Asthma Severity in Children & Fine Particle Composition

儿童哮喘严重程度

• 批准号: 7099808
• 负责人: Brian P Leaderer
• 金额: $ 66.06万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-07-09 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7099808
• 关键词: air filtration; air pollution; air sampling /monitoring; airborne allergen; asthma; child (0-11); clinical research; disease /disorder etiology; disease /disorder proneness /risk; engine exhaust; environmental exposure; environmental health; environmental transport; human data; particle; patient oriented research; respiratory function; statistics /biometry; trace elements

DESCRIPTION (provided by applicant): Ambient fine particle matter (< 2.5 |j,m in diameter [PM2.s]) is hypothesized to be a factor in the exacerbation of asthma. The current US EPA standard for fine particles may not protect a sensitive sub-group-children with asthma. Limitations in the few cross-sectional and panel studies of the health effects of particle exposure are numerous and include: small subject numbers, narrow range of asthma severity, narrow time frame of observation, no control for household characteristics and allergic status, limited information on particles (chemical speciation and sources), and poor control of gaseous co-pollutants. We recently completed a prospective, 1-year follow-up study of 466 physician-diagnosed asthmatic children residing in southern New England, a region that includes an area of non-attainment of the EPA standard. Preliminary analysis using data from our Childhood Asthma Study and using limited, publicly available data on chemical constituents of PM2.5, suggests that daily respiratory health is compromised by exposure to particular components of PM2.s. In this grant application, we propose to acquire and analyze the stored, fine-particle collection filters from EPA monitoring sites in our region for trace elements and elemental carbon. We further propose to take advantage of the 158,000 subject-days of symptom and medication use data from our Childhood Asthma Study to examine the impact of exposure to PM2.5 and PM2.5 constituents on respiratory health. The primary health outcomes are: mother-reported daily respiratory symptoms (wheeze, persistent cough, chest tightness and shortness of breath) and medication use; and monthly asthma severity, assessed using the Global Initiative for Asthma (GINA) guidelines. Associations will be assessed with longitudinal repeated measures analyses using generalized estimating equations as well as empirical Bayes methods that will take into account sources of variability of exposures. Gaseous co-pollutants, meteorological variables and potential confounders (season of the year, atopic status of the child, local traffic density) will also be included in the evaluation. Relevance: Results of this study will provide important information necessary to assess the adequacy of the EPA PM2.5 standard, could identify the component(s) of PM2.s having the strongest impact on respiratory health, and could lead to more cost-effective strategies for source-targeted air-pollution interventions.

描述（由申请人提供）：环境细粒子物质（<2.5 | j，直径[PM2.S]）被认为是哮喘加重的因素。当前的美国EPA标准可能无法保护哮喘敏感的亚组孩子。少数横断面和面板研究的局限性在颗粒暴露的健康效应的研究中有很多，包括：较小的受试者数量，哮喘严重程度狭窄的范围，狭窄的观察时间范围，对家庭特征和过敏状态没有控制，颗粒（化学物种形成和来源）的信息有限（化学物质形成和来源）以及对气体collut剂的控制不良。我们最近完成了一项针对居住在新英格兰南部的哮喘儿童的466名医师诊断的预期的，为期1年的随访研究，该地区包括EPA标准的非稳定区域。使用我们童年哮喘研究中的数据以及使用有限的PM2.5化学成分的有限公开可用数据的初步分析表明，每日呼吸健康受到暴露于PM2.S的特定成分的损害。在此赠款应用程序中，我们建议从我们地区的EPA监测站点获取和分析痕量元素和元素碳中存储的细粒子收集过滤器。我们进一步建议利用童年哮喘研究中的158,000个症状和药物使用数据，以研究暴露于PM2.5和PM2.5成分对呼吸健康的影响。主要的健康结果是：母报告的每日呼吸道症状（喘息，持续的咳嗽，胸部紧绷和呼吸急促）和用药；和每月哮喘的严重性，使用全球哮喘（GINA）指南进行评估。将使用纵向重复措施分析进行关联，并使用广义估计方程以及经验贝叶斯方法来考虑暴露范围的可变性来源。评估还将包括气态的共污染剂，气象变量和潜在的混杂因素（一年中的季节，儿童特征状态，当地的交通密度）也将包括在评估中。相关性：这项研究的结果将提供必要的重要信息，以评估EPA PM2.5标准的充分性，可以确定PM2.S的成分对呼吸健康的影响最大，并可能导致更具成本效益的策略，以实现源为准的空气污染干预措施。