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Research Project

The changing COVID-19 landscape: A feasibility study to capture momentary residential environmental exposures and asthma symptoms in adults

Aim 1. Determine the feasibility and usability of (1) EMA to assess self-report residential environmental exposures and asthma symptoms, (2) home monitoring of objective environmental exposures (VOC, PM2.5), and lung function (home spirometry). Aim 2a. Assess the frequency and degree of residential environmental exposures (e.g., disinfectants/cleaners, second-hand smoke, pesticides) via (1) EMA self-reported data, and (2) home monitoring objective measures. Aim 2b. Assess the level of asthma control as indicated by self-reported asthma symptoms and lung function (FEV1%). Aim 3. Explore associations of self-reported and objective measures of residential environmental exposures with self-reported and objective measures of asthma control.

Principal Investigator
Eldeirawi, Kamal M
Start Date
2021-03-15
End Date
2024-09-29
Funding Source
University of Kansas

Abstract

The global pandemic of coronavirus 2019 (COVID-19) is a substantial cause for concern among individuals with chronic respiratory diseases, including those with asthma. It is estimated that more than 60% of adults with asthma have uncontrolled symptoms and this represents a substantial health and economic impact. Compared to children, adults are nearly five times more likely to die from asthma and the asthma-related death rate is highest among those 65 years and older. Viral infections are a prominent risk factor for asthma exacerbation and, thus, SARS-CoV-2, the virus responsible for COVID-19, is cause for alarm among those diagnosed with asthma. Sheltering-in-place orders and recommendations, physical distancing, wearing face coverings, hand hygiene, and increased cleaning and disinfecting are primary COVID-19 preventative measures advocated. The effects of home-based strategies to prevent COVID-19, specifically increased residential exposure to cleaning/disinfecting agents and particulates on adults with asthma is unknown. Our long term goal is to characterize the impact of COVID-19 on existing asthma risk factors so as to develop tailored, home-based asthma interventions that adequately acknowledge COVID-19 and are responsive to the changing home environment and home routines resulting from this pandemic. The aims of this study are: 1) determine the feasibility and usability of: (a) ecological momentary assessment (EMA) to assess self-report residential environmental exposures and asthma symptoms, (b) home monitoring of objective environmental exposures (total volatile organic compounds [VOCs], particulates [PM2.5]), and lung function (home spirometry); 2a) assess the frequency and degree of residential environmental exposures (e.g., disinfectants/cleaners, second-hand smoke) via (a) self-reported data, and (b) home monitoring objective measures, 2b) assess the level of asthma control as indicated by self-reported asthma symptoms and lung function; and 3) explore associations of self-reported and objective measures of residential environmental exposures with self-reported and objective measures of asthma control. We will recruit 50 adults with asthma who completed our ongoing online COVID-19 and asthma survey, indicated willingness to be contacted for future studies, reported high use of disinfectant/cleaning products, and have not-well controlled asthma. Participants will receive an indoor air quality monitor and a home spirometer to measure VOCs, PM2.5, and FEV1% respectively. EMA will be collected using a personal smartphone and EMA software platform. Participants’ will be sent scheduled and random EMA notifications to assess asthma symptoms, environmental exposures, lung function, and mitigation strategies. After the 14-day data collection period, participants will respond to survey items related acceptability, appropriateness, and feasibility. Findings from this feasibility study will support a powered study to address the impact of environmental exposures related to COVID-19 and to enhance preparedness for future infectious disease outbreaks by developing innovative intervention strategies for those with asthma.