Air pollution and cardiopulmonary health: Susceptibility by HIV infection status

空气污染与心肺健康：艾滋病毒感染状况的易感性

• 批准号: 10458456
• 负责人: Jessica L Elf
• 金额: $ 13.18万
• 依托单位: COLORADO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10458456
• 关键词: Adult; Advisory Committees; African; Age; Air; Air Pollution; Blood Pressure; Carbon Black; Carbon Monoxide; Cardiopulmonary; Cardiopulmonary Physiology; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Chronic Obstructive Pulmonary Disease; Clinic; Clinical Research; Coal; Country; Death Rate; Development; Development Plans; Disease; Epidemiology; Exposure to; Forced expiratory volume function; Foundations; General Population; Generations; Goals; Guidelines; HIV; HIV Infections; HIV Seronegativity; Health; Hour; Household; Hypertension; Infection; Inflammation; Intervention; Kerosene; Life; Life Expectancy; Lung; Measurement; Measures; Medicine; Mentors; Mentorship; Mining; Morbidity - disease rate; Myocardial Infarction; Nitrogen Dioxide; Outcome; Participant; Particulate Matter; Persons; Policies; Population; Predisposition; Prevalence; Prevention strategy; Pulmonary Function Test/Forced Expiratory Volume 1; Pulmonary Heart Disease; Research; Research Training; Respiratory Disease; Risk; Risk Factors; Smoking; Source; South Africa; Spirometry; Standardization; Subgroup; Time; Training; Virus Diseases; Vital capacity; Vulnerable Populations; Woman; Wood material; Work; World Health Organization; antiretroviral therapy; blood pressure elevation; burden of illness; cardiovascular risk factor; career; career development; chronic infection; comorbidity; disorder risk; experience; fine particles; high risk; men; modifiable risk; mortality; peer; peri-urban; premature; prevent; preventive intervention; pulmonary function; respiratory; secondary outcome; treatment strategy

PROJECT SUMMARY/ABSTRACT Air pollution is a leading cause of mortality globally, contributing to nearly 1 in 10 deaths and 147 million years of healthy life lost annually. Fine particulate matter (PM2.5) is a key component of air pollution; it is highly regulated and is the component of the air pollution mixture most consistently and strongly associated with cardiovascular and respiratory mortality. While exposure to PM2.5 is associated with adverse cardiopulmonary effects in the general population, associations are even stronger among susceptible populations, including those with preexisting cardiovascular or respiratory disease. Identifying subgroups experiencing differential PM2.5-related health effects is key to informing policy and intervention strategies to protect our most vulnerable populations. There are 38 million people with human immunodeficiency virus (HIV) infection worldwide and 1.7 million new HIV infections each year. Improvements in antiretroviral therapy have led to longer life expectancies for people with HIV, but other health risks have arisen from chronic infection. Cardiopulmonary disease is a leading cause of morbidity and mortality among people with HIV due to long-term inflammation from infection as well as some antiretroviral therapy. Further, people with HIV may be at higher risk for adverse cardiopulmonary health effects from traditional risk factors as compared to the general population. The majority of the world's population is exposed to PM2.5 levels higher than the World Health Organization's (WHO) guideline for healthy air, but it is unknown if people with HIV are more susceptible to cardiopulmonary disease resulting from this exposure than the general population. The specific aims of this project are to 1) examine HIV infection as a potential modifier of the association between PM2.5 and systolic blood pressure, and 2) examine HIV infection as a potential modifier of the association between PM2.5 and percent predicted forced expiratory volume in the first second (FEV1). This study will take place in Matlosana, South Africa, a peri-urban district experiencing a confluence of high HIV prevalence and ambient PM2.5 levels regularly exceeding the WHO's 24-hour guideline of 25 µg/m3. With 7.5 million people with HIV, South Africa has the highest absolute burden of HIV in the world and an increasing burden of cardiovascular disease and chronic obstructive pulmonary disease (COPD). South Africa also has the second highest age-standardized death rate attributable to air pollution among all sub-Saharan African countries. The career development plan includes didactic and experiential training in cardiopulmonary physiology and air pollution exposure assessment, which will help the candidate implement the current project with fidelity and achieve her long-term goals of reducing air pollution exposure and prevent cardiopulmonary disease among people with HIV. She will have the support of a mentoring team and Advisory Committee with extensive experience in air pollution epidemiology and measurement, HIV clinical research, and cardiopulmonary physiology and health outcomes.

项目概要/摘要 空气污染是全球死亡的主要原因，造成近十分之一的死亡和 1.47 亿年 每年损失的健康生命。细颗粒物 (PM2.5) 是空气污染的一个重要组成部分； 受到监管，并且是空气污染混合物中与以下因素最一致且密切相关的组成部分： 心血管和呼吸系统死亡率。而暴露于 PM2.5 与心肺不良有关。 对一般人群的影响，在易感人群中的关联性甚至更强，包括 那些患有先前存在的心血管或呼吸系统疾病的人识别经历差异的亚组。 PM2.5 相关的健康影响是为保护我们最弱势群体的政策和干预策略提供信息的关键 全球有 3800 万人感染人类免疫缺陷病毒 (HIV)，其中 1.7 人感染艾滋病毒。 每年有 100 万人感染艾滋病毒，抗逆转录病毒治疗的改进导致寿命延长。 艾滋病毒感染者的期望，但慢性感染还产生了其他健康风险。 由于长期炎症，这种疾病是艾滋病毒感染者发病和死亡的主要原因 此外，艾滋病毒感染者可能面临更高的不良风险。 与一般人群相比，传统危险因素对心肺健康的影响。 世界人口接触的 PM2.5 水平高于世界卫生组织 (WHO) 的水平 健康空气指南，但尚不清楚艾滋病毒感染者是否更容易患心肺疾病 该项目的具体目标是 1) 检查 HIV 感染是 PM2.5 与收缩压之间关联的潜在调节因素，2) 检查 HIV 感染是否是 PM2.5 与预测强制百分比之间关联的潜在修正因素 第一秒呼气量 (FEV1) 这项研究将在南非马特洛萨纳 (Matlosana) 的一个城郊进行。 该地区艾滋病毒高感染率和环境 PM2.5 水平经常超过正常水平 世界卫生组织的 24 小时指导值是 25 µg/m3，南非有 750 万艾滋病毒感染者，绝对值最高。 全球艾滋病毒负担以及心血管疾病和慢性阻塞性肺病负担日益增加 南非的年龄标准化死亡率也位居第二。 职业发展计划包括教学和培训。 心肺生理学和空气污染暴露评估的体验式培训，这将有助于 候选人忠实地实施当前项目并实现减少空气污染的长期目标 她将得到艾滋病毒感染者的支持。 指导团队和咨询委员会在空气污染流行病学和 测量、艾滋病毒临床研究以及心肺生理学和健康结果。