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BEGIN:VEVENT
DTSTART;TZID=America/New_York:20260114T130000
DTEND;TZID=America/New_York:20260114T140000
DTSTAMP:20260421T150614
CREATED:20251224T031731Z
LAST-MODIFIED:20260203T211523Z
UID:17652-1768395600-1768399200@echochildren.org
SUMMARY:Jean Kerver\, PhD\, MSc\, RD: Incorporating Early Life Micronutrient Status in ECHO studies of Neurodevelopment
DESCRIPTION:Incorporating Early Life Micronutrient Status in ECHO studies of Neurodevelopment \nKey Takeaways: \nIt is known that early life nutrition\, including pregnancy diet and infant feeding\, is critical for brain development\, yet the impact of the suboptimal micronutrient status of the US population is unknown. In this presentation\, Dr. Kerver discusses micronutrient status\, highlighting biomarkers rather than dietary intake\, and its impact on neurodevelopment. She reviews often overlooked interactions between nutrients and environmental toxicants. Dr. Kerver suggests areas where ECHO can better leverage existing knowledge about nutrition’s impact on neurodevelopment. She advocates for greater integration of these interactions in ECHO analyses. \n \nJean Kerver\, PhD\, MSc\, RD  \nDepartment of Epidemiology and Biostatistics\nCollege of Human Medicine\, Traverse City Campus\nMichigan State University\nContact Principal Investigator of ECHO Award 129 \nSpeaker Biography: \nJean Kerver\, PhD\, MSC\, RD\, is the contact Principal Investigator of ECHO Award 129 at Michigan State University. An epidemiologist and registered dietitian\, Dr. Kerver investigates perinatal causes of childhood disorders and develops strategies to promote healthy lifestyle behaviors among families experiencing poverty or other challenges. Based in Traverse City\, Dr. Kerver supports MSU’s College of Human Medicine rural research network initiative. Her primary research focuses on micronutrients and neurodevelopment\, with an emphasis on biomarkers and exposures. \nDownload the slide presentation
URL:https://echochildren.org/event/jean-kerver-phd-msc-rd-incorporating-early-life-micronutrient-status-in-echo-studies-of-neurodevelopment/
CATEGORIES:environmental,innovations,neuro,pregnancy
END:VEVENT
BEGIN:VEVENT
DTSTART;TZID=America/New_York:20251210T130000
DTEND;TZID=America/New_York:20251210T140000
DTSTAMP:20260421T150614
CREATED:20251208T163911Z
LAST-MODIFIED:20260105T161334Z
UID:17515-1765371600-1765375200@echochildren.org
SUMMARY:Allan C. Just\, PhD: Air pollution and temperature as spatial factors impacting child health
DESCRIPTION:Air pollution and temperature as spatial factors impacting child health \nKey Takeaways: For this talk\, Dr. Just explores how air pollution and temperature act as spatial factors impacting child health\, with a focus on advanced exposure modeling using satellite data and machine learning. It highlights unique opportunities within the ECHO program to build spatiotemporal exposure models\, integrate diverse data sources\, and improve the accuracy of environmental health studies. Dr. Just also discusses technical challenges\, model comparisons\, and the importance of analyzing short-term exposures and humidity’s role in heat-related health outcomes. \n \nAllan C. Just\, PhD \nNazareth-Ferguson Family University Associate Professor \nof Public Health in the Department of Epidemiology and \nInstitute at Brown for Environment and Society \nSpeaker Biography: Allan C. Just\, PhD\, is an Associate Professor of Public Health in the Department of Epidemiology and the Institute at Brown for Environment and Society at Brown University. Dr. Just specializes in environmental exposure modeling and epidemiology\, leveraging satellite data and earth observations to enhance exposure assessment for large health registries and cohort studies. Dr. Just is recognized for advancing methodologies in air pollution and temperature modeling to support child health research. \nDownload the slide presentation
URL:https://echochildren.org/event/allan-c-just-phd-air-pollution-and-temperature-as-spatial-factors-impacting-child-health/
CATEGORIES:airways,environmental,innovations,outcomes
END:VEVENT
BEGIN:VEVENT
DTSTART;TZID=America/New_York:20251008T130000
DTEND;TZID=America/New_York:20251008T140000
DTSTAMP:20260421T150614
CREATED:20250916T154449Z
LAST-MODIFIED:20251224T025142Z
UID:17225-1759928400-1759932000@echochildren.org
SUMMARY:Christine Loftus\, MS\, MPH\, Ph.D: Where there’s smoke… there’s action?  What ECHO can do to protect children from wildfire smoke
