PROJECT SUMMARY (See instructions):
Fossil-fuel-related outdoor particulate matter, ozone, and first- or second-hand cigarette smoke collectively
afflict over 545 million people globally, half of which is made up of chronic obstructive pulmonary disease
(COPD) and the other half with asthma cases [1] As of 2020, Pennsylvania led the country with the highest
excess mortality due to air pollution [2]. Lehigh Valley in eastern Pennsylvania, and Allentown, in particular, a
city within Lehigh Valley, represents one of the worst metropolitan regions in the nation with one of the highest
risks of asthma in the US [2]. However, there is an absolute absence of an early-warning system of
environmentally attributable risks for lower respiratory infection, asthma, and COPD, referred to herein as
chronic respiratory syndrome (CRS) for the general US population and vulnerable citizens of Pennsylvania in
particular. Furthermore, parsing out the emergent (ie., air pollution-attributable) from the legacy (ie., systemic
built environment, access, and socioeconomic disparity) risks represents a direct answer to the respiratory
health needs in Pennsylvania.
Our overarching goals focus on instituting an intelligent and agile early-warning system for two primary
stakeholders - citizens who can visualize CRS risks in maps and clinical providers in local healthcare settings
who can manage the patient flow through outbreak prediction. Our proposed Pennsylvania Asthma-COPD
Syndromic Surveillance (PASS) builds a nimble data analytic infrastructure capable of teasing apart the legacy
of underlying health vulnerabilities, apart from emergent environmental risks (e.g., fossil-fuel-related air
pollution), to protect the public from CRS by integrating publicly available secondary data streams. Ours will be
the first study to clarify how Pennsylvania's recurrent air pollution episodes and erratic weather patterns
contribute to 'outbreaks' of lower respiratory infections in children and asthma and COPD outbreaks in all age
groups within specific geographic locations. Accordingly, we will distinguish the time-varying nature of
Pennsylvania population vulnerabilities as a function of pollutant exposure burden, apart from built infrastructure
disparity, socioeconomic barriers, as well as the underlying susceptibility of the residents to propose a novel
definition of environmental justice target region (Al M 1 ). We will determine the burden of poor air quality on
CRS across Pennsylvania (AIM 2). Finally, we will build syndromic surveillance systems of CRS hotspots by
combining air quality data with underlying susceptibilities of the population (defined in terms of health, social,
and resource disparities) (AIM 3).