Despite the burgeoning literature documenting the effects of breast-feeding on cognition and educational attainment over the past several decades, there remains important gaps in our knowledge regarding whether this relationship is dictated by sociodemographic factors. The current investigations, which examined the literature on the effects of breast-feeding on cognition and educational attainment in children, adolescents, and older adults addressed these gaps. Chapter 2 was an up-to-date global systematic review of population studies in individuals ≤ 25 years and ≥ 25 years of age. Results indicate that the majority of published studies conducted by researchers demonstrated a positive relationship between the effect of breast-feeding on cognitive outcomes and educational attainment. Additionally, findings highlighted the importance of possible confounders and how adjusting for them can change the relationship between breast-feeding and cognition and educational attainment. Chapter 3 investigated the breast-feeding-cognition/educational attainment relationship across race, as well as whether mother-child stimulation might mediate this relationship. The National Longitudinal Study of Adolescent to Adult Health (Add Health) was used to examine the effect of being breast-fed or not, and duration on cognitive outcomes and grade point average (GPA). Results indicate that individuals who were breast-fed had slightly higher GPAs and performance on both a vocabulary test and a number recall test compared to adolescents who were not breast-fed. There was an effect for race, but no interaction between race and breast-feeding. Mother-child stimulation had a limited effect on the relationship between breast-feeding and cognitive outcomes and GPA. Chapter 4 explored whether the effect observed in adolescence persists into older adulthood. The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort was used to examine this relationship in adults age ≥ 45 years. The covariates included sex of adolescent, race (Black or White), maternal education, paternal education, maternal smoking history, number of other children mother has, resident location (urban/not-urban), and a financial adversity index. This was a composite score consisting of yes or no responses to (1) do you have health insurance, (2) have you been employed within the past 12 months, (3) are you on public assistance, and (4) do you have enough money to pay your bills? Results show that self-report history of being breast-fed did not current predict performance on cognitive tests. Additionally, neither race nor sex moderated this relationship between breast-feeding and cognition. Overall, evidence from the review and two studies highlight the important of assessing the effect of breast-feeding on cognition and educational attainment in populations with varying confounding factors, however, while some of the results are inconsistent with our hypothesis, replication is clearly essential to further explore the possible underlying mechanism.

Despite having the highest life expectancy rate in the world, Hong Kong people do not necessarily lead a healthy life and may suffer from various ailments due to unhealthy lifestyle. For example, more than half of the adult population does not meet the recommended standard of physical activity set by the World Health Organization. Health status of individuals is influenced by different factors such as healthcare input, biological endowment, environment, and lifestyle. Among these factors, only the factor of lifestyle can be managed by an individual. What people can do to improve their health status is to manipulate or change their lifestyle. The present study examines the relationship between lifestyle parameters and self-rated health status of the adult population in Hong Kong. The relationship between physical activity, eating behavior, smoking behavior, and alcohol drinking behavior of individuals on self-rated physical and mental health were analyzed. A total of 1,277 samples were collected among 18 districts in Hong Kong. Structural equation modeling and regression analysis were employed to specify the relationship between lifestyle behavior and individual self-rated health status. Two-way analysis of variance was used to examine the lifestyle behavior across gender and three categorical groups (i.e. age group, education level, marital status). For the physical health, the relationships between eating behavior and physical health, smoking dependence and physical health, alcohol dependence and physical health were negative but statistically insignificant. For the mental health, the relationships between eating behavior and mental health, and smoking dependence and mental health were negative but statistically insignificant. The present study is the pioneer to use latent variables of cigarette dependence and alcohol dependence as a measure of substance use in the empirical tests of Grossman model. Also, this study overcomes the limitations that using one categorical item in measuring self-rated health. The results of the present study provide information on lifestyles and health that can be used by policy-makers, the community, and other stakeholders to promote advocacy and revamp public health policies and practices. It can also provide evidence to guide the development and implementation of public health promotion campaign.

