Estimating the Environmental Burden in Two Orphan Lung Diseases

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Investigator: Paul D. Blanc, MSPH, MD
Sponsor: NIH National Institute of Environmental Health Science

Location(s): United States

Description

The major goals of this project are to study the role of environmental factors in pulmonary alveolar proteinosis and extrinsic alveolitis.

The population attributable fraction (PAF) estimates the amount of a disease that is due to a specific factor, quantifying the burden of disease that would be prevented if that factor was eliminated. For selected orphan lung diseases, quantifying the environmentally-related PAF would provide important guidance for clinicians in diagnosis and disease management and for prevention strategies to reduce the burden of new disease prospectively. Linking biomarker data to other metrics of exposure in an integrated risk modeling approach will yield more accurate PAF estimates. Hypersensitivity pneumonitis (HP) and pulmonary alveolar proteinosis (PAP) are ideal candidate diseases for which to apply this biomarker-linked PAF strategy.

Cases and referents recruited through multiple source. Environmental exposures and biomarkers, including for secondhand smoke, will assessed through structured interviews and through home visits. Residential addresses will be geocoded for linkage to supplemental environmental exposure data. The varying contributions of occupation, outdoor ambient pollution, and home indoor exposures, including secondhand smoke, to HP and PAP are likely to be relevant not only for patient diagnosis but also for management and clinical outcomes. Linking biomarker data to other metrics of exposure in an integrated risk modeling approach is key to deriving more accurate PAF estimates