1999 Progress Report: Indoor and Outdoor Air Contaminant Exposures and Asthma Aggravation Among Children (Asthma Exposure)

EPA Grant Number: R826710C001
Subproject: this is subproject number 001 , established and managed by the Center Director under grant R826710
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).

Center: Michigan Center for the Environment and Children’s Health
Center Director: Israel, Barbara A.
Title: Indoor and Outdoor Air Contaminant Exposures and Asthma Aggravation Among Children (Asthma Exposure)
Investigators: Robins, Thomas
Current Investigators: Israel, Barbara A. , Keeler, Gerald J. , Remick, Daniel , Parker, Edith , Philbert, Martin , Brown, Randall , Robbins, Tom , Lin, Xihong
Institution: University of Michigan
EPA Project Officer: Klieforth, Barbara I
Project Period: January 1, 1998 through January 1, 2002
Project Period Covered by this Report: January 1, 1998 through January 1, 1999
Project Amount: Refer to main center abstract for funding details.
RFA: Centers for Children's Environmental Health and Disease Prevention Research (1998) RFA Text |  Recipients Lists
Research Category: Children's Health , Health Effects , Health


The prevalence of asthma has increased markedly over the past 15 years. It is the most common chronic disease of childhood in the developed world, affecting about 10 million U.S. children under the age of 16. Asthma is most common among urban and minority populations. The causes of these increases and the greater risk for urban, minority populations are not well understood. The causation, and aggravation, of childhood asthma is complex and involves many factors including genetic disposition, demographic variables, psychosocial stresses, and environmental exposures. Environmental exposures include both ambient (outdoor) exposures as well as indoor exposures within the home and at school. The first specific aim of the Asthma Exposure research project is to determine the prevalence of questionnaire-defined asthma among the elementary age school children in African-American and Latino populations in Detroit. Students and their families from 10 to 12 elementary schools (approximately 6000 students) in two areas in which the investigators have pre-existing strong community ties (i.e., southwest Detroit and the east side of Detroit) will be asked to complete a short, well validated asthma screening questionnaire. The second specific aim is to identify which components of the outdoor air, of indoor air contaminants, and family and neighborhood characteristics are associated with increased risk for asthma in this population. The third specific aim is to examine whether seasonal and daily changes in outdoor air pollution and indoor air contaminants explain fluctuations in the severity of asthma. The last specific aim is to provide ambient (community/neighborhood level), micro-environmental (inside schools and homes), and personal monitoring data to investigate the relationships between various exposure metrics and activity patterns of asthmatic children living in the southwest and east sides of Detroit. This approach will improve on the design of prior studies by collecting detailed multiple daily measures of ambient air contaminants together with comprehensive assessment of indoor air contaminants in households and schools and individual family and neighborhood measures of psychosocial factors, and assessing the association of these with a comprehensive set of health status measures, including lung function testing (FEV1), also collected on a daily basis.

Progress Summary:

The Intervention and Exposure Cores continue to have the same specific aims as stated in the proposal, but because the two are so integrated and have the same participants and coordinated goals, their research teams and activities have been combined into one “meta”-project called: Community Action Against Asthma, or CAAA. A Steering Committee, which meets monthly and is comprised of the university and Detroit community partners involved in both projects, oversees and is directly involved in decision making and other activities regarding the implementation of the research protocol. A separate Research Work Group, comprised of the university-based faculty and staff for CAAA, oversees the technical aspects of research issues and works closely and in coordination with the CAAA Steering Committee.

Specific Aims: A Screening Questionnaire, along with incentives and a descriptive brochure, was developed and mailed and/or delivered through the schools to over 11,000 families in the target area of southwest and east side Detroit. Follow-up mailings and a community awareness campaign to encourage participation was also conducted. Currently, 439 children between the ages of 6-10, who have either moderate to severe asthma (336) or mild persistent asthma (103), have been identified who are eligible to participate in the study. Of those, 175 families have already attended a Skin Testing Fair where they received an orientation to the project, signed an informed consent form, and received training on use of a breathing monitor. Participants were also weighed and measured, and received a skin test for nine different allergens and two controls. Additional Skin Testing Fairs are planned with the goal of enrolling 450 families.

