Air pollution and health disparities in liver disease and cancer

空气污染与肝病和癌症的健康差异

• 批准号: 10411960
• 负责人: Trang VoPham
• 金额: $ 14.89万
• 依托单位: FRED HUTCHINSON CANCER CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-15 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10411960
• 关键词: Address; Affect; Age; Air Pollutants; Air Pollution; Anatomy; Animals; Automobile Driving; Berry; Biometry; Blood Circulation; Caliber; Censuses; Chemicals; Chronic Hepatitis B; Chronic Hepatitis C; Clinical; Collagen; Data; Deposition; Diabetes Mellitus; Diagnosis; Dyslipidemias; Electronic Health Record; Ensure; Environment; Environmental Epidemiology; Environmental Exposure; Environmental Risk Factor; Epidemiologist; Epidemiology; Ethnic Origin; Etiology; Exposure to; Fibrosis; Fred Hutchinson Cancer Research Center; Future; Geographic Information Systems; Geography; Goals; Health Personnel; Healthcare Systems; Hepatitis B Virus; Hepatitis C virus; Hepatology; Hispanic Populations; Hospitalization; Human; Incidence; Individual; Inflammation; Inhalation; Interdisciplinary Study; Knowledge; Lead; Link; Lipids; Liver; Liver diseases; Location; Malignant neoplasm of liver; Mentors; Methodology; Methods; Midwestern United States; Modeling; Mus; Non obese; Obesity; Participant; Particulate Matter; Patients; Play; Population; Prevention; Primary Malignant Neoplasm of Liver; Primary carcinoma of the liver cells; Race; Research; Research Personnel; Research Training; Resolution; Resources; Risk; Risk Factors; Risk Reduction; Role; Science; Scientist; Severity of illness; Signal Transduction; Small-Area Study; Socioeconomic Status; Source; Subgroup; Thinness; Time; Tissues; Training; Training Programs; Transforming Growth Factor beta; United States; United States Department of Veterans Affairs; Universities; Veterans; Veterans Health Administration; Washington; Work; base; cancer epidemiology; career development; chronic liver disease; data warehouse; demographics; disease disparity; disorder risk; epidemiology study; ethnic diversity; experience; fine particles; geographic difference; health disparity; high risk; innovation; insight; men; non-alcoholic fatty liver disease; non-diabetic; novel; oxidative damage; particle; patient population; programs; prospective; racial disparity; racial diversity; regional difference; research and development; respiratory; risk perception; sex; skills; sound; spatiotemporal; translational potential

PROJECT SUMMARY / ABSTRACT The long-term goal of the K01 candidate, Dr. Trang VoPham, is to become an independent investigator in the epidemiology of environmental risk factors for liver disease using methods in geospatial science and health disparities. Dr. VoPham is a highly skilled epidemiologist and geospatial scientist and requires additional training in (1) liver disease epidemiology, (2) health disparities, and (3) electronic health record (EHR) analytics for her to become a successful independent researcher in liver disease. She has worked closely with her Mentors comprised of preeminent investigators in hepatology, disparities, epidemiology, and biostatistics: Dr. George Ioannou (Primary Mentor) and Co-Mentors, Drs. Jason Mendoza, Joel Kaufman, and Kristin Berry, to develop a comprehensive training and research program that builds on her research experience in liver cancer, epidemiology, and geographic information systems (GIS). Nonalcoholic fatty liver disease (NAFLD), the most common cause of chronic liver disease, and hepatocellular carcinoma (HCC), the most common type of primary liver cancer, are increasing in incidence worldwide. Recent evidence, including our preliminary data, show that ambient exposure to particulate matter less than 2.5 microns in diameter (PM2.5), a ubiquitous air pollutant, may increase NAFLD and HCC risk. Further, there is evidence suggesting that PM2.5 may differentially impact NAFLD and HCC risk in particular subgroups according to race/ethnicity, geography, and sex. Yet, to date, epidemiologic studies have been cross-sectional, limited to small study areas with little exposure variability, and/or did not adjust for potential confounders. EHRs are a valuable and underutilized resource for large-scale, prospective epidemiologic studies of time-varying environmental exposures, including rich information on residential address locations, clinical conditions, and demographics. Dr. VoPham proposes to fill these gaps in knowledge by examining the associations between ambient PM2.5 exposure and NAFLD risk (Aim 1) and HCC risk (Aim 2) and determining the role of PM2.5 on NAFLD and HCC incidence disparities by race/ethnicity, geography, and sex (Aim 3). The applicant will leverage the geographically expansive, racially and ethnically diverse Veterans Affairs (VA) patient population, conducting a state-of-the-science geospatial exposure assessment by linking VA patient geocoded residential addresses from EHRs with a high-resolution, validated PM2.5 exposure model using GIS. This interdisciplinary research will provide new insights into the potential role of PM2.5 as a novel, modifiable, biologically plausible risk factor for NAFLD and HCC, and as a potential environmental factor driving incidence disparities, providing translational insights to help identify individuals at high risk for liver disease. The world- class interdisciplinary expertise of the Mentoring Team, along with the outstanding supportive research environment at Fred Hutchinson Cancer Research Center, University of Washington, and VA Puget Sound Health Care System, will ensure that Dr. VoPham achieves all of her career development and research goals and will facilitate her transition to become a successful independent researcher in liver disease.

