World Trade Center Adolescent Health Study
23 januari 2017 bijgewerkt door: NYU Langone Health
Early Identification of World Trade Center Conditions in Adolescents
The proposed study builds upon preliminary studies in self-selected populations to identify opportunities for early identification of World Trade Center-related health consequences in adolescents.
If adverse health consequences are identified, proactive cardiometabolic and pulmonary screening of exposed children may be indicated, with targeted interventions intended to prevent development of chronic obstructive pulmonary disease, and adverse cardiometabolic outcomes in adulthood.
Studie Overzicht
Toestand
Voltooid
Gedetailleerde beschrijving
The study will assess the potential for longer-latency cardiometabolic and pulmonary effects of early life exposure to the World Trade Center (WTC) disaster, and to identify opportunities for early identification of WTC-related health consequences. Preliminary data from the only investigators who regularly provide clinical care to children who lived/attended school near the WTC site identified decrements in spirometry associated with dust cloud exposure, and a remarkably high frequency of cardiometabolic risk factors. Findings from this clinically, self-selected population cannot be extrapolated to the entire population of children who were exposed to the disaster but nonetheless suggest that further study is warranted of the possible metabolic and cardiovascular consequences of WTC exposures. If associated with WTC exposures in a larger, more representative sample, two new and innovative techniques, oscillometry and pulse wave velocity assessment, hold great promise for earlier detection of WTC-related pulmonary and cardiometabolic disease, for whom dietary, environmental and medication interventions may prevent disease progression in later life.
The study will recruit 225 adolescents who respond to the WTC Health Registry (WTCHR), the most representative pediatric population and best-characterized from an environmental exposure standpoint. Connecting the study to the WTCHR also presents efficiency of federal resource utilization, providing more objective clinical data to support self-reported findings of increased persistent respiratory symptoms captured by the WTCHR, thereby improving reliability of the registry data. We will compare pulmonary and cardiometabolic outcomes to carefully matched (age, race/ethnicity, gender, and socioeconomic status) and unexposed control (not resident/attending school south of Houston Street on September 11, 2001) populations from NYU School of Medicine affiliated primary care (private and public clinics).
Studietype
Observationeel
Inschrijving (Werkelijk)
402
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
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New York
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New York, New York, Verenigde Staten, 10016
- NYU School of Medicine
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
12 jaar tot 20 jaar (Kind, Volwassen)
Accepteert gezonde vrijwilligers
Ja
Geslachten die in aanmerking komen voor studie
Allemaal
Bemonsteringsmethode
Niet-waarschijnlijkheidssteekproef
Studie Bevolking
The study population for the present proposal will be drawn from the pediatric component of the WTCHR, a cohort of 71,436 adults and children who were first interviewed in 2003-04.
To further investigate the associations of WTC exposures with health outcomes, we will compare health parameters in the cohort of WTCHR registrants with 225 subjects in a control cohort drawn from pediatric and adolescent clinics in Manhattan and Brooklyn.
Beschrijving
Inclusion Criteria:
- WTCHR participants (exposed group): previous response to WTCHR, born between September 11, 1993 and September 10, 2001
- Controls who are did not live or attend school south of Canal Street on September 11, 2001, matched for age, race/ethnicity, socioeconomic status and other characteristics
Exclusion Criteria:
- Inability to follow procedures.
- Serious lung or heart condition
- Heart or lung surgery
- Uncontrolled asthma
- Current upper respiratory infection
- Pregnancy
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
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World Trade Center exposed group
After informed consent, anthropometric and blood pressure/brachial artery distensibility assessments; physical examination and environmental and respiratory history questionnaire completion; heart rate variability measurement; and spirometry/IOS will be performed on the World Trade Center exposed group.
A research assistant well trained in pediatric phlebotomy will collect 23 mL of fasting blood.
Spirometry and IOS, diet diary collection, lung volumes by plethysmography, and arterial wall stiffness.
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Unexposed comparison group
After informed consent, anthropometric and blood pressure/brachial artery distensibility assessments; physical examination and environmental and respiratory history questionnaire completion; heart rate variability measurement; and spirometry/IOS will be performed on the unexposed comparison group.
A research assistant well trained in pediatric phlebotomy will collect 23 mL of fasting blood.
Spirometry and IOS, diet diary collection, lung volumes by plethysmography, and arterial wall stiffness.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Pulmonary Function Testing
Tijdsspanne: One time
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We will perform spirometry according to standards outlined by the American Thoracic Society and the European Respiratory Society.
Specifically, we will assess forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, and forced expiratory flow over 25-75% of the vital capacity (FEF25-75%; Jaeger Masterscreen IOS; Carefusion, Yorba Linda, CA).
National Health and Nutrition Examination Survey (NHANES) III reference equations will be used to determine normative values, with statistical analysis to be applied to percents of predicted volumes based on these norms.