In addition to the Screening Questionnaire, a Baseline Questionnaire, a Child Baseline Questionnaire, and an Environmental Walk-Through Check-list have also been developed. Training has been completed for Community Interviewers who will conduct interviews in the homes of families this fall using these instruments. Purchase of equipment and development of protocols for collection of dust in the homes is in progress. Based on the advice of the MCECH External Advisory Committee, the only significant modification to the study is a decision to focus enrollment efforts on children with moderate to severe asthma instead of both moderate to severe and mild asthma.

Significance: The asthma intervention core will test the ability of individually tailored interventions to reduce exposure to environmental contaminants and to improve asthma related health status. At the same time, the intervention will provide direct benefit to the children and families enrolled in the study. The central hypothesis being addressed in the asthma exposure core is that exposure to ambient air contaminants will aggravate the health status of asthmatic children largely through the potentiation of the adverse effects of common indoor air contaminants. Proving or refuting this hypothesis will lead to substantial advances in scientific knowledge and have a direct impact on public health recommendations.

Future Activities:

Completion of study enrollment will occur in the next budget year. Baseline interviews, environmental walk-throughs, and dust collection in the homes of families will be conducted in fall 1999. After the baseline, the study population will be split into two on a random basis. One group will begin to receive the household intervention provided by the Community Environmental Specialists starting in the fall. The other group will begin to receive the intervention a year later. As a part of the Exposure Study, all participants will be asked to use the Airwatch monitors to measure their child’s breathing during a 2-week period each season. Parents will also complete a daily diary about their child’s symptoms during this time period. This information will be collected and analyzed. A sub-group will also have air-monitoring devices installed in their homes and the children will be asked to wear a personal monitoring device. Air quality information will also be collected in two representative schools in the target area.

Journal Articles on this Report : 1 Displayed | Download in RIS Format

Other subproject views: All 3 publications 1 publications in selected types All 1 journal articles
Other center views: All 45 publications 24 publications in selected types All 22 journal articles
Type Citation Sub Project Document Sources
Journal Article Clark NM, Brown RW, Parker E, Robins TG, Remick Jr. DG, Philbert MA, Keeler GJ, Israel BA. Childhood asthma. Environmental Health Perspectives 1999;107(Suppl 3):421-429. R826710 (Final)
R826710C001 (1999)
R826710C002 (1999)
R826710C003 (1999)
  • Full-text from PubMed
  • Abstract from PubMed
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  • Supplemental Keywords:

    asthma, ambient air, indoor air, exposure, health effects, children, stressor, pathogens, community-based, social science, pathology, monitoring, Detroit., RFA, Health, Scientific Discipline, Air, Geographic Area, Environmental Chemistry, Health Risk Assessment, Epidemiology, State, Risk Assessments, Susceptibility/Sensitive Population/Genetic Susceptibility, Allergens/Asthma, Children's Health, genetic susceptability, indoor air, Biology, Gulf of Mexico, African American, asthma, health effects, minority population, school based study, sensitive populations, urban air, outdoor air, airway disease, biological response, latino, exposure, Human Health Risk Assessment, lung function testing, airway inflammation, children, assessment of exposure, childhood respiratory disease, children's vulnerablity, inhalation, minorities, epidemeology, indoor air quality, exposure assessment, Michigan (MI), indoor environment, air quality, environmental hazard exposures, toxics, air contaminant exposure

    Progress and Final Reports:

    Original Abstract
  • 1998
  • 2000 Progress Report
  • Final

  • Main Center Abstract and Reports:

    R826710    Michigan Center for the Environment and Children’s Health

    Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
    R826710C001 Indoor and Outdoor Air Contaminant Exposures and Asthma Aggravation Among Children (Asthma Exposure)
    R826710C002 Chemokines in the Pathogenesis of Asthma (Asthma Chemokines)
    R826710C003 A Community-Based Intervention to Reduce Environmental Triggers for Asthma Among Children (Asthma Intervention)