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{
"created_at": "2024-04-01T11:43:32.011648Z",
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"answer": "Air pollution is the most cited environmental factor for the onset of asthma.",
"context": {
"0df24827-df9f-46ee-a43d-dc5465c62f0d": [
{
"document_id": "0df24827-df9f-46ee-a43d-dc5465c62f0d",
"text": "INTRODUCTION\n\nAsthma is a chronic disease of the airways defined by its symptoms, which include reversible airflow obstruction, inflammation, and bronchial hyperresponsiveness.The ancient Egyptians, Greeks, and Romans made reference to the symptoms of asthma, and today the disease is estimated to affect 235-334 million people worldwide (44,53)."
},
{
"document_id": "0df24827-df9f-46ee-a43d-dc5465c62f0d",
"text": "\n\nThe atopic triad.Perhaps the most widely recognized pattern of co-occurrence is the one of asthma, atopic dermatitis (eczema), and allergic rhinitis (hay fever), which together are referred to as the atopic triad and characteristically present clinically in a temporal sequence known as the atopic march.Within this sequence, atopic dermatitis is typically the first component to manifest, with approximately 20-30% of individuals with mild disease and 70% of those with severe disease going on to develop asthma.Individuals who undergo this distinctive sequence of disease progression frequently exhibit a more severe and persistent phenotype, with increased risk of allergen sensitization."
}
],
"14cad5a7-e53a-4ab8-9d4f-8f0b827ae427": [
{
"document_id": "14cad5a7-e53a-4ab8-9d4f-8f0b827ae427",
"text": "\n\nClinically, asthma is characterized by episodes of coughing, chest tightness, wheezing, dyspnea, or sputum production.Often, asthma sufferers experience a combination of these symptoms, or some symptoms more than others.Pulmonary breathing tests typically demonstrate variable airway obstruction and hyperreactivity, but may be normal, even in patients with severe and uncontrolled disease [8].Thus, the diagnosis of asthma, which is based on general clinical symptoms and variable lung function testing, is non-specific and heavily dependent on clinical history.Within the \"umbrella\" diagnosis of asthma there exists a diverse array of differing clinical phenotypes [9].For example, childhood asthma is often associated with personal and parental atopic diseases (i.e., atopic dermatitis, food allergy, eosinophilic esophagitis, allergic rhinitis), viral infections, and tobacco smoke exposure [10].Alternatively, adult-onset asthma is less associated with atopic disease [11,12], but more associated with female sex [13], sinus disease [14], and preceding respiratory infections such as pneumonia [15].In addition, adult-onset disease is often of higher severity [12,16] with a faster and more persistent decline in lung function [17].Moreover, although severe patients are found in every demographic and age group, the most common phenotype is an adult female that is older and obese [18]."
},
{
"document_id": "14cad5a7-e53a-4ab8-9d4f-8f0b827ae427",
"text": "Introduction\n\nAn estimated 9% of children and 6% of adults in the United States have asthma [1].The total number of asthma sufferers worldwide is estimated to be over 300 million, with an additional 100 million expected to develop asthma by 2025 [2][3][4][5].Developed countries are the most affected, with some of the highest rates found in the United Kingdom, Australia, New Zealand and the Republic of Ireland [3].Asthma prevalence is rising significantly in developing countries in transition to a more Western lifestyle [3].In 2007, the cost of disease in the United States was estimated to be $56 billion in relation to medical expenses, missed days of work, and early deaths [1].The rate of asthma deaths has likely plateaued, but is still as high as 250,000 per year worldwide [6].Morbidity and mortality are particularly high in ethnic minorities living below or near the poverty line, and African American children had a death rate 10 times that of non-Hispanic white children in 2015 [7].Thus, asthma is a costly, growing health problem associated with high morbidity and mortality."
