Birth cohort study on the effects of desert dust exposure on children's health: protocol of an adjunct study of the Japan Environment & Children’s Study - best air purifier for asthma

Desert dust is estimated to account for 35% of the aerosol in the atmosphere.
Deserts, climate change and global warming can all lead to dust formation.
This study aims to study the possible health effects of desert dust exposure on pregnant women and their children.
The purpose of this report is to introduce research programmes.
Methods and analysis of these 4-
The birth cohort study, which began in 2011, is a supplementary study of the Japanese study of environment and children, covering three regions of Kyoto, Toyama and Tottori.
The above three regions also agreed that the subject s participants who participated in this supplementary study were registered before delivery.
Optical detection and ranging (LIDAR) using a polarization analyzer that can distinguish mineral dust particles from other particles for exposure measurement.
The result was allergic symptoms in the mother and asthma and other allergic or respiratory diseases in the child.
Get the data in time by connecting the local LIDAR equipment to the online questionnaire system.
Participants answered the online questionnaire using their mobile phone or personal computer.
The research programme was approved by Kyoto University, Toyama University and the ethics committee of the university.
Written informed consent is provided by all participants.
The results of this study will be published in the peer
Disseminate review journals to the scientific community and the public.
Trial registration number UMIN000010826.
It is estimated that desert dust accounts for about 35% of the aerosol in the atmosphere.
Deserts, climate change and global warming can all lead to dust formation.
This study aims to study the possible health effects of desert dust exposure on pregnant women and their children.
The purpose of this report is to introduce research programmes.
Methods and analysis of these 4-
The birth cohort study, which began in 2011, is a supplementary study of the Japanese study of environment and children, covering three regions of Kyoto, Toyama and Tottori.
The above three regions also agreed that the subject s participants who participated in this supplementary study were registered before delivery.
Optical detection and ranging (LIDAR) using a polarization analyzer that can distinguish mineral dust particles from other particles for exposure measurement.
The result was allergic symptoms in the mother and asthma and other allergic or respiratory diseases in the child.
Get the data in time by connecting the local LIDAR equipment to the online questionnaire system.
Participants answered the online questionnaire using their mobile phone or personal computer.
The research programme was approved by Kyoto University, Toyama University and the ethics committee of the university.
Written informed consent is provided by all participants.
The results of this study will be published in the peer
Disseminate review journals to the scientific community and the public.
Trial registration number UMIN000010826.
Brief introduction desert dust and human health aerosol particles are produced by various natural and human processes, and it is estimated that desert dust accounts for about 35% of the aerosol mass with a diameter of less than 10 μm.
1 Mulitza et al reported that with the emergence of commercial agriculture in the Sahelian region, dust emissions from the desert have increased dramatically, indicating that human-
In about 200 years, induced dust emissions caused atmospheric dust loads.
Desert dust is mainly composed of rocks.
Minerals such as quartz are formed, and clay minerals such as cloud mother Stone and coal Stone are formed.
Additional particle analysis revealed the presence of microbial agents such as bacteria, fungal spores, and viruses3-6, as well as human air pollutants that may be absorbed during transportation.
Recent evidence suggests that these dust particles may have some negative effects on human health.
Applying desert dust sand to the trachea of mice will have an auxiliary effect in airway8 and 9, and inhalation of desert dust sand in mild asthma patients will lead to a significant reduction in forced breath.
Ten epidemiology studies have shown that desert dust events are associated with health outcomes such as increased asthma in Spain, the Caribbean, Japan, South Korea, China, Taiwan and elsewhere.
11-21 Although many studies on urban pollution have examined direct linkages and vulnerable groups, as well as possible responses and their effectiveness, only a few people quantify the direct link between desert dust and human health.
Several aspects of desert dust exposure are still unknown, such as its long-term exposure
Long-term impact on health and vulnerable groups, who are the vulnerable groups, whether it is increasing the incidence of asthma or sensitivity to allergens, which components of dust particles will have a negative impact on health, if there is any effect modifier, how to reduce the effect and whether it will affect the long time
Long-term disease progression, such as asthma.
This information is particularly important for future public health measures, as there is growing evidence that the three main factors that affect dust activity in the desert --
Climate change and global warming-
All of this can lead to the formation of dust.
The developed countries spend about 90% of their time indoors.
27 we found that the arrival of Asian dust (desert dust from China and Mongolia) caused 50-
The number of outdoor particles has doubled, 20-
In daily conditions, double in the interior (apartment), the use of windows and air purifiers greatly affects the amount of indoor particulate matter.