DESCRIPTION:Where there’s smoke… there’s action? What ECHO can do to protect children from wildfire smoke \nCLICK HERE TO JOIN THE PRESENTATION VIA TEAMS \nKey Takeaways: \nWildfire smoke exposure is a growing public health crisis\, causing significant harm to children nationwide. In 2025 alone\, an estimated 12\,000 ECHO participants have experienced at least one serious smoke event. Dr. Loftus’s presentation will describe wildfire smoke research in progress across the ECHO Program\, including a new study collecting time-sensitive data after smoke events\, aiming to characterize short-term health impacts and parents’ efforts to reduce child smoke exposure. Dr. Loftus will also discuss potential future research directions for the program\, focusing on solution-oriented studies that leverage key strengths of the ECHO Cohort. \n \nChristine Loftus\, MS\, MPH\, Ph.D\nClinical Associate Professor\nEnvironmental and Occupational Health Sciences\nUniversity of Washington \nProject Director  within Cohort 306\nAward PI: ECHO Opportunities and Innovation Fund (OIF)\nCo-chair: ECHO Air Pollution and Wildfire Smoke Interest Group \nSpeaker Biography: \nDr. Christine Loftus is a Clinical Associate Professor of Environmental and Occupational Health Sciences at the University of Washington. Her research program focuses on environmental exposures and child health\, including through applications of advanced study designs and statistical methods\, community-engaged methods for remote and rural settings\, and intervention research. She served as the science director of the PATHWAYS Consortium in ECHO Cycle 1 and is currently the project director of a new ECHO site in the Yakima Valley\, recruiting new pregnancies. She’s the co-chair of the ECHO Air Pollution and Wildfire Smoke Interest Group and is principal investigator of an ECHO Opportunities and Innovation Fund award in progress\, The Development and Evaluation of a Wildfire Smoke Protocol for Rapid Response (WiSPRR). \nKeywords: Wildfires\, smoke\, interventions\, disaster response \nDownload the slide presentation
URL:https://echochildren.org/event/christine-loftus-ms-mph-ph-d-where-theres-smoke-theres-action-what-can-echo-do-to-protect-children-from-wildfire-smoke/
CATEGORIES:environmental,innovations,outcomes
ORGANIZER;CN="Samia Baluch":MAILTO:saimia.baluch@duke.edu
END:VEVENT
BEGIN:VEVENT
DTSTART;TZID=America/New_York:20250813T130000
DTEND;TZID=America/New_York:20250813T140000
DTSTAMP:20260421T150614
CREATED:20250721T201428Z
LAST-MODIFIED:20250902T132912Z
UID:16809-1755090000-1755093600@echochildren.org
SUMMARY:Dr. Maxwell Mansolf - Predictors of Child Eating and Parent Feeding in the ECHO Cohort
DESCRIPTION:Predictors of Child Eating and Parent Feeding in the ECHO Cohort \nKey Takeaways: Dr. Mansolf will present findings from a study using data from over 3\,500 children in the ECHO cohort to examine the complex relationships between child eating behaviors and parental feeding practices. Using machine learning approaches such as random forests and regression trees\, the research identified key predictors of these behaviors\, revealing both independent and interdependent patterns. Results showed that caregiver and child age were the strongest predictors\, followed by caregiver stress\, child BMI\, and social support. These findings highlight potential intervention opportunities and provide new insights into the multifaceted nature of family food dynamics and their implications for child nutritional health. \n \nMaxwell Mansolf\, PhD \nAssistant Professor in the Department of Medical Social Sciences \nNorthwestern University’s Feinberg School of Medicine \nCo-PI\, ECHO Measurement Core \nSpeaker Biography: \nDr. Maxwell Mansolf is an Assistant Professor in the Department of Medical Social Sciences at Northwestern University’s Feinberg School of Medicine. His research focuses on psychometric methods and child health outcomes\, with expertise in classical test theory\, item response theory\, and computerized adaptive testing. Dr. Mansolf serves as a data scientist on large-scale longitudinal studies\, including the Environmental influences on Child Health Outcomes (ECHO) Cohort\, where he manages and analyzes harmonized data from 69 cohorts to advance understanding of child health and development. His recent work includes developing assessment tools such as the NIH Baby Toolbox neurodevelopmental assessment system and contributing to psychometric research published in venues including Multivariate Behavioral Research and the Handbook of Structural Equation Modeling. He is proficient in R statistical programming and recently published the AlignLV package to CRAN. Dr. Mansolf is also author of an upcoming Cambridge University Press textbook on MATLAB programming for non-technical audiences. \nDownload the slide presentation
