Volume | Number | October 2012 Children’s Health Research Table of Contents About this Issue In the News Understanding Exposures in Children’s Environments PredicƟng the Future of Children’s Health 12 Mothers MaƩers 14 Ask a ScienƟst QA with Sally Darney 18 Closing the Asthma Gap for Minority and ProtecƟng Growth and Poor Children Development 20 NaƟonal Children’s Study ProtecƟng Children’s Health for a Science MaƩers Podcast with Peter GrevaƩ 10 LifeƟ 22 me About this Issue: Science Matters to Children’s Environmental Health Picking food up from the floor, playing in dirt, exploring the world through touch and taste These are all normal parts of child development But they are also some of the behaviors that may mean trouble for young children under the wrong circumstances October: Children’s Health Month President Obama marked Child Health Day on October 1, 2012 with a ProclamaƟon that states: From an environmental health perspecƟve, the behavior of children may increase their risk of exposure to potenƟally harmful chemicals What’s more, poundfor-pound children eat, drink, and breathe more than adults And because their bodies and internal systems are sƟll growing and developing, the earliest stages of life are periods when the potenƟally harmful effects of environmental exposures can be most pronounced A safe environment in which our children can live and grow is also essenƟal to their wellbeing Because clean water is the foundaƟon for healthy communiƟes, we are working to reduce contaminants in our drinking water by updaƟ ng standards and beƩ er protecƟng our water sources from polluƟon We are also building on the successes of the Clean Air Act to improve our air quality and help decrease harmful toxins that can lead to acute bronchiƟ s, asthma, cancer, and impaired development Keeping children safe is the focus across the government during EPA scienƟsts and their research partners have been working to support clean water, clean air, and fewer toxins in the environment for more than 40 years Much of that work has focused specifically on advancing children’s health Today, EPA research conƟnues to provide a beƩer understanding of how young people at every stage of development can be exposed to harmful substances in the environment and what those exposures might mean to their health today and well into the future Please enjoy this issue of EPA’s Science MaƩ to learn more ers about how EPA researchers and their partners are working to protect children from environmental threats and promote environmental health wherever they live, learn, and play | In the News BPA Linked to Thyroid Hormones in Pregnant Women and Newborn Boys Researcher with Storied Career to Head EPA’s NaƟonal Center for Environmental Assessment Kenneth Olden, Ph.D., has been a trailblazer his whole life From paying for his college educaƟon by shining shoes to establishing environmental jusƟce as a compelling field of scienƟfic research, Olden’s story encompasses many accomplishments Now, he is the new director of EPA’s NaƟonal Center for Environmental Assessment (NCEA) and hopes to change how the country looks at disease Greenwire covers Dr Olden’s life, career, and plans as NCEA’s new director A recently published study from the EPA/ NIEHS funded UC Berkeley Center for Children’s Environmental Health links Bisphenol A (BPA) to thyroid funcƟon in pregnant women and newborn boys The study, published in Environmental Health PerspecƟ , found a correlaƟon between increased ves levels of BPA in pregnant women and decreased levels of thyroid hormones in pregnant women and newborn boys BPA can be found in the lining of Ɵ ns cans, in hard plasƟcs, and on thermal receipts Link: hƩp://bit.ly/BerkeleyBPA Read the study: hƩp://bit.ly/EHP_BerkeleyBPA Link: hƩp://bit.ly/GreenwireOlden EPA Increasing the Efficiency of Chemical Toxicity Tests An efficient way to find out if a chemical could harm an unborn child is by running the mouse embryonic stem cell test (EST) The ScienƟ st interviewed EST experts about the best ways to use the test and about EST variaƟons One expert, EPA researcher Sidney Hunter, tells The ScienƟst how EPA is developing easier ways to culture the cells, making the test even faster and cheaper to run Read about it in the arƟ cle Stemming the Toxic Tide Link: hƩ p://bit.ly/TheScien ƟstEPA | Vanderbilt Research Team Uses Spinach to Harness Solar Energy A research team at Vanderbilt University has developed a way to use spinach to harness solar energy The team combined silicon with Photosystem 1, a protein involved in photosynthesis, to make a solar cell that is more efficient than other “biohybrid” solar cells Through an award from EPA’s People, Prosperity, and the Planet (P3) program, the team will develop a prototype and potenƟally take the innovaƟve technology to the market Link: hƩp://bit.ly/VanderbiltP3 More about EPA’s P3 Program: hƩp://epa.gov/ncer/ p3/ Understanding Exposures in Children’s Environments EPA scienƟsts and their partners provide key research outcomes for understanding