Acute Effects of Diesel Exhaust in Asthmatic Children

柴油机尾气对哮喘儿童的急性影响

• 批准号: 7474593
• 负责人: TOBY C LEWIS
• 金额: $ 12.84万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-06 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7474593
• 关键词: Acids; Acute; Adverse effects; Aerosols; Air; Air Pollutants; Allergens; Allergic; Asthma; Automobile Driving; Biological Assay; Biological Markers; Breathing; Bronchodilator Agents; Caliber; Canis familiaris; Carbon; Carbon Black; Caregivers; Caring; Child; Child health care; Communities; Complex; Complex Mixtures; Control Groups; Count; Daily; Data; Data Set; Dictyoptera; Diesel Exhaust; Dust; Education; Engine Exhaust; Environment; Environmental Exposure; Environmental Tobacco Smoke; Enzyme-Linked Immunosorbent Assay; Epidemiologic Studies; Exhalation; Exposure to; Felis catus; Gases; Health; Health Care Visit; Health Status; Home environment; Hospitalization; House Dust; Household; Hydrogen; Hydrogen Peroxide; Hypersensitivity; Individual; Indoor Air Pollution; Inflammation; Intervention; Knowledge; Laboratories; Life; Measurement; Measures; Mediating; Michigan; Microscopic; Modeling; Morbidity - disease rate; Neighborhoods; Nicotine; Numbers; Outcome; Outcome Measure; Particulate Matter; Phase; Play; Pneumonia; Policies; Pollution; Population; Prospective Studies; Public Health; Quartz; Randomized Controlled Clinical Trials; Reporting; Research Methodology; Research Personnel; Respiratory physiology; Role; Sampling; Skin; Social support; Source; Stimulus; Symptoms; Techniques; Testing; Training; Transportation; Visit; Work; airway inflammation; asthmatic patient; base; cockroach allergen; community based participatory research; design; environmental intervention; improved; inner city; insight; interest; novel; outreach; particle; pollutant; respiratory; spatial temporal variation; therapy design; trafficking; ultrafine particle; vapor; volatile organic compound

DESCRIPTION (provided by applicant): Exposure to diesel exhaust, a significant source of particulate matter (PM) in urban residential environments, adversely effects respiratory health of asthmatics and augments allergic sensitization to allergens. Yet much remains unknown about which aspects of diesel exposure are driving the observed health effects, the effect of diesel exhaust exposure in combination with other asthma triggers, and whether any of the effects of diesel are modifiable on an individual basis. The Michigan Center for the Environment and Children's Health (MCECH) recently conducted an integrated ambient PM exposure assessment, health effects epidemiologic study, and home intervention to reduce indoor allergens among asthmatic children in Detroit. Fluctuations in lung function associated with PM2.5 or PM10 exposure were more prominent in children who were allergic to cockroach compared to those who were not allergic. These data suggest a model in which PM, specifically that derived from diesel exhaust, and indoor allergen exposures interact synergistically to increase pulmonary inflammation in asthmatic patients. To test this hypothesis, the investigators propose these specific aims: 1) Determine whether the fraction of ambient PM arising from diesel exhaust determines pollution-related respiratory health effects in children with asthma in an inner-city environment. Statistical associations between ambient elemental carbon (EC), a marker for diesel exhaust, and acute respiratory outcomes (lung function, symptoms, bronchodilator use, acute care visits) will be investigated in children with asthma. 2) Determine the potential interactions between the effects of ambient diesel exhaust (as traced by EC) and exposure to allergens and environmental tobacco smoke (lETS). Interactive effects between EC and household exposure to indoor allergens, and ETS exposure, on health status will be investigated in children with asthma. 3) Determine the causal relationship between indoor allergen exposure and heightened sensitivity to air pollutants by performing an intervention designed to reduce indoor allergen exposure. A new integrated health effects study and prospective randomized trial of home environmental intervention will be conducted with extensive spatial and temporal assessment of ambient diesel exposure, assessed by EC concentration and ultrafine particle number, and health outcomes. The investigators will compare the acute air pollutant-associated fluctuations in asthma health status in the intervention group to that in a control group. They will also investigate associations between exhaled hydrogen a biomarker of asthma activity, and diesel exhaust exposure.

