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.

项目摘要摘要 癌症治疗的心血管（CV）和呼吸毒性是导致发病率的主要原因 青少年和年轻人（AYA）癌症的存活。这种毒性可能会降低生存的中和能力 短期空气污染暴露所增加的生理压力，导致心血管风险更高 和呼吸问题。但是，暴露于空气污染对AYA癌症存活的健康影响是 在很大程度上未知。为了填补这一知识差距，我们将研究特定的特定问题（PM2.5） 在诊断为五种最常见的AYA癌症的生存期间的简历和呼吸健康事件中 犹他州（甲状腺，黑色素瘤，乳房，淋巴瘤，有证明）在1997年至2016年之间（n = 9,382）。我们将 员工嵌套在此先前存在的队列中的案例交叉设计，以检查短期PM2.5的影响 由全州医院出院定义的心血管和呼吸健康事件的风险 紧急部门数据以及犹他州两个最大卫生系统的门诊记录，> 85％ 犹他州。使用来自犹他州人口数据库的数据，我们可以测量居民PM2.5在 我们样本的地址级别。我们将：1）调查短期PM2.5和简历之间的关联 AYA癌症生存中的呼吸健康事件，并比较生存与PM2.5相关健康的风险 无癌样本的事件，以及2）确定已知毒性的治疗是否改变了 AYA癌症存活之间的短期PM2.5与CV与呼吸健康事件之间的关联。我们 将确定从诊断到随访结束的生存期间这些关联的临时趋势。 将研究表面亚组，以确定吸烟，种族/种族和其他 相关因素。犹他州由于冬季反转和夏季野火而造成严重的PM2.5污染。因为 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 癌症存活，该项目代表了确定空气污染是否是危险因素的独特机会 对于AYA癌症存活中的心血管和呼吸健康问题。我们的研究将为深刻 检查癌症治疗，医疗保健利用和PM2.5暴露，并在已建立的 生存研究的观点，通过添加信息对健康事件风险的空气污染作用 在癌症存活中。