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Title: Leveraging Time-Activity Data to Improve Exposure Estimation and Lung Health Interventions in Environmental Justice Communities
Abstract: Children living in communities on the fenceline of petrochemical and other industrial facilities reside in locations where concentrations of air pollutants are frequently elevated compared to the general population. How and where these children spend time, as compared to children in the general population, may further contribute to children’s inhaled doses of air pollutants. Our project aims to collect primary evidence to demonstrate that exposure estimates relying solely on air pollutant concentrations may mischaracterize true inhaled air pollutant doses by ignoring critical differences in how and where people spend time. We aim to collect and use high-resolution time-activity pattern data for children in a fenceline community to develop quantitative adjustment factors for air pollutant exposure estimation. We will administer time-activity surveys to caregivers of children <6 years in a fenceline community on one weekday and one weekend for three seasons. We will compare distributions of time-activity patterns for children in a fenceline community to two other communities and US EPA’s initial National Human Activity Pattern Survey. We will generate age-adjusted average daily inhaled air volumes and quantitative adjustment factors for fenceline communities for use in future risk assessments of children’s exposure to air pollution. Knowledge gained from this study will be communicated to community members with recommendations for low-no cost behavioral modifications to reduce exposure. We will work with regulatory colleagues to integrate the approach demonstrated in this pilot into agency guidance to advance the practice of exposure and cumulative risk assessment to improve and protect children’s environmental health.
Email: slupolt1@jhu.edu
Title: Assessing the social network structure of high-risk pregnant patients: A novel research method in Obstetrics
Abstract: Prenatal environmental exposures play a significant role in the development of child respiratory diseases such as asthma. The strength of social networks in the mother, assessed by mapping her immediate connections to others, represents a critical component of the early life exposome. Similar to other non-chemical environmental exposures such as maternal psychosocial stress, social networks may alter fetal programming to increase risks of child respiratory disease. While social networks have been demonstrated to influence other disease outcomes such as obesity and stroke among adults, the contribution of maternal social networks to the development of childhood respiratory disease is unknown. This study hypothesizes that a weak maternal social network may enhance fetal vulnerability and increase the risk of poor neonatal outcomes predisposing towards child asthma. This application proposes a pilot study of 15 women recruited from an ethnically diverse, NYC cohort of pregnant mothers with active asthma, in which relationships between indoor air pollution and dietary exposures and maternal-fetal health are currently under investigation. Features of the pregnant mother’s social network, such as the size and density, will be quantitatively characterized at one time point in gestation. Associations between these characteristics and birth outcomes on the pathway to asthma, including low birth weight and prematurity, will be explored. This work represents a critical opportunity to identify novel environmental factors that influence the risk of respiratory disease among children. Study results will directly inform a subsequent larger study of the longer-term impact of early-life social exposures on child asthma.
Email: rachel.meislin@mssm.edu
Title: Contribution of Metal Exposures to Chronic Lung Risks from Use of Electronic Cigarettes
Abstract: The goal of this research is to understand the contribution of heavy metals inhaled at a young age to long term health outcomes. We will use questionnaire data to assess e-cigarette use, and will analyze metals in urine, blood, and aerosol from user e-cig devices. Enhancing our understanding of excess risk from vaping will inform policy makers on the risks of using e-cigarettes over a lifetime, which can direct public health guidance on youth nicotine use. Heavy metals such as Cr and Ni have been found in e-cigarette aerosols and elevated in user’s blood/urine, but it is unknown how low-level inhalation of metals with exposure patterns like e-cigarettes will affect long-term risk of lung outcomes. Although links between respiratory health effects and metal exposures from ambient air and occupation have already been found, a risk assessment quantitating the excess hazard of exposure to metals from behaviors such as e-cigarette use, has not been done. Our hypothesis is that heavy metal exposure from e-cigarette use will be associated with increased body burden (metals in blood) leading to increased risk of respiratory effects.