28 reducing exposure to air pollutants to reduce the risk of worsening symptoms is considered a common sense solution that may lead to biased estimates of the health impact of pollution exposure.
For our cohort, we would like to have quick access to information about individual behavior to reduce this bias and estimate how much dust exposure risk can be reduced by avoiding behavior.
In 2010, 95% of Japanese households owned mobile phones and 99% of households aged 20-49 used the Internet.
30 make proper use of these networks
Communication-based tools can strengthen epidemiology studies beyond regular studies, especially for young participants.
The expected benefits compared to traditional methods include facilitating participants, as well as saving researchers a lot of cost and efficient collection of data.
31-35 on the other hand, web-
There are several limitations based on the survey, such as sampling issues, participants' inability to access computers with internet connections, and Internet privacy issues.
31, 33, 35 more research may be needed to better quantify the risks and benefits of online marketing
Based on research.
31 our birth cohort uses web-to check possible effects of desert dust exposure on health outcomes
A questionnaire-based connection to the environmental measurement system allows the collection of information in a short period of time.
This report is intended to present our research objectives, design and progress to relevant research groups.
Objective the objectives of this study are as follows: (1) Long termterm effects;
Check the possible impact of desert dust exposure on infant allergies or asthma development, (2) Short termterm effects;
Deterioration of respiratory and allergic symptoms in pregnant women, (3) further analysis to check long-term and short-
Term effects, including the extent to which behavior mitigation effects are avoided, or the degree to which other contaminants (including pollen) coexist to enhance effects, identify groups that are susceptible to dust exposure, explore possible local differences in the impact of dust exposure in the desert, and what factors in dust particles will have an impact, and learn more about web-
Based on the questionnaire, by comparing the demographic features between networks
Respondents and non-respondents based on survey
Respond and check the consistency of web-
Paper answersbased answers.
The main hypothesis is that people exposed to high levels of desert dust develop more than 1 asthma at the age of four.
Five times more than exposed to low-level desert dust.
Desert dust and human health aerosol particles are generated by a variety of natural and human processes, and it is estimated that desert dust accounts for about 35% of the aerosol mass with a diameter of less than 10 μm.
1 Mulitza et al reported that with the emergence of commercial agriculture in the Sahelian region, dust emissions from the desert have increased dramatically, indicating that human-
In about 200 years, induced dust emissions caused atmospheric dust loads.
Desert dust is mainly composed of rocks.
Minerals such as quartz are formed, and clay minerals such as cloud mother Stone and coal Stone are formed.
Additional particle analysis revealed the presence of microbial agents such as bacteria, fungal spores, and viruses3-6, as well as human air pollutants that may be absorbed during transportation.
Recent evidence suggests that these dust particles may have some negative effects on human health.
Applying desert dust sand to the trachea of mice will have an auxiliary effect in airway8 and 9, and inhalation of desert dust sand in mild asthma patients will lead to a significant reduction in forced breath.
Ten epidemiology studies have shown that desert dust events are associated with health outcomes such as increased asthma in Spain, the Caribbean, Japan, South Korea, China, Taiwan and elsewhere.
11-21 Although many studies on urban pollution have examined direct linkages and vulnerable groups, as well as possible responses and their effectiveness, only a few people quantify the direct link between desert dust and human health.
Several aspects of desert dust exposure are still unknown, such as its long-term exposure
Long-term impact on health and vulnerable groups, who are the vulnerable groups, whether it is increasing the incidence of asthma or sensitivity to allergens, which components of dust particles will have a negative impact on health, if there is any effect modifier, how to reduce the effect and whether it will affect the long time
Long-term disease progression, such as asthma.
This information is particularly important for future public health measures, as there is growing evidence that the three main factors that affect dust activity in the desert --
Climate change and global warming-
All of this can lead to the formation of dust.
The developed countries spend about 90% of their time indoors.
27 we found that the arrival of Asian dust (desert dust from China and Mongolia) caused 50-
The number of outdoor particles has doubled, 20-
In daily conditions, double in the interior (apartment), the use of windows and air purifiers greatly affects the amount of indoor particulate matter.
28 reducing exposure to air pollutants to reduce the risk of worsening symptoms is considered a common sense solution that may lead to biased estimates of the health impact of pollution exposure.
For our cohort, we would like to have quick access to information about individual behavior to reduce this bias and estimate how much dust exposure risk can be reduced by avoiding behavior.
In 2010, 95% of Japanese households owned mobile phones and 99% of households aged 20-49 used the Internet.
30 make proper use of these networks
Communication-based tools can strengthen epidemiology studies beyond regular studies, especially for young participants.
The expected benefits compared to traditional methods include facilitating participants, as well as saving researchers a lot of cost and efficient collection of data.
