The Impact of Unconventional Natural Gas Development on Maternal, Perinatal, and Childhood Health: an Electronic Health Record Approach

非常规天然气开发对孕产妇、围产期和儿童健康的影响：电子健康记录方法

• 批准号: 10200037
• 负责人: Joan A Casey
• 金额: $ 24.9万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-15 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10200037
• 关键词: Acute respiratory infection; Address; Affect; Age; Air; Air Pollutants; Air Pollution; Anxiety; Asthma; Award; Biological Models; Birth; Birth Weight; Caring; Catchment Area; Chemicals; Child; Child Care; Child Health; Childhood; Childhood Asthma; Chronic; Code; Cohort Studies; Complex; Data; Data Collection; Development; Diagnosis; Electronic Health Record; Environment; Environmental Epidemiology; Environmental Exposure; Environmental Health; Environmental Policy; Environmental Risk Factor; Exposure to; Geographic Information Systems; Geography; Gestational Diabetes; Goals; Health; Health system; Healthcare Systems; Hospitals; Hypertension; Infant Care; Inflammation; Injury; Institution; Interdisciplinary Study; Irritants; Joints; Link; Logistics; Longevity; Maternal Health; Maternal and Child Health; Measures; Mediating; Mediation; Mediator of activation protein; Mental Depression; Methods; Mission; Modeling; Mothers; National Institute of Environmental Health Sciences; Natural Gas; Nature; Neonatal; Outcome; Outcome Study; Particulate Matter; Pathway interactions; Pennsylvania; Perinatal; Phase; Policies; Policy Making; Population Heterogeneity; Poverty; Pregnancy; Premature Birth; Primary Health Care; Production; Psychological Stress; Public Health; Questionnaires; Race; Reading; Reporting; Research; Respiratory System; Risk Factors; Sleep Disorders; Socioeconomic Status; Stress; Technology; Term Birth; Time; Training; Work; adverse birth outcomes; air monitoring; air sampling; apprenticeship; asthma exacerbation; base; bioinformatics tool; career; data mining; design; early childhood; electronic data; elementary school; environmental stressor; epidemiology study; experience; experimental study; health data; improved; in utero; neonatal health; pediatric patients; population health; psychosocial; respiratory; respiratory health; skills; social; social determinants; social factors; social stress; social stressor; stressor; study population; text searching; volatile organic compound

PROJECT SUMMARY/ABSTRACT Recent studies have linked unconventional natural gas development (UNGD) to adverse birth outcomes. The relative contributions of specific risk factors, such as related air pollutants, socioeconomic status, and maternal health during pregnancy, however, remain unclear, as do the consequences of UNGD for childhood health. The objective of this K99/R00 application is to use UNGD in Pennsylvania as a model system–because it repre- sents a rapid, widespread social experiment with chemical and psychosocial exposures and as well as communi- ty changes–to disentangle the effects of environmental and social co-exposures on maternal, neonatal, and child health. The proposed project will link UNGD activity to mothers' electronic health records (EHRs) in combination with primary data collected by questionnaires, passive air samplers, and geographic information systems. EHR data are particularly well suited for environmental health research because they provide inexpensive access to longitudinal health data on large and diverse populations (i.e., in terms of age, socioeconomic status, race, and geography). Considerable logistical and analytic skills are required to optimize use of EHR data, supplement it with primary data collection, and complete causal analyses. The K99 is designed to augment the candidate's prior research experience through coursework, apprenticeships in environmental epidemiology, and directed readings, with specific training in: (1) maternal and child health; (2) EHR text mining; (3) causal mediation analysis; (4) primary data collection; and (5) analysis of co-exposures. The skills gained during this award are critical to the long-term goal to use EHR data from multiple healthcare systems to conduct environmental epi- demiology studies across the lifecourse, in order to inform environmental policy-making. The proposed research will utilize Geisinger Health System's EHR data, which provides access to >15,000 births that have spatial and temporal overlap with UNGD in Pennsylvania. Aim 1 (K99 phase) combines text mining strategies and diagnosis codes to extract mothers' pregnancy-related health conditions from EHR data and then applies causal inference methods to evaluate pregnancy-related hypertension, gestational diabetes, sleep disorders, depression, and anx- iety as mediators of the observed associations between UNGD and term birth weight and preterm birth. Aim 2 (K99 phase) pilots primary data collection of chronic social stressors via questionnaires and ambient air samples near elementary schools attended by Geisinger pediatric patients. The R00 phase builds upon K99 data collec- tion and follows the primary care infants until 2021 (ages 8-15 years) to evaluate associations of types and timing of UNGD activity in relation to asthma diagnosis and acute respiratory infection. Aims 3-4 (R00 phase) begin to disentangle the environmental and social determinants of childhood respiratory outcomes. The proposal ad- dresses logistical and analytic challenges in environmental epidemiology and will prepare the applicant for an independent research career. This work will evaluate joint effects of environmental and social stressors on health across the lifespan and advance use of EHR data in environmental epidemiology.

