Asthma is the leading chronic pediatric disease in the U.S., disproportionately affecting African American children. Because asthma has no cure, identifying triggers is critical for disease management and control. Emerging evidence, including our preliminary data, suggests that some of the most commonly used antimicrobial agents in personal care products (PCPs), parabens and triclosan, may be asthma triggers and contribute to increased asthma morbidity. Still, studies relating exposure to antimicrobial agents in PCPs with asthma morbidity are scarce and no studies have assessed this risk among highly vulnerable populations experiencing both high morbidity and high exposure to antimicrobial agents. These potential associations are particularly relevant to African American (AA) children as they have biomarker concentrations for select antimicrobial agents that are nearly 8 times higher than White children, they are twice as likely to have asthma, and are 10 times more likely to die of asthma complications than their non-AA peers. By leveraging infrastructure and two Johns Hopkins pediatric cohort studies the proposed research will be the first to: (1) examine the effects of parabens and triclosan on asthma morbidity among AA children with asthma using longitudinal data; (2) apply qualitative research methods to develop a culturally-tailored PCP survey to identify use patterns associated with exposures to these compounds; and (3) conduct a pilot intervention with antimicrobial-free PCPs to inform future intervention research. Results from this work have the potential to lead to effective public health strategies to improve asthma-related outcomes for children with asthma. This project is also in line with NHLBI?s research agenda to solve problems related to pulmonary diseases in populations suffering disproportionately from these conditions. Dr. Quiros-Alcala is an environmental health scientist by training, and this career development award will provide her with an exceptional training platform to acquire new complementary skills crucial to achieve independence, including in pediatric respiratory disease, qualitative research methods, structural equation modeling, and intervention design and implementation. Expertise in these areas will be acquired under the guidance of an interdisciplinary mentoring team of content area experts from the candidate?s home institution, the University of Maryland, and the Johns Hopkins School of Medicine and Bloomberg School of Public Health. The career development plan entails a structured approach to mentoring, didactic coursework, field and clinic experience, participation in scientific meetings, and regular assessment of career milestones. The strong mentoring team and institutional environments will ensure the successful completion of all training and research activities during the award period. In summary, this award will provide the candidate with protected time to acquire the necessary skills and experience to become an independent researcher, positioning her at the dynamic intersection of environmental health and epidemiology, from which she intends to design targeted interventions to improve children?s respiratory health.

Public Health Relevance

Asthma is the leading chronic pediatric disease in the United States, affecting 6.3 million children, and disproportionately affecting African American children. Our study will be the first to test the central hypothesis that exposure to antimicrobial agents in personal care products (e.g., shampoo, lotions), parabens and triclosan, increases the risk of asthma morbidity among African American children, a vulnerable population experiencing high morbidity and high exposure to select antimicrobial agents. The proposed work has the potential to inform future research, and the development of effective public health interventions to improve the quality of life among those suffering from asthma.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Scientist Development Award - Research & Training (K01)
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Special Emphasis Panel (ZHL1)
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Lu, Qing
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Johns Hopkins University
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Levy, Jonathan I; Quirós-Alcalá, Lesliam; Fabian, M Patricia et al. (2018) Established and Emerging Environmental Contributors to Disparities in Asthma and Chronic Obstructive Pulmonary Disease. Curr Epidemiol Rep 5:114-124
Buckley, Jessie P; Quirós-Alcalá, Lesliam; Teitelbaum, Susan L et al. (2018) Associations of prenatal environmental phenol and phthalate biomarkers with respiratory and allergic diseases among children aged 6 and 7?years. Environ Int 115:79-88
Quirós-Alcalá, Lesliam; Buckley, Jessie P; Boyle, Meleah (2018) Parabens and measures of adiposity among adults and children from the U.S. general population: NHANES 2007-2014. Int J Hyg Environ Health 221:652-660