}
],
"2a7da18e-3756-45c5-b18c-a2231685fefd": [
{
"document_id": "2a7da18e-3756-45c5-b18c-a2231685fefd",
"text": "Getting accurate estimates\nof exposures is difficult, whether this is air pollution or toxins in our food and\ndrink, but these are important questions. Rutter: That is an important point. From the twin study data it is clear that\nenvironmental effects account for quite a lot of the variance on all the multifactorial disorders. Yet the kinds of measures that are used aren’t terribly solid. They\ninclude broad thing such as socio-economic status (SES). Even where there are\ngood measures the care taken in testing for environmental mediation is usually\npoor."
},
{
"document_id": "2a7da18e-3756-45c5-b18c-a2231685fefd",
"text": "Bronchiolitis, a disease\nthat happens in the first year of life in many infants, is strongly associated with\nsubsequent asthma. We ascertained it in the first years of life and have been following these people to age 25 now. For the people who had bronchiolitis and now\nhave asthma, their parents recall much better that they had bronchiolitis than those\nwho don’t have asthma now. It is at least twice more. Extraordinarily, some of\nthese latter parents don’t recall that they took their child to the doctor in the fi rst\nyear of life."
},
{
"document_id": "2a7da18e-3756-45c5-b18c-a2231685fefd",
"text": "If you arrive in the USA when\nyou are young you have almost the same prevalence of asthma as an adult as those\nwho are born in the USA and who are not Mexican. But if you arrive at older ages\nyou have less asthma. If you arrive at the age of 20 you have the same asthma risk\nas those born in Mexico (Eldeirawi et al 2005). Kotb: This is extremely interesting. There is a relationship between depression\nand the immune system. This especially applies to natural killer (NK) cells, which\nare the main cells that fight cancers."
},
{
"document_id": "2a7da18e-3756-45c5-b18c-a2231685fefd",
"text": "A colleague of mine in\nGeorgia found this may have a protective effect against later development of\nasthma (Ownby et al 2002). Martinez: We find significantly decreased likelihood of asthma if you have a dog\nin a home, but not if you have a cat. The reason for this is not that I hate cats,\nwhich I do, but most likely because cats are stealth hunters, and they have to be\nvery clean. Dogs are collective hunters and they don’t care if they smell."
}
],
"443efea1-ffe7-446e-b2fb-37d8ec3cb74a": [
{
"document_id": "443efea1-ffe7-446e-b2fb-37d8ec3cb74a",
"text": "; Guffey, S.E. Investigation into pedestrian exposure to near-vehicle exhaust emissions. Environ. Health\n2009, 8, 13. [CrossRef] [PubMed]\nOur World in Data.org. 2017. Available online: https://ourworldindata.org/data-review-air-pollution-deaths (accessed on\n10 January 2022). Pope, C.A. , III. Respiratory disease associated with community air pollution and a steel mill, Utah Valley. Am. J. Public Health\n1989, 79, 623–628. [CrossRef] [PubMed]\nPope, C.A. , III. What do epidemiologic findings tell us about the health effects of environmental aerosols? J. Aerosol. Med. 2000,\n13, 335–354. [CrossRef] [PubMed]\nPope, C.A. , III."
}
],
"58714c13-954b-46b3-bd0e-69ccadd9dc6a": [
{
"document_id": "58714c13-954b-46b3-bd0e-69ccadd9dc6a",
"text": "Case for Support BBSRC Grant Application September 2005\n“Integrative Analysis of the Genetic Factors behind Asthma and Atopic Dermatitis”\n\nPart I: Research Proposal\nBackground\nA\nIntroduction of topic of research and its academic and wider context\nAsthma is the most common disease of childhood, and affects one child in seven in the United\nKingdom. Atopic Dermatitis (AD, eczema) affects similar numbers of children. About 60% of children with\nsevere AD will have concomitant asthma. Treatments for both diseases are unsatisfactory. Abandonment of\northodox medical therapy for AD is common in many families who have children with the disease."
