ASTHMA SEVERITY IN CHILDREN AND ENVIRONMENTAL AGENTS

儿童哮喘的严重程度和环境因素

• 批准号: 6382099
• 负责人: Brian P Leaderer
• 金额: $ 67.16万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-09-29 至 2004-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6382099
• 关键词: acids; aerosols; air pollution; air sampling /monitoring; female; human subject; infant human (0-1 year); interview; longitudinal human study; petroleum oil; pollution related respiratory disorder; preschool child (1-5); questionnaires; respiratory airflow disorder; respiratory airway clearance; respiratory disorder diagnosis; respiratory disorder epidemiology; respiratory hypersensitivity; respiratory toxin; statistics /biometry; young adult human (21-34)

Recent but limited epidemiologic data suggest that the current national ambient standard for particle matter may not be adequate to protect public health and that particle acidic sulfate aerosol may be associated with adverse respiratory effects. An Ambient Air Quality Standard for acidic aerosol is being considered. we will examine these two air pollutants, which are of major interest to outdoor air quality, in an indoor environment where multiple and potentially interacting exposures to complex mixtures can be quantified with more reliability than is done in outdoor studies. We have identified unvented kerosene space heaters as a major source of residential particle mass, sulfate and vapor and particle acid. A pilot study has indicated that kerosene heater users are at higher risk for respiratory symptoms and as such constitute a unique population in which to determine the nature of an association between particle mass, sulfate mass and vapor and particle acid exposures and respiratory health effects. This study tests the hypothesis that exposures to elevated concentrations of particle mass (including fine particle mass), and acidic sulfate aerosol air contaminants, resulting from kerosene heater use are associated with an increased risk of acute or chronic upper and lower respiratory symptoms in infants age 3-15 months (a sensitive population), including cough, phlegm, wheeze, runny/stuffy nose, etc. Also tested is the hypothesis that the exposed mothers of the infants are at an increased risk of respiratory symptoms and reversible decrements in peak expiratory flow. These associations will be evaluated for an exposure response relation while adjusting for other known or potential risk factors (NO., HN02, SES, health status, etc.). The study population, selected from live deliveries occurring at four Connecticut hospitals, will exclude homes where passive smoking exposure occurs. Study subjects will be recruited into three exposure categories: a) no unvented combustion sources (N=450 infants and their mothers); b) gas ranges only (N=225 infants and their mothers); and, c) kerosene heaters only (N=225 infants and their mothers). Data will be gathered for one year on a bi-weekly basis, covering a full heating and cooling season, including reports of respiratory symptoms in both the infants and mothers and concurrent use of the heater and gas stove. Diurnal peak flow differences for the mothers for a 4 week period during the heating and non-heating seasons will be recorded. A nested exposure assessment protocol will be used and potential confounding factors will be controlled. Continuous versus categorical responses in the exposure groups will be compared using longitudinal analysis. This design will allow for a distinction between exposure effects and seasonal variation effects. The results would provide data needed to address the recently raised public health issues of whether the particle ambient standard protects public health and whether a national ambient acid standard is needed. It will also identify any increased risk for the large population of kerosene heater users.

最近但有限的流行病学数据表明，当前国家 粒子物质的环境标准可能不足以保护 公共卫生和颗粒酸性硫酸盐气溶胶可能与 具有不良呼吸作用。 环境空气质量标准 正在考虑酸性气溶胶。我们将检查这两个空气 在室外空气质量的主要兴趣的污染物中 室内环境多次相互作用的暴露 可以用比完成的更可靠性来量化复杂的混合物 在户外研究中。 我们已经确定了未通风的煤油太空加热器是 住宅颗粒质量，硫酸盐和蒸气和颗粒酸。 飞行员 研究表明，煤油加热器用户的风险更高 呼吸道症状，因此构成了独特的人群 确定颗粒质量，硫酸盐之间关联的性质 质量，蒸气和颗粒酸暴露和呼吸健康 效果。 这项研究检验了暴露于浓度升高的假设 颗粒质量（包括细颗粒质量）和酸性硫酸盐 由煤油加热器的使用引起的气溶胶空气污染物是 与急性或慢性上层和下部的风险增加有关 婴儿3-15个月的呼吸道症状（敏感人群）， 包括咳嗽，痰，喘息，流鼻涕/鼻子等。还测试的是 婴儿裸露的母亲处于 呼吸症状的风险增加和峰值可逆下降 呼气流。 这些关联将被评估以进行暴露 在调整其他已知或潜在风险的同时，响应关系 因素（No。，HN02，SES，健康状况等）。 研究人群，从四个现场交付中选择 康涅狄格州医院将排除被动吸烟暴露的房屋 发生。 研究对象将被招募为三个曝光类别： a）没有意外的燃烧来源（n = 450名婴儿及其母亲）； b） 气体范围仅为（n = 225个婴儿及其母亲）；并且，c）煤油 仅加热器（n = 225名婴儿及其母亲）。 数据将收集 每两周一年，覆盖完整的供暖和冷却 季节，包括婴儿和 母亲以及加热器和燃气炉的同时使用。 昼夜峰 在加热期间，母亲的流动差异为4周 并记录非加热季节。 嵌套暴露评估 协议将被使用，潜在的混杂因素将是 受控。 曝光中的连续反应与分类响应 将使用纵向分析比较组。 这个设计将 允许区分暴露效果和季节性变化 效果。 结果将提供解决最近所需的数据 提出了粒子环境标准的公共卫生问题 保护公共卫生以及国家环境酸标准是否 需要。 它还将确定大型风险的增加 煤油加热器用户的人口。