Email: atiller2@jh.edu
Title: A One-Two Punch: Providing a greenspace at a local youth boxing gym
Abstract: Boxing is a demanding and rewarding sport for its participants. It necessitates commitment that incorporates physical activity, nutrition, and mental health. Mental health is critical, as the well-being of a boxer plays a role in a participant’s ability to focus in the ring and benefit from the sport. Through our collaboration with the Lung Health Ambassador Program of the BREATHE Center, we have been introduced to education on climate factors that impact our neighborhood and boxing organization. Therefore, we propose an environmental focus at our gym, tailored to a youth boxing community, that allows for the acquisition of a greenhouse, whereby the gym participants benefit from an accessible green space, providing opportunities for community gatherings and meetings.
Title: Development of a Biomarker of Early Toxicity from Electronic Cigarette Metal Exposure
Abstract: Electronic cigarettes (e-cigs) are currently the most used tobacco product among youth (<18 years old) with 2.06 million reporting use.1 Health effects concerning e-cig use are expected to be from chronic long-term exposure2; however, current knowledge on long-term e-cig health effects is limited.
Metals such as lead (Pb), chromium (Cr), and nickel (Ni) can be found in e-cig aerosols and blood samples collected from users in concentrations that correlate with the frequency of use. Exposure to Pb, Ni, and Cr has been associated with immune dysfunction and respiratory illnesses. Based on this knowledge, we hypothesize that inhaled metals in e-cig aerosols are transported across the lung epithelial barrier and are taken up differentially by cells in the blood.
Analyzing metal accumulation in single cells is a powerful tool for early disease detection. For example, accumulation of Cu in hepatocytes has been shown as an early indicator of Wilsons’s disease, indicating that single-cell analysis can detect early changes before a biomarker of clinical disease.10 Based on this we also hypothesize that single-cell analysis of metals in peripheral blood monocular cells (PBMCs) can serve as biomarkers of early immune dysfunction.
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Title: The Lung Health Ambassador Program (LHAP): A Health Equity Initiative for Cystic Fibrosis
Abstract: The Lung Health Ambassador Program (LHAP) is a program that will focus on improving the science literacy of school-aged youth and promote the young to engage in an understanding of healthcare-related fields and the importance of equity within medicine. Specifically, this program will utilize hands-on teachings on pulmonary-related studies such as understanding basic lung anatomy physiology, negative effects of toxic lung inhalations (i.e. tobacco, electronic cigarette usage, and marijuana), and health disparities in lung conditions such as asthma.
In regards to lung diseases, there will be a strong emphasis on cystic fibrosis since studies have shown that minorities are also very suspectable to this genetic disease and it has been challenging to manage in these populations due to disparities and implicit biases. The program will be designed on a curriculum that will be four 1-hour sessions over the course of an academic school year with elementary and middle school students. We will target four high schools in Baltimore City Maryland. Our program will fuel the interest and excitement for careers in healthcare. Additionally, and more importantly, we hope to help provide knowledge and critical thinking skills to explore the basic sciences of the respiratory system and students to understand health disparities and the necessity for exploring various factors within health equity.
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Title: A pilot study to determine the utility of silicone wristbands to assess novel chemical exposures in pediatric asthma studies
Abstract: Phthalates and newer highly understudied phthalate replacements are high production volume plasticizers widely used in consumer products. Their pervasive use has led to widespread exposure in children and racial/ethnic exposure disparities are reported. Many of these chemicals are also hormone disruptors and animal data show they may increase allergic immune response, contribute to airway remodeling, and induce asthma. Altogether this data supports investigating the role that these chemicals may play on excess asthma morbidity among pediatric populations suffering a disparate asthma burden and experiencing elevated exposures. There is also a need to identify non-invasive novel personal exposure samplers to reliably assess environmental exposures of concern in large pediatric studies. This pilot study seeks to leverage the robust infrastructure in two ongoing racially/ethnically diverse studies to execute the following aims: (1) to characterize exposure to plasticizers (phthalates and newer replacements) in 40 children and assess the suitability of silicone wristbands as a novel, non-invasive exposure matrix for plasticizers in pediatric environmental health studies as compared to respective gold standard biomarkers in children’s urine, and (2) to examine associations between exposure to plasticizers as measured in wristbands and urinary biomarkers and pediatric asthma morbidity measures. The data generated from this pilot study will be among the first exposure data for Latinx and Black children with asthma and allow for preliminary examination of the potential role of these exposures in asthma disparities.
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The BREATHE Children Center is supported by the National Institute of Environmental Health Sciences (NIEHS) of the National Institutes of Health under award number P2CES033415.