PR000894 (Project)

Description:The HAPI study seeks to leverage a community-engaged research approach to reduce exposure to asthmagens in the homes of an environmental justice community of Latino children residing in an area of intense dairy and crop based agricultural production. These children with asthma experience high morbidity and our preliminary research finds significant effects of ambient concentrations of fine particulate matter and ammonia. Yet children spend the majority of their time indoors. Studies conducted in urban settings demonstrate that indoor particulate matter (PM) influences asthma outcomes and HEPA (high efficiency particulate air) cleaners can reduce indoor and ambient generated PM. Data on asthma in rural settings is sparse and trials incorporating HEPA portable air cleaners are lacking. This study seeks to characterize key indoor pollutant exposures for 80 children with asthma who reside within 400 meters of crop production or dairy operations. Prioritizing methods with low participant burden as well as innovative approaches, we will evaluate the effectiveness of the enhanced intervention on 1) Reducing indoor measures of PM and NH3 across seasons, 2. Improving clinically relevant measures of asthma health (Asthma Control Test, lung function, self-reported symptom days, oral steroid treatment, unscheduled clinical utilization), and 3. Reducing biomarkers of inflammation - urinary cysteine leukotriene (uLTE4) and exhaled nitric oxide (eNO). Caregiver psychosocial stress and behavioral components will be evaluated as mediators of these effects. The study design, procedures, translation of research results for multiple stakeholders and development of an environmental action plan to control/eliminate exposures are conducted within El Proyecto Bienestar, a longstanding UW-community research to action partnership. The project incorporates each of the NIEHS 2012-17 strategic themes and directly addresses 7 of the 11 sub goals.