描述（由申请人提供）： 暴露于柴油排气，这是城市居民环境中颗粒物（PM）的重要来源，对哮喘患者的呼吸健康不利影响，并增强对过敏原过敏敏化。 然而，关于柴油暴露的哪些方面正在推动观察到的健康影响，柴油排气暴露与其他哮喘触发因素的影响以及柴油的任何影响是否可在单独修改。密歇根州环境与儿童健康中心（MCECH）最近进行了综合的环境PM暴露评估，健康影响流行病学研究和家庭干预，以减少底特律哮喘儿童的室内过敏原。与没有过敏反应的儿童相比，与蟑螂过敏的儿童中，与PM2.5或PM10暴露有关的肺功能波动更为突出。这些数据表明了一个模型，其中PM，特别是源自柴油机排气的PM，室内过敏原暴露有协同相互作用，以增加哮喘患者的肺部炎症。为了检验这一假设，研究人员提出了这些具体目的： 1）确定由柴油排气产生的环境PM的比例是否决定哮喘儿童在城市内部环境中与污染有关的呼吸健康影响。环境元素碳（EC），柴油排气的标记与急性呼吸结局（肺功能，症状，支气管扩张剂使用，急性护理访问）之间的统计关联。 2）确定环境柴油排气的影响（如EC所追踪）与过敏原和环境烟草烟雾（Lets）之间的潜在相互作用。 EC与家庭接触室内过敏原之间的交互作用以及ETS暴露于哮喘儿童将研究健康状况。 3）通过执行旨在减少室内过敏原暴露的干预措施，确定室内过敏原暴露与对空气污染物的敏感性提高之间的因果关系。一项新的综合健康效应研究和家庭环境干预的前瞻性随机试验将通过对环境柴油暴露的广泛空间和时间评估进行，并通过EC浓度和超铁颗粒数量以及健康结果进行评估。 研究人员将比较干预组的哮喘健康状况中与急性空气污染物相关的波动与对照组中的急性相关性波动。 他们还将研究呼出氢的哮喘活性生物标志物与柴油排气暴露之间的关联。

项目成果

"I wouldn't look at it as stress": conceptualizations of caregiver stress among low-income families of children with asthma.

• DOI: 10.1353/hpu.2013.0021
• 发表时间: 2013-02
• 期刊: Journal of health care for the poor and underserved
• 影响因子: 1.4
• 作者: Sampson NR;Parker EA;Cheezum RR;Lewis TC;O'Toole A;Zuniga A;Patton J;Robbins TG;Keirns CC
• 通讯作者: Keirns CC

A life course perspective on stress and health among caregivers of children with asthma in Detroit.

• DOI: 10.1097/fch.0b013e31826d7620
• 发表时间: 2013-01
• 期刊: Family & community health
• 影响因子: 2.3
• 作者: Sampson NR;Parker EA;Cheezum RR;Lewis TC;O'Toole A;Patton J;Zuniga A;Robins TG;Keirns CC
• 通讯作者: Keirns CC

Nightwatch: Sleep Disruption of Caregivers of Children With Asthma in Detroit.

守夜人：底特律哮喘儿童护理人员的睡眠中断。

• DOI: 10.1177/2150129713478635
• 发表时间: 2013
• 期刊: Journal of asthma & allergy educators
• 作者: Cheezum,RebeccaR;Parker,EdithA;Sampson,NatalieR;Lewis,TobyC;O'Toole,Ashley;Patton,Jean;Robins,ThomasG;Keirns,CarlaC
• 通讯作者: Keirns,CarlaC