ECHO Researchers Analyze Potential Toxicity of Chemicals, Discover Gaps in Chemical Research

 

Edo Pellizzari, PhD, RTI International, ECHO Researcher

In a recent article in Environmental Health Perspectives, ECHO researchers discuss their work on identifying and ranking chemicals that have not been biomonitored nationally but may negatively affect child health. Biomonitoring is a process that detects chemicals that people are exposed to and measures how much of those chemicals get into the body.

To collect information, researchers examined different environmental elements (i.e., food, water, air, house dust) and household products that may contain toxic chemicals. Among other tasks, they put the chemicals into three groups:

  1. Chemicals recommended for biomonitoring
  2. Chemicals that need more information
  3. Chemicals that are a low priority for biomonitoring

Of the identified 720 chemicals, 155 were selected for prioritization, and of these, 36 were recommended for biomonitoring, 108 need additional research, and 11 were considered low priority. The chemicals recommended for biomonitoring add to the list of those currently studied by the ECHO Program. The chemicals that did not meet the three criteria – prevalence in environmental media or biospecimens, toxicity and a biomarker for its measurement – show the gap in current chemical research.

“There is a large opportunity to expand our ability to measure and evaluate chemicals to which the public is likely exposed,” the authors note. “These opportunities include performing exposure measurements, developing methods for biomonitoring, and toxicity testing of chemicals.”

While several thousand chemicals are approved for use in the United States, there is little information on biomonitoring of exposures in pregnant women, babies, and children. This limits the ability to evaluate the potential health impact of a variety of chemicals.

Through this study, the research team hopes others in the science community will be encouraged to study the identified chemicals and improve understanding of the potential health consequences they present in pregnant women, infants, and young kids.

ECHO Researchers Identify Gaps in Prenatal Opioid Exposure Research

Elisabeth Conradt, PhD

This week, Pediatrics published results from ECHO researcher Elisabeth Conradt and her team’s efforts to learn more about prenatal opioid exposure and its effects on child development. Conradt and her team reviewed 52 publications to summarize what is known and make suggestions on how to expand knowledge in this area. The resulting article includes perspectives on how the ECHO Program can help learn more about this important topic.

“The number one question mothers, fathers, and clinicians have when they see that a mother is using opioids while pregnant is ‘how will this opioid exposure affect the child’s health?’ We cannot answer that question right now with the existing data,” Conradt said.

The team analyzed existing publications on three age groups: birth, infancy, and 2 years and older. Because of inconsistent and limited data, Condradt’s team was not able to understand a connection between prenatal opioid exposure and how children’s minds develop throughout life. However, they predict that the effects of the exposure at birth and infancy are small and subtle, but may increase as children age and have more demands on their attention at home and school.

Current studies were limited because of small sample sizes and difficulty controlling for confounding factors such as where a person lives or how much money their family makes.

Moving forward, the team will use ECHO data to test how prenatal opioid exposure affects learning, understanding, behavior, and attention span in middle childhood. They will also consider other possible factors such as poverty. Conradt noted that the team will also look at whether newborns who have neonatal opioid withdrawal syndrome (NOWS) have worse effects compared with newborns exposed to opioids who do not have NAS/NOWS.

Read the study summary and full media release.

New ECHO-funded Research Shows Chronic Illnesses in Children Do Not Necessarily Lead to Dissatisfaction

The ECHO researchers’ findings suggest that children with chronic illnesses are just as happy as their peers who do not have chronic illnesses.

The May 2019 issue of Pediatrics published findings from a recent study by ECHO researchers Courtney Blackwell, Amy Elliott, Jody Ganiban, Julie Herbstman, Kelly Hunt, Chris Forrest, and Carlos Camargo. The publication, titled “General Health and Life Satisfaction in Children With Chronic Illness,” focuses on children’s general health and life satisfaction in the context of chronic illness.

The study found that while children with chronic illnesses have worse health overall, their life satisfaction was comparable with that of their peers without chronic illnesses, suggesting that children with chronic illnesses may still lead happy lives.

As reported by the American Academy of Pediatrics, the authors noted, “the current study suggests that having a chronic illness is certainly a health challenge (evidenced by lower parent-reported general health) but does not preclude these children from having happy and satisfying lives that are comparable with those of peers without illness.”

This multi-cohort study evaluated results from questionnaires completed by 1113 caregivers completed on behalf of 1253 children aged 5-9 years with illnesses such as asthma, attention deficit hyperactivity disorder (ADHD), and digestive disorders. The study used the Patient-Reported Outcomes Measurement Information System Parent-Proxy measures for Global Health and Life Satisfaction.

Consistent with one of the primary goals of ECHO to leverage existing cohorts through harmonization of extant data and standardization of newly collected data, this study evaluated data from existing cohorts associated with the ECHO Program, with a specific focus on ECHO’s Positive Health outcome area.

“Overall, this work highlights clinical opportunities to broaden the perspective of health beyond the absence of disease to one in which all children, regardless of illness or impairment, can have well-being,” the authors said.

Read the full article to learn more.

Related links:

Link to AAP story

NIH, ECHO, and the Navajo Nation Make History with New Data-Sharing and Use Agreement

This landmark agreement enables the Navajo Birth Cohort Study (NBCS) to continue as part of the ECHO Program.

A Mother’s Love. Mallery Quetawki (Zuni Pueblo). University of New Mexico College of Pharmacy-Community Environmental Health Program

May 8, 2019

The National Institutes of Health (NIH) facilitated a data-sharing and use agreement between the Navajo Nation and NIH grantees of the Environmental influences on Child Health Outcomes (ECHO) Program at the Navajo Nation Head Start Center in Leupp, Arizona. This agreement, signed by the Navajo Nation, Johns Hopkins University, and RTI International, enables the Navajo Birth Cohort Study to continue participating in the ECHO Program while maintaining respect for Navajo Nation cultural beliefs, Tribal sovereignty, and community values. Additionally, the agreement serves as the first Tribal data-sharing agreement for a nationwide research consortium creating a large-scale database.

“Through this agreement I am confident that data sharing will benefit our Navajo people and allow us to further understand the relationship between uranium exposure, birth effects and childhood development,” said Navajo Nation President Jonathan Nez. “I am optimistic that through this partnership, the Navajo Birth Cohort Study will continue to progress and clarify the environmental impacts on our children’s health.”

The landmark agreement is the culmination of two years of discussion facilitated by NIH, and lays the groundwork for discussions with other Tribal Nations considering participation in biomedical research programs. Most importantly, the study is poised to benefit Navajo mothers and children as well as mothers and children everywhere. More information about the agreement can be found in the NIH news release here.