Air pollution, biomarkers of exposure, and lung function in vulnerable populations - PROJECT SUMMARY/ABSTRACT Ambient air pollution exposure is a significant risk factor for the development and progression of pulmonary disease. Short- and long-term exposure to air pollution constituents such as fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC), and ozone (O3) has been associated with respiratory health effects including negative impacts on lung function, increased incidence of respiratory infections, and increased morbidity and mortality in patients with COPD. Individuals who live in communities with higher proportions of historically marginalized populations and/or individuals with lower socioeconomic status (i.e. “overburdened” or “Environmental Justice” [EJ] communities) have higher levels of air pollution exposure and may be at increased risk of negative respiratory outcomes related to air pollution exposure. However, disparities in exposures and their respiratory health effects in these vulnerable populations have been poorly characterized. Additionally, there is a lack of adequate clinical tools to identify patients with higher burdens of air pollution exposure and thus may be at increased risk of negative health effects. The objective of this project is to characterize the relationship between combustion-related air pollution exposure and respiratory health among vulnerable populations, including those who live in environmentally overburdened communities, and to investigate clinically useful biomarkers of air pollution exposure in high-risk individuals. The first aim of this proposal is to examine the effects of short-term exposure to air pollution, including PM2.5, NO2, BC, and O3, on lung function in a large, nationwide cohort of adults, and to evaluate the effects of neighborhood context and community-level factors (i.e. residence in an overburdened community) on the relationship between air pollution exposure and pulmonary outcomes. The second and third aims of this proposal focus on the assessment of novel biomarkers of air pollution exposure in a cohort of COPD patients utilizing an innovative methodology, nasosorption, to collect nasal fluid samples from the upper respiratory tract. Levels of inflammatory mediators and metals in these nasal fluid samples will be analyzed in order to assess levels of these biomarkers in association with personal air pollution exposure, with the ultimate goal of developing clinically useful tools for air pollution exposure assessment in high-risk patients. This project will be conducted with the guidance of an expert team of environmental pulmonary epidemiologists and physician-investigators. The principal investigator will partake in formal coursework in epidemiology and biostatistics and will receive hands-on mentorship and training from leaders in the field of environmental health and pulmonary medicine. The research will take place primarily at the Institute for Lung Health at Beth Israel Deaconess Medical Center, with additional support and collaboration from the Harvard School of Public and the Harvard Combined Pulmonary and Critical Care Fellowship Program.