URL:https://echochildren.org/event/dr-maxwell-mansolf-predictors-of-child-eating-and-parent-feeding-in-the-environmental-influences-on-child-health-outcomes-echo-study/
CATEGORIES:environmental,innovations
END:VEVENT
BEGIN:VEVENT
DTSTART;TZID=America/New_York:20211110T130000
DTEND;TZID=America/New_York:20211110T140000
DTSTAMP:20260421T150614
CREATED:20211011T182343Z
LAST-MODIFIED:20220801T194319Z
UID:4846-1636549200-1636552800@echochildren.org
SUMMARY:Christy Porucznik: Systematic Collection of Biospecimens in the Periconceptional Period
DESCRIPTION:Christy Porucznik: Systematic Collection of Biospecimens in the Periconceptional Period\nECHO Discovery Summary\nTraditional studies investigating environmental exposures during pregnancy often recruit women during their first trimester\, and as a result these studies exclude data from around the time of conception and create an incomplete and biased understanding of the exposure’s effect. Environmental exposures experienced by both the mother and the father around the time of conception can influence their success in achieving and maintaining a pregnancy. \nChristy Porucznik\, PhD\, MSPH of the University of Utah Health shared an example of how studies can successfully collect data on environmental exposures from before conception. Her presentation discussed the success of the Home Observation of Peri-conceptional Exposures (HOPE) study\, which recruited couples who were planning a pregnancy before they conceived. \nDr. Porucznik explained how the HOPE study was able to train women to track their ovulation cycle and have both members of the couple collect regular biospecimen samples throughout that cycle until pregnancy was achieved. Urine\, hair\, saliva\, and semen samples were collected and banked for future studies. The timing of the collection allowed Dr. Porucznik and her team to investigate how certain exposures affected time to pregnancy\, sperm count and morphology\, and sperm epigenetics—analyses that would all be missed by a traditional environmental exposure study. \nDr. Porucznik also highlighted the potential for ECHO studies sites to specialize in and implement a similar remote preconception protocol to gather more extensive and diverse preconception data. Participants who achieve pregnancy can then be transferred into a traditional ECHO cohort for further follow up. \n \nSpeaker: \nChristy Porucznik\, PhD\, MSPH \nUniversity of Utah Health \n  \n  \nSpeaker Bio: \nChristy Porucznik\, PhD\, MSPH\, is the President of the Academic Senate at the University of Utah and a professor in the Division of Public Health\, Department of Family and Preventive Medicine in the School of Medicine.  She completed graduate training in epidemiology at the University of North Carolina at Chapel Hill School of Public Health. Dr. Porucznik is broadly interested in efficient exposure assessment and research questions that can be easily explained to non-scientists. \nSlides\nDate: Wednesday\, November 10th\, 1 to 2pm ET \n \n 
URL:https://echochildren.org/event/christy-porucznik-systematic-collection-of-biospecimens-in-the-periconceptional-period/
CATEGORIES:environmental,pregnancy
END:VEVENT
BEGIN:VEVENT
DTSTART;TZID=America/New_York:20210609T130000
DTEND;TZID=America/New_York:20210609T140000
DTSTAMP:20260421T150614
CREATED:20210520T174030Z
LAST-MODIFIED:20230614T191108Z
UID:4180-1623243600-1623247200@echochildren.org
SUMMARY:Dr. Johnnye Lewis: Navajo Birth Cohort: Understanding Diversity\, Disparity\, and Resilience Through ECHO
