Improved estimation of pollen exposure, mixtures, and risk of respiratory illness

PROJECT SUMMARY Through this predoctoral fellowship focused pollen, air pollution, and respiratory health, I will obtain in-depth training in exposure assessment and health effect estimation, biostatistical methods for environmental mixtures, science communication, and teaching and mentorship. Pollen-related illnesses affect 60 million Americans, with direct medical expenses estimated in the billions of dollars annually. Trends suggest that the prevalence of pollen-induced asthma and allergic rhinitis is on the rise, which is expected to increase health disparities and the already-substantial health costs associated with these conditions. There is emerging evidence that pollen is an under-appreciated environmental justice issue that adds to the disproportionate environmental burdens faced by people from racial and ethnic minority groups or lower income groups. Nevertheless, pollen is an understudied environmental risk factor with scarce evidence on several important questions related to pollen-health associations. The project proposed here fills significant gaps in our understanding through the following specific aims: 1) Implement a multi-location time-series study of pollen and respiratory morbidity that includes assessment of individual- and area-level indicators of social vulnerability; 2) investigate how pollen and air pollution may interact to influence the risk of respiratory morbidity; and 3) develop a city-wide automated pollen monitoring network in that emphasizes community-level data production to improve exposure estimates and quantify potential exposure disparities. I hypothesize that individual- and area-level disparities in pollen-associated risk of respiratory illness exist (Aim 1) and may be exacerbated by the synergistic effects of pollen and air pollution (Aim 2) as well as heterogeneous local pollen exposures (Aim 3). The proposed research will yield insight into pollen-related risk disparities across populations in 23 U.S. locations, potential synergistic effects of pollen and air pollution via implementation of environmental mixtures methods, and potential within-city exposure disparities via community-level pollen exposure monitoring. By investigating the unequal burden of pollen-associated respiratory illnesses and improving how we monitor and assess pollen exposure, this research has the potential to guide public health recommendations and improve health outcomes for millions of people. The proposed work complements the NIH Climate Change and Health Initiative Strategic Framework and connects directly to several NIH special interest areas on climate change and health (NOT-ES-22-006; NOT-HD-23-006).