Asthma currently affects nearly 22 million adults and children in the U.S., and results in direct and indirect costs exceeding $18 billion/year. (CDC, 2012, AAFA, 2012) Disparities in asthma prevalence and morbidity across economic and racial lines are striking, with prevalence rates exceeding 25% in some low-income urban areas. (Nicholas et al., 2005) The need for improvements in healthcare and for interventions which mitigate environmental exposures within these communities are significant. In order to examine the potential for "green" improvements to the home environment to reduce exposures to chemicals and other asthma triggers within the home, the Centers for Disease Control and Prevention (CDC) initiated the Green Housing Study (GHS). As stated in the RFP, the specific aims of the GHS are as follows:
Specific Aim 1 To conduct an exposure assessment of chemical and biological contaminants, pesticides, volatile organic compounds (VOCs), fungi, indoor allergens (in terms of variety and concentration) in green vs. comparison housing. a. Measure interior levels of pesticides in surface wipe samples;fungi and indoor allergens in dust samples;and VOCs in air samples. b. Compare levels of biomarkers of VOCs and pesticides (in terms of variety and concentration) from the participating residents of green and comparison housing.
Specific Aim 2 To examine the relationship between living in green vs. comparison housing and asthma morbidity (e.g., symptoms, emergency department visits, use of medications, lost school/work days) of children with doctor-diagnosed asthma (ages 7-12 years). Adjustments for allergic sensitization and environmental tobacco smoke (ETS) will be made. In 2011, two study sites were established: Boston and Cincinnati. Fieldwork began in the summer of 2011 and baseline assessments are being conduction currently. The requested funding will provide support for follow-up measurements of exposures and respiratory health outcomes of children who are enrolled in GHS. Our project team is a collaboration that builds upon the significant expertise and resources of colleagues from the Harvard School of Public Health (HSPH), Tufts School of Medicine, the Boston Medical Center and the University of Massachusetts, Lowell. To date, our team has developed significant expertise in all field procedures and has successfully implemented all categories of principal study activities. We propose to complete all 6- and 12-month follow-up fieldwork by June 2013.
Residential exposures to allergens and pollutants contribute to asthma morbidity. Green building and renovation methods provide opportunities to reduce these exposures and thus, improve health. This project provides follow-up measurements for a CDC-led study of the effects of green renovations on environmental exposures and health for children diagnosed with asthma living in low-income communities.