Effect of Indoor Fine Particulate Matter Exposure on Respiratory Health Outcomes in Premature Infants

室内细颗粒物暴露对早产儿呼吸健康结果的影响

基本信息

批准号：
10440458
负责人：
Jessica Lynne Rice
金额：
$ 20.86万
依托单位：
CHILDREN'S HOSP OF PHILADELPHIA
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-06-01 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10440458
关键词：
Adult Affect Age-Months Air Asthma Baltimore Bronchopulmonary Dysplasia Caring Child Childhood Childhood Asthma Chronic Chronic lung disease Clinic Clinical Clinical Trials Cotinine Coughing Data Development Disease Education Emergency department visit Enrollment Environmental Epidemiology Environmental Health Event Exposure to Funding Future Gestational Age Goals Growth Health Health Policy Healthcare Home Hospitalization Hospitals Indoor Air Pollution Indoor Air Quality Infant Infant Mortality Inhalation Interdisciplinary Study International Intervention Intervention Trial K-Series Research Career Programs Life Link Lung Lung diseases Measurement Measures Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methods Morbidity - disease rate National Institute of Environmental Health Sciences Nicotine Nursery Schools Observational Study Obstructive Lung Diseases Outcome Outpatients Particulate Matter Pathology Patients Pharmaceutical Preparations Pilot Projects Pollution Population Pregnancy Pregnant Women Premature Birth Premature Infant Primary Health Care Prospective cohort study Public Policy Pulmonology Randomized Controlled Trials Registries Research Research Personnel Respiratory Signs and Symptoms Rice Risk Risk Factors Salivary Secondary to Smoker Smoking Source Steroids Symptoms Testing Time Tissues Training United States Environmental Protection Agency Visit Vulnerable Populations Wheezing aged base career clinical care clinical practice cohort design early childhood environmental tobacco smoke environmental tobacco smoke exposure experience fine particles follow-up health care service utilization high risk improved indoor air indoor particulate matter infancy inner city interest lung development modifiable risk monitoring device multi-component intervention premature prevent primary outcome programs prospective pulmonary function recruit respiratory respiratory health respiratory morbidity secondary outcome skills skills training suburb success urban setting urgent care

项目摘要

Project Abstract and Summary This mentored Patient-Oriented Research Career Development Award will provide Dr. Jessica Rice with the experience and training to become an independent investigator in pediatric pulmonology with a focus on the effects of indoor air pollution (fine particulate matter, PM2.5) on respiratory morbidity in premature infants. Premature birth affects 10 percent of infants born in the U.S. and is the leading cause of infant mortality. Bronchopulmonary dysplasia (BPD) is one of the most common and serious complications of preterm birth and infants are at risk for chronic respiratory symptoms and lung function abnormalities throughout childhood and into adulthood. While exposure to indoor air pollution has been shown to be detrimental in other populations (children with asthma) and secondhand smoke (SHS) exposure has been linked to adverse respiratory outcomes in premature infants, the effect of measured indoor PM2.5 on respiratory outcomes in a vulnerable population of premature infants is not known. The central hypothesis is that exposure to PM2.5 leads to an increased risk of respiratory-related morbidity among premature infants. To test this hypothesis, we propose a prospective observational study evaluating the effect of PM2.5 in two cohorts of patients who will be followed for one year. The first cohort will be recruited at the time of initial hospital discharge and will include infants born ≤ 32 weeks (with and without BPD) (aim 1) and the second cohort will include preschool aged children who were born prematurely with established BPD (aim 2). These two cohorts will allow us to evaluate a full clinical spectrum of chronic lung disease related to prematurity. Outcomes will include healthcare utilization, medication use, symptoms, and markers of SHS exposure (air nicotine and salivary cotinine). The goal of this proposal is to collect preliminary data and obtain the necessary training and skills in environmental epidemiology and clinical trial methods in order to design a future intervention trial to evaluate the impact improving indoor air quality in this population. This approach focuses on identifying a modifiable risk factor and intervening early when developing tissues are most susceptible to environmental insults in order to prevent disease. Results of this study have the potential to impact clinical practice and eventually, public policy. Dr. Rice has assembled a multidisciplinary research team with extensive research and mentorship experience. Her primary mentor, Dr. Gregory Diette is the co-director of the EPA/ NIEHS funded Center for Childhood Asthma in the Urban Environment and is an international expert on inner city exposures and their contribution to obstructive lung disease. Her co-mentors Dr. Sharon McGrath-Morrow and Dr. J. Michael Collaco, are both pediatric pulmonologists and experts in the field of chronic lung disease of prematurity. Dr. Kirsten Koehler, an expert in environmental health science will provide guidance related to exposure measurement and analysis. This career development award will provide Dr. Rice with the necessary skills, training, and mentorship needed to develop her research program and will be key to her success in transitioning to an independent investigator.

项目摘要和摘要这个受到指导的以患者为导向的研究职业发展奖将为杰西卡·赖斯博士提供经验和培训成为小儿肺病学独立研究者的经验和培训，重点是室内空气污染（特殊物质，PM2.5）对早产婴儿呼吸发病率的影响。早产会影响美国出生的婴儿中10％，是婴儿死亡率的主要原因。支气管肺发育不良（BPD）是早产和最严重的并发症之一婴儿有慢性呼吸症状和肺功能异常的风险成年。虽然暴露于室内空气污染在其他人群中有害（哮喘儿童）和二手烟（SHS）暴露与不良呼吸有关早产婴儿的结果，测量的室内PM2.5对脆弱的呼吸结局的影响早产婴儿的人口尚不清楚。中心假设是暴露于PM2.5导致早产婴儿中与呼吸有关的发病率的风险增加。为了检验这一假设，我们提出了一个前瞻性观察性研究评估PM2.5在两名患者中的影响一年。第一个队列将在初次出院时招募，并将包括出生≤的婴儿 32周（有和没有BPD）（AIM 1），第二个队列将包括学龄前儿童与既定的BPD过早出生（AIM 2）。这两个队列将使我们能够评估完整的临床慢性肺疾病的光谱与早产有关。成果将包括医疗保健利用， SHS暴露的药物使用，符号和标记（空气尼古丁和唾液可替宁）。目标的目标建议是收集初步数据并获得必要的环境培训和技能流行病学和临床试验方法为了设计以后的干预试验以评估影响改善该人群的室内空气质量。这种方法着重于确定可修改的危险因素和当开发组织时，尽早介入最容易受到环境侮辱的影响，以防止疾病。这项研究的结果有可能影响临床实践，并最终影响公共政策。博士赖斯（Rice）召集了一个具有广泛的研究和精神经验的多学科研究团队。她主要导师Gregory Diette博士是EPA/ NIEHS资助的儿童哮喘中心的联合导演在城市环境中，是城市内城的国际专家及其对阻塞性肺部疾病。她的联合官员Sharon McGrath-Morrow博士和J. Michael Collaco博士都是慢性肺部早产疾病领域的小儿脉搏理学家和专家。 Kirsten Koehler博士，环境健康科学实验将提供与暴露测量和分析有关的指导。该职业发展奖将为赖斯博士提供所需的必要技能，培训和精通技术为了制定她的研究计划，将是她成功过渡到独立调查员的关键。