研究背景：顆性空氣污染物（PM₁₀）的危害作用已經為許多病學研究所證實。有學者認為，空氣動學直徑小於2.5 微米的細顆（PM₂.₅）和空氣動學直徑介於2.5 和10 微米之間的粗顆（PMc）屬於種同的污染物，應當分別測。區分粗、細顆的健康效應將為今後分別制訂有關粗、細顆的空氣質標準提供依據。同時，空氣污染物是由顆污染物和氣態污染物構成的複雜混合物，二者之間存在一定程上的合或交互作用。 / 研究目的：以每天心血管系統、呼吸系統疾病急性入院人為研究結局，區別估計顆污染物PM₁₀ 中粗、細顆的健康危害作用，并探討PM₁₀與氣態污染物（二氧化氮，NO₂；二氧化，SO₂；臭氧，O₃）的交互作用。 / 研究方法：收集香港1998 1 月至2007 12 月每天心腦血管疾病、呼吸系統疾病急性入院人，日均污染物濃，日均氣溫、相對濕等資，採用時間序分析的研究方法，應用Poisson 廣義相加模型分析顆污染物中粗、細顆的同健康效應。同時應用三個平的時間序研究模型（雙變反應面模型、合效應模型和分層模型）探討顆污染物和氣態污染物之間潛在的交互作用。 / 研究結果：研究發現，在校正PM₂.₅的影響后，PMc 對呼吸系統疾病導致的急性入院作用顯著，但對心腦血管疾病引起的急性入院則無明顯作用。在雙污染物（PMc 和PM₂.₅）模型中，空氣中每一個IQR（四分位間距）的PM[subscript c] 和PM₂.₅濃的增加將使每天急性呼吸系統疾病入院分別增加1.05% (95% CI: 0.19%, 1.91%)和1.81% (95% CI: 0.78%,2.87%)，使急性心腦血管疾病入院分別改變 -0.16% (95% CI: -1.07%,0.76%) 和1.86% (95% CI: 0.85%, 2.88%)。研究發現某種程6 的顆污染物和氣態污染物的交互作用。在NO₂ 或SO₂ 高水平（NO₂ 濃高於64.4μg/m³ 或 SO₂ 濃高於20.9μg/m³）的日子，PM₁₀ 對急性心臟疾病入院的影響高於NO₂ 或SO₂ 低、中水平的日子；而在臭氧高水平（O₃濃高於46.8μg/m³）的日子，PM₁₀ 對急性呼吸和循環系統疾病入院的作用低於O₃ 中、低水平的日子。 / 研究結：粗、細顆污染物對呼吸系統疾病的危害均作用顯著且相對獨，但對循環系統疾病的危害作用則主要體現於細顆污染物。同時，顆性污染物的健康危害可能被空氣中的氣態污染物水平所修飾：研究發現PM₁₀ 與NO₂ 或SO₂ 之間的協同作用，以及PM₁₀ 與O₃ 之間的拮抗作用。 / BACKGROUND: The adverse effects of particulate matter (PM) air pollution have been confirmed by many epidemiological studies. Fine and coarse particles should be considered as separate classes of pollutants and measured separately. Differentiating the effects of fine (PM₂.₅, particles with an aerodynamic diameter less than 2.5 microns) and coarse particles (PM[subscript c], particles with an aerodynamic diameter between 2.5 and 10 microns) would help in the future to support a PM[subscript c] standard. Meanwhile, ambient air pollution is a complex mixture of PM and gaseous pollutants. PM might interact with gaseous pollutants to affect the population health. / STUDY OBJECTIVES: To differentiate the effects of fine and coarse fractions of PM₁₀ and to explore the possible interaction between PM₁₀ and gaseous pollutants (nitrogen dioxide, NO₂; sulfur dioxide, SO₂; ozone, O₃) on emergency hospital admissions for cardio-respiratory diseases in Hong Kong. / METHODS: This is a time series study. Daily counts of emergency hospital admissions for cardio-respiratory diseases, daily mean air pollution concentrations and weather conditions were collected from January 1998 to December 2007 in Hong Kong. We used generalized additive Poisson model with log link allowing overdispersion and autocorrelation to examine the differential effects of PM₂.₅ and PM[subscript c]. Three parallel time series approaches (bivariate response surface model, joint effect model and parametric stratified model) were used to explore the possible interactions between PM₁₀ and gaseous pollutants. / MAIN RESULTS: The associations between PM[subscript c] and emergency hospital admissions were statistically significant for respiratory diseases but not for circulatory diseases. In two-pollutant (PM₂.₅and PM[subscript c]) model, an interquartile range increase in the 4-day moving average (lag₀₃) concentrations of PM[subscript c] and PM₂.₅ corresponded to 1.05% (95% CI: 0.19%, 1.91%) and 1.81% (95% CI: 0.76%, 2.87%) increase of respiratory admissions, respectively. The effect estimates of PM₂.₅and PM[subscript c] remained robust when adjusting for gaseous pollutants. Meanwhile, an interquartile range increase in lag₀₁ concentrations of PM[subscript c] and PM₂.