DESCRIPTION:Dr. Johnnye Lewis: Navajo Birth Cohort: Understanding Diversity\,\nDisparity\, and Resilience Through ECHO\n\n\n\n\n\nECHO Discovery Summary\nNavajo Birth Cohort: Understanding Diversity\, Disparity\, and Resilience through ECHO \nDr. Johnnye Lewis of the University of New Mexico gave a presentation where she discussed the ECHO Program’s Navajo Birth Cohort. \nIn 2019\, NIH facilitated a data-sharing and use agreement between the Navajo Nation and ECHO Program grantees. The agreement was created to respect Navajo Nation cultural beliefs\, Tribal sovereignty\, and community values. The first Tribal data-sharing agreement for a nationwide research consortium creating a large-scale database\, it lays the groundwork for discussion with other Tribal Nations considering participation in biomedical research programs. \nDuring her presentation\, Dr. Lewis highlighted the importance of understanding diversity\, disparity\, and resilience of indigenous peoples in research and ECHO’s role in building and maintaining diversity of these peoples among its cohorts. \nIn a follow-up conversation with Dr. Lewis\, she discussed the Navajo Birth Cohort and why it’s important to include indigenous peoples in child health research. \nUnderstanding Tribal Sovereignty \nThe Navajo population holds a unique position in the country as the first and only peoples who retain their sovereign (self-governance) status within the U.S.\, says Dr. Lewis. Sovereignty is the basis for holding a negotiation status on policies of the federal government that impact tribal members\, and for their control and ownership of data collected on tribal lands. \n“The mistreatment of indigenous peoples has occurred through a series of broken treaty promises since the time of first contact\,” Dr Lewis notes. “This process has been formally documented within the congressional record as lands guaranteed in perpetuity have been taken away.” \nThe Navajo Birth Cohort and ECHO \nWhile the Navajo Birth Cohort is not the only source of tribal participants in ECHO\, their recruitment across tribal lands and by tribal members makes this cohort the most representative of an indigenous population as a whole still living on tribal land. \n“The Navajo Birth Cohort has already raised questions on the appropriateness of assessment tools\, understanding the potential variability in developmental trajectories\, and continuing to remain sensitive to the appropriateness for our tools and methods before interpreting our data and generalizing our results\,” says Dr. Lewis. \nThrough inclusion of the broad range of cohorts in ECHO\, and making sure that all remain included and the variability continues to be examined\, ECHO provides the opportunity through its research efforts to truly understand factors that contribute to child health and development in the U.S. population. \nSpeaker: \nDr. Johnnye Lewis\, PhD \nUniversity of New Mexico \n  \n  \n  \n  \nSpeaker Bio: Dr. Johnnye Lewis is a toxicologist and the founder and Director of the Community Environmental Health Program at the University of New Mexico’s Health Sciences Center College of Pharmacy.  She holds a MA in Psychology (University of Victoria)\,  Ph.D. in Pharmacology (University of Manitoba)\, and did her postdoctoral work in inhalation toxicology at the DOE Inhalation Toxicology Research Institute.  After running her own environmental health consulting business\, she went to the University of New Mexico in 1996 and began building community/research partnerships\, primarily with Indigenous communities\, to address environmental injustice concerns through team science that integrates population and field  studies with mechanistic laboratory studies to link exposures to outcomes\, confirm mechanisms\, and develop environmental and health interventions to reduce risk.  She is the Director of the UNM METALS Superfund Center (NIEHS)\, MPI of the Navajo Birth Cohort/ECHO study (NIH-OD) and of the Center for Native American Environmental Health Research Equity (NIMHD). \n  \nDate: Tuesday\, June 9th\, 1 to 2pm \nSlides
URL:https://echochildren.org/event/dr-johnnye-lewis-navajo-birth-cohort-understanding-diversity-disparity-and-resilience-through-echo/
LOCATION:WebEx
CATEGORIES:environmental,pregnancy
END:VEVENT
BEGIN:VEVENT
DTSTART;TZID=America/New_York:20210113T130000
DTEND;TZID=America/New_York:20210113T140000
DTSTAMP:20260421T150614
CREATED:20201203T142510Z
LAST-MODIFIED:20240529T184852Z
UID:2758-1610542800-1610546400@echochildren.org
SUMMARY:Manish Arora: Application of Tooth Matrix Biomarkers to Environmental Biodynamics
