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: 10066618
• 负责人: Irena Gorski Steiner
• 金额: $ 4.55万
• 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/10066618
• 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; Fracture; Gases; General Population; Goals; Health; Health Policy; Health Services; Health system; Home environment; 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; 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）随着其规模的扩大而急剧扩大。 UNGD 具有化学、物理和社会心理危害以及更广泛的社区影响。 十多年来一直受到公众关注，但尚未有研究评估 UNGD 与 尽管人们认识到儿童可能是最脆弱的群体，但青少年的心理健康结果 识别与抑郁症相关的因素。 焦虑非常重要，因为这些疾病可能导致残疾、降低生活质量， 需要高额的临床护理和公共卫生支出。 先前的研究表明有两个主要途径。 UNGD 活动、空气质量和压力，这两者都会影响儿童的心理健康。 因此，假设 UNGD 活动有助于增加新发内化的可能性 我们建议使用电子健康记录（EHR）来检验这一假设。 宾夕法尼亚州的盖辛格卫生系统对两者之间的关联进行了流行病学研究 UNGD 活动（使用包含空间和时间的现有指标单独分配给患者） 有关 UNGD 的信息（按井期、大小、产气量以及患者居住地）以及新发病情况 内化疾病，使用诊断代码和用药顺序的组合对我们的结果进行分类， 对于我的子目标，分析将针对效果。 该关联的修改，特别是通过性别、医疗​​援助的接受情况、处方 我的第二个目标建议是审查 UNGD 协会。 使用 Patient Health 的评分，对约 28,000 名青少年的抑郁症状活动进行了调查 问卷 (PHQ-9) 使用 PHQ-9 数据将使我们能够评估更广泛的短期问题。 抑郁症状具有更高的敏感性，而诊断和药物处方将识别出更严重的症状 在子目标中，我将评估具有更高特异性的焦虑和抑郁症是否存在关联。 当 UNGD 活动指标仅限于钻井和水力压裂阶段时，该指标会增强 （因为报告的卡车流量较高）以及当将评估的症状限制为那些时是否会加强 拟议的研究将是第一个调查 UNGD 活动的研究。 通过利用广泛地区的大样本 EHR 数据。 UNGD 活动中，这些研究可以提高对 UNGD 潜在健康影响的认识。 通过全面的培训计划和密切的指导，PI 将接受以下主题领域的培训： 青少年心理健康、环境流行病学分析方法的使用以及沟通 因此，该项目将为 PI 的长期目标做出贡献。 从事环境流行病学研究，为循证健康政策提供信息。