Climate Variability and Respiratory Health in Asthma and COPD

Dr. Nicholas Nassikas is a pulmonary and critical care physician whose long-term career goal is to determine how climate-related exposures affect the respiratory health of people with chronic lung disease and to devise strategies to prevent or mitigate such effects in the context of climate change. He has assembled a multidisciplinary and multi-institutional mentorship team with expertise in environmental epidemiology (Drs. Rice and Gold) and asthma disparities (Dr. Israel), who have demonstrated a firm commitment to his long-term success as a clinical investigator. As part of the award, Dr. Nassikas will extend his skills in biostatistics, epidemiology, and statistical programming through formal coursework to obtain a Master of Public Health. Rates of global warming are doubling every decade, causing heavier precipitation and warmer, more variable temperatures across the United States, with significant implications for human health. Dr. Nassikas’ study will evaluate associations of temperature and precipitation, and the extremes of each, on the respiratory health of those with chronic obstructive lung disease and in vulnerable populations, including Black/Latinx communities who may be differentially exposed. His central hypothesis is that higher levels and variability of temperature and precipitation will be associated with more respiratory symptoms and exacerbations, lower lung function, and higher airway inflammation in adults with asthma and COPD. Dr. Nassikas will leverage three existing well-characterized cohorts and recruit a prospective cohort of adults with asthma. He is well positioned to test his hypotheses in the following aims: (1) Determine if monthly extreme weather events (high/extreme heat, high wet-bulb globe temperature, heavy precipitation), temperature, and temperature variability are associated with respiratory symptoms and events in adults with chronic obstructive lung disease, (2) Determine if short-term differences in weather conditions are associated with lung function and airway inflammation in adults with chronic obstructive lung disease, and (3) Determine if temperature, temperature variability, and precipitation are associated with differences in symptoms and lung function in adults with asthma and, secondarily, to evaluate if associations are mediated by exposure to mold and aeroallergens. There is a very strong working history between the members of Dr. Nassikas’ mentorship team (Drs. Rice, Gold and Israel), who have published over 27 peer-reviewed manuscripts together. The well-coordinated supervision of Dr. Nassikas’ research activities and career development by his mentorship team follows an existing successful mentorship model. He will benefit from the outstanding and complementary environments at Beth Israel Deaconess Medical Center, Harvard School of Public Health, Brigham and Women’s Hospital, and the Harvard-NIEHS Center. This proposal will provide valuable data and training in epidemiology and prospective study design and execution, which will lead directly to future R01 applications and support his development as an independent, grant-funded investigator.