ALLERGENS IN INNER-CITY SCHOOLS AND CHILDHOOD ASTHMA

内城区学校的过敏原和儿童哮喘

• 批准号: 7803652
• 负责人: WANDA PHIPATANAKUL
• 金额: $ 83.85万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 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 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7803652
• 关键词: Administrator; Affect; Age; Allergens; American; Americas; Area; Asthma; Boston; Canis familiaris; Child; Childhood; Childhood Asthma; Chronic Disease; Collaborations; Cross-Sectional Studies; Development; Dictyoptera; Disease; Environment; Environmental Epidemiology; Epidemiology; Europe; Evaluation; Exposure to; Extrinsic asthma; Felis catus; Future; Goals; Gold; Government; Health; Health Policy; Home environment; Hospitalization; Hospitals; Hour; Hypersensitivity skin testing; Interdisciplinary Study; Intervention; Irritants; Laboratories; Link; Longitudinal Studies; Massachusetts; Measures; Medical; Molds; Morbidity - disease rate; Mus; Parents; Pediatric Hospitals; Physicians; Prevalence; Prevention; Public Health; Public Health Schools; Recruitment Activity; Relative (related person); Research; Research Design; Risk; Risk Factors; Role; School-Age Population; Schools; Source; System; Testing; Time; United States; Universities; Visit; Wheezing; Woman; base; cohort; elementary school; fungus; inner city; policy implication; public health relevance; statistics

DESCRIPTION (provided by applicant): Allergic asthma is the most common chronic disease of childhood in the United States. Asthma is also the number one cause of school absences in America. The role of indoor allergen exposure in homes and asthma development and morbidity has been extensively studied. Because children spend a significant amount of time in school, the school classroom environment may be as significant a source of allergen exposure and consequent asthma morbidity as allergen exposure in the home. However, little is known about the role of allergen exposure in schools and asthma morbidity. We hypothesize that exposure to common indoor allergens in the classroom will increase the risk of asthma morbidity in inner-city children with asthma, even after controlling for home allergen exposures. In a longitudinal study of 600 elementary school-aged children with asthma from multiple classrooms in 25 Boston inner-city schools, we will examine the following specific aims: 1) to test whether elevated levels of allergens in the classroom increase the risk of asthma morbidity, even after controlling for allergen exposure in the home; and 2) to test whether the risk of increased asthma morbidity in relation to elevated classroom levels of a specific allergen will be highest for those specifically sensitized to that allergen. An understanding of exposure risk factors specific to the school classroom is critical, because the school classroom environment could potentially be considered as an effective target for prevention of inner-city asthma morbidity by reducing exposures to many symptomatic children through school- based interventions. While the potential importance of the classroom environment to the health of asthmatic children has been recognized nationally, study of this area has lacking. This unique application will build on significant collaborations between the Channing Laboratory at the Brigham and Women's Hospital, Children's Hospital Boston, the Harvard School of Public Health, the University of Massachusetts Amherst, and the Boston Public School System. Our multidisciplinary research group has significant expertise in asthma epidemiology and environmental epidemiology (Drs. Phipatanakul and Gold), environmental assessment (Drs. Phipatanakul, Gold, Muilenberg, and Rogers), and statistics (Drs. Ryan, Hoffman, and Sankaranarayanan [Subramanian]). In addition to its public health relevance, this proposal will recruit a unique school pediatric cohort that will facilitate future hypothesis testing. PUBLIC HEALTH RELEVANCE: Asthma is a disease that affects more than 12% of Americans under the age of 18 for over 14 million missed school days per year, and is the number one cause of school absences in America. Elementary school children spend 6 to 10 hours a day in school, and most of that time is spent in one classroom. The goals of this project are to provide an understanding of exposure risk factors specific to the classroom. This is critical, because the classroom environment could potentially be considered as an effective target for prevention of inner-city asthma morbidity by reducing exposures to many symptomatic children through an intervention in the school classrooms.

描述（由申请人提供）：过敏性哮喘是美国儿童最常见的慢性疾病。哮喘也是美国缺课的第一大原因。室内过敏原暴露在家庭中的作用以及哮喘的发展和发病已得到广泛研究。由于儿童在学校度过大量时间，因此学校教室环境可能与家庭中的过敏原暴露一样，是过敏原暴露和随之而来的哮喘发病率的重要来源。然而，人们对过敏原暴露在学校和哮喘发病中的作用知之甚少。我们假设，即使在控制了家庭过敏原暴露之后，在教室中接触常见的室内过敏原也会增加患有哮喘的内城区儿童的哮喘发病风险。在一项对波士顿市中心 25 所学校多个教室的 600 名患有哮喘的小学生进行的纵向研究中，我们将研究以下具体目标：1) 测试教室中过敏原水平升高是否会增加哮喘发病风险，即使在控制了家中的过敏原暴露之后； 2) 测试对于那些对该过敏原特别敏感的人来说，与教室中特定过敏原水平升高相关的哮喘发病率增加的风险是否最高。了解学校教室特有的暴露风险因素至关重要，因为通过基于学校的干预措施减少许多有症状儿童的暴露，学校教室环境可能被视为预防市中心哮喘发病的有效目标。虽然课堂环境对哮喘儿童健康的潜在重要性已在全国范围内得到认可，但该领域的研究仍然缺乏。这一独特的应用程序将建立在布莱根妇女医院查宁实验室、波士顿儿童医院、哈佛大学公共卫生学院、马萨诸塞大学阿默斯特分校和波士顿公立学校系统之间的重要合作基础上。我们的多学科研究小组在哮喘流行病学和环境流行病学（Phipatanakul 博士和 Gold 博士）、环境评估（Phipatanakul 博士、Gold、Muilenberg 和 Rogers 博士）和统计学（Ryan、Hoffman 博士和 Sankaranarayanan [Subramanian] 博士）方面拥有丰富的专业知识。 ）。除了与公共卫生相关之外，该提案还将招募一个独特的学校儿科队列，以促进未来的假设检验。公共卫生相关性：哮喘是一种疾病，影响超过 12% 的 18 岁以下美国人，每年缺课超过 1400 万天，是美国缺课的首要原因。小学生每天在学校的时间为 6 至 10 个小时，其中大部分时间是在一间教室里度过的。该项目的目标是让人们了解课堂特定的暴露风险因素。这一点至关重要，因为通过对学校教室进行干预，减少许多有症状儿童的接触，教室环境可能被视为预防市中心哮喘发病的有效目标。