Environmental Determinants of Sleep Disparities and the Consequences for Low Income Children with Asthma

睡眠差异的环境决定因素以及低收入哮喘儿童的后果

• 批准号: 10683760
• 负责人: MEREDITH C MCCORMACK
• 金额: $ 69.17万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10683760
• 关键词: Address; Adult; Affect; African American; Air; Air Pollutants; Air Pollution; Allergens; Asthma; Bacteria; Baltimore; Beds; Biological; Biological Markers; Black race; Child; Childhood; Childhood Asthma; Chronic Disease; Cities; Collection; Data; Disparity; Dust; Emergency Situation; Environment; Environmental Exposure; Environmental Monitoring; Environmental Science; Epidemiology; Exposure to; Goals; High Prevalence; Home; Home environment; Hospitalization; Household; Individual; Indoor Air Quality; Indoor environment; Inflammation; Inflammatory; Intervention; Link; Liquid substance; Literature; Low income; Lung; Measures; Mediating; Mediator; Medicine; Microbe; Microbiology; Monitor; Morbidity - disease rate; Nasal Epithelium; Needs Assessment; Neighborhoods; Nitrogen Dioxide; Nocturnal Asthma; Nose; Outcome; Oxidative Stress; Particulate Matter; Patient Self-Report; Proteins; Questionnaires; Recommendation; Reporting; Research; Risk; Severities; Sleep; Sleep Apnea Syndromes; Sleep disturbances; Spirometry; Staphylococcus aureus; Symptoms; Thailand; Time; Visit; Work; World Health Organization; actigraphy; air monitoring; airway inflammation; ambient air pollution; biological adaptation to stress; cockroach allergen; design; disparity reduction; environmental intervention; environmental tobacco smoke; experience; follow-up; health assessment; health disparity; household environmental exposure; indoor particulate matter; inner city; microbial; mouse allergen; multidisciplinary; poor sleep; pulmonary function; sleep quality; therapeutic target; therapy design; urban setting

Asthma and sleep disordered breathing (SDB) are common chronic diseases that disproportionately affect Black children and those living in poor neighborhoods. Household environmental exposures have been shown to increase asthma morbidity and there is strong biologic rationale that these will impact sleep quality, but to date, there have been limited studies of the indoor environment and sleep. Our overarching goal is to define home environmental determinants of sleep disparities and the contribution of sleep disparities to childhood asthma morbidity among low-income, predominantly Black children living in Baltimore City. The home environment is critical as children spend the majority of their time indoors, most in their own home and ~1/3 in the bedroom, the environment most relevant for sleep. We propose to comprehensively study the bedroom environment, including air quality, allergens, microbes, and the relationship with sleep quality in children with asthma. Our prior studies have shown that children in Baltimore City live in homes where bedroom levels of air pollution are three times the concentrations recommend by the World Health Organization Indoor Air Quality standards and that mouse allergen, present in high concentrations, is a driver of asthma morbidity in Baltimore. Bedroom dust and nasal carriage of Staphylococcus aureus are prevalent, and emerging evidence suggests bedroom exposure to this bacteria and its toxic protein products are associated with nocturnal asthma. There is biological plausibility that the bedroom environmental exposures increase inflammation and oxidative stress responses in the upper airway that contribute to risk for and severity of SDB. While there is emerging evidence that environmental exposures impact sleep, there is a need for studies with objective assessments in children. Our research team has extensive experience in the conduct of home environmental monitoring and simultaneously assessing health outcomes in children. In the proposed project, we aim to determine the association between a) bedroom environmental exposures (air quality, allergens, microbes) and sleep quality among children with asthma in Baltimore City 2) bedroom environmental exposures and upper airway inflammation/oxidative stress 3) sleep quality and asthma morbidity among children with asthma in Baltimore City. This comprehensive study of bedroom environment and sleep among inner-city African American children has the potential to provide foundational evidence for environmental drivers of poor sleep quality that are needed to design interventions to reduce sleep and asthma health disparities.

哮喘和睡眠失调的呼吸（SDB）是常见的慢性疾病 不成比例地影响黑人儿童和居住在贫困社区的人。家庭 环境暴露已被证明会增加哮喘发病率，并且有很强的 生物学理由认为这将影响睡眠质量，但迄今为止，研究有限 室内环境和睡眠。我们的总体目标是定义家庭环境 睡眠差异的决定因素和睡眠差异对儿童哮喘的贡献 低收入，主要是黑人儿童居住在巴尔的摩市的发病率。家 环境至关重要，因为孩子大部分时间都在室内度过自己的家中 〜1/3在卧室，环境与睡眠最相关。我们建议 全面研究卧室环境，包括空气质量，过敏原，微生物和 哮喘儿童与睡眠质量的关系。我们先前的研究表明 巴尔的摩市的儿童住在房屋中，卧室水平的空气污染是三倍 世界卫生组织推荐的浓度室内空气质量标准和 高浓度的小鼠过敏原是巴尔的摩哮喘发病率的驱动力。 金黄色葡萄球菌的卧室灰尘和鼻腔载体很普遍，并且出现了 有证据表明卧室暴露于该细菌及其有毒蛋白质产品是 与夜间哮喘有关。卧室环境有生物学合理性 暴露会增加上呼吸道中的炎症和氧化应激反应 有助于SDB的风险和严重性。尽管有新的证据表明环境 暴露会影响睡眠，需要对儿童进行客观评估的研究。我们的 研究团队在家庭环境监测和 同时评估儿童的健康结果。在拟议的项目中，我们的目标是 确定a）卧室环境暴露（空气质量，过敏原， 微生物）和巴尔的摩市哮喘儿童的睡眠质量2）卧室 环境暴露和上气道炎症/氧化应激3）睡眠质量和 巴尔的摩市哮喘儿童的哮喘发病率。这项全面研究 卧室环境和在非洲裔美国儿童中的卧室环境和睡眠有可能 提供基本的证据，表明需要睡眠不佳的环境驱动因素需要 设计干预措施以减少睡眠和哮喘健康差异。

项目成果

When It Rains It Pours: Inflammation Storms the Airways.

• DOI: 10.1513/annalsats.202302-178ed
• 发表时间: 2023-05
• 期刊: Annals of the American Thoracic Society
• 影响因子: 8.3