}
],
"8b4276be-c77e-4e80-a5bb-54e9ff75d2ba": [
{
"document_id": "8b4276be-c77e-4e80-a5bb-54e9ff75d2ba",
"text": "This is most common during the rainy\nseason when aerosols are created, which results in repeated inhalation of Bp [43, 44]. Environmental sampling studies reveal there is a positive association between the\nprevalence of disease and the degree of environmental contamination [7]. In addition to\nenvironmental factors, data suggests that host factors play an important role in mounting\nan immune response against infectious diseases [45] such as melioidosis. While healthy\npersons can contract melioidosis, most patients in endemic regions have an underlying\npredisposition [28], which suggests that the immunological status of the patient can\ninfluence disease initiation and progression [15]."
}
],
"98d443c7-8d99-4139-a27d-e447b0f6630f": [
{
"document_id": "98d443c7-8d99-4139-a27d-e447b0f6630f",
"text": "Sensitivity analysis\n\nWe did two sets of post-hoc sensitivity analyses to assess the effects of potential poor recall of age of onset among individuals with adult-onset asthma, and the effects of misclassification of COPD as asthma among the adultonset cases, even with exclusion of cases with a reported diagnosis of COPD, emphysema, or chronic bronchitis.First, to assure that the adult-onset cases did not include a significant proportion of childhood-onset asthma in which symptoms remitted in early life but then relapsed in adulthood, we replaced adult-onset cases with increasing proportions of randomly selected childhood-onset cases, and then tested for association at the two most significant childhood onset-specific loci.This procedure was repeated 20 times for each proportion to quantify the sampling variability (appendix pp 7-8).Second, we did two analyses in which we removed either individuals with ages of asthma onset between 46 and 65 years or adult-onset cases and controls with FEV₁/FVC <0•70.For each, we compared p values and ORs with the GWAS including all adult-onset cases (appendix pp 8-9)."
},
{
"document_id": "98d443c7-8d99-4139-a27d-e447b0f6630f",
"text": "\n\nWe used data for British white individuals from UK Biobank data release July 19, 2017. 8We extracted disease status (asthma, allergic rhinitis, atopic dermatitis, food allergy, chronic obstructive pulmonary disease (COPD), emphysema, and chronic bronchitis), age of on set of asthma, and sex from self-reported question naires and hospital records (International Classification of Diseases 10th revision [ICD-10] codes) by querying our in-house protected UK Biobank database server. 9For our main case analysis, we included individuals who self-reported that they had doctor-diagnosed asthma.Further details of our research approach are provided in the appendix (pp 4-7)."
}
],
"a1c91fbe-9f6c-45fe-af9a-46c162d340ed": [
{
"document_id": "a1c91fbe-9f6c-45fe-af9a-46c162d340ed",
"text": "; Guffey, S.E. Investigation into pedestrian exposure to near-vehicle exhaust emissions. Environ. Health\n2009, 8, 13. [CrossRef] [PubMed]\nOur World in Data.org. 2017. Available online: https://ourworldindata.org/data-review-air-pollution-deaths (accessed on\n10 January 2022). Pope, C.A. , III. Respiratory disease associated with community air pollution and a steel mill, Utah Valley. Am. J. Public Health\n1989, 79, 623–628. [CrossRef] [PubMed]\nPope, C.A. , III. What do epidemiologic findings tell us about the health effects of environmental aerosols? J. Aerosol. Med. 2000,\n13, 335–354. [CrossRef] [PubMed]\nPope, C.A. , III."
}
],
"c449650e-a0ac-4023-b3c8-82cf3463b0f3": [
{
"document_id": "c449650e-a0ac-4023-b3c8-82cf3463b0f3",
"text": "8 The\nsocio-ecologic framework posits that various aspects of a child’s environment directly and indirectly impact the\nchild’s health and development.9 Drawing on this framework, Beck and colleagues10 examined several biologic,\nsocial and ecologic variables to provide a greater understanding of factors influencing asthma-related hospital\nreadmissions for black children compared to their white counterparts. The study revealed that black children\nwere over two times as likely to be readmitted for an asthma-related illness compared to white children; this\nresulted from significant differences in almost every socio-ecologic variable measured, including disease\nmanagement practices and access to primary care."
