Aggravating Factors of Asthma in a Rural Environment (AFARE)

Principal Investigator: Catherine Karr, MD, PhD
Professor, Pediatrics and Environmental and Occupational Health 
University of Washington
NIEHS 2009-2014
Communities living in rural agricultural settings may be exposed to an array of biological (e.g. organic dust from animal and crop products, bacteria, fungi, endotoxins) and non-biological particles and gases (e.g. pesticides, hydrogen sulfide and ammonia). This community-based project characterized ambient triggers of asthma in the rural setting by following 50 (children and adults) asthmatic community participants, mapping their exacerbations and comparing these with known agricultural exposures. 
Ambient sampling with an innovative and adaptable sampler confirmed the nature of the exposures. A multifaceted evaluation assessed the process, outcomes, and impact of the program on the partnership, the participants, the clinical providers, and the community. This project was conducted through El Proyecto Bienestar.
In 2016, Dr. Karr won one of only 102 Presidential Early Career Awards given by the White House. Dr. Karr was nominated because of this project and her ongoing community-engaged approach to studying environmental contaminants and the impact on children’s health – especially asthma. Winning the award is an honor that reinforces the value of this kind of research built with strong community partners. “I feel like working with communities to respond to their priority concerns should be an important part of our national research portfolio. But it requires a commitment to taking the time to develop and maintain collaborative relationships. Having a national award recognize this type of research is terrific and hopefully will encourage others,” Karr said. Results are being shared back to the Yakima community, industry stakeholders, clinicians and the scientific community.
Partners and Advisories
Yakima Valley Farmworker Clinic
El Proyecto Bienestar
Northwest Communities Education Center/Radio KNDA
Armstrong JL, Fitzpatrick CF, Loftus CT, Yost MG, Tchong-French M, Karr CJ. Development of a unique multi-contaminant air sampling device for a childhood asthma cohort in an agricultural environment. Environ Sci Process Impacts. 2013 Sep;15(9):1760-7. doi: 10.1039/c3em00330b. PubMed PMID: 23896655; PubMed Central PMCID: PMC4751038.
Loftus C, Yost M, Sampson P, Arias G, Torres E, Vasquez VB, Bhatti P, Karr C. Regional PM2.5 and asthma morbidity in an agricultural community: a panel study. Environ Res. 2015 Jan;136:505-12. doi: 10.1016/j.envres.2014.10.030. Epub 2014 Nov 27. PubMed PMID: 25460673; PubMed Central PMCID: PMC4425279.
Loftus C, Yost M, Sampson P, Torres E, Arias G, Breckwich Vasquez V, Hartin K, Armstrong J, Tchong-French M, Vedal S, Bhatti P, Karr C. Ambient Ammonia Exposures in an Agricultural Community and Pediatric Asthma Morbidity. Epidemiology. 2015 Nov;26(6):794-801. doi: 10.1097/EDE.0000000000000368. PubMed PMID: 26352250; PubMed Central PMCID: PMC4587379.