DESCRIPTION:Application of Tooth Matrix Biomarkers to Environmental Biodynamics\n\n\n\n\n\nSpeakers: \n \nManish Arora\, PhD \nIcahn School of Medicine at Mount Sinai \n  \n  \n  \n  \nSpeaker Bio:  \nDr. Arora is an exposure biologist and environmental epidemiologist with training in advanced analytical chemistry methods. He was awarded an Australian government scholarship to study the uptake of environmental metal toxicants and its impact on human health. He was later accepted as postdoctoral fellow at the Environmental and Occupational Medicine and Epidemiology program at the Harvard School of Public Health. He is current a Professor and Vice Chairman of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai in New York\, as well as Division Chief of Environmental Health\, and Director of the Laboratory for Exposomic Innovation and Precision Environmental Medicine. \nDr. Arora has developed sophisticated laboratory methods to measure chemical signatures in teeth and hair as markers of environmental chemical exposures\, with a focus on reconstructing early life exposure history. \nDate: Wednesday\, January 13\, 1 to 2pm \n  \nSlides
URL:https://echochildren.org/event/manish-arora-application-of-tooth-matrix-biomarkers-to-environmental-biodynamics/
LOCATION:WebEx
CATEGORIES:environmental,neuro
END:VEVENT
BEGIN:VEVENT
DTSTART;TZID=America/New_York:20200513T130000
DTEND;TZID=America/New_York:20200513T140000
DTSTAMP:20260421T150614
CREATED:20200417T172707Z
LAST-MODIFIED:20220602T161352Z
UID:2088-1589374800-1589378400@echochildren.org
SUMMARY:Emily Oken: Using Cohort Studies to Understand Joint Effects of the Environment and Lifestyle on Health
DESCRIPTION:Using Cohort Studies to Understand Joint Effects of the Environment and Lifestyle on Health\n\n\n\n\nSpeaker: \nEmily Oken \nDepartment of Population Medicine at Harvard Pilgrim Health Care Inc \n  \n  \n  \nSpeaker Bio: Dr. Oken was trained in internal medicine and pediatrics and is currently a Professor in the Department of Population Medicine at Harvard Medical School and the Harvard Pilgrim Health Care Institute\, and in the Department of Nutrition at the Harvard School of Public Health.  Dr. Oken Directs the Division of Chronic Disease Research Across the Lifecourse within the Department of Population Medicine.  Her research focuses on the influences of nutrition and other environmental factors during pregnancy and early childhood on pregnancy outcomes as well as long-term maternal and child health\, especially cardiometabolic health\, cognitive development\, asthma\, and atopy.   Since 2016 she has led Project Viva\, a pre-birth cohort study that has followed pregnant women and their children since 1999.  Project Viva is currently conducting in follow-up visits with teens aged 17-19 and their moms.  The team is doing a fantastic job weathering the challenges of transition to remote data collection. \n  \nDate: Wednesday\, May 13\, 1 to 2pm \nSlides
URL:https://echochildren.org/event/using-cohort-studies-to-understand-joint-effects-of-the-environment-and-lifestyle-on-health/
LOCATION:WebEx
CATEGORIES:environmental,pregnancy
END:VEVENT
BEGIN:VEVENT
DTSTART;TZID=America/New_York:20191015T130000
DTEND;TZID=America/New_York:20191015T140000
DTSTAMP:20260421T150614
CREATED:20190827T142507Z
LAST-MODIFIED:20220602T182441Z
UID:1612-1571144400-1571148000@echochildren.org
SUMMARY:Leo Trasande: Endocrine Disrupting Chemicals: A Costly Public Health Threat with Opportunities for Policy Prevention
DESCRIPTION:Endocrine Disrupting Chemicals: A Costly Public Health Threat with Opportunities for Policy Prevention\n\n\n\n\n\nSpeaker: \nLeo Trasande\, MD\, MPP \nNYU School of Medicine\, Professor of Pediatrics \n  \n  \n  \nAbout the Speaker:\nLeonardo Trasande\, MD\, MPP is a professor in the departments of Pediatrics\, Environmental Medicine\, and Public Health at New York University\, and is a leader in children’s environmental health researcher. His research focuses on the roles of environmental exposures in childhood obesity\, and on the economic costs of failing to address these environmental factors to prevent diseases in children proactively. \nDr. Trasande received his bachelors\, medical\, and public policy degrees from Harvard University. He also completed the Boston Combined Residency in Pediatrics and a legislative fellowship in the Office of Senator Hillary Rodham Clinton. \nOutcome Areas: Obesity; Neurodevelopment \nDate: Tuesday\, October 15\, 1 to 2pm \nSlides
URL:https://echochildren.org/event/leo-trasande-endocrine-disrupting-chemicals-a-costly-public-health-threat-with-opportunities-for-policy-prevention/
LOCATION:WebEx
CATEGORIES:environmental,obesity
END:VEVENT
BEGIN:VEVENT
DTSTART;TZID=America/New_York:20190612T130000
DTEND;TZID=America/New_York:20190612T140000
DTSTAMP:20260421T150614
CREATED:20190517T163247Z
LAST-MODIFIED:20220602T182752Z
UID:1373-1560344400-1560348000@echochildren.org
