Reducing Particulate Matter-Associated Cardiovascular Health Effects for Seniors

减少颗粒物对老年人心血管健康的影响

基本信息

批准号：
10427306
负责人：
Robert Daniel Brook
金额：
$ 52.75万
依托单位：
MICHIGAN STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-06-06 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10427306
关键词：
Accounting Acute Address Adrenal Glands Adult Air Air Pollution Airborne Particulate Matter American Asia Blood Blood Pressure Blood Vessels Cardiovascular system Cessation of life Chronic Clinical Clinical Trials Cross-Over Studies Data Diastolic blood pressure Double-Blind Method Effectiveness Elderly Environment Event Exposure to Face Filtration Glucocorticoids Grant Guidelines Hair Health Heart failure Hospitalization Hot Spot Housing Hydrocortisone Hypertension Incidence Insulin Resistance Intervention Intervention Studies Location Long-Term Effects Low income Mediator of activation protein Mineralocorticoids Morbidity - disease rate Myocardial Infarction NIH Program Announcements Outcome Particulate Particulate Matter Pathway interactions Population Population Heterogeneity Populations at Risk Prevention strategy Public Health Randomized Residential Facilities Resolution Rest Risk Risk Factors Salivary Steroids Stroke Time Translating Vulnerable Populations World Health Organization air filtration blood pressure elevation cardiometabolism cardiovascular health cardiovascular risk factor clinically relevant cost evidence base fine particles hemodynamics hypothalamic-pituitary-adrenal axis improved indexing indoor air indoor particulate matter insight insulin sensitivity mortality novel novel strategies pollutant portability primary endpoint primary outcome residence scale up secondary outcome success trend

项目摘要

Project Summary/Abstract Fine particulate matter <2.5 µm (PM2.5) air pollution is the fifth leading risk factor for mortality worldwide. Over 88 thousand deaths per year are attributable to PM2.5 in the US alone, with the largest portion from cardiovascular (CV) causes (myocardial infarctions, strokes, heart failure). Despite improvements across the US, PM2.5 remains above World Health Organization Air Quality Guidelines (<10 µg/m3) in numerous hot-spots (e.g., near roadways). Therefore, it is critical to develop feasible and effective personal strategies to protect “vulnerable” (urban/near-roadway) and “susceptible” (elderly) populations at risk from the harmful effects of PM2.5. Emerging trials have shown that portable indoor air filtration units (AFUs) with high-efficiency particulate arrestance filters can reduce PM2.5 exposures by 30-50% and improve CV health endpoints (e.g., BP, vascular function). Our recent clinical trial results confirm that even low PM2.5 levels pose significant risks to CV health and that portable indoor air filtration units (AFUs) represent a promising preventative strategy. However, no study has addressed whether exposure reductions and health improvements can be sustained over more clinically relevant periods of intervention (i.e., several weeks) which are required to plausibly yield decreases in actual CV events. In addition, the efficacy of the novel practical (i.e., less expensive and more feasible in real- world settings) approach of using a single AFU only in the bedroom to focus on reducing nocturnal PM2.5 exposure is currently unknown. This proposal seeks to conduct a randomized double-blind 3-way crossover intervention study (AFUs in 2 rooms vs. bedroom AFU use alone vs. sham filtration) in 50 adults living in a low-income senior residence impacted by roadway pollutants. Specific Aims are: (1) determine if long-term, 2-room AFU usage provides sustained reductions in PM2.5 exposure and persistent improvements in cardiometabolic outcomes; (2) determine if nocturnal PM2.5 exposure reduction alone improves cardiometabolic outcomes; and (3) demonstrate the key role of adrenal activation as a novel mechanism explaining PM2.5-induced cardiometabolic changes. Our proposal will help validate the benefits of novel strategies to employ AFUs in an elderly vulnerable population. Positive results would represent a key step in forming the evidence base required to promote more wide-scale AFU use; in the long term, given their low cost and burden, AFU use could be up- scaled to help protect diverse populations.