项目摘要 /摘要 K01候选人Trang Vopham博士的长期目标是成为独立研究者 使用地理空间科学与健康中方法的环境危险因素流行病学 差异。 Vopham博士是一位高技能的流行病学家和地理空间科学家，需要额外的培训 在（1）肝病流行病学，（2）健康差异和（3）电子健康记录（EHR）分析 成为成功的独立研究人员。她与导师紧密合作 由肝病学，差异，流行病学和生物统计学的杰出研究者组成：乔治博士 ioannou（主要导师）和联合官员，博士。杰森·门多萨（Jason Mendoza），乔尔·考夫曼（Joel Kaufman）和克里斯汀·贝里（Kristin Berry） 以她在肝癌研究经验为基础的全面培训和研究计划， 流行病学和地理信息系统（GIS）。非酒精性脂肪肝病（NAFLD），最多 慢性肝病和肝细胞癌（HCC）的常见原因，这是最常见的原发性类型 肝癌，全球发病率正在增加。最近的证据，包括我们的初步数据，表明 环境暴露于颗粒物的直径小于2.5微米（PM2.5），一种无处不在的空气污染物，可能 增加NAFLD和HCC风险。此外，有证据表明PM2.5可能会差异地影响NAFLD 根据种族/种族，地理和性别，尤其是亚组的HCC风险。然而，迄今为止的流行病学 研究是横断面的，仅限于小型研究区域，但暴露量很小，/或没有 调整潜在的混杂因素。 EHR是一种有价值的，未充分利用的资源，用于大规模，潜在的 时间变化环境暴露的流行病学研究，包括有关住宅地址的丰富信息 位置，临床状况和人口统计。 Vopham博士建议通过 检查环境PM2.5暴露与NAFLD风险（AIM 1）和HCC风险（AIM 2）和 确定PM2.5对种族/种族，地理和性别的NAFLD和HCC发病率差异的作用 （目标3）。申请人将利用地理上广阔，种族和种族多样化的退伍军人事务 （VA）患者人群，通过将VA患者联系 使用GIS的高分辨率，验证的PM2.5暴露模型，来自EHR的地理编码住宅地址。 这项跨学科研究将为PM2.5作为一种新颖，可修改的潜在作用提供新的见解 NAFLD和HCC的生物学上合理的危险因素，作为潜在的环境因素驱动发生率 差异，提供翻译见解，以帮助识别患有肝病高风险的人。世界 - 班级跨学科专业知识以及杰出的支持研究 华盛顿大学弗雷德·哈钦森癌症研究中心和VA Puget Sound的环境 医疗保健系统将确保Vopham博士实现她的所有职业发展和研究目标 并将促进她的过渡，成为成功的肝病独立研究人员。