项目摘要/摘要 最近的研究已将非常规的天然气发展（UNGD）联系起来，以降低出生结果。这 特定危险因素的相对贡献，例如相关的空气污染物，社会经济状况和母亲 但是，怀孕期间的健康状况尚不清楚，UNGD对儿童健康的后果也尚不清楚。 该K99/R00应用程序的目的是将宾夕法尼亚州的UNGD用作模型系统，因为它代表了 通过化学和社会心理暴露以及社区进行快速，广泛的社会实验 变化 - 解开环境和社会共同曝光对母校，新生儿和儿童的影响 健康。拟议的项目将联合使用UNGD活动与母亲的电子健康记录（EHR） 通过问卷，被动空气样本和地理信息系统收集的主要数据。 EHR 数据特别适合环境健康研究，因为它们可提供廉价的访问 关于大多潜水人群的纵向健康数据（即，在年龄，社会经济地位，种族和 地理）。需要相当大的后勤和分析技能来优化EHR数据的使用，并补充它 收集主要数据并完成因果分析。 K99旨在增加候选人的 通过课程的事先研究经验，环境流行病学的学徒制和指导 阅读，并在以下特定的培训中进行：（1）物物和儿童健康； （2）EHR文字挖掘； （3）因果关系 分析; （4）主要数据收集； （5）共曝光分析。该奖项中获得的技能是 对于长期目标至关重要的是使用来自多个医疗保健系统的EHR数据来进行环境表演 为了为环境政策制定提供信息，跨整个生命的研究。拟议的研究 将利用Geisinger Health System的EHR数据，该数据可访问> 15,000个具有空间和空间的分娩 与宾夕法尼亚州的UNGD暂时重叠。目标1（K99阶段）结合了文本挖掘策略和诊断 从EHR数据中提取母亲妊娠相关的健康状况的代码，然后应用因果推断 评估妊娠相关高血压，妊娠糖尿病，睡眠障碍，抑郁和焦虑的方法 作为观察到的UNGD与期限出生体重与早产之间观察到的关联的介体。目标2 （K99阶段）飞行员通过问卷调查和环境空气样本的慢性社会压力源的主要数据收集 在小学附近，吉辛格小儿患者就读。 R00阶段建立在K99数据收集的基础上 - 直到2021年（8-15岁）的初级保健婴儿，以评估类型和时机的关联 与哮喘诊断和急性呼吸道感染有关的UNGD活性。目标3-4（R00阶段）开始 解开儿童呼吸结果的环境和社会决定者。提案ad- 在环境流行病学中的后勤和分析挑战，将为申请人做好准备 独立研究职业。这项工作将评估环境和社会压力源对健康的联合影响 在整个生命周期中，并在环境流行病学中提前使用EHR数据。

项目成果

Naming Civic Health in Environmental Justice Discourse: The Jackson Water Crisis.

在环境正义话语中命名公民健康：杰克逊水危机。

• DOI: 10.1016/j.lana.2022.100378
• 发表时间: 2022
• 期刊: Lancet regional health. Americas
• 作者: Nwanaji-Enwerem,JamajiC;Casey,JoanA
• 通讯作者: Casey,JoanA

Historic redlining and the siting of oil and gas wells in the United States.

• DOI: 10.1038/s41370-022-00434-9
• 发表时间: 2023-01
• 期刊: JOURNAL OF EXPOSURE SCIENCE AND ENVIRONMENTAL EPIDEMIOLOGY
• 影响因子: 4.5
• 作者: Gonzalez, David J. X.;Nardone, Anthony;Nguyen, Andrew, V;Morello-Frosch, Rachel;Casey, Joan A.
• 通讯作者: Casey, Joan A.