项目概要/摘要 <2.5 µm 细颗粒物 (PM2.5) 空气污染是全球第五大死亡风险因素。仅在美国，每年就有超过 8.8 万人死于 PM2.5，其中最大部分来自 PM2.5 心血管（CV）原因（心肌梗塞、中风、心力衰竭）尽管有所改善。美国许多热点地区的 PM2.5 仍高于世界卫生组织空气质量准则（<10 µg/m3）（例如，靠近道路），制定可行且有效的个人保护策略至关重要。 “弱势群体”（城市/近道路）和“易感群体”（老年人）面临以下有害影响的风险 PM2.5。新兴试验表明，具有高效颗粒物的便携式室内空气过滤装置 (AFU) 阻滞过滤器可将 PM2.5 暴露量减少 30-50%，并改善 CV 健康终点（例如血压、血管我们最近的临床试验结果证实，即使 PM2.5 水平较低也会对心血管健康构成重大风险。便携式室内空气过滤装置（AFU）代表了一种有前途的预防策略。研究探讨了暴露减少和健康改善是否可以持续更长时间临床相关的干预期（即几周）需要合理地减少此外，新颖实用的功效（即在现实中更便宜且更可行）世界设置）仅在卧室使用单个 AFU 的方法，专注于减少夜间 PM2.5 目前曝光情况未知。该提案旨在开展一项随机双盲三向交叉干预研究（AFUs in 2 房间与卧室（单独使用 AFU 与假过滤）对居住在低收入高级住宅的 50 名成年人进行受道路污染物的影响具体目标是： (1) 确定 2 室 AFU 的长期使用是否能够提供 PM2.5 暴露持续减少并持续改善心脏代谢结果 (2) 确定仅减少夜间 PM2.5 暴露是否可以改善心脏代谢结果；以及 (3) 证明肾上腺激活作为解释 PM2.5 诱导的心脏代谢的新机制的关键作用我们的建议将有助于验证在老年人中使用 AFU 的新策略的好处。弱势群体的积极结果将代表着形成所需证据基础的关键一步。促进更广泛的 AFU 使用；从长远来看，鉴于 AFU 的成本和负担较低，AFU 的使用可能会增加规模化以帮助保护不同人群。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Cardiometabolic Risk Factor Control During Times of Crises and Beyond.

危机时期及之后的心脏代谢风险因素控制。

DOI：
发表时间：
2020
期刊：
影响因子：
0
作者：
Brook, Robert D;Levy, Phillip;Rajagopalan, Sanjay
通讯作者：
Rajagopalan, Sanjay

Reduction of personal PM2.5 exposure via indoor air filtration systems in Detroit: an intervention study.

底特律通过室内空气过滤系统减少个人 PM2.5 暴露：一项干预研究。

DOI：
发表时间：
2019
期刊：
影响因子：
0
作者：
Maestas, Melissa M;Brook, Robert D;Ziemba, Rosemary A;Li, Fengyao;Crane, Ryan C;Klaver, Zachary M;Bard, Robert L;Spino, Catherine A;Adar, Sara D;Morishita, Masako
通讯作者：
Morishita, Masako

Limitations in the Methodology Assessing Blood Pressure and the Need for Strict Exclusion Criteria-Reply.

评估血压方法的局限性和严格排除标准的必要性-答复。

DOI：
发表时间：
2019
期刊：
影响因子：
39
作者：
Brook, Robert D;Morishita, Masako
通讯作者：
Morishita, Masako

Reduction of Outdoor and Indoor PM2.5 Source Contributions via Portable Air Filtration Systems in a Senior Residential Facility in Detroit, Michigan.

在密歇根州底特律的高级住宅设施中，通过便携式空气过滤系统减少室外和室内 PM2.5 来源。

DOI：
发表时间：
2023-12-14
期刊：
影响因子：
4.6
作者：
Klaver, Zachary M;Crane, Ryan C;Ziemba, Rosemary A;Bard, Robert L;Adar, Sara D;Brook, Robert D;Morishita, Masako
通讯作者：
Morishita, Masako