₅was associated with -0.16% (95% CI: -1.07%, 0.76%) and 1.86% (95% CI: 0.85%, 2.88%) change of circulatory admissions, respectively. Some interactions between PM₁₀ and gaseous pollutants were found. The effects of PM₁₀ on circulatory hospitalizations were greatest during the days when NO₂ or SO₂ concentrations were high (the 3rd tertile, NO₂>64.4 or SO₂>20.9μg/m³). The effects of PM₁₀ on both respiratory and circulatory admissions were greatest during the days when O₃ concentrations were in low to medium levels (<=46.8μg/m³). / CONCLUSION: We found PM[subscript c] to be associated with emergency hospital admissions for respiratory diseases independent of the effect of PM₂.₅, but not for circulatory diseases in Hong Kong. The effects of PM₁₀ on cardio-respiratory hospital admissions were modified by gaseous pollutants. There were synergetic interactions between PM₁₀ and NO₂ or SO₂ on cardiac hospitalizations and antagonistic interactions between PM₁₀ and ozone on cardio-respiratory hospitalizations. These findings provide supportive evidence for a future PM[subscript c] regulation and contribute to the development of a multipollutant air quality management. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Qiu, Hong = 顆粒污染物對人群健康的短期效應 : 時間序列研究 / 邱宏. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 122-137). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese. / Qiu, Hong = Ke li wu ran wu dui ren qun jian kang de duan qi xiao ying : shi jian xu lie yan jiu / Qiu Hong. / Abstract (English) --- p.v / Abstract (Chinese) --- p.viii / List of Contents --- p.x / List of Tables --- p.xiv / List of Figures --- p.xvi / List of Abbreviation --- p.xviii / Acknowledgements --- p.xix / Chapter Chapter 1 --- Introduction --- p.1 / Chapter Chapter 2 --- Literature Review --- p.5 / Chapter 2.1. --- Review on the differential health effects of fine and coarse particles --- p.5 / Chapter 2.1.1 --- A brief description of particulate matter air pollution --- p.5 / Chapter 2.1.2 --- The objective of this part of literature review --- p.7 / Chapter 2.1.3 --- Methods --- p.8 / Chapter 2.1.3.1 --- Inclusion and exclusion criteria of studies/papers --- p.8 / Chapter 2.1.3.2 --- Search terms and keywords --- p.9 / Chapter 2.1.3.3 --- Information abstracted --- p.9 / Chapter 2.1.4 --- Results --- p.10 / Chapter 2.1.4.1 --- Short-term effects of PM₂.₅and PM[subscript c] on mortality --- p.10 / Chapter 2.1.4.2 --- Short-term effects of PM₂.₅and PM[subscript c] on morbidity --- p.14 / Chapter 2.1.4.3 --- Biological mechanisms underlying the differential effects of PM₂.₅and PM[subscript c] --- p.18 / Chapter 2.1.5 --- Conclusion remarks --- p.19 / Chapter 2.1.5.1 --- Health effects of PM₂.₅and PM[subscript c] on mortality --- p.19 / Chapter 2.1.5.2 --- Health effects of PM₂.₅and PM[subscript c] on morbidity --- p.20 / Chapter 2.2. --- Review on the joint effects/interactions of particulate matter and gaseous pollutants --- p.21 / Chapter 2.2.1 --- Concept of Interaction --- p.21 / Chapter 2.2.2 --- The objective of this part of literature review --- p.21 / Chapter 2.2.3 --- Methods --- p.22 / Chapter 2.2.3.1 --- Search terms and key words --- p.22 / Chapter 2.2.3.2 --- Information abstract --- p.22 / Chapter 2.2.4 --- Results --- p.23 / Chapter 2.2.4.1 --- Studies on the interaction between particulate matter and gaseous pollutants --- p.23 / Chapter 2.2.4.1.1 --- Studies on the interaction between PM₁₀ and NO₂ --- p.23 / Chapter 2.2.4.1.2 --- Studies on the interaction between PM₁₀ and O₃ --- p.24 / Chapter 2.2.4.1.3 --- Studies on the interaction between PM and SO₂ --- p.26 / Chapter 2.2.4.1.4 --- Modifiers identified through multicity study --- p.30 / Chapter 2.2.4.2 --- Methodology used to detect interaction in time series studies --- p.33 / Chapter 2.2.4.2.1 --- Nonparametric bivariable response surface model --- p.33 / Chapter 2.2.4.2.2 --- Non-stratification interaction model --- p.34 / Chapter 2.2.4.2.3 --- Parametric stratified model --- p.34 / Chapter 2.2.4.2.4 --- Time series classification and regression tree (CART) model --- p.35 / Chapter 2.2.4.3 --- Biological mechanisms of interaction between pollutants --- p.36 / Chapter 2.2.5 --- Conclusion remarks --- p.38 / Chapter Chapter 3 --- Differential health effects of fine and coarse particles --- p.39 / Chapter 3.1 --- Objectives --- p.39 / Chapter 3.2 --- Materials and Methods --- p.39 / Chapter 3.2.1 --- Data on particulate pollutants and meteorology variables --- p.39 / Chapter 3.2.2 --- Data on emergency hospital admissions for cardio-respiratory diseases --- p.40 / Chapter 3.2.3 --- Statistical models --- p.42 / Chapter 3.2.3.1 --- Core model set up --- p.42 / Chapter 3.2.3.2 --- Single-pollutant and two-pollutant models --- p.44 / Chapter 3.2.3.3 --- Concentration-response relationship --- p.45 / Chapter 3.2.3.4 --- Sensitivity analysis --- p.46 / Chapter 3.3 --- Results --- p.47 / Chapter 3.3.1 --- Location of Tsuen Wan station, Tsuen Wan region --- p.47 / Chapter 3.3.2 --- Air pollution concentrations and meteorological factors --- p.47 / Chapter 3.3.3 --- Emergency hospital admissions for cardio-respiratory diseases --- p.50 / Chapter 3.3.4 --- Regression results and Sensitivity analysis --- p.51 / Chapter 3.3.4.1 --- Effects of coarse particulate matter on emergency hospital admissions for respiratory diseases --- p.51 / Chapter 3.3.4.2 --- Differential effects of fine and coarse particles on emergency hospital admissions for cardiovascular diseases --- p.56 / Chapter 3.4 --- Discussion --- p.61 / Chapter 3.4.1 --- Main findings of this study --- p.61 / Chapter 3.4.2 --- Compared with findings from the literature --- p.62 / Chapter 3.4.3 --- Exposure windows selection and possible misclassification --- p.64 / Chapter 3.4.4 --- Sensitivity analyses of main findings --- p.65 / Chapter 3.4.5 --- Biological mechanisms of the differential effects of fine and coarse particles --- p.67 / Chapter 3.4.6 --- Limitations of this study --- p.68 / Chapter 3.5 --- Conclusion and recommendations --- p.69 / Chapter Chapter 4 --- Joint effects/Interactions of PM₁₀ and gaseous pollutants --- p.70 / Chapter 4.1 --- Objectives --- p.70 / Chapter 4.2 --- Materials and Methods --- p.70 / Chapter 4.2.1 --- Data on air pollution and meteorology variables --- p.70 / Chapter 4.2.2 --- Data on emergency hospital admissions for cardio-respiratory diseases --- p.71 / Chapter 4.2.3 --- Statistical models --- p.72 / Chapter 4.2.3.1 --- Core model set up --- p.72 / Chapter 4.2.3.2 --- Three parallel time series models --- p.73 / Chapter 4.3 --- Results --- p.76 / Chapter 4.3.1 --- Air pollution concentrations and meteorological factors --- p.76 / Chapter 4.3.2 --- Emergency hospital admissions for cardio-respiratory diseases --- p.79 / Chapter 4.3.3 --- Results from single-pollutant model --- p.81 / Chapter 4.3.3.1 --- Pollution effects on emergency hospital admissions for respiratory diseases --- p.81 / Chapter 4.3.3.2 --- Pollution effects on emergency hospital admissions for circulatory diseases --- p.83 / Chapter 4.3.4 --- Joint effects/Interactions between PM₁₀ and NO₂ on cardio-respiratory hospitalizations --- p.85 / Chapter 4.3.5 --- Joint effects/Interactions between PM₁₀ and O₃ on cardio-respiratory hospitalizations --- p.91 / Chapter 4.3.6 --- Joint effects/Interactions between PM₁₀ and SO₂ on cardio-respiratory hospitalizations --- p.96 / Chapter 4.4 --- Discussion --- p.102 / Chapter 4.4.1 --- Main findings --- p.102 / Chapter 4.4.1.1 --- Effect estimates compared with previous Hong Kong studies --- p.102 / Chapter 4.4.1.2 --- Interactions between particulate matter and gaseous pollutants --- p.103 / Chapter 4.4.1.2.1 --- Interactions between PM₁₀ and NO₂ on cardiac hospitalizations --- p.103 / Chapter 4.4.1.2.2 --- Interactions between PM₁₀ and O₃ on cardio-respiratory hospitalizations --- p.109 / Chapter 4.4.1.2.3 --- Interactions between PM₁₀ and SO₂ on cardiac hospitalizations --- p.113 / Chapter 4.4.2 --- Strengths and limitations of this study --- p.116 / Chapter 4.5 --- Conclusion and recommendations --- p.119 / Chapter Chapter 5 --- Concluding remarks --- p.120 / References List --- p.122 / Chapter Appendix --- Relevant Publications and Submitted/Drafted Papers --- p.138

The complex interplay between climate change, demographics and socioeconomic conditions is transforming the global environmental health landscape. In the aftermath of recent heat waves around the world, especially the 2003 heat wave in Europe, heat is being recognized as an emerging public health issue worldwide, particularly in urban areas. This work explores the historical and future heat-related mortality in New York City, from the beginning of the 20th until the end of the 21st century. New York City is among the largest cities in the world and has been a thriving metropolis over the entire period covered by this study. The unique makeup of the city makes it particularly suitable for studying the impacts of heat over an extended period of time. The presented work encompasses multiple domains of knowledge and illustrates the necessity for applying highly interdisciplinary approaches in addressing the emerging challenges of our time. The background chapter provides an overview of methodological approaches and findings from previous studies with direct relevance to the specific aims of this work. Chapter I is focused on characterizing the impacts of heat on daily mortality since 1900. Here, heat effects are presented in a historical context and changes over time are analyzed and discussed. Chapter II provides a comparative assessment of recent historical and heat impacts until 2100 in New York City, Boston and Philadelphia. This analysis illustrates the differences and similarities between heat impacts in New York City and the other two major urban areas in the U.S. Northeast. Chapter III provides a more comprehensive assessment of future heat-related mortality in New York City under a number of adaptation, climate change and demographic scenarios. The concluding chapter presents a summary of findings and recommendations for future research.