SUMMARY:Singleton/Semmens: Working with Rural Communities to Improve Household Air Quality and Health: Strategies to Guide Environmental Interventions in the ECHO IDeA States Pediatric Clinical Trials Network
DESCRIPTION:Working with Rural Communities to Improve Household Air Quality and Health: Strategies to Guide Environmental Interventions in the ECHO IDeA States Pediatric Clinical Trials Network\n\n\n\n\nSpeakers: \nRos Singleton\, MD\, MPH; Alaska Native Tribal Health Consortium\, Anchorage  \nSpeaker Bio: Rosalyn Singleton graduated from Northwestern University Medical School\, Chicago and completed a Pediatric residency and MPH. She initially worked as a pediatrician in a Navajo hospital. Since 1988 she has worked as a pediatrician\, immunization consultant and researcher for Alaska Native Tribal Health Consortium\, and guest researcher at Arctic Investigations Program – CDC. Ros has worked with Alaska Native people on clinical studies related to vaccine preventable infections\, respiratory infections\, vitamin D deficiency\, indoor air quality and bronchiectasis. \n  \nErin Semmens\, PhD\, MPH; University of Montana \nSpeaker Bio: Erin Semmens graduated with a degree in Biology and Political Science from Duke University and received an MPH in Environmental and Occupational Health and a PhD in Epidemiology from the University of Washington. She is an Assistant Professor of Epidemiology in the School of Public and Community Health Sciences at the University of Montana. Erin’s research investigates the effects of environmental and occupational factors– and more recently their interaction with social influences– on long-term health. Specifically\, she focuses on the health impacts of air pollution from multiple sources including wildfires\, wood smoke\, and traffic. \nOutcome Areas: Airways \nDate: Wednesday\, June 12 from 1 to 2pm \nSlides\n \n  \nDiscussion: \nQ: I would like to know the hypotheses that link those special populations\, including Alaskan Natives\, to a prevalence of bronchiectasis? \nRos Singleton: It is clear in collaborations with Australia and New Zealand and Canada and other researchers on bronchiectasis that this orphan disease is prevalent in these populations because of environmental and social factors. We did a three country analysis and discovered that household crowding was one of the most prevalent common factors. In Alaska lack of running water\, and in Australia access to basic household features like a working refrigerator and a working sink\, are the factors that are associated with both pneumonia and childhood pneumonia\, which is the driver of bronchiectasis. Bronchiectasis was common in many other populations around the world until vaccines and improvements in running water and basic public health measures have really reduced that risk around the world. But it is still prevalent in much of the developing world and low income countries\, although rarely identified because CT scans are not available. We have identified very high rates in many different indigenous populations. \nQ: Indoor PM2.5 did not decrease after intervention\, was it possible that PM2.5 from outdoors and neighboring houses played a role and that is why you do not see the decreased PM2.5?          \nRos Singleton: I don’t think that is a major factor based on the feedback that we received from the environmental health specialist. It is possible that in a time when there is a lot of wood burning that you could have ambient 2.5 that comes in and so that could be a factor. Many of these homes are on a very windy tundra so that ambient 2.5 level is not very high in general\, but we don’t have the data to prove that so that is one possibility.  I think one other major thing that we identified was just the challenges for accessing dry wood.  You have to find dry wood and in many areas there is no wood available and so people use driftwood and sometimes unfortunately trash.  