and reducing environmental risks to children’s health Anyone who has ever watched a toddler barreling around knows that trouble lurks around every corner Young children crawl around on the floor, play in dirt, and put just about anything they can into their mouths, whether it’s a cookie from the floor, a plasƟc toy, or a dust-covered curiosity grabbed from under the sofa These types of behaviors put kids at risk of being exposed to something toxic By developing beƩer sciencebased knowledge about how kids are exposed to harmful things in their environments, it’s possible to reduce their risks and take acƟon to beƩer protect them That’s the goal of EPA’s childhood exposure research EPA’s work to understand childhood exposure began shortly aŌer the Agency was established in 1970 The early studies focused primarily on how young people might encounter pesƟcides during their daily rouƟ nes “Products or behaviors that parents think are perfectly acceptable might come with unintended consequences,” said Nicolle Tulve, PhD, a research physical scienƟst at EPA “In all our research, we’re focused on day-to-day behavior; we want to understand what exposures are like for kids leading typical lifestyles.” One important way that EPA has increased the understanding of children’s exposures is by developing the Child-Specifi c Exposure Factors Handbook, which provides informaƟ on on various physiological and behavioral factors commonly used in assessing children’s exposure to environmental chemicals It is used by scienƟsts, economists, health assessors, and others within and outside EPA conducƟng exposure assessments, a criƟcal step in idenƟfy human health risks— including those to children’s health—from exposure to chemical contaminants and other environmental stressors To conduct an exposure assessment, scienƟsts need to understand aspects of exposure, such as how much | EPA-Expo-Box EPA is using the informaƟon available in the Exposure Factors Handbook, the Child-Specific Exposure Factors Handbook, EPA exposure assessment guidelines, and other sources to develop the EPA-Expo-Box, a compendium of exposure assessment and risk characterizaƟon tools that provide step-by-step guidance for conducƟng an exposure assessment EPA-Expo-Box will also include links to exposure assessment databases, models, and references – all in a user friendly format organized by the various components of exposure assessment EPA-Expo-Box will provide one stop shopping for the latest tools and techniques for exposure assessment It will become a criƟcal tool for EPA and beyond by providing informaƟ on to support scienƟfically defensible exposure and risk assessments to inform decisions to protect human health air a person breathes or how much water a person drinks on a daily basis EPA’s Exposure Factors Handbook, a standard reference tool, helps by summarizing informaƟ on and recommendaƟons on factors relevant to exposure assessments Recently updated in 2011, it provides the most accurate and relevant informaƟon on factors ranging from the intake of fruits and vegetables to consumer product use | But because a child’s exposure differs from an adult’s exposure, EPA developed the Child-Specifi c Handbook in 2008 The childspecific handbook takes into account that children typically have different diets, higher inhalaƟon rates per unit of body weight, and come into contact with contaminated surfaces when they play close to the ground Understanding these differences is criƟcal for evaluaƟng potenƟ al environmental hazards from pollutants and will help protect children from dangerous exposures “By understanding exposure, we can help parents and other caregivers make more informed decisions about how to protect their child’s health,” explained Tulve Closing the Asthma Gap for Minority and Poor Children EPA scienƟsts and their partners are working to beƩer understand why asthma disproporƟonately affects minority and poor children Nearly 26 million Americans, including seven million children, are affected by asthma, a chronic respiratory disorder that causes airways in the lungs to swell and narrow, leading to wheezing, coughing, and shortness of breath The annual economic cost of asthma, including direct medical costs from hospital stays and indirect costs such as lost school and work days, amounts to approximately $56 billion But when emergency room doors burst open for someone with an asthma aƩack, chances are the paƟent will be a poor, minority child According to the Centers for Disease Control and PrevenƟ on (CDC), minority children living in poor socioeconomic condiƟons are at greatest risk For instance, 16% of African American children had asthma in 2010 compared to 8.2% of white children, and they are twice as likely to be hospitalized with an asthma aƩack and four Ɵmes more likely to die than white children The asthma rate among children living in poverty was 12.2% in 2010, compared to 8.2% among children living above the poverty line “Across America we see low-income and minority children and families