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One time
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Oscillometry
Tijdsspanne: One time
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Oscillometry provides a noninvasive measure of the impedance to airflow within the lung.
An externally-generated pressure impulse is applied during tidal breathing in a seated position for 30 seconds, and volume and flow measurements are made.
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One time
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Plethysmography
Tijdsspanne: One time
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Measured lung volumes will include total lung capacity (TLC), vital capacity (VC), residual volume (RV), and functional residual capacity (FRC) and will be compared to normative values, using established pediatric reference equations.
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One time
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Blood Pressure
Tijdsspanne: One time
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We will perform assess systolic (first Korotkoff phase) and diastolic (fifth Korotkoff phase) BP three consecutive times in all participants.
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One time
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Arterial Wall Stiffness
Tijdsspanne: One time
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Pulse Wave Velocity (PWV) will be measured using the SphygmoCor CPV System (AtCor Medical, Sydney, Australia).
PWV measures the speed for the pressure wave generated by cardiac ejection to reach the periphery.
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One time
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Heart Rate Variability
Tijdsspanne: One time
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Assessment of Heart Rate Variability (HRV) will be performed using the SphgymoCor SCOR-CPV device (AtCor Medical, Sydney, Australia).
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One time
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Insulin resistance
Tijdsspanne: One time
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Fasting insulin and blood glucose will be assessed.
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One time
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Lipid levels
Tijdsspanne: One time
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Fasting blood draw will be performed.
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One time
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Psychosocial stress and mental health outcomes
Tijdsspanne: One time
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One time
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Tobacco smoke exposure
Tijdsspanne: One time
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We will measure tobacco smoke exposure from salivary cotinine.
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One time
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Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Physical activity questionnaire
Tijdsspanne: One time
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Questionnaire adapted from the International Physical Activity Questionnaire-Short last seven days
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One time
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Diet history questionnaire
Tijdsspanne: One time
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web-based Diet History Questionnaire II developed by the National Cancer Institute
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One time
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Onderzoekers
- Hoofdonderzoeker: Leonardo Trasande, MD, MPP, NYU Sch of Med
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Algemene publicaties
- Trasande L, Fiorino EK, Attina T, Berger K, Goldring R, Chemtob C, Levy-Carrick N, Shao Y, Liu M, Urbina E, Reibman J. Associations of World Trade Center exposures with pulmonary and cardiometabolic outcomes among children seeking care for health concerns. Sci Total Environ. 2013 Feb 1;444:320-6. doi: 10.1016/j.scitotenv.2012.11.097. Epub 2012 Dec 29.
- Gaylord A, Berger KI, Naidu M, Attina TM, Gilbert J, Koshy TT, Han X, Marmor M, Shao Y, Giusti R, Goldring RM, Kannan K, Trasande L. Serum perfluoroalkyl substances and lung function in adolescents exposed to the World Trade Center disaster. Environ Res. 2019 May;172:266-272. doi: 10.1016/j.envres.2019.02.024. Epub 2019 Feb 16.
- Trye A, Berger KI, Naidu M, Attina TM, Gilbert J, Koshy TT, Han X, Marmor M, Shao Y, Giusti R, Goldring RM, Trasande L. Respiratory Health and Lung Function in Children Exposed to the World Trade Center Disaster. J Pediatr. 2018 Oct;201:134-140.e6. doi: 10.1016/j.jpeds.2018.06.009. Epub 2018 Jul 18.
- Trasande L, Koshy TT, Gilbert J, Burdine LK, Marmor M, Han X, Shao Y, Chemtob C, Attina TM, Urbina EM. Cardiometabolic profiles of adolescents and young adults exposed to the World Trade Center Disaster. Environ Res. 2018 Jan;160:107-114. doi: 10.1016/j.envres.2017.09.026. Epub 2017 Sep 30.
- Koshy TT, Attina TM, Ghassabian A, Gilbert J, Burdine LK, Marmor M, Honda M, Chu DB, Han X, Shao Y, Kannan K, Urbina EM, Trasande L. Serum perfluoroalkyl substances and cardiometabolic consequences in adolescents exposed to the World Trade Center disaster and a matched comparison group. Environ Int. 2017 Dec;109:128-135. doi: 10.1016/j.envint.2017.08.003. Epub 2017 Sep 8.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start
1 december 2013
Primaire voltooiing (Werkelijk)
1 maart 2016
Studie voltooiing (Werkelijk)
1 maart 2016
Studieregistratiedata
Eerst ingediend
22 januari 2014
Eerst ingediend dat voldeed aan de QC-criteria
18 februari 2014
Eerst geplaatst (Schatting)
21 februari 2014
Updates van studierecords
Laatste update geplaatst (Schatting)
24 januari 2017
Laatste update ingediend die voldeed aan QC-criteria
23 januari 2017
Laatst geverifieerd
1 januari 2017
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- S12-03116
- U01OH010394 (Subsidie/contract van de Amerikaanse NIH)
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