Identifying the role of short-term fine particulate matter air pollution in the heart and lung health outcomes of adolescent and young adult cancer survivors

确定短期细颗粒物空气污染对青少年和年轻成年癌症幸存者的心脏和肺部健康结果的作用

• 批准号: 10308109
• 负责人: Anne C Kirchhoff
• 金额: $ 7.63万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-01 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10308109
• 关键词: Accident and Emergency department; Address; Adolescent and Young Adult; Affect; Age; Air Pollution; Anthracycline; Bleomycin; Breast Lymphoma; Breathing; Cancer Survivor; Cardiac health; Cardiomyopathies; Cardiovascular system; Chemotherapy and/or radiation; Chest; Communities; Cross-Over Studies; Crossover Design; Data; Development; Diagnosis; Disease; Emergency department visit; Environmental Pollutants; Ethnic Origin; Event; Exposure to; General Population; Goals; Health; Health system; Heart; Hospitalization; Hospitals; Hour; Individual; Institutes; Knowledge; Link; Lung; Malignant Neoplasms; Measures; Medical History; Modification; Morbidity - disease rate; Myocardial Infarction; Outcome; Outpatients; Particulate Matter; Persons; Physiological; Pollution; Population; Population Database; Predisposition; Public Health; Quality of life; Race; Radiation; Radiation therapy; Records; Registries; Reporting; Research; Respiratory Disease; Risk; Role; SEER Program; Sampling; Smoking; Smoking Status; Socioeconomic Status; Stress; Stroke; Subgroup; Survivors; Thyroid Gland; Time; Time trend; Tissues; Toxic effect; Treatment Protocols; United States; Utah; Wildfire; Withholding Treatment; adolescent health outcomes; anticancer research; cancer therapy; cardiovascular health; cardiovascular risk factor; chemotherapy; cohort; data resource; experience; fine particles; follow-up; health care service utilization; high risk; improved; insight; interest; lung health; lung injury; melanoma; mortality; neoplasm registry; physiologic stressor; prevent; respiratory; respiratory health; sex; survivorship; young cancer survivor

PROJECT SUMMARY ABSTRACT Cardiovascular (CV) and respiratory toxicity from cancer treatments are a major causes of morbidity among adolescent and young adult (AYA) cancer survivors. This toxicity may reduce a survivor’s ability to neutralize the added physiologic stress from short-term air pollution exposure, leading to a higher risk for cardiovascular and respiratory problems. However, the health effects of exposure to air pollution on AYA cancer survivors are largely unknown. To fill this knowledge gap, we will examine how fine particulate matter (PM2.5) is associated with CV and respiratory health events among survivors diagnosed with the five most common AYA cancers in the state of Utah (thyroid, melanoma, breast, lymphoma, testicular) between 1997 and 2016 (N=9,382). We will employ a case-crossover design nested in this preexisting cohort to examine the effects of short-term PM2.5 on the risk for cardiovascular and respiratory health events defined from statewide hospital discharge and emergency department data, and outpatient records from Utah’s two largest health systems serving >85% of Utah. Using data from the Utah Population Database, we can measure residential PM2.5 exposure at the address level for our sample. We will: 1) Investigate the association between short-term PM2.5 and CV and respiratory health events among AYA cancer survivors, and compare survivors’ risk of PM2.5-associated health events to a cancer-free sample, and 2) Determine whether treatments with known toxicities modify the association between short-term PM2.5 and CV and respiratory health events among AYA cancer survivors. We will identify temporal trends in these associations among survivors from diagnosis to the end of follow-up. Subgroups of survivors will be investigated to determine differences by smoking, race/ethnicity, and other relevant factors. Utah has severe PM2.5 pollution due to winter inversions and summer wildfires. Because of the pervasiveness of air pollution in United States and the lack of data on how environmental pollutants affect cancer survivors, this project represents a unique opportunity to determine whether air pollution is a risk factor for cardiovascular and respiratory health problems among AYA cancer survivors. Our study will provide a deep examination of cancer treatment, health care utilization, and PM2.5 exposure, and expand upon the established perspective of survivorship research by adding information the role air pollution on the risk for health events among cancer survivors.

项目概要摘要 癌症治疗引起的心血管（CV）和呼吸系统毒性是癌症患者发病的主要原因 青少年和青年 (AYA) 癌症幸存者这种毒性可能会降低幸存者的中和能力。 短期空气污染暴露带来的额外生理压力，导致心血管疾病风险更高 然而，暴露于空气污染对 AYA 癌症幸存者的健康影响是巨大的。 为了填补这一知识空白，我们将研究细颗粒物 (PM2.5) 之间的关联。 被诊断患有五种最常见 AYA 癌症的幸存者中的心血管和呼吸系统健康事件 1997 年至 2016 年间犹他州（甲状腺、黑色素瘤、乳腺癌、淋巴瘤、睾丸）（N=9,382）。 采用嵌套在此现有队列中的病例交叉设计来检查短期 PM2.5 对 被告出院时定义的心血管和呼吸系统健康事件的风险，以及 犹他州两个最大的卫生系统的急诊科数据和门诊记录，为超过 85% 的患者提供服务 犹他州。使用犹他州人口数据库中的数据，我们可以测量住宅 PM2.5 暴露情况。 我们将： 1) 研究短期 PM2.5 和 CV 之间的关联。 AYA 癌症幸存者的呼吸系统健康事件，并比较幸存者的 PM2.5 相关健康风险 2) 确定已知毒性的治疗是否会改变 AYA 癌症幸存者中短期 PM2.5 与 CV 和呼吸系统健康事件之间的关联。 将确定幸存者从诊断到随访结束这些关联的时间趋势。 将调查幸存者亚组，以确定吸烟、种族/民族和其他方面的差异 受冬季逆温和夏季山火影响，犹他州PM2.5污染严重。 美国空气污染的普遍性以及缺乏有关环境污染物如何影响的数据 对于癌症幸存者来说，该项目提供了一个独特的机会来确定空气污染是否是一个风险因素 我们的研究将为 AYA 癌症幸存者的心血管和呼吸系统健康问题提供深入的研究。 检查癌症治疗、医疗保健利用和 PM2.5 暴露，并在既定的基础上进行扩展 通过添加空气污染对健康事件风险的作用的信息来看待生存研究 在癌症幸存者中。