Although the incidence of new cases of asthma has decreased in recent years, the prevalence of asthma morbidity continues to be a significant clinical and public health issue. The measures of morbidity include the need for urgent medical care and high-dose asthma medications due to uncontrolled asthma symptoms. However, the risk factors for uncontrolled asthma symptoms are poorly defined, especially for the adult asthmatic. Much interest in the host-environment interaction has evolved in response to the greater morbidity observed in adult asthmatics. Thus, the need to identify risk factors is greater than ever. An underlying problem is that surveillance for asthma does not exist at the local or state level. Here we address the concept of environmental health surveillance by demonstrating the utility of local asthma hospitalization data to estimate the burden of asthma morbidity in hopes of identifying environmental risk factors. We examine this burden within 2 geographic settings: 1. a selected urban-rural setting in Pennsylvania and 2. within the 89 zip codes in Allegheny County, Pennsylvania. We also demonstrate that such hospitalization records are a rich source for data needed to generate hypotheses with respect to the prevalence of environmental risk factors and chronic disease morbidity. Lastly, we demonstrate the use of a non-invasive biomarker (i.e. antibodies specific for atypical respiratory pathogens) to assess the risk of exposure to a biological environmental agent to adult asthma morbidity. Given the poor understanding of risk factors for adult asthma prevalence and morbidity, this research is both relevant and important in addressing environmental public health disparities.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-12022005-113551 |
| Date | 03 February 2006 |
| Creators | Ramos, Rosemarie Govea |
| Contributors | Bruce R. Pitt, PhD, Ada O. Youk, PhD, MS, Evelyn O. Talbott, DrPH, MPH, Meryl H. Karol, PhD |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-12022005-113551/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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