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: 8729486
• 负责人: MEREDITH C MCCORMACK
• 金额: $ 24.06万
• 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 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8729486
• 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; 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）：气候变化导致温度的全球升高和极端热量事件预计变得更加频繁和强烈。了解极端热量暴露的健康影响对于制定缓解策略以保护最大风险的人至关重要。研究表明，极端热量与死亡率的增加有关，并且已经确定了脆弱的高风险群体，包括那些患有潜在的心肺疾病的人，穷人，儿童，老年人以及居住在城市地区和温带气候的人。关于发病率的结果知之甚少，对特定疾病的结果知之甚少，这对于估计这种暴露的医疗保健负担至关重要。迄今为止，环境温度已被用作暴露度量，这是一种错误分类的方法，可能会低估某些组的健康影响。尽管在环境研究中一直强调个人水平的暴露评估，并且这种方法已成功地用于研究空气污染，但在研究与热相关的健康效应方面几乎没有应用。我们建议研究使用特定疾病的结局指标研究哮喘和老年人患有COPD的弱势群体儿童的弱势群体人群中个人暴露于极热的影响。我们将利用现有NIEHS资助的队列中的大量资源来解决独特的目标：1。确定a）个人暴露于极端热量和b）极度热量和空气污染暴露对生活在巴尔的摩市中心哮喘的哮喘儿童哮喘发病率的互动效果； 2。确定a）个人暴露于极端热量和b）极热和空气污染的热量对COPD居住在巴尔的摩的COPD的发病率的相互作用对COPD发病的影响。详细的参与者表征和热量事件期间完成的日常活动日记使我们能够确定这些脆弱人群中处于最高风险的特征，信息批判性地制定缓解策略。在AIM 3中，我们将对环境和个体热暴露之间的关系进行建模，并确定改变这种关系的因素，这将为未来的人口水平研究中的暴露指标提供信息。我们将首次使用个人暴露评估和特定疾病的健康结果来促进对极热的健康影响的理解，预计会随着气候变化的增加，对COPD和COPD和哮喘高度脆弱的人群增加。