Dissertation
Combinations of environmental risk factors (fine particles, aeroallergens, community level respiratory infections): their independent and joint effects on childhood asthma exacerbation
Doctor of Philosophy (Ph.D.), Drexel University
Dec 2022
DOI:
https://doi.org/10.17918/00001416
Abstract
Pediatric asthma/asthma exacerbation is the most common chronic disease in children. Ambient air pollution (e.g., fine particulate matter - PM2.5) and aeroallergens (e.g., pollen, mold) are risk factors for asthma exacerbation, with both independent and synergistic effects. Multiple mechanisms have been proposed to support potential interactions between air pollution and aeroallergens on asthma exacerbation - including within the ambient environment and the respiratory system. In addition, respiratory virus infections, accounting for up to 80 percent of asthma childhood exacerbations, are well-known risk factors. Joint effects between environmental risk factors make efforts in asthma control more difficult. Yet, the management of environmental risk factors including PM2.5 and aeroallergens are critical for asthma control at the population level. This dissertation added epidemiologic evidence on the potential impact of interactions between time-varying environmental and viral exposures on childhood asthma exacerbation, as important real-world data in Philadelphia, PA, during the 'pollen season' (mid-March to October) from 2011 to 2016, through three aims. In the first aim, we estimated synergistic effects of PM2.5 and aeroallergen levels on childhood asthma exacerbations, hypothesizing that joint effects of PM2.5 and aeroallergen would be stronger than the independent effect of each. In the second aim, we evaluated the effect modification of respiratory virus infection rates on the association between PM2.5/aeroallergen and childhood asthma exacerbation. We hypothesized stronger associations for both PM2.5 and aeroallergens in the relationship with asthma exacerbation. When respiratory virus infection rates were high. In the last aim, we developed a predictive model of daily asthma exacerbation rates, based on different environmental and viral risk factors. We hypothesized that the predicted 'high-risk' asthma exacerbation days would have elevated levels of multiple risk factors.
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Details
- Title
- Combinations of environmental risk factors (fine particles, aeroallergens, community level respiratory infections)
- Creators
- Wanyu Huang
- Contributors
- Anneclaire De Roos (Advisor)Amy H. Auchincloss (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- xi, 90 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Dana and David Dornsife School of Public Health; Epidemiology and Biostatistics; Drexel University
- Other Identifier
- 991019910713204721