31-35 on the other hand, web-
There are several limitations based on the survey, such as sampling issues, participants' inability to access computers with internet connections, and Internet privacy issues.
31, 33, 35 more research may be needed to better quantify the risks and benefits of online marketing
Based on research.
31 our birth cohort uses web-to check possible effects of desert dust exposure on health outcomes
A questionnaire-based connection to the environmental measurement system allows the collection of information in a short period of time.
This report is intended to present our research objectives, design and progress to relevant research groups.
Objective the objectives of this study are as follows: (1) Long termterm effects;
Check the possible impact of desert dust exposure on infant allergies or asthma development, (2) Short termterm effects;
Deterioration of respiratory and allergic symptoms in pregnant women, (3) further analysis to check long-term and short-
Term effects, including the extent to which behavior mitigation effects are avoided, or the degree to which other contaminants (including pollen) coexist to enhance effects, identify groups that are susceptible to dust exposure, explore possible local differences in the impact of dust exposure in the desert, and what factors in dust particles will have an impact, and learn more about web-
Based on the questionnaire, by comparing the demographic features between networks
Respondents and non-respondents based on survey
Respond and check the consistency of web-
Paper answersbased answers.
The main hypothesis is that people exposed to high levels of desert dust develop more than 1 asthma at the age of four.
Five times more than exposed to low-level desert dust.
Methods and analytical background: The Japanese environmental and child study and its affiliated study, "Effects of desert dust exposure on children's health", the Japanese environmental and child study, is an ongoing birth cohort study, starting in 2011, the impact of various environmental factors on children's health and development has been assessed.
In 15 regions of Japan, a total of 100000 children and their parents participated in 36 events and 37 events
From early pregnancy to children who are involved in the program reaching the age of 13, plan to regularly check their health status.
Assessment of exposure to environmental factors by biochemical analysis
Samples using monitoring data and questionnaires, including blood, household environmental measurements, and computational simulations.
36 The main criteria for eligibility are: (1) residence in the study area and (2) expected to be between August 1, 2011 and
2014 and (3) are able to participate in the study without difficulty.
JECS allows additional investigations or ancillary studies related to the primary study.
"The impact of desert dust exposure on children's health" is our supplementary study involving three regional centers in Kyoto, Toyama and totake (Figure 1 ).
These areas are located in the western part of Japan, in a basin in which Toyama and totake face the Sea of Japan.
All three areas have urban, suburban and local areas, but the Kyoto area is the most urban of the three, including part of the Kyoto city (population 1. 5 million).
The Fushan area includes the city of Fushan (population, 420000) and the City of Yongna (population, 000 ).
No known area
Specific air pollution problems in these areas.
Dust in Asia is a seasonal event in western Japan, including these areas, and in spring and autumn, when dust blows out of the Asian continent, it will experience a few days of yellow air. The year-
The average suspended particulate matter (SPM) level in the study area is about 15g/m3, day-
During the Dust event in Asia, the average SPM can be increased to 70g/m3. For PM2. 5, the year-
The average level in these areas is about 10-15g/m3, dayaverage PM2.
5 during the Dust events in Asia and some other days (for example, when the pollutant plume arrives from the Asian continent), it can be increased by up to 50 µg/m3.
In the auxiliary study, download figureOpen in Figure 1 of the new tabDownload powerpoint.
The three regions also agreed that the sample selection subjects participating in this assisted study were registered before delivery.
Admission in August 2011 ended in March 2014.
Written informed consent is provided by all participants.
Of the 7038 eligible pregnant women registered in Kyoto, Toyama or Tottori Regional Centre in 2011, 2012, as of the end of 2012, 3425 provided consent for this assisted study (Figure 2 ).
The average duration between admission and expected delivery is 95 days (an average of 98 days );
By the end of 2012, the maximum was 218 days.
Eligible participants registered after 2012 were added to the study in an ongoing manner.
Given the high penetration rate of these devices in the target population, mobile phones/PCs do not provide for potential participants without mobile phones.
As of the end of 2012, participants in the environmental and child studies (JECS) and auxiliary studies in Japan.
Figure 3 and Figure 4 show the design of the study.
Those who participated in the panel in Kyoto, Toyama or the Regional Centre of totake were informed of the auxiliary study.
People who agree to participate can access the URL of the baseline network
Based on the questionnaire.
URL of the network-
Questionnaires based on the assessment of individual exposure levels and allergy symptoms were observed on the observed day dust and the Asian dust season (February-5, October-November ).
Comparison of symptom development between exposure days and non-exposure daysexposed days.
