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

描述（由申请人提供）：我的长期职业目标是研究南卡罗来纳州社区内肺部疾病（如哮喘，反应性气道功能障碍综合征，纤维化肺病，过敏性肺炎等）的环境决定因素。为了实现这一目标，我的研究策略是利用我目前的联合职位来利用南卡罗来纳州社区内的协作和多学科社区参与性研究（CBPR）的能力，这些研究在肺部健康结果方面存在差异。我有三个短期目标：更好地识别其他存在肺部疾病差异的社区。建立更好的机制，在南卡罗来纳存在肺病差异的社区内建立伙伴关系和联盟。将我的研究策略整合到一个存在肺部健康差异的现有社区中，作为一个模范社区（研究项目）。几位导师已同意协助我实施我的战略并完成我的目标，其中包括具有成功门生历史的强大知名研究人员。目标1和目标2已在我的职业发展计划中提及，并将主要在卫生部门内实施，目的是通过学术界的伙伴关系将这些活动与CBPR联系起来。为了完成我的研究项目，我编制了一份超过950名在社区环境灾难中严重暴露于氯气的受害者的登记队列。该研究项目的目标是完成必要的初步研究，以获得纵向队列研究的R01资金。我们将检验以下关于急性暴露于氯气的假设：(1)儿童和成人的肺功能降低，气道反应性和炎症随着暴露/急性肺损伤的增加而增加；(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、特应性、职业接触肺部刺激物的历史和肥胖是长期肺部预后不良的危险因素。这一拟议方案具有重大的公共卫生意义，因为它解决了疾病预防控制中心的目标（健康的人在健康的地方；人们为新出现的健康威胁做好准备）和启动目标（健康社区：36；新出现的健康威胁；化学/Rad）。目标：加强公众和专业人员对化学/放射性灾害的准备)。

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).