Indoor and Outdoor NO2 and Asthma Severity in Children

室内和室外二氧化氮与儿童哮喘严重程度

• 批准号: 7629628
• 负责人: Brian P Leaderer
• 金额: $ 123.63万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-09-29 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7629628
• 关键词: 10 year old; Address; African American; Age; Air; Allergens; Allergic; Antibiotics; Antigens; Area; Asthma; Blood specimen; Breast Feeding; Calendar; Candidate Disease Gene; Canis familiaris; Censuses; Characteristics; Child; Connecticut; Control Animal; DNA; Data; Day Care; Dermatophagoides farinae antigen f 1; Dermatophagoides pteronyssinus antigen p 1; Dictyoptera; Dust; Education; Environment; Environmental Exposure; Environmental Tobacco Smoke; Epidemiologic Studies; Ethnic Origin; Exposure to; Family history of; Felis catus; Frequencies; Gases; Gender; Genes; Genotype; Guidelines; Hispanics; Home environment; Home visitation; House Call; House Dust; Household; Human; Hypersensitivity; IgE; Income; Infant; Infection; Information Systems; Interview; Length; Life; Literature; Low Birth Weight Infant; Measures; Molds; Monitor; Morbidity - disease rate; Mothers; Motor Vehicles; Nitrogen Dioxide; Perinatal; Pharmaceutical Preparations; Phase; Pollution; Population Study; Premature Birth; Prevalence; Puerto Rican; Questionnaires; Research; Research Personnel; Respiratory physiology; Risk; Risk Factors; Sampling; School-Age Population; Schools; Severities; Source; Spirometry; Symptoms; Telephone Interviews; Testing; Time; Treatment Protocols; United States; Vehicle Emissions; Visit; air contaminant; airborne allergen; allergen Bla g 1; cohort; density; design; effective intervention; elementary school; experience; follow-up; fungus; gene interaction; health care service utilization; infancy; mortality; novel; particle; pet animal; primary outcome; programs; prospective; pyroglyphid; residence; respiratory; trafficking

DESCRIPTION (provided by applicant): Exposure to aeroallergens and air contaminants is hypothesized to be a major factor in the exacerbation of asthma. Results of our ongoing studies suggest that nitrogen dioxide (NO2) associated indoors with gas appliance use and outdoors with motor vehicle emissions, at levels well below the EPA Air Quality Standard, may be associated with respiratory symptoms in children at risk for developing asthma and with the exacerbation of asthma in asthmatic children. Our data are also suggestive of an interaction between indoor aeroallergens and NO2 concentrations in enhancing respiratory symptoms in infants and asthmatic children. The potential impact is great since 57% of homes in the US use natural or LP gas, traffic volume is increasing and virtually all homes have significant dust allergen levels. We propose a prospective epidemiologic study of 1,533 children with active asthma (5 to 10 years of age), to test the hypothesis that carefully quantified NO2 concentrations associated with indoor sources and vehicle traffic on state and interstate roads are associated with asthma severity. In addition, we will determine if home levels of NO2, in the presence of common indoor dust allergens (Der p 1, Der f 1, Bla g 1, Pel d 1, Can f 1 and fungi), are associated with an increased risk of asthma severity in children sensitized to those allergens. The above hypotheses will be evaluated while adjusting for factors known or suspected to increase risk of more severe asthma, including household and school characteristics. The study population will be drawn from elementary schools in 16 Connecticut towns using a modified version of the ISAAC questionnaire to identify children with active asthma. Initial risk factors will be assessed in a home interview, and asthma severity (symptoms, frequency of ER visits, medication use, lung function.) will be assessed prospectively for one year using telephone interviews administered quarterly. At the home visit, dust samples will be collected for allergen and fungi determinations and blood samples collected for antigen specific IgE determinations. Indoor and outdoor NO2 levels will be obtained quarterly for each home. Global Information Systems in combination with road vehicle density data will be used to assess the impact of traffic on asthma severity and outdoor NO2 concentrations at the home. Household gas appliances and traffic-related pollution may represent important environmental exposures for asthmatic children, for which effective interventions can be developed to reduce asthma morbidity.

描述（由申请人提供）：假设暴露于空气过敏原和空气污染物是加剧哮喘的主要因素。我们正在进行的研究的结果表明，二氧化氮（NO2）在室内与气体设备的使用和室外相关的机动车排放室，远低于EPA空气质量标准的水平，可能与患哮喘患有风险的儿童呼吸道症状有关，并且患有哮喘患者的呼吸道症状，哮喘儿童患哮喘患者的呼吸道症状。我们的数据还表明，室内气溶胶与NO2浓度之间的相互作用在增强婴儿和哮喘儿童的呼吸道症状方面存在相互作用。潜在的影响很大，因为美国有57％的房屋使用天然或LP气体，交通量正在增加，几乎所有房屋都具有明显的灰尘过敏原水平。我们建议对1,533名活跃哮喘儿童（5至10岁）进行一项前瞻性流行病学研究，以检验以下假设：仔细量化了与州和州际道路上室内和车辆交通相关的NO2浓度与哮喘严重程度相关。此外，我们将确定在存在常见的室内灰尘过敏原的情况下，NO2的家用水平是否与对这些过敏原的儿童哮喘严重程度的风险增加有关。在调整已知或怀疑的因素时，将评估上述假设，以增加更严重的哮喘风险，包括家庭和学校特征。该研究人群将使用以撒问卷的修改版本从16个康涅狄格州城镇的小学中吸引，以识别患有活跃哮喘的儿童。最初的危险因素将在家庭面试中评估，哮喘严重程度（症状，急诊就诊频率，使用药物，肺功能。）将使用每季度进行的电话采访进行一年的前瞻性评估。在家庭访问中，将收集灰尘样品，以进行过敏原和真菌的测定以及收集的血液样本，以确定抗原特定的IgE。每个房屋每季度将获得室内和室外NO2水平。全球信息系统与道路车辆密度数据结合使用，以评估交通对哮喘严重程度和室外NO2浓度的影响。家用气体用具和与交通相关的污染可能代表哮喘儿童的重要环境暴露，可以为此开发有效的干预措施以降低哮喘发病率。