The complex interplay between climate change, demographics and socioeconomic conditions is transforming the global environmental health landscape. In the aftermath of recent heat waves around the world, especially the 2003 heat wave in Europe, heat is being recognized as an emerging public health issue worldwide, particularly in urban areas. This work explores the historical and future heat-related mortality in New York City, from the beginning of the 20th until the end of the 21st century. New York City is among the largest cities in the world and has been a thriving metropolis over the entire period covered by this study. The unique makeup of the city makes it particularly suitable for studying the impacts of heat over an extended period of time. The presented work encompasses multiple domains of knowledge and illustrates the necessity for applying highly interdisciplinary approaches in addressing the emerging challenges of our time. The background chapter provides an overview of methodological approaches and findings from previous studies with direct relevance to the specific aims of this work. Chapter I is focused on characterizing the impacts of heat on daily mortality since 1900. Here, heat effects are presented in a historical context and changes over time are analyzed and discussed. Chapter II provides a comparative assessment of recent historical and heat impacts until 2100 in New York City, Boston and Philadelphia. This analysis illustrates the differences and similarities between heat impacts in New York City and the other two major urban areas in the U.S. Northeast. Chapter III provides a more comprehensive assessment of future heat-related mortality in New York City under a number of adaptation, climate change and demographic scenarios. The concluding chapter presents a summary of findings and recommendations for future research.

Between May 1985 and December 1986, a cohort of 1,502 pregnant women was recruited at two government clinics in Kosovo (formerly a province of Yugoslavia) for a study of the relationship between environmental lead (Pb) exposure and birth outcomes. Subsequently, a representative group of 541 of their children were selected for long-term follow up. The children were followed longitudinally at six-month intervals for 12 years to examine the effects of environmental Pb exposure on a variety of health outcomes including cognitive and motor function, anemia, endocrine function and growth. This work produced numerous landmark publications (Popovac et al, 1982; Graziano et al., 1990, 1991, 2004; Murphy et al., 1990; Factor-Litvak et al, 1993, 1996, 1998, 1999; Wasserman et al,. 1992, 1994, 1997, 1998, 2000) that contributed to the modification of environmental policies to reduce Pb exposure worldwide. The long-term study ultimately linked environmental Pb exposure from the Trepca mining and smelting operations in Mitrovica to adverse effects on intelligence, motor function, blood pressure, renal, endocrine and hematological functioning. Follow up rates over time were excellent in that 70% of the total cohort was evaluated at 6 years of age, and 65% were evaluated at 12 years of age, at which point the study was - until now - concluded. For the present study, we located 101 members of the original study cohort and requested their participation in a follow-up study in which participants were evaluated to assess their current blood lead (BPb) levels and health outcomes as follows: a) blood pressure; b) biomarkers of endothelial cell function that are associated with cardiovascular disease; c) and measurements of erythropoietin, a glycoprotein hormone produced in the kidney that regulates the production of red blood cells in the bone marrow. The participants, whose environmental exposure history is very well documented from 12 weeks of gestation through 12 years of age, were between 25-26 years of age during the follow-up study. We found a statistically significant association between BPb and systolic blood pressure (sBP), and a marginally significant association between BPb and diastolic blood pressure (dBP), which is consistent with a multitude of studies and meta-analyses referenced in this dissertation. These results provide further evidence that recent circulating dose, as estimated by BPb, or as estimated by lifetime cumulative exposure, is associated with slight increase in sBP. Furthermore, we detected a suggestive relationship between BPb and levels of circulating serum intercellular adhesion molecules (sICAM-1) and serum intravascular adhesion molecules (sVCAM-1), possibly a mechanism by which Pb may lead to increased BP. These findings support the hypothesis that the exposure to Pb either prenatally or in early adulthood, may lead to increased BP and increased circulating levels of sICAM-1 and sVCAM-1 later in life. Lastly, the results regarding the serum erythropoietin (EPO) production presented here resemble the findings reported in this cohort at 4.5 and 6.5 years of age and in contrast with the findings in this cohort when the study participants were 9.5 and 12 years of age (Graziano et al., 2004). In addition, they also contrast the findings reported in the anemic mothers of this study cohort (Graziano et al., 1991) where serum-EPO levels were lower in those with higher BPb levels.