at a disproporƟonately higher risk | for asthma and respiratory illnesses Air polluƟon and other challenges are having serious health effects, which compound economic challenges through medical bills and missed school and work days,” said EPA Administrator Lisa P Jackson “As the mother of a child with asthma, I know what it means for our children to have clean and healthy air to breathe.” Administrator Jackson made those remarks during the unveiling of the Coordinated Federal AcƟon Plan to Reduce Racial and Ethnic Asthma DispariƟes (see sidebar), a blueprint for how EPA and other federal agencies can team up to reduce asthma dispariƟ es A major part of that effort is the work conducted by EPA scienƟsts and their partners exploring environmental causes and triggers of asthma, including how socioeconomic factors contribute to childhood asthma The overall goal is to illuminate the underlying factors of asthma to support work on prevenƟ on and intervenƟon strategies What increases the risk of developing asthma? While part of the answer certainly lies with geneƟcs, as more than half of all children with asthma also have close relaƟves with the illness, the environment also plays a key role Air pollutants, allergens, mold, and other environmental agents trigger asthma aƩacks EPA researchers and their partners are leading the effort to develop new scienƟfic methods, models, and data for assessing how such triggers increase the risk for asthma and asthma aƩacks The impact of this research has already contributed to current regulatory standards for two priority air pollutants regulated under the NaƟ onal Photograph of the 2008 wildfire in No Ambient Air Quality Standards (NAAQS) (see sidebar): ozone and parƟculate maƩ er (PM) EPA’s asthma research has also been factored into health assessments for diesel emissions The next step is to learn ways to beƩer protect those most at risk “Now we’re digging into the dispariƟes side of the asthma problem,” said Martha Carraway, Coordinated Federal AcƟon Plan In May 2012, the President’s Task Force on Environmental Health Risks and Safety Risks to Children released the Coordinated Federal AcƟon Plan to Reduce Racial and Ethnic Asthma DispariƟes The goal of the plan is to build on the strength of past and exisƟng federal programs while developing collaboraƟve strategies to plug the knowledge gap with resources that already exist Low-income and minority asthma sufferers face challenges such as limited access to quality medical care, low levels of health literacy, and inability to afford medicaƟ on AddiƟonally, they face higher levels of environmental exposure to allergens | took advantage of a 2008 lightning strike that occurred in Pocosin Lakes NaƟonal Wildlife Refuge in North Carolina The 40,000-acre (16,000-hectare), smoldering peat fire sparked by the lightning sent thick, billowing clouds of smoke waŌing into the air MD, a researcher at EPA “Kids with poorly controlled asthma are more likely to be treated in the emergency room than kids with controlled asthma So for public health reasons we need to understand how environmental factors, including air polluƟon, aff ect asthma control in vulnerable populaƟons.” In collaboraƟon with scienƟsts at the University of North Carolina Center for Environmental Medicine, Asthma, and Lung Biology, a team of EPA researchers led by David Diaz-Sanchez, PhD compared emergency room visits for asthma with air quality reports Looking at the results geographically, they found that low income counƟes had significantly more visits than more affluent counƟes, even though air quality and exposure levels were the same To advance that work, EPA researchers and their partners “EPA studies suggest that children and others living in orth Carolina to Reduce Racial and Ethnic Asthma DispariƟ es and pollutants that exacerbate asthma and lack community level acƟ Ɵes to reduce vi outdoor air polluƟ on The acƟon plan, in which EPA is a major partner, focuses on the following four strategies: • Reduce barriers to the implementaƟon of guidelines-based asthma management • Enhance capacity to deliver integrated, comprehensive asthma care to children in communiƟes with racial and ethnic asthma dispariƟ es • Improve capacity to idenƟ fy the children most impacted by asthma dispariƟ es • Accelerate eff orts to idenƟfy and test intervenƟons that may prevent the onset of asthma among ethnic and racial minority children Progress of the acƟon plan will be documented semi-annually and made public at www.epa gov/childrenstaskforce Science to Support NaƟonal Ambient Air Quality Standards ProtecƟng the health of children and other vulnerable life stages and populaƟons is a key consideraƟ on in seƫng the NaƟonal Ambient Air Quality Standards (NAAQS), which set pollutant limits to protect human health and the environment EPA scienƟsts support the development of NAAQS in many ways Two specific examples include reviewing the body of research about pollutants through Integrated Science Assessments (ISAs) and making children’s