Spatio-temporal analyses of the role of environmental factors on cystic fibrosis severity, with a focus on fungal infections
Lead Research Organisation:
Imperial College London
Department Name: School of Public Health
Abstract
Air pollution is a major environmental health problem worldwide. Subjects with lung diseases such as cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD) and asthma are especially vulnerable to the negative effects of air pollution. Particulate matters (PM2.5 and PM10), NO2 and O3 have been identified as air pollutants which have a major impact on health reported by the World Health Organisation.
There are over 12,000 people with CF in the UK. Despite growing evidence of the health impact of environmental factors (e.g. air pollution, exposure to second-hand smoke) and socio-economic status, there is limited evidence from the UK on the role of environmental factors in the severity of CF, including pulmonary exacerbations and other complications. Fungal infections, which are believed to be closely associated to local environmental characteristics, are also linked to a rapid decline in lung function.
The aims of my Ph.D. are to fill in this important research gap, building on findings from the US and some European countries. First, I want to assess the short-term influence of air quality, climate, and housing properties (particularly humidity, dampness and molds) on disease severity in CF. Second, I would like to contribute to a better understanding of the influence of where individuals with CF live on the prevalence of fungal infections.
My project will use data from the UK CF Registry (2007-2017), which includes data from every specialist centre and clinic across the UK, representing over 99% of people with CF. I will focus on using spatio-temporal analyses based on small-area methods to study environment-health associations and to rigorously quantify possible causative interactions. A better understanding of these interactions and the identification of possible environmental risk factors could have direct benefits for CF individuals.
This project, conducted in the UK Small-Area Health Statistics Unit (SAHSU, https://www.sahsu.org), is funded by UK CF Trust (https://www.cysticfibrosis.org.uk/) and the MRC DTP at Imperial (https://www.imperial.ac.uk/mrc-dtp-studentships), in collaboration with the CF-EpiNet Strategic Research Centre (https://www.cysticfibrosis.org.uk/the-work-we-do/research/research-we-are-funding/strategic-research-centres/src-4-bilton-data).
There are over 12,000 people with CF in the UK. Despite growing evidence of the health impact of environmental factors (e.g. air pollution, exposure to second-hand smoke) and socio-economic status, there is limited evidence from the UK on the role of environmental factors in the severity of CF, including pulmonary exacerbations and other complications. Fungal infections, which are believed to be closely associated to local environmental characteristics, are also linked to a rapid decline in lung function.
The aims of my Ph.D. are to fill in this important research gap, building on findings from the US and some European countries. First, I want to assess the short-term influence of air quality, climate, and housing properties (particularly humidity, dampness and molds) on disease severity in CF. Second, I would like to contribute to a better understanding of the influence of where individuals with CF live on the prevalence of fungal infections.
My project will use data from the UK CF Registry (2007-2017), which includes data from every specialist centre and clinic across the UK, representing over 99% of people with CF. I will focus on using spatio-temporal analyses based on small-area methods to study environment-health associations and to rigorously quantify possible causative interactions. A better understanding of these interactions and the identification of possible environmental risk factors could have direct benefits for CF individuals.
This project, conducted in the UK Small-Area Health Statistics Unit (SAHSU, https://www.sahsu.org), is funded by UK CF Trust (https://www.cysticfibrosis.org.uk/) and the MRC DTP at Imperial (https://www.imperial.ac.uk/mrc-dtp-studentships), in collaboration with the CF-EpiNet Strategic Research Centre (https://www.cysticfibrosis.org.uk/the-work-we-do/research/research-we-are-funding/strategic-research-centres/src-4-bilton-data).
Studentship Projects
Project Reference | Relationship | Related To | Start | End | Student Name |
---|---|---|---|---|---|
MR/N014103/1 | 01/10/2016 | 30/09/2025 | |||
2250794 | Studentship | MR/N014103/1 | 01/10/2018 | 31/07/2022 |
Description | PhD studentship |
Amount | £42,500 (GBP) |
Organisation | Cystic Fibrosis Trust |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 10/2018 |
End | 03/2022 |
Description | Collaboration with Cystic Fibrosis Trust |
Organisation | Cystic Fibrosis Trust |
Country | United Kingdom |
Sector | Charity/Non Profit |
PI Contribution | i linked CF data with air pollution and composting sites data for analysis. |
Collaborator Contribution | Cystic Fibrosis trust provided data on all CF patient in the UK during 2007 to 2018 |
Impact | not yet |
Start Year | 2019 |
Description | Collaboration with Imogen Felton |
Organisation | Royal Brompton Hospital |
Country | United Kingdom |
Sector | Hospitals |
PI Contribution | A collaboration has been set up with Dr Imogen Felton, a CF clinician, to build on her previous work on "Prevalence and Clinical Associations of Fungal Airway Isolates in the UK Adult CF population", where she focused on CF adults between 2007-2012 period. |
Collaborator Contribution | Dr Imogen Felton requested UK CF registry for additional including the postcode for geographical variation in prevalence fungal infection in people with Cystic Fibrosis in the UK. |
Impact | not yet |
Start Year | 2020 |
Description | Collaboration with PHE |
Organisation | Public Health England |
Department | Centre for Radiation, Chemicals and Environmental Hazards (CRCE) |
Country | United Kingdom |
Sector | Public |
PI Contribution | I collated all composting data received from all environmental agencies in the UK and linked with our health data to explore the impact of living near composting sites on lung function in people with Cystic fibrosis. |
Collaborator Contribution | Pippa Douglas from PHE shared her experience and expertise on exposure related to composting sites. She also helped in getting composting sites data from environmental agencies in the UK. |
Impact | not yet |
Start Year | 2019 |
Description | collaboration with the Frank Kelly's environmental research team |
Organisation | Imperial College London |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | We have a collaboration with the Frank Kelly's environmental research team, which moved from Kings College London to Imperial College London recently, for NO2, PM2.5 and O3 concentrations using the King's College London urban model (KCLurban). We have combined the postcode for our all CF patients during 2007 to 2017. Due to the sensitivity of the information of the cystic fibrosis patients, we added 10 dummy postcodes for each real postcode - an approach approved by the UK CF Registry - before sharing the data with Frank Kelly's team for extraction of air pollutant data. After receiving the data on pollutants will be linked with our clinical CF data for the analysis. I aim to explore the impact of NO2, PM2.5 and O3, concentrations on ppFEV1 over a 10-year period: 2007-2017 among PwCF in Greater London. |
Collaborator Contribution | Frank Kelly's environmental research team using their King's College London urban model (KCLurban) will extract NO2, PM2.5 and O3 concentrations at the geographical centroid of all CF patient residential postcode in Greater London for 3 time periods: i) yearly average exposure; ii) average exposure over a week preceding the annual report; and iii) average exposure over 24 hours preceding the annual report. |
Impact | not yet |
Start Year | 2019 |