Asthma Epidemiology, Prevention and Planning

1.  Activity: Asthma Epidemiology, Prevention and Planning

2.  Project Leader: Stanley H. Weiss, MD, FACP, weiss@umdnj.edu

3.  Mission/Vision:

Increased quality of life for asthmatics throughout the State. Increased understanding of the possible effects of low levels of air pollution below current federal guidelines, on the risk of on symptoms and reduced peak expiratory flow rate in asthmatics, especially very sensitive asthmatics. Increased understanding of the definition of asthma. Promote awareness of proper asthma disease management among asthmatics, parents/guardians of asthmatics, and providers of public and private education and child-care (i.e. following NHBLI guidelines, asthma action plans in schools, reduced exposure to known indoor/outdoor asthma triggers, reduced outdoor activity on high air pollution (e.g. ozone, SO 2 , PM 2.5 , etc.) days.

4.  Collaborators and Staff:

Collaborators:

•  Clifford P. Weisel, PhD (Environmental and Occupational Health Sciences Institute [EOHSI] and Robert Wood Johnson Medical School, Piscataway)

•  Amy L. Davidow, PhD, Department of Preventive Medicine and Community Health

Staff:

• Azadeh Tasslimi, BA, tassliaz@umdnj.edu

5. Specifics about activity:

A. Understand the advantages and limitations of various methodological approaches in ascertaining asthma prevalence in a community, and the factors that affect apparent asthma prevalence such as the definition of asthma and the transient nature of symptoms.

B.  Developed a web-based questionnaire for adolescent asthmatics to determine asthma-related symptoms, visits to medical personnel, exposure to asthma triggers, peak flow rate and medication, with supplementary information on when the event occurred/medication taken and for what duration/amount.

C.  Conducted a prospective cohort study of 64 pediatric/adolescent asthmatics, grades 4-12, in northwestern New Jersey. Students recorded their daily asthma symptoms, medication use, and peak flow rate with the web-based survey over a period of 5 months.

D.  Determine if changes in peak flow expiratory flow rate (PEFR) and exacerbation of asthma-related symptoms among school children in Warren County, NJ are related to both short-term and lagged effects levels of sulfur dioxide (SO2). Compare SO 2 levels of effect with current federal guidelines.

E.  Examine the association between the number of pupils absent from school for respiratory-related ailments with the daily air quality near schools, after controlling for potential confounders. School absenteeism is captured daily through the distribution of surveys to school nurses at Harmony, White, and Belvidere Elementary Schools and Belvidere High School. There are three air-monitoring stations in Warren County which collect hourly and 5-minute concentrations of SO 2 , PM 2.5 , and various volatile organic compounds.

F. Asthma Action Plans in New Jersey Schools

6. Publications from project:

Weiss SH, Tasslimi A, Davidow AL, Weisel CP. Are peak expiratory flow rates of asthmatics impaired by levels of SO2 in the EPA 'safe' zone? The 132nd Annual Meeting (November 2004) of the American Public Health Association, Washington DC, Session 3118.0: Monday, November 8, 2004 (oral).

Weisel CP, Weiss SH, Tasslimi A, Diamond A, Alimoktari S. Use of a web-based questionnaire to collect exposure and symptom data in asthmatic adolescents. 14th Annual Conference of the International Society of Exposure Analysis. Platform Session W2C �Exposure and Health Interface,� Abstract W2C-03, 2004. Page 290. (Online at http://www.isea2004.org/ )

Weiss SH, Tasslimi A, Lee N, Alimokhtari S, Morales L, Hom HL, Weisel CP. Understanding the prevalence of asthma in a community: Impacts of study design and definition. The 131st Annual Meeting (November 15-19, 2003) of the American Public Health Association, San Francisco, Session 4262.0 [Tuesday, November 18, 2003], Abstract #60074.

Diamond AC, Weisel CP, Lee N, Weiss SH. Design, implementation and monitoring of Internet-based prospective data collection in an epidemiologic study of asthma and the environment. Research Symposium on Genomics, Proteomics, Pharmacogenomics and Bioinformatics. Robert Wood Johnson Medical School, Piscataway, NJ, May 9, 2003.

Diamond AC, Weisel CP, Lee N, Weiss SH. Design and implementation of an Internet-based questionnaire for daily ascertainment of asthma status in a prospective study. The 8th Annual Public Health Symposium, Rutgers University, Piscataway, NJ, April 7, 2003.

Tasslimi A, Weisel CP, Belby K, Morales L, Lee N, Weiss SH. Apparent prevalence of adolescent asthma: impacts of asthma definition and sources of information. The 8th Annual Public Health Symposium, held at Rutgers University, Piscataway, NJ, April 7, 2003.

7.   Other related websites: www.pacnj.org

8. Opportunities for students:

Graduate students are currently working with Dr. Weiss on assessments of the activities of the Pediatric/Adult Asthma Coalition of New Jersey (PACNJ).

Additional opportunities may be available for students to work on asthma projects. Contact Dr. Weiss at weiss@umdnj.edu or Ms. Tasslimi at tassliaz@umdnj.edu

9.  Opportunities for volunteers: none at the moment

10. Hidden text and keywords

asthma; peak flow; air pollution; SO 2 ; sulfur dioxide; particulate matter; respiratory symptoms; peak expiratory flow rate; asthma action plan; epidemiology; asthma prevalence; air quality

Date Revised: 3/30/05