acƟ vity data easily available to decision makers through the Consolidated Human AcƟvity Database (CHAD): ISAs: Two pollutants of parƟ cular concern for asthma are parƟculate maƩer (PM) and ozone To provide the scienƟfic basis for the NAAQS for PM, EPA scienƟsts assessed the latest research on the effects PM has on public health and welfare The findings were published in the Integrated Science Assessment (ISA) for ParƟculate MaƩ er (available at hƩp://bit.ly/PM_ISA) EPA is also developing an ozone ISA to ensure the NAAQS for ozone is supported by the best up-to-date science CHAD: EPA research also supports the NAAQS through the Consolidated Human AcƟ vity Database (CHAD) CHAD provides informaƟon on the acƟ Ɵ vi es of children and adults Using this informaƟon, scienƟsts and engineers can simulate children’s acƟ Ɵes and breathing rates to vi see how much of a pollutant a child inhales during daily acƟ Ɵ vi es This informaƟon ensures that the NAAQS protect children as well as adults | low-income counƟes could be less resilient to air polluƟ on, possibly because of social factors such as inadequate nutriƟ on For example, if you’re poor and you’re not eaƟng well, your asthma may be more severe,” said Nsedu Obot Witherspoon, MPH, the ExecuƟve Director of the Children’s Environmental Health Network, a naƟ onal mulƟ-disciplinary organizaƟ on whose mission is to protect the developing child from environmental health hazards and promote a healthier | environment “Of course, other factors may also be involved, such as whether kids take medicaƟons correctly and whether they have access to good medical care.” EPA’s research on asthma dispariƟes can help guide newer and beƩer intervenƟons for reducing exposure to asthma triggers and limiƟng the impacts of the ailment, helping to close the gap for minority and poor children and improving the health of children everywhere EPA’s “Science MaƩers” will feature Safe and Sustainable CommuniƟes Research, including the links between income dispariƟes and environmental health and jusƟce issues in a future issue Subscribe now at: hƩp://bit.ly/SOT6a5 EPA and the NaƟonal InsƟtute of Environmental Health Predicting the Future of Children’s Health EPA’s Virtual Embryo project is helping scienƟsts understand how chemical exposure affects a developing embryo According to the Centers for Disease Control and PrevenƟ on, approximately one in every 33 babies born in the United States is born with a birth defect Birth defects can heighten the risk of long-term disability as well as increase the risk of illness, potenƟally impacƟng a child for the rest of his or her life Unfortunately, the causes of most birth defects are unknown EPA researchers are tapping powerful, high-tech computer systems and models to beƩ er determine how prenatal | 12 exposure to environmental factors might impact embryo and fetal development Working on EPA’s Virtual Embryo (v-Embryo™) project, they create computer models of developing body systems and combine them with data from a number of EPA studies and toxicity databases to “virtually” examine the effects of a variety of prenatal exposures Virtual Embryo simulates how chemicals and pesƟ cides, including those that disrupt the endocrine system (see ProtecƟ ng Growth and Development in this issue), interact with important biological processes that could disrupt fetal development The chemicals used in simulaƟ ons are idenƟfied by EPA’s Toxicity Forecaster (ToxCast - see sidebar) as having the potenƟal to aff ect development The predicƟons from the computer simulaƟons need to be further tested against nonvirtual observaƟons However, the models provide scienƟsts with a powerful tool for screening and prioriƟzing the chemicals that need to be more closely examined, greatly reducing the cost and number of targeted studies needed “We’ve built small prototype systems, now what we want to is move into complex systems models that will be more relevant to environmental predicƟons,” said Thomas B Knudsen, Ph.D., an EPA systems biologist who is leading the project Virtual Embryo models have focused on blood vessel development and limb development, but are being expanded to include early development of the male reproducƟve system, which is known to be parƟ cularly sensiƟve to endocrine disrupƟ ng chemicals Knudsen says that having more models is important because different chemicals can aff ect biological systems in various ways Luckily, the Ɵme it takes to develop new models decreases as researchers’ modeldeveloping knowledge grows “The important challenge for us is to try to integrate some of this work with other issues of broad importance to children’s health,” said Knudsen “We’re focused primarily on embryonic development, but a person doesn’t stop developing at birth We have to take what we are learning from the embryo and extend that informaƟon into life stages beyond birth.” The Tox21 robot helps conduct high-throughput screenings EPA Speeds Up Chemical TesƟng Using ToxCast™ Children, for a variety of reasons, can face