My colleagues have done a lot of education around the best practices in wood burning\, and that’s why I’m excited about this new potential project in incorporating indigenous knowledge and really coming together to determine what are the best things to burn and how to burn so that it is most efficient and has the lowest PM2.5. \nQ: How prevalent is secondary cigarette exposures in the studies described today? Has smoking cessation education been combined with indoor air quality interventions discussed today? \nErin Semmens: In the ARTIS study we excluded homes where there was an active smoker in the home\, and in our ongoing study we did not make that exclusion because we thought that would exclude too many families. We don’t include smoking cessation as part of the education. We do nicotine wipes in the home as an indicator of whether there is smoking inside the home. I can say from looking at Montana birth certificate data that about 15% of women report smoking during pregnancy which is likely an underestimate\, but still fairly high. \nRos Singleton: In Alaska\, smoking rates are very high among Alaskan native people. Over 40% of adults smoke\, as compared to about 20% in other populations. In Navajo smoking is actually very rare.  In our study we did do tobacco cessation education and there are major tobacco cessation projects underway in Alaskan Native communities in collaboration with Mayo Clinic\, and specifically with pregnant women because the rate of tobacco use including both smoking and also chew is extremely prevalent and smoking cessation is challenging.  However\, the homes in this study\, as well as homes of families that have children hospitalized\, have told us for many years that they do not smoke in the home.  I believe that household education has really hit on fertile ground and people do understand the message about not smoking indoors. But smoking itself is very prevalent. \nQ: In our region (South Dakota)\, many of our families are pretty mobile between seasons. Is this a common occurrence in your region?  If so\, how did you handle this in the analysis? \nRos Singleton: In our smaller study\, we did have one family withdraw because of moving\, but in general we were able to work with families that were there for the year.  Moving is very common and that was a challenge. One family was actually living in a Conex (shipping container) at the initial part of the study and then had other housing. \nErin Semmens: Moving has been a challenge in our study\, so when we provide potential participants with information about the study\, we ask if they plan to be in the same home over the next two years.  So to be in the study they have to plan to be stable with respect to their residence\, but that isn’t always the case. That is the primary reason participants drop out of the study is because they move and when we are utilizing interventions that are aimed at improving indoor air quality it is very difficult when a person moves to a different home\, even if it is another home with a wood stove to compare that.  Unfortunately that has resulted in lost to follow-up or participants withdrawing from the study due to moving.  A somewhat related point is when children spend part of their time during the week with one parent and part of the time with another parent. In those cases the child can be in the study\, but we just do all of our sampling at the one residence. \nQ: Did the stove change-out help decrease particulate matter? \nRos Singleton: In our first study\, even with education we did not show a decrease in PM2.5.  We did show a decrease in volatile organic compounds and we actually added volatile organic compounds late\, but we found that it is a significant contributor to some aspects of indoor air pollution. In our region houses are small and villages often do not have a workshop available\, and so the home is often used as a workshop and it is not unusual to have a father that is working on a snow machine or snow mobile inside the house.  Also because of the cold temperatures\, fuel is often stored in the house and people try to store it in the artic entry way but that is another potential source of volatile organic compounds.  So we have some unusual sources of volatile organic compounds and we did some education around that. \nErin Semmens: In the Libby change-out there was a decrease in ambient PM2.5\, which is a huge achievement\, and it was such a large scale change-out. 1200 wood stoves and the population of Libby is under 3000 people\, so that was a very large scale change-out in that community. But within the homes\, indoor air quality reductions varied from home to home and the reason we hypothesized that there weren’t universal reductions is just having the new cleaner burning wood stove is not sufficient and that there are all these other best burning practices and education around how to use the wood stove that are needed as well. Another consideration is that people with new wood stoves might end up using their new stoves more. \nRos Singleton: In a pre-study home visit\, the healthy home specialist said that the house was so smoky you could hardly see across the room. Obviously if you have a wood stove that is that bad and you have an alternative like a Toyo stove you are going to use the Toyo stove\, but then if you get a great new wood stove that is much more efficient than you will probably revert to using the wood stove. That is one of our hypotheses\, that no matter what you do to a wood stove it still has more PM2.5 than not using a wood stove. So if the use of the wood stove increase\, then your PM2.5 may increase just because of that. \nQ: I’m curious about your comments about best burn practices. What are people burning\, what were they burning and talk more about best burn practices? \nRos Singleton: What you burn is so critical and like I mentioned a lot of the houses in Alaska are in non-treed areas. People burn driftwood and you have to leave driftwood for a long time for it to become dried\, and by default people often use wet wood and burn wood that is wet. The wetter it is then the more inefficiently it burns and you have higher PM2.5 gas and other things. What you burn is critical.  If you burn trash you can imagine what is in newspaper print and other things. There are all kinds of volatile compounds that are in trash and in other paper products that may have plastic also.  Sometimes families revert to burning trash because that is what they have available. There has been many efforts to try to improve this. One effort is education on stacking and drying wood\, and the emphasis on using only wood. There are also some very innovative projects that provide very efficient pellets. We’ve received feedback from some of those\, but unfortunately it is pretty expensive to have them shipped up to Alaska so we haven’t done that intervention yet. \nErin Semmens: Having dry wood is not always available even if you live in a place like Montana that has a lot of trees and a lot of wood available\, you may not have dry wood available. One of the main factors we saw in our pre-intervention year in the ARTIS study was that letting your wood dry out for a year or more was associated with lower PM2.5 concentrations\, so it is a really important feature of best burning practices. In one community in a different study taking place in Idaho that tries to address that by having a community-level intervention with a community wood yard where the wood is stored properly and in season for the recommended length of time and then distributed to elders living in the community to provide them with access to dry wood. That is one way to try and address that challenge. \nQ: I wanted to know more details about the air filtration device used in their study. Erin says it was a 3M electrostatic precipitator but I was interested in knowing more details about this device such as model and how they were maintained in the study. The info would help me understand why they did not observe reductions in PM2.5. \nErin Semmens: We used a large 3M filtrate with an electrostatic filter. We recommended that homes run the filter continuously on the highest setting\, and we saw substantial reductions (nearly 70% greater than those observed in the placebo arm) from the pre- to post-intervention winter. We replaced the filter approximately once per month. It was the wood stove change-out arm\, in which we did not see significant reductions in PM2.5 from the pre- to post-intervention winter. \nQ: Have insulation in the homes had been investigated? \nRos Singleton: For Alaska studies – In general\, the houses are insulated and tend to be tight homes for heating efficiency which can exacerbate indoor air pollution.  For the most part\, homes for our study had already had insulation evaluated through weatherization programs. \nErin Semmens: That is a great question and reminds me that we did blower door tests in the ARTIS study to evaluate airtightness. I recall we had a wide range of values but I am not sure if or to what degree home tightness varied between treatment arms. Theoretically\, it should have balanced out\, but I would need to look back to see if it actually did.
URL:https://echochildren.org/event/working-with-rural-communities-to-improve-household-air-quality-and-health-strategies-to-guide-environmental-interventions-in-the-echo-idea-states-pediatric-clinical-trials-network/
LOCATION:WebEx
CATEGORIES:airways,environmental
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