Exposure to aeroallergens and air contaminants is hypothesized to be a major factor in the exacerbation of asthma. Results of our ongoing studies suggest that nitrogen dioxide (NO2) associated indoors with gas appliance use and outdoors with motor vehicle emissions, at levels well below the EPA Air Quality Standard, may be associated with respiratory symptoms in children at risk for developing asthma and with the exacerbation of asthma in asthmatic children. Our data are also suggestive of an interaction between indoor aeroallergens and NO2 concentrations in enhancing respiratory symptoms in infants and asthmatic children. The potential impact is great since 57% of homes in the US use natural or LP gas, traffic volume is increasing and virtually all homes have significant dust allergen levels. We propose a prospective epidemiologic study of 1,533 children with active asthma (5 to 10 years of age), to test the hypothesis that carefully quantified NO2 concentrations associated with indoor sources and vehicle traffic on state and interstate roads are associated with asthma severity. In addition, we will determine if home levels of NO2, in the presence of common indoor dust allergens (Der p 1, Der f 1, Bla g 1, Pel d 1, Can f 1 and fungi), are associated with an increased risk of asthma severity in children sensitized to those allergens. The above hypotheses will be evaluated while adjusting for factors known or suspected to increase risk of more severe asthma, including household and school characteristics. The study population will be drawn from elementary schools in 16 Connecticut towns using a modified version of the ISAAC questionnaire to identify children with active asthma. Initial risk factors will be assessed in a home interview, and asthma severity (symptoms, frequency of ER visits, medication use, lung function.) will be assessed prospectively for one year using telephone interviews administered quarterly. At the home visit, dust samples will be collected for allergen and fungi determinations and blood samples collected for antigen specific IgE determinations. Indoor and outdoor NO2 levels will be obtained quarterly for each home. Global Information Systems in combination with road vehicle density data will be used to assess the impact of traffic on asthma severity and outdoor NO2 concentrations at the home. Household gas appliances and traffic-related pollution may represent important environmental exposures for asthmatic children, for which effective interventions can be developed to reduce asthma morbidity.

National Institute of Health (NIH)
National Institute of Environmental Health Sciences (NIEHS)
Research Project (R01)
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Epidemiology of Clinical Disorders and Aging Study Section (ECDA)
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Gray, Kimberly A
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Yale University
Public Health & Prev Medicine
Schools of Medicine
New Haven
United States
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Dannemiller, Karen C; Gent, Janneane F; Leaderer, Brian P et al. (2016) Indoor microbial communities: Influence on asthma severity in atopic and nonatopic children. J Allergy Clin Immunol 138:76-83.e1
Dannemiller, K C; Gent, J F; Leaderer, B P et al. (2016) Influence of housing characteristics on bacterial and fungal communities in homes of asthmatic children. Indoor Air 26:179-92
Belanger, Kathleen; Holford, Theodore R; Gent, Janneane F et al. (2013) Household levels of nitrogen dioxide and pediatric asthma severity. Epidemiology 24:320-30
Zhang, Lixun; Guan, Yongtao; Leaderer, Brian P et al. (2013) ESTIMATING DAILY NITROGEN DIOXIDE LEVEL: EXPLORING TRAFFIC EFFECTS. Ann Appl Stat 7:
Gent, Janneane F; Kezik, Julie M; Hill, Melissa E et al. (2012) Household mold and dust allergens: exposure, sensitization and childhood asthma morbidity. Environ Res 118:86-93
DellaValle, Curt T; Triche, Elizabeth W; Leaderer, Brian P et al. (2012) Effects of ambient pollen concentrations on frequency and severity of asthma symptoms among asthmatic children. Epidemiology 23:55-63
Ebisu, Keita; Holford, Theodore R; Belanger, Kathleen D et al. (2011) Urban land-use and respiratory symptoms in infants. Environ Res 111:677-84
Lee, Hyung Joo; Gent, Janneane F; Leaderer, Brian P et al. (2011) Spatial and temporal variability of fine particle composition and source types in five cities of Connecticut and Massachusetts. Sci Total Environ 409:2133-42
Holford, Theodore R; Ebisu, Keita; McKay, Lisa A et al. (2010) Integrated exposure modeling: a model using GIS and GLM. Stat Med 29:116-29
Bundy, Kemp W; Gent, Janneane F; Beckett, William et al. (2009) Household airborne Penicillium associated with peak expiratory flow variability in asthmatic children. Ann Allergy Asthma Immunol 103:26-30

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