increased risks for adverse health effects To beƩer protect children and others, EPA researchers are working to test thousands of chemicals using the innovaƟve Toxicity Forecaster (ToxCast™) Since 2007, EPA has been using ToxCast™ to predict the potenƟal toxicity of chemicals and help prioriƟ ze chemicals in a more eff Ɵ ec ve and efficient manner ToxCast™ is currently screening thousands of chemicals that can be found in a wide variety of places including industrial and consumer products, food addiƟves and pesƟ cides It uses over 600 rapid, automated tests called highthroughput in vitro assays that screen chemicals for different types of adverse effects such as endocrine disrupƟon, reproducƟ ve toxicity, developmental toxicity, cancer, and other disease outcomes The program is cost-eff Ɵ ec ve because it is faster than tradiƟonal tesƟng and helps scienƟsts prioriƟ ze which chemicals necessitate further inquiry Such prioriƟ Ɵon reduces the za need for animal tesƟ ng ToxCast™ data is publicly available in online, searchable databases at hƩp://www.epa.gov/ncct/ toxcast/ | 13 Mothers Matter: Looking for a Healthy Start EPA researchers and their partners are exploring the links between early exposures to polluƟon and potenƟal health effects later in life There’s a lot that expectant mothers can to give their babies a beƩer chance for a healthy start: get plenty of rest, take prenatal vitamins, get regular checkups, and avoid alcohol and smoking What they can’t do: stop eaƟng, drinking water, or breathing EPA scienƟsts and their partners, including researchers supported by grants from the Agency’s Science to Achieve Results (STAR) Program and sister Federal agencies such as the NaƟ onal InsƟtute of Environmental Health Sciences (NIEHS) are exploring potenƟal links between a mother’s everyday exposures to environmental pollutants during pregnancy and | 14 the health consequences those exposures might have for her baby in the future vulnerable to unintended consequences from pesƟ cide exposure The results of the research will help mothers know what they can add to their “to do” (or “to not do”) lists when preparing for a healthy new arrival The research will also provide important informaƟon to public policy officials and healthcare providers Children’s health research has already idenƟfi ed—and helped diminish—increased risks that children face from pesƟcide exposure through everyday acƟ Ɵes By exploring vi possible links between prenatal exposures to pesƟcides and potenƟal health effects aŌ er birth, researchers and their partners are further advancing the science of protecƟ ng children’s health Reducing Children’s Health Risks from Exposure to PesƟ cides Every year, approximately one billion pounds of pesƟ cides are used in the United States Unfortunately, the early life stages can be parƟ cularly There is strong evidence that prenatal exposure to even low levels of organophosphate (OP) pesƟcides can harm children’s health Studies by university- based scienƟsts funded by EPA and NIEHS have revealed links between prenatal exposure to two OP pesƟcides—chlorpyrifos and diazinon—and reduced birth weight and length While EPA has banned the use of both pesƟcides in residenƟ al seƫngs, they (and other OP pesƟcides) are sƟll widely used in agriculture and can be applied in public spaces such as parks and golf courses As a result, children living in agricultural communiƟes can sƟll be exposed, and residues of the pesƟcides can be present on some convenƟonally-grown produce Recent advances in OP pesƟ cide exposure research gained naƟonal aƩ Ɵon in 2011, en when several landmark scienƟfi c papers were published by three of the EPA/NIEHS Children’s Environmental Health and Disease PrevenƟon Research Centers (see also ProtecƟ ng Children’s Health for a LifeƟ me in this issue) The results of those studies revealed links between prenatal exposure to OP pesƟcides and disrupted brain and nervous system development Beginning in 1998 and1999, the three studies measured OP pesƟcide levels in mothers’ blood, urine, and in-home environments during pregnancy and aŌer children were born The mulƟ-year studies allowed researchers to gather health informaƟon from birth to childhood, allowing them to invesƟgate early life stage exposures, behavior, and other health outcomes later in childhood One of these studies, by scienƟsts at the Center for Environmental Research and Children’s Health (CERCH) at the University of California, Berkeley, found that higher prenatal levels of OP pesƟcides in mothers’ urine were associated with lower scores for working memory (memory the brain uses while acƟvely engaged in a task), verbal comprehension, Intelligence QuoƟent (IQ), and other measures in children from the “CHAMACOS” cohort at age seven CHAMACOS | 15 stands for Center for the Health Assessment of Mothers and Children of Salinas, a study looking at the health impacts of pesƟcides and other environmental chemicals that may affect children’s health, growth, and brain development mothers had higher levