Environmental Determinants of Sleep Disparities and the Consequences for Low Income Children with Asthma

睡眠差异的环境决定因素以及低收入哮喘儿童的后果

• 批准号: 10469620
• 负责人: MEREDITH C MCCORMACK
• 金额: $ 70.88万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10469620
• 关键词: Address; Adult; Affect; African American; Air; Air Pollutants; Air Pollution; Allergens; Asthma; Bacteria; Baltimore; Beds; Biological; Biological Markers; Black race; Child; Childhood; Childhood Asthma; Chronic Disease; Cities; Collection; Data; Dust; Emergency Situation; Environment; Environmental Exposure; Environmental Monitoring; Environmental Science; Epidemiology; Exposure to; Foundations; Goals; Health; High Prevalence; Home; Home environment; Hospitalization; Household; Individual; Indoor Air Quality; Indoor environment; Inflammation; Inflammatory; Intervention; Link; Liquid substance; Literature; Low income; Lung; Measures; Mediating; Mediator of activation protein; Medicine; Microbe; Microbiology; Monitor; Morbidity - disease rate; Nasal Epithelium; Needs Assessment; Neighborhoods; Nitrogen Dioxide; Nocturnal Asthma; Nose; Outcome; Oxidative Stress; Particulate Matter; Patient Self-Report; Proteins; Questionnaires; Reporting; Research; Risk; Severities; Sleep; Sleep Apnea Syndromes; Spirometry; Staphylococcus aureus; Symptoms; Thailand; Time; Visit; Work; World Health Organization; actigraphy; air monitoring; airway inflammation; ambient air pollution; biological adaptation to stress; cockroach allergen; design; disparity reduction; environmental intervention; environmental tobacco smoke; experience; follow-up; health disparity; household environmental exposure; indoor particulate matter; inner city; microbial; mouse allergen; multidisciplinary; poor sleep; pulmonary function; reduce symptoms; sleep quality; therapeutic target; therapy design; urban setting

Asthma and sleep disordered breathing (SDB) are common chronic diseases that disproportionately affect Black children and those living in poor neighborhoods. Household environmental exposures have been shown to increase asthma morbidity and there is strong biologic rationale that these will impact sleep quality, but to date, there have been limited studies of the indoor environment and sleep. Our overarching goal is to define home environmental determinants of sleep disparities and the contribution of sleep disparities to childhood asthma morbidity among low-income, predominantly Black children living in Baltimore City. The home environment is critical as children spend the majority of their time indoors, most in their own home and ~1/3 in the bedroom, the environment most relevant for sleep. We propose to comprehensively study the bedroom environment, including air quality, allergens, microbes, and the relationship with sleep quality in children with asthma. Our prior studies have shown that children in Baltimore City live in homes where bedroom levels of air pollution are three times the concentrations recommend by the World Health Organization Indoor Air Quality standards and that mouse allergen, present in high concentrations, is a driver of asthma morbidity in Baltimore. Bedroom dust and nasal carriage of Staphylococcus aureus are prevalent, and emerging evidence suggests bedroom exposure to this bacteria and its toxic protein products are associated with nocturnal asthma. There is biological plausibility that the bedroom environmental exposures increase inflammation and oxidative stress responses in the upper airway that contribute to risk for and severity of SDB. While there is emerging evidence that environmental exposures impact sleep, there is a need for studies with objective assessments in children. Our research team has extensive experience in the conduct of home environmental monitoring and simultaneously assessing health outcomes in children. In the proposed project, we aim to determine the association between a) bedroom environmental exposures (air quality, allergens, microbes) and sleep quality among children with asthma in Baltimore City 2) bedroom environmental exposures and upper airway inflammation/oxidative stress 3) sleep quality and asthma morbidity among children with asthma in Baltimore City. This comprehensive study of bedroom environment and sleep among inner-city African American children has the potential to provide foundational evidence for environmental drivers of poor sleep quality that are needed to design interventions to reduce sleep and asthma health disparities.

哮喘和睡眠呼吸障碍 (SDB) 是常见的慢性疾病， 黑人儿童和生活在贫困社区的儿童受到不成比例的影响。家庭 环境暴露已被证明会增加哮喘发病率，并且有很强的影响 生物学原理认为这些会影响睡眠质量，但迄今为止，研究还很有限 室内环境和睡眠。我们的首要目标是定义家庭环境 睡眠差异的决定因素以及睡眠差异对儿童哮喘的影响 居住在巴尔的摩市的低收入儿童（主要是黑人儿童）的发病率。家 环境至关重要，因为孩子们大部分时间都在室内度过，尤其是在自己的家里 约 1/3 位于卧室，这是与睡眠最相关的环境。我们建议 全面研究卧室环境，包括空气质量、过敏原、微生物等 哮喘儿童与睡眠质量的关系。我们之前的研究表明 巴尔的摩市的儿童所居住的家庭中卧室空气污染程度是普通家庭的三倍 世界卫生组织室内空气质量标准推荐的浓度 高浓度的小鼠过敏原是巴尔的摩哮喘发病的一个驱动因素。 卧室灰尘和鼻腔携带金黄色葡萄球菌很普遍，并且正在出现 有证据表明卧室接触这种细菌及其有毒蛋白质产物 与夜间哮喘有关。卧室环境有生物学合理性 暴露会增加上呼吸道的炎症和氧化应激反应 影响 SDB 的风险和严重程度。尽管有新的证据表明环境 暴露会影响睡眠，因此需要对儿童进行客观评估的研究。我们的 研究团队在家庭环境监测方面拥有丰富的经验 同时评估儿童的健康结果。在拟议的项目中，我们的目标是 确定 a) 卧室环境暴露（空气质量、过敏原、 微生物）和巴尔的摩市哮喘儿童的睡眠质量 2）卧室 环境暴露和上呼吸道炎症/氧化应激 3) 睡眠质量和 巴尔的摩市哮喘儿童的哮喘发病率。这项综合研究 市中心非裔美国儿童的卧室环境和睡眠有可能 为睡眠质量差的环境驱动因素提供基础证据 设计干预措施以减少睡眠和哮喘健康差异。