Health Effects of Extreme Heat among Vulnerable Populations with Asthma and COPD

极端高温对哮喘和慢性阻塞性肺病易感人群的健康影响

• 批准号: 8473337
• 负责人: MEREDITH C MCCORMACK
• 金额: $ 20.25万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-02 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8473337
• 关键词: Address; Admission activity; Adult; Adult asthma; Age; Air; Air Pollutants; Air Pollution; Asthma; Baltimore; Biometry; Cessation of life; Characteristics; Child; Childhood; Childhood Asthma; Chronic Disease; Chronic Obstructive Airway Disease; Climate; Cohort Studies; Communities; Data; Developed Countries; Development; Disease; Ecology; Elderly; Environmental Exposure; Environmental Health; European; Event; Exposure to; Funding; Future; Goals; Health; Healthcare; Heat Waves; Heating; Home environment; Hospital Mortality; Human; Humidity; Individual; Life; Link; Lung; Measurement; Measures; Medicine; Methods; Metric; Minority; Modeling; Morbidity - disease rate; National Institute of Environmental Health Sciences; Outcome; Outcome Measure; Participant; Particulate Matter; Pollution; Population; Population Characteristics; Poverty; Predisposition; Public Health; Pulmonary Function Test/Forced Expiratory Volume 1; Pulmonary Heart Disease; Research; Resolution; Resources; Respiratory physiology; Risk; Symptoms; Temperature; Time; Vulnerable Populations; Work; climate change; cohort; design; diaries; extreme temperature; high risk; inner city; mortality; multidisciplinary; pollutant; population based; public health relevance; respiratory; time use; urban area

DESCRIPTION (provided by applicant): Climate change has resulted in global increases in temperature and extreme heat events are projected to become more frequent and intense. Understanding health effects of extreme heat exposure is critical to developing mitigation strategies to protect those at greatest risk. Research has shown that extreme heat is linked to increases in mortality and has identified vulnerable, high-risk groups, including those with underlying cardiopulmonary disease, the poor, children, the elderly, and those living in urban areas and temperate climates. Far less is known about morbidity outcomes and very little is known about disease-specific outcomes, which are critical to estimate the healthcare burden of this exposure. To date, ambient temperatures have been used as the exposure metric, an approach subject to misclassification that may underestimate health effects in some groups. While there has been emphasis on individual level exposure assessment in environmental research, and this approach has been applied successfully to study air pollution, there has been little application to study heat-related health effects. We proposed to study the effect of individual exposure to extreme heat in vulnerable populations of inner-city minority children with asthma and older adults with COPD, using disease-specific outcome measures. We will leverage substantial resources from existing NIEHS-funded cohorts to address unique aims: 1. To determine a) the effect of individual exposure to extreme heat and b) the interactive effect of extreme heat and air pollution exposure on asthma morbidity among minority children with asthma living in inner-city Baltimore; 2. To determine a) the effect of individual exposure to extreme heat and b) the interactive effect of extreme heat and air pollution exposure heat on COPD morbidity among older adults with COPD living in Baltimore. Detailed participant characterization and daily activity diaries completed during heat events allow us to identify characteristics of those at highest risk within these vulnerable populations, information critical o development of mitigation strategies. In aim 3, we will model the relationship between ambient and individual heat exposure and identify factors that modify this relationship, which will inform exposure metrics in future population-level studies. We will, for the first time, use individual exposure assessment and disease- specific health outcomes to advance the understanding of health effects of extreme heat, projected to increase with climate change, on highly vulnerable populations with COPD and asthma.

描述（由申请人提供）：气候变化导致全球气温升高，极端高温事件预计将变得更加频繁和强烈。了解极端高温对健康的影响对于制定缓解策略以保护高危人群至关重要。研究表明，极端高温与死亡率增加有关，并确定了易受伤害的高风险群体，包括患有潜在心肺疾病的人、穷人、儿童、老年人以及居住在城市地区和温带气候的人。我们对发病结果知之甚少，对特定疾病的结果知之甚少，而这对于估计这种暴露的医疗负担至关重要。迄今为止，环境温度已被用作暴露指标，这种方法容易被错误分类，可能会低估某些群体的健康影响。虽然环境研究一直强调个人水平的暴露评估，并且这种方法已成功应用于研究空气污染，但很少应用于研究与热相关的健康影响。我们提议使用特定于疾病的结果指标来研究个体暴露于极端高温对内城区少数患有哮喘的儿童和患有慢性阻塞性肺病的老年人的脆弱人群的影响。我们将利用现有 NIEHS 资助的队列的大量资源来实现独特的目标：1. 确定 a) 个人暴露于极端高温的影响，b) 极端高温和空气污染暴露对少数民族儿童哮喘发病率的交互影响居住在巴尔的摩市中心的哮喘病； 2. 确定 a) 个人暴露于极端高温的影响，以及 b) 极端高温和空气污染暴露热对居住在巴尔的摩的慢性阻塞性肺病老年人的慢性阻塞性肺病发病率的交互影响。在高温事件期间完成的详细参与者特征和日常活动日记使我们能够识别这些弱势群体中风险最高的人的特征，这些信息对于制定缓解策略至关重要。在目标 3 中，我们将模拟环境与个人热暴露之间的关系，并确定改变这种关系的因素，这将为未来人口水平研究中的暴露指标提供信息。我们将首次利用个人暴露评估和特定疾病的健康结果来加深对极端高温对患有慢性阻塞性肺病和哮喘的高度脆弱人群的健康影响的了解，预计这种影响会随着气候变化而增加。