},
{
"document_id": "c449650e-a0ac-4023-b3c8-82cf3463b0f3",
"text": "Specific Aims\nAsthma is the most common chronic pediatric medical condition in the United States, with a prevalence\nover 9.6% in children under 18 years of age.1, 2 Low-income, urban children incur a disproportionate share of\nasthma prevalence and morbidity;2-4 13% of children living below the poverty threshold are diagnosed with\nasthma compared to 8% of non-poor (>200% poverty),3 and poverty is associated with higher rates of asthma\nattacks.1 Living in an urban area confers additional risk for asthma and increased ED utilization.4, 5\nImplementation of the National Asthma Education and Prevention Program’s (NAEPP) Guidelines has\ncontributed to reductions in asthma morbidity and mortality rates, and these guidelines emphasize establishing\na partnership between healthcare providers and patients/families to promote effective asthma management.6\nThe NAEPP expert panel states, “building a partnership requires that clinicians promote open\ncommunication and ensure that patients have a basic and accurate foundation of knowledge about asthma…”\n(p.124),6 yet care partnerships also require that the patient/parent effectively communicate issues such as\nemerging symptoms or response to medications."
},
{
"document_id": "c449650e-a0ac-4023-b3c8-82cf3463b0f3",
"text": "Vital & health statistics Series 3, Analytical and epidemiological studies. 2012(35):1-58. CDC. Current Asthma Prevalence. https://www.cdc.gov/asthma/most_recent_data.htm. 2015. Updated\nJune 2017. Accessed March 9, 2018. Northridge J, Ramirez OF, Stingone JA, Claudio L. The role of housing type and housing quality in\nurban children with asthma. Journal of urban health : bulletin of the New York Academy of Medicine. 2010;87(2):211-224. Flores G, Snowden-Bridon C, Torres S, et al. Urban minority children with asthma: substantial\nmorbidity, compromised quality and access to specialists, and the importance of poverty and specialty\ncare."
},
{
"document_id": "c449650e-a0ac-4023-b3c8-82cf3463b0f3",
"text": "Asthma Prevalence and Disparities\nAsthma is the most common chronic pediatric medical condition in the United States,1 affecting an\nestimated 6.2 million children annually.2 Poorly controlled pediatric asthma contributes to over 700,000 visits a\nyear to emergency departments (ED).1 Children living in impoverished, urban settings are disproportionately\naffected by asthma,3 and the disparate impact of asthma is even worse among black and Latino children, and\nchildren whose parents have limited English proficiency (LEP) in these urban low-income areas.4-6 A 2017\nlongitudinal study revealed that black race and Latino ethnicity are significantly associated with worse asthma\noutcomes including 1) asthma knowledge, 2) asthma-related quality of life, 3) asthma severity, and\n4) asthma control."
},
{
"document_id": "c449650e-a0ac-4023-b3c8-82cf3463b0f3",
"text": "The Journal of asthma : official journal of the Association for the Care of Asthma. 2017:16. Inkelas M, Garro N, McQuaid EL, Ortega AN. Race/ethnicity, language, and asthma care: findings from\na 4-state survey. Annals of allergy, asthma & immunology : official publication of the American College\nof Allergy, Asthma, & Immunology. 2008;100(2):120-127. National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the\nDiagnosis and Management of Asthma Bethesda, MD: National Institutes of Health, National Heart,\nLung, and Blood Institute; 2007. Publication no. 08-045.1. NIH Consensus Group. Video report: What is mHealth?"
},
{
"document_id": "c449650e-a0ac-4023-b3c8-82cf3463b0f3",
"text": "Contact PD/PI: Coker, Tumaini Rucker\n\nINTRODUCTION TO APPLICATION\nResearch Plan Overview\nChildhood asthma is the most common pediatric medical condition in the United States, and\ndisproportionately affects children living in low-income, urban settings. Many low-income, urban families rely on\nemergency department (ED) services as their source for sick care for their child. This is often due to not having\na primary care provider or sufficient access to their primary care provider for asthma management."
}
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