Complex WTC Exposures Impacting Persistent Large and Small Airflow Limitation and Vulnerable Subgroups in the WTC Survivor Population

复杂的世贸中心暴露影响了世贸中心幸存者群体中持续的大、小气流限制和弱势群体

• 批准号: 10749125
• 负责人: Mengling Liu
• 金额: $ 49.91万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10749125
• 关键词: Complex; WTC; Exposures; Impacting; Persistent

Project Abstract Today, more than 20 years after the 9/11 terrorist attacks, many exposed community members continue to have persistent lower airway symptoms with functional abnormalities in large and/or small airways as indicated by spirometry measures of airflow and/or oscillometry measures of airway heterogeneity. Prior studies and knowledges have been focused on the health effects of World Trade Center (WTC) exposures on the average lung function profiles or discrete lung function patterns, however, systematic investigations on the severe spectrum of the disease are limited. Post-bronchodilator (BD) measurements may identify persistent lung injury as residual airflow limitation with significant morbidity and reduced quality of life, and thus are important and clinically relevant parameters to investigate. Moreover, it is of key public health importance to study the heterogeneous health impacts of the disaster and disparities in healthcare and wellbeing within subgroups. In this project, we propose to address the important scientific questions related to respiratory disease in WTC Survivor population and within vulnerable subgroups, through the following aims: Aim 1: Evaluate the extreme quantiles of cross-sectional measurements of post-BD airway function, including large and small airway metrics, and their association with WTC exposures and comorbidities. Aim 2: Conduct longitudinal quantile analysis to investigate WTC exposures and other risk factors as determinants of the trajectory of extreme quantiles of post-BD large and small airway metrics. Aim 3: Identify and evaluate vulnerable subgroups who show heterogeneous susceptibilities to WTC exposures. Upon its completion, the proposed project will expand our knowledge about health effects on severe respiratory diseases related to the 9/11 terrorist attacks, help to answer complex interplays of physical and mental health comorbidities, and apply lessons to the management of disaster events.

项目摘要 今天，9/11 恐怖袭击发生 20 多年后，许多暴露在外的社区成员仍在继续 具有持续的下呼吸道症状，并伴有大和/或小气道功能异常（如所示） 通过气流测定法测量气流和/或气道异质性的示波测量法。之前的研究和 知识重点关注世界贸易中心 (WTC) 暴露对健康的平均影响 肺功能概况或离散肺功能模式，然而，对严重的系统研究 该疾病的谱系有限。支气管扩张剂后 (BD) 测量可识别持续性肺损伤 残余气流受限会导致严重的发病率和生活质量下降，因此非常重要且重要 临床相关参数进行研究。此外，研究对公共卫生具有重要意义 灾难对健康的影响不同，亚组内的医疗保健和福祉存在差异。在 在这个项目中，我们建议解决世贸中心与呼吸系统疾病相关的重要科学问题 幸存者群体和弱势亚群体，通过以下目标： 目标 1：评估 BD 后气道功能横截面测量的极端分位数，包括大和小 气道指标及其与 WTC 暴露和合并症的关联。目标2：纵向开展 分位数分析来调查 WTC 暴露和其他风险因素作为轨迹的决定因素 BD 后大小气道指标的极端分位数。目标 3：识别和评估脆弱性 对世贸中心暴露表现出不同敏感性的亚组。完成后，拟议的 该项目将扩大我们对与 9/11 相关的严重呼吸道疾病的健康影响的了解 恐怖袭击，帮助解决身心健康合并症的复杂相互作用，并应用 灾害事件管理的经验教训。