Environmental Influences on Health Outcomes-Integrating Real-Time Exposure Measures from Homes into Longitudinal Cohort Studies: Lessons from the Field

摘要

In North America, adults and children of all ages spend much of their time indoors with the home where a majority of time is passed. Exposure to respirable particulate matter (PM) of varying sizes has been linked to cardiovascular and respiratory problems. Exposures to PM2.5 contribute to childhood respiratory ailments such as asthma. Utah collaborators with pediatric cohorts aligned with the National Institutes of Health (NIH) ECHO program and NIH PRISMS program conducted pilot projects aimed at using innovative, real-time, low-cost air quality sensors to provide spatio-temporal records of particulate matter (PM) exposures. The projects evaluated participant acceptance, feasibility, and efficacy in building exposure profiles using instrumentation, extant data, models and health information integrated with a single informatics platform. The PM sensors are small and feature secure Wi-Fi and data storage capability. More than 30 participant homes had one outdoor and two indoor sensors capturing time stamped PM counts every minute which were aggregated to daily data for initial analyses. Participants were supportive of using their personal Wi-Fi for sensor data transmission. From the PRISMS project (n=6), mixed modeling showed the daily estimated marginal mean level of small (PM2.5) and large (PM10) particle counts was lower indoors than outdoors (p < 0.001). Among 6 pediatric asthmatic participants reporting daily asthma treatment usage via eAsthma Tracker, indoor PM counts were not related to treatment usage (p > 0.05). Higher levels of PM2.5 outdoors were related to increases in asthma treatment (p < 0.001) while outdoor PM10 were not related to treatment usage (p = 0.52) in this small sample. These pilot projects demonstrated the feasibility of gathering environmental exposure data from low-cost sensors at a very fine level of resolution, and ability to integrate and analyze data across disparate data sources using the Utah PRISMS developed infrastructure.