Spatial and Temporal Modeling of PM2.5 and Infant Morbidity

PM2.5 和婴儿发病率的时空建模

• 批准号: 8306911
• 负责人: Veronica M Vieira
• 金额: $ 34.61万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-25 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8306911
• 关键词: Address; Aerosols; Affect; Air; Air Pollution; Birth; Bronchiolitis; Burn injury; Caliber; Cardiac; Chemosensitization; Child; Childhood; Code; Communities; Congenital Abnormality; Cross-Over Studies; Data; Data Set; Databases; Disease; Environmental Epidemiology; Environmental Tobacco Smoke; Epidemiologic Studies; Epidemiology; Exposure to; Family; Fetal Death; Goals; Healthcare; Hospitals; Infant; Infant Health; Infection; Information Systems; Inpatients; Life; Link; Live Birth; Longitudinal Studies; Maps; Massachusetts; Measures; Methods; Modeling; Monitor; Morbidity - disease rate; Nested Case-Control Study; Optics; Otitis Media; Outcome; Outpatients; Particulate Matter; Pattern; Perinatal; Population; Pregnancy; Prevalence; Process; Public Health; Recording of previous events; Registries; Research; Research Design; Residual state; Risk; Risk Factors; Siblings; Smoke; Staging; Statistical Methods; Statistical Models; Structure; Subgroup; Testing; Time; Wood material; Work; base; case control; cohort; cost; data modeling; ear infection; high risk infant; improved; innovation; novel; population based; premature; prenatal; programs; remote sensing; respiratory; spatial temporal variation

DESCRIPTION (provided by applicant): The potential association between ambient PM2.5 exposure and the risk of infant bronchiolitis and otitis media is a significant public health concern. This concern is supported by growing toxicologic and epidemiologic evidence that ambient PM2.5 exposure increases potentiation of the disease process. Infant bronchiolitis and otitis media may have serious long-term consequences for the affected infants and the healthcare related costs are substantial. However, available studies are sparse and have important limitations. This study will address many of these weaknesses and make significant contributions to understanding the relationship between ambient PM2.5 exposure and infant bronchiolitis and otitis media. The first aim is to improve PM2.5 exposure assessment compared to earlier studies by supplementing data from ground monitors with remote sensing data from satellites. Instead of linking infant ZIP code centroids to data from the closest monitor, advanced statistical modeling will be used to predict the PM2.5 concentration at the infants' geocoded addresses. This will reduce exposure misclassification compared to existing studies. The second aim is to integrate the PM2.5 exposure with data from a large longitudinal Massachusetts (MA) birth cohort linked to hospital data and the MA Birth Defects Registry. With more than 40,000 cases of inpatient and outpatient infant bronchiolitis and 125,000 cases of inpatient and outpatient otitis media, analyses will have sufficient power to detect small effects as well as examine vulnerable subpopulations including infants born premature or with pre- existing respiratory or cardiac conditions and/or congenital anomalies. The linked PELL dataset allows for case-crossover analyses for short-term exposures and analyses of long-term exposures using sibling controls to minimize confounding bias. The combination of traditional epidemiologic study designs with innovative methods will reduce confounding bias often associated with registry-based analyses. To examine the possibility of residual confounding, the third aim will use generalized additive models to examine the space- time pattern of residual risk after including ambient PM2.5 exposure and adjusting for known risk factors. The results of the proposed study will provide new information on infant bronchiolitis and otitis media, two outcomes for which there is a strong indication of an environmental component and for which there is increasing prevalence in the vulnerable infant population. For an exposure as widespread as ambient PM2.5, even small associations can have a significant public health impact.

描述（由申请人提供）：环境PM2.5暴露与婴儿细支气管炎和中耳炎的风险之间的潜在关联是一个重大的公共健康问题。这一担忧是通过日益增长的毒理学和流行病学证据来支持的，即环境PM2.5暴露会增加疾病过程的增强。婴儿支气管炎和中耳炎培养基可能会对受影响的婴儿产生严重的长期后果，与医疗保健相关的成本很大。但是，可用的研究很少，并且具有重要的局限性。这项研究将解决许多此类弱点，并为了解环境PM2.5暴露与婴儿细支气管炎和中耳炎之间的关系做出了重要贡献。首先，与早期研究相比，通过补充来自卫星遥感数据的地面监视器的数据，可以改善PM2.5的暴露评估。高级统计建模将不用将婴儿邮政编码质心与来自最接近监视器的数据联系起来，以预测婴儿地理编码地址的PM2.5浓度。与现有研究相比，这将减少暴露错误分类。第二个目的是将PM2.5的暴露与来自大型马萨诸塞州纵向的数据（MA）出生队列与医院数据和MA出生缺陷注册中心有关。拥有40,000例住院和门诊婴儿细胞纤维炎以及125,000例住院和门诊性的中产阶级培养基，分析将具有足够的能力来检测小小的效果，并检查包括婴儿出生早期或有现有呼吸或心脏病或心脏病或心脏病和/或先生性和/或先生性和/或先生性的弱点。链接的Pell数据集允许使用同级控制措施对短期暴露和长期暴露的短期暴露和分析，以最大程度地减少混杂偏见。传统流行病学研究设计与创新方法的结合将减少通常与基于注册表的分析相关的混杂偏见。为了检查残留混淆的可能性，第三个目标将使用通用的添加剂模型来检查剩余风险的时空模式，包括环境PM2.5暴露并调整已知风险因素。拟议研究的结果将提供有关婴儿支气管炎和中耳炎的新信息，这两个结果有很强的迹象表明环境成分，并且易受伤害的婴儿人群的患病率越来越高。对于像环境PM2.5一样广泛的曝光，即使是小型关联也会产生重大的公共卫生影响。