Development and exacerbation of asthma have long been associated with exposure and sensitization to allergens. While exposure to respiratory allergens such as German cockroach, mouse, cat, and dust mite is thought to occur largely by inhalation, the best method to measure the exposure remains unclear. Similarly ambiguous are the ideal measurement and allergic or respiratory effects of exposure to fungi. As most people in the industrialized world, especially small children, spend the majority of their time indoors, the home environment is of prime importance. Previous researchers have shown that poor housing quality or maintenance lead to growth of fungi, increased pest populations, and higher concentrations of other allergens and irritants. These elevated levels in turn are associated with greater rates of sensitization and asthma in the occupants. This dissertation focused on exposure measurement, assessment of sensitization to common molds, and estimating the effects of neighborhood-level pest prevalence and housing quality on asthma symptoms. The study subjects and homes were part of either the Puerto Rican Asthma Study (PRAS), a longitudinal cohort study focused on identifying how multiple risk factors affected allergic sensitization and asthma development in U.S.-born Puerto Rican children with atopic mothers, or the Head Start Study (HSS), which examined allergen exposure and sensitization in young children of low-income families. From 199 of these New York City homes, settled dust, high-volume air, and nasal air sample measurements were simultaneously collected and analyzed for cockroach, mouse, dog, cat, rat, and mite allergens. Cockroach and mouse allergens were quantified from all three sample types while the other allergens were measured from air samples only. Ninety-three women from PRAS were tested for sensitization to six species of mold using the halogen immunoassay and four mold species using ImmunoCAP. The results were compared to previously quantified specific-IgE to other inhalant allergens as well as to self-reported allergy and asthma symptoms and demographic characteristics. Finally in a cross-sectional sample of 225 children from both study populations, the impacts of housing conditions and pests on current asthma at both the individual and neighborhood level were examined. Questionnaire data on demographics, housing factors, asthma symptoms, and health behaviors were evaluated with allergic sensitization and environmental sampling results for each child. They were also grouped and contrasted by neighborhood using United States Census neighborhood-level data on reported pest prevalence and housing quality. The effects of individual and neighborhood factors on current asthma symptoms were estimated using a generalized linear model. Allergen concentrations were generally highest in settled dust, followed by high-volumetric air, and then nasal air samples. Mouse allergen was most frequently detected in air samples, followed by dog, cat, and cockroach. No samples contained rat or any of three types of mite allergens above the detection limit. While all three measurements enhanced the exposure picture for mouse allergen, air samples rarely had detectable cockroach allergen despite being detected in settled dust. This led to the conclusion that settled dust sampling is still crucial when assessing a child's exposure to cockroach allergen but may be less important for buoyant mammalian allergens such as mouse. Nearly one-third of the 93 mothers were sensitized to one or more molds as determined by either assay. Being sensitized was positively associated with sensitization to tree, grass, or pigeon allergens but not to other inhalant allergens. Moreover there was no association seen between sensitization to the fungal species and asthma or allergy symptoms. Of note, however, interesting differences between the halogen immunoassay and ImmunoCAP were identified that merit additional investigation. For the 225 children, current asthma symptoms were positively associated with early respiratory infections, presence of environmental tobacco smoke, having higher concentrations of cockroach allergen in bed dust, a higher intensity sensitization level to one or more inhalant allergens, and current asthma in the mothers. After adjusting for individual-level factors (cockroach allergen in bed dust, environmental tobacco smoke, and study population), no effect of neighborhood-level characteristics could be associated with current asthma prevalence. The lack of effect was likely due to a combination of factors including: small sample size, self and other selection biases, and insufficient diversity across the study population and neighborhoods

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