory research (CBPR) within South Carolina communities with disparities in pulmonary health outcomes. I have three short-term objectives: 1. to better identify additional communities with disparities in pulmonary disease 2. to establish better mechanisms for building partnerships and coalitions within South Carolina communities with disparities in pulmonary disease 3. to integrate my research strategy into an existing community with disparities in pulmonary health as an exemplary community (Research Project). Several mentors have agreed to assist me with the implementation of my strategy and towards completion of my objectives, including strong established researchers with a history of successful proteges. Objectives 1 & 2 are addressed in my career development plan, and will be implemented primarily within the health department with the goal of linking those activities to CBPR with the partnership of academia. To accomplish my research project, I have compiled a registry cohort of over 950 victims acutely exposed to chlorine gas during a community environmental disaster. The goal of the research project is to complete the preliminary research necessary to procure R01 funding for a longitudinal cohort study. We will test the following hypotheses regarding acute exposure to chlorine gas: (1) children and adults have reduced lung function and increased airway reactivity and inflammation with increasing exposure/acute lung injury (2) patients treated with corticosteroids are less likely to have more severe long-term lung morbidity (3) cigarette smoking, atopy, history of occupational exposures to lung irritants, and obesity are risk factors for poor long-term lung prognosis. This proposed program is of great public health significance, since it addresses CDC goals (Healthy People in Healthy Places; People Prepared for Emerging Health Threats) and Starter Objectives (Healthy Communities: 36; Emerging Health Threats; Chem/Rad. Objective: Increase public and professional preparedness for chemical/radiological disasters).