1015- Peru- Effects of ambient air pollution on asthma and allergic outcomes

Aeroallergens are airborne particles, both biological and non-biological, that trigger allergic reactions. These include outdoor sources such as pollen from grass, weeds and trees, fungi and mold spores, pesticide sprays and ambient air pollutants; and indoor sources such as dust mites, cockroaches, mold spores, pet dander, and indoor air pollutants. Aeroallergen exposures are the result of complex interactions between individuals and aeroallergens present in their home and community environments and are the main risk factor for the development of allergic conditions including asthma, allergic rhinitis, and eczema. Climate change has been implicated in the increasing aeroallergen exposures. An uptick in greenhouse gases including carbon dioxide (CO2), NO2, and ozone has been linked to increasing allergenicity to various aeroallergens. This appears to be mediated through changes in ambient temperature, relative humidity and concomitant personal exposure to particulate matter. Changes in weather conditions have led to longer pollen seasons and increasing presence of dust mites at higher altitudes than previously reported, However, a clear link between climate change, aeroallergen exposures and health outcomes has not been yet established. More research is needed to document and understand how weather variability, and ultimately climate change, affects aeroallergen exposures above and beyond the effects of air pollution. Here we seek to study how airborne allergen exposures are affected by ambient temperature which in turn may affects asthma and allergy symptoms in Lima, Peru. Our hypotheses are: 1) there will be higher levels of airborne allergen exposures to dust mite, cockroach and mold with higher ambient temperatures; 2) there will be higher levels of self-reported asthma and rhinitis symptoms in households with higher airborne allergen concentrations.

Starting in May 2024, we will recruit 50 children with persistent asthma aged 9–18 years across both Pampas de San Juan de Miraflores and Villa El Salvador communities in Lima, Peru. Our research team has been involved in One child will be recruited per household. Asthma severity will be classified as according to the National Asthma Education and Prevention Program (NAEPP) guidelines. Children will be assessed for asthma control and rhinitis quality of life on a monthly basis for an entire year using the validated Spanish language versions of the asthma control test and the 7-point Juniper rhinoconjunctivitis quality of life questionnaires for children aged 9–11 years and the adolescent version of the questionnaire for those aged 12–18 years. Eligibility criteria are as follows: Age 9-18 years with persistent asthma as per NAEPP guidelines; does not have active pulmonary tuberculosis or is receiving treatment for pulmonary tuberculosis; not pregnant; parents must be able to provide informed consen; and, child is able to provide assent

We will monitor ambient temperature, relative humidity and PM2.5 concentrations using Purple Air monitors (Purple Air PA-II-SD, Purple Air, Draper, Utah, USA) installed at the children’s houses. Ambient monitoring including air quality will take place over the period of one year. We will collect household dust samples from the bed and bedroom floor and assay for dog (Can f 1), cat (Fel d 1), mouse (Mus m 1), dust mite (Der p 1), and cockroach (Bla g 1) allergens in the laboratories at UPCH. Dust samples will be collected using DUSTREAM nylon mesh filters (INDOOR Biotechnologies, Charlottesville, VA, USA) inserted into a portable vacuum (AB Electrolux, Stockholm, Sweden) using a DUSTREAM adaptor. The bed sample will be collected by vacuuming the mattress and bedding for approximately 3 minutes and the floor sample will be collected by vacuuming a square meter area under and around the bed, for approximately 2 minutes. After sampling, the adaptor and enclosed filter will be sealed in a plastic Ziploc bag and stored at −30°C until analysis. Dust sample will be sieved (sieve size, 300 μm) and an aqueous extract of each dust sample will be prepared using phosphate buffered saline and stored at 30°C until assayed using antibody-based ELISA methods. We will collect a total of four dust samples per child at during each season during an entire year.

Students participating in this project will work with the field team to collect exposure (pollution and allergen data) and health outcomes (asthma exacerbations, quality of life and spirometry) in study participants (children 9 -17 years with a history of persistent asthma). Students will have an opportunity to conduct analysis or air pollution data and assist in the integration and analysis of exposure and outcome data.

Collegial and collaborative. Students will work closely with our field team and join weekly meetings via Zoom to provide updates.

Interested in environment health in low- and middle-income countries.

Name: William Checkley, Department of Medicine, wcheckl1@jhmi.edu

I would describe my communication and mentorship styles as... 

One-on-one mentoring, teaches skills and how to work in LMIC settings

A complementary student would have a working style and mentorship expectations that are..

Flexible, able to adapt to challenges in LMICs

$550/MONTH, INCLUDING $250/MONTH FOR RENT, $250/MONTH FOR FOOD, AND $50/MONTH FOR LOCAL TRANSPORTATION

An additional stipend is possible.