Two methods were used to study the avoidance behavior, vulnerability features and impact correction potential of other air pollutants including pollen
A factor model with an interactive item.
Exposed to SPM and PM2.
5. it is also used to study the effects of particulate matter.
During the dust season in Asia, particulate matter (total suspended particulate matter) in the air is also sampled every day at each location, and chemical/biological analysis is planned to explore which components in the dust play a role, or what is the effect modifier. A web-
The child sends a basic questionnaire of the child's results every 6 months after birth until the child reaches 4 years of age.
Participants answered the questionnaire using their personal phone or personal computer according to the set time limit (within 28 hours after issuance.
Compare the development of asthma or other allergic diseases with those exposed to high or low levels of desert dust.
Time of occurrence of asthma or other allergic diseases between the two groups was also examined.
During pregnancy, download figureOpen in the new tabDownload powerpoint figure 3 auxiliary research protocol. A web-
The basic questionnaire to assess individual exposure levels and allergic symptoms was published during the day (Brown) of the Asian dust season (February-5) and some randomly selected days (green, japan Centre for Environmental and children studies, October-November;
Lidar, light detection and ranging ).
After birth, download figureOpen in the new tabDownload powerpoint figure 4 Auxiliary research protocol. A web-
On the day of the observation of dust (Brown) and some randomly selected days (green), a basic questionnaire was published to assess the level of exposure of children. A web-
The basic questionnaire to assess the results of children is sent every 6 months after the birth of the child until the child reaches 4 years of age (lidar, light detection and ranging ).
Sample size the main purpose of this study was to evaluate the relationship between desert dust exposure and the development of asthma in children.
A sample of 9000 children will provide 80% of the ability to detect OR 1.
5 A 5% significant level between children exposed to high and low levels of desert dust, assuming a low level of exposure to asthma in children was 1. 5%.
We also evaluated the sample size required for our second target, that is, to assess the association between maternal desert dust exposure and allergic symptoms deterioration, and to confirm that the sample size used for the main target was sufficient.
Measurement of sdemographicson study registration, baseline information, such as a history of asthma or any other allergic disease, by network Collection
Based on the questionnaire.
In addition, various lifestyle parameters such as diet, exercise, family environment and housing environment were obtained during the JECS process.
During pregnancy, three serum samples were collected for JECS, and the remaining serum will be used to measure vitamin D and inflammatory cytokines levels in some participants.
The details of the measurement items are shown in Table 1 and the questionnaire is shown in the online Supplementary Appendix.
View this table: a summary of the auxiliary research measurement and data collection items is defined in the protocol, that is, the number of days system measurement of light detection and ranging (LIDAR) is greater than 0.
Desert dust at 07/km (median daily), based on previous studies, is 135 m above sea level.
17,18 lidar is an optical remote sensing technology that measures the properties of scattered light to obtain information about distant targets.
Combined with the polarization analyzer, it can distinguish non-
Spherical dust particles from other spherical particles.
17, 38-41, Asian dust Day, from
The management questionnaire is automatically distributed to participants and the URL is sent to their mobile phone and/or personal computer.
The various questions raised are shown in the online Supplementary Appendix.
On other days of the Asian dust season, the same questionnaire was sent for comparison to be random-
Selected participants with a probability of about 10% per day. SPM and PM2.
5 also measured at each location, the same analysis will be performed for exposure measurements.
Results of the development of allergic diseases in infants (long-
Long-term impact on babies), a self
After delivery, a questionnaire is sent to the mother every 6 months through the mobile phone.
The questionnaire includes an international study of asthma and allergies in children (Isaac) questionnaire 42 and a doctor's diagnosis of asthma and other allergic diseases (see Supplementary Appendix online ).
We define the development of asthma as continuous breathing and/or a doctor's diagnosis of asthma or asthma bronchitis.
For one-day measurementto-
Daytime symptoms (short-
Long-term impact on pregnant women), a self
Management questionnaires including Japanese version allergy control score 43 items were distributed to participants via mobile phones and/or personal computers.
We will compare the proportion of any symptoms (symptom score above 0) between Asian dust Day and control day.
Statistical analysis plan for primary analysis (1)
Long-term effects on infants), we compared the development of 4-year-old asthma between high exposure and low exposure (lower than the first score, higher than the fourth score of the daily cumulative value)
Average dust levels at birth.
The Cox proportional risk model also examined the timing of the occurrence of asthma or other allergic diseases between the two groups. (2) For short-
The effect of the term on pregnant women, we will compare the proportion of any symptoms (symptom score higher than 0) between Asian dust days (dust level ≥ 0.
07/km) and control days (dust level