The Association of Unconventional Natural Gas Development with Adolescent Internalizing Disorders

非常规天然气开发与青少年内化障碍的关联

• 批准号: 10350572
• 负责人: Irena Gorski Steiner
• 金额: $ 4.85万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-15 至 2022-07-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10350572
• 关键词: Address; Adolescent; Adult; Adverse effects; Age; Air; Air Pollutants; Antidepressive Agents; Anxiety; Area; Birth; Categories; Chemicals; Child; Child Mental Health; Childhood; Code; Communication Research; Communities; Complex; County; Data; Development; Diagnosis; Disease; Electronic Health Record; Environmental Epidemiology; Environmental Exposure; Environmental Impact; Equation; Expenditure; Exposure to; Gases; General Population; Goals; Health; Health Policy; Health Services; Health system; Home; Human; ICD-9; Individual; Industry; Knowledge; Lead; Literature; Logistic Regressions; Medical Assistance; Mental Depression; Mental Health; Mentorship; Modeling; Modification; Moods; Natural Gas; Nested Case-Control Study; Noise; Outcome; Outpatients; Pathological anxiety; Pathway interactions; Patient Outcomes Assessments; Patients; Pennsylvania; Pharmaceutical Preparations; Phase; Policies; Population; Pregnancy; Production; Public Health; Quality of life; Questionnaires; Reporting; Research; Research Design; Risk; Sample Size; Screening procedure; Sleep; Specificity; Stress; Symptoms; Testing; Training; United States; Vulnerable Populations; analytical method; asthma exacerbation; care seeking; career; child depression; clinical care; depressive symptoms; disability; epidemiology study; evidence base; hazard; health care service; hydraulic fracturing; improved; infant outcome; psychosocial; residence; response; service organization; sex; time use

ABSTRACT Unconventional natural gas development (UNGD) has dramatically expanded since 2000 along with its chemical, physical, and psychosocial hazards as well as more general community impacts. While UNGD has been of public concern for over a decade, no study yet has evaluated the relationship between UNGD and mental health outcomes in adolescents, despite the recognition that children may be the most vulnerable population for the adverse effects of environmental exposures. Identifying factors associated with depression and anxiety is of high importance because these disorders can lead to disability, decrease quality of life, and require high expenditures for clinical care and public health. Prior research implicates two primary pathways from UNGD activity, air quality and stress, both of which can impact the mental health of children. My hypothesis is therefore that UNGD activity is contributing to increased odds of new onset internalizing disorders in adolescents. We propose to test this hypothesis using electronic health records (EHRs) from the Geisinger health system in Pennsylvania, conducting an epidemiologic study of the association between UNGD activity (assigned individually to patients using existing metrics which incorporate spatial and temporal information on UNGD by well phase, size, and gas production, and the patient’s residence), and new onset internalizing disorders, classifying our outcome using combinations of diagnosis codes and medication orders, in an adolescent population of approximately 35,000. For my sub-aims, analysis will be directed toward effect modification of this association, specifically by sex, receipt of Medical Assistance, prescription of antidepressants, and residential greenness. My second aim proposes to examine the association of UNGD activity with depressive symptoms among approximately 28,000 adolescents, using scores from Patient Health Questionnaires (PHQ-9). Using PHQ-9 data will enable us to evaluate a broader range of shorter-term depressive symptoms with higher sensitivity, while diagnoses and medication orders will identify more severe anxiety and depression disorders with higher specificity. In sub-aims, I will assess if the association strengthens when the UNGD activity metric is limited to specifically the drilling and hydraulic fracturing phases (because of higher reported truck traffic) and if it strengthens when limiting the symptoms evaluated to those regarding sleep and concentration. The proposed studies will be the first to investigate UNGD activity in relation to adolescent mental health. By utilizing EHR data with a large sample size in a region with extensive UNGD activity, these studies can advance the state of knowledge on potential health impacts of UNGD. Through a comprehensive training plan and close mentorship, the PI will receive training in the subject area of adolescent mental health, the use of analytic methods for environmental epidemiology, and the communication of research findings to policy stakeholders. Thus, this project will contribute to the PI’s long-term goal of a career in environmental epidemiologic research to inform evidence-based policies for health.

抽象的 自2000年以来，非常规天然气开发（UNGD）及其 化学，身体和社会心理危害以及更一般的社区影响。而UNGD拥有 十多年来一直在公众关注，尚无研究评估UNGD与 青少年的心理健康成果，认识到儿童可能是最脆弱的 对环境暴露的不利影响的种群。识别与抑郁有关的因素 动画非常重要，因为这些疾病会导致残疾，降低生活质量，以及 需要大量支出来临床护理和公共卫生。先前的研究暗示了两个主要途径 来自UNGD活动，空气质量和压力，这两者都会影响儿童的心理健康。我的 因此，假设UNGD活动有助于增加新发作内在化的几率 青少年的疾病。我们建议使用电子健康记录（EHR）从 宾夕法尼亚州的盖辛格卫生系统，对 UNGD活动（使用现有指标分别分配给患者，这些指标合并了空间和临时性 有关井相，尺寸和天然气生产以及患者的住所的信息）以及新的发病 内部化疾病，使用诊断代码和药物订单的组合对我们的结果进行分类， 在大约35,000的青少年人口中。对于我的子目标，分析将针对效果 修改该协会，特别是通过性别的收到的医疗援助，处方的处方 抗抑郁药和居民绿色。我的第二个目标是研究UNGD的关联 使用患者健康的分数，大约28,000名青少年的活动有抑郁症状 问卷（PHQ-9）。使用PHQ-9数据将使我们能够评估较短的较短期限 具有较高灵敏度的抑郁症状，而诊断和药物订单将确定更严重 具有更高特异性的焦虑和抑郁症。在Sub-aims中，我将评估协会是否 当UNGD活性度量限制为专门的钻孔和氢化断裂阶段时的优势 （由于报告的卡车流量较高），以及在将症状评估为那些时是否有优势 关注的睡眠和集中。拟议的研究将是第一个研究UNGD活性的研究 与青少年心理健康有关。通过使用具有广泛样本的EHR数据具有较大样本量的数据 UNGD活动，这些研究可以提高对UNGD潜在健康影响的知识状态。 通过全面的培训计划和仔细的心态，PI将在主题领域接受培训 青少年心理健康，用于环境流行病学的分析方法以及交流 政策利益相关者的研究结果。那，该项目将有助于PI的长期目标 环境流行病学研究的职业为循证健康政策提供信息。

项目成果

Geographic disparities in new onset of internalizing disorders in Pennsylvania adolescents using electronic health records.

• DOI: 10.1016/j.sste.2021.100439
• 发表时间: 2022-06
• 期刊: SPATIAL AND SPATIO-TEMPORAL EPIDEMIOLOGY
• 影响因子: 3.4
• 作者: Gorski-Steiner, Irena;O'Dell, Sean;Bandeen-Roche, Karen;Volk, Heather E.;Goes, Fernando S.;Schwartz, Brian S.
• 通讯作者: Schwartz, Brian S.

The association of unconventional natural gas development with diagnosis and treatment of internalizing disorders among adolescents in Pennsylvania using electronic health records.

• DOI: 10.1016/j.envres.2022.113167
• 发表时间: 2022-09
• 期刊: ENVIRONMENTAL RESEARCH
• 影响因子: 8.3
• 作者: Gorski-Steiner, Irena;Bandeen-Roche, Karen;Volk, Heather E.;O'Dell, Sean;Schwartz, Brian S.
• 通讯作者: Schwartz, Brian S.