Indoor woodsmoke PM and asthma: a randomized trial

室内木烟 PM 与哮喘：一项随机试验

• 批准号: 8016051
• 负责人: Curtis William Noonan
• 金额: $ 33.93万
• 依托单位: UNIVERSITY OF MONTANA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-01 至 2013-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8016051
• 关键词: Address; Air; Area; Asthma; Biological Markers; Biomass; Burn injury; Chemicals; Child; Communities; Data; Developing Countries; Devices; Environment; Exhalation; Forced expiratory volume function; Frequencies; Health; Heating; Home environment; Household; Idaho; Indian reservation; Indoor Air Pollution; Indoor Air Quality; Intervention; Intervention Trial; Life; Link; Measures; Montana; Nitric Oxide; Outcome; Outcome Measure; Particulate; Particulate Matter; Peak Expiratory Flow; Pharmaceutical Preparations; Placebo Control; Placebos; Population; Public Health; Pulmonary Function Test/Forced Expiratory Volume 1; Quality of life; Randomized; Randomized Controlled Trials; Rural; Rural Community; Smoke; Source; Symptoms; Testing; Urine; Wood material; abietic acid; air filtration; arm; clinically relevant; clinically significant; cooking; health care service utilization; improved; levoglucosan; post intervention; randomized trial; respiratory; smoking intervention; urban area

DESCRIPTION (provided by applicant): Although particulate matter (PM) exposures have been linked with poor respiratory health outcomes, most of these studies have focused on air sheds with urban and industrial sources of PM2.5. Wood smoke-derived PM also contributes to ambient PM in these urban areas, and is the major source of PM in many US rural or peri-urban areas, as well as in many communities within developing countries. This study will focus on indoor air quality and clinically relevant changes in health effects among asthmatics living in homes whose primary heating sources are non EPA-certified woodstoves. The Primary Aim of this study is to assess the efficacy of residential interventions to reduce indoor PM exposure from woodstoves and the corresponding improvements in quality of life and health outcomes for asthmatic children. The study area for this project will be three rural communities in Idaho and western Montana, including one Indian Reservation. This study will use a three arm (Tx1, Tx2, and Tx3) randomized placebo-controlled intervention trial. The interventions will be at the household level, and exposure and outcomes will be assessed for one asthmatic child in each household. Households in Tx1 will receive inactive high efficiency particulate air (HEPA) devices and will serve as the placebo group. Households in Tx2 will receive a new EPA-certified woodstove, while households in Tx3 will receive active HEPA devices. The Secondary Aims of this study are to assess the impact of these interventions on residential PM2.5 exposures and other health outcomes. Secondary exposure outcomes measured prior to and following the intervention will include PM2.5 mass, chemical wood smoke markers on PM2.5 filters (including levoglucosan and abietic acids), and biomarkers of wood smoke exposure in urine and exhaled breath condensate. Secondary asthma-related health outcomes measured prior to and following the intervention will include peak expiratory flow (PEF) and forced expiratory volume in first second (FEV1), biomarkers in exhaled breath condensate (i.e., pH and nitric oxide), and frequency of asthma symptoms, medication usage, and healthcare utilization. To our knowledge, this will be the first randomized trial in the US to utilize a wood smoke intervention to assess the impact of the consequent reductions in indoor PM on health outcomes in a susceptible population. The results from this project will be translatable to other regions in the US and the world where biomass burning is commonly used for heating and cooking. Relevance: This study will determine if reductions in PM2.5 from residential woodstoves, a common source of indoor air pollution, will result in health improvements among asthmatic children. Clinically significant health outcomes will be measured. Results from this study will provide important information for implementing public health strategies for asthma management in the presence of this common exposure.

描述（由申请人提供）：尽管颗粒物（PM）的暴露与呼吸健康状况不佳有关，但这些研究中的大多数都集中在PM2.5的城市和工业来源的空气棚上。伍德烟雾衍生的PM在这些城市地区也有助于环境PM，并且是许多美国农村或郊区地区以及发展中国家的许多社区的主要PM来源。这项研究将着重于室内空气质量和临床相关的健康效应变化，这些哮喘患者生活在主要的供暖源是非EPA认证的木窝的家庭中。这项研究的主要目的是评估住宅干预措施的疗效，以减少室内PM暴露于木stoves中，以及相应的哮喘儿童生活质量和健康成果的改善。该项目的研究区域将是爱达荷州和蒙大拿州西部的三个农村社区，其中包括一个印度保留地。这项研究将使用三臂（TX1，TX2和TX3）随机安慰剂对照的干预试验。干预措施将在家庭一级，每个家庭中的一个哮喘儿童的暴露和结果将进行评估。 TX1中的家庭将接收不活动的高效率颗粒空气（HEPA）设备，并将作为安慰剂组。 TX2中的家庭将获得新的EPA认证的木炉，而TX3中的家庭将获得活跃的HEPA设备。这项研究的次要目的是评估这些干预措施对住宅PM2.5暴露和其他健康结果的影响。在干预之前和之后测得的次要暴露结果包括PM2.5质量，PM2.5过滤器上的化学木烟标记（包括左旋葡聚糖和阿贝酸），以及尿液中木烟的生物标志物以及尿液中的烟气和呼气呼吸凝结物。在干预之前和之后测得的与哮喘相关的健康结果将包括第一秒（FEV1）中的峰值呼气流量（PEF）和强迫呼气量，呼出的呼吸凝结物中的生物标志物（即pH和一氧化氮），以及ASTHAMA症状，药物，药物，药物使用，以及医疗保健的频率。据我们所知，这将是美国首次利用木烟干预措施来评估随之而来的室内PM减少对易感人群健康结果的影响。该项目的结果将可以转换为美国和世界上通常用于供暖和烹饪的世界的其他地区。相关性：这项研究将确定室内空气污染的常见来源的PM2.5降低是否会导致哮喘儿童的健康改善。将测量临床上重要的健康结果。这项研究的结果将为在这种共同暴露的情况下为哮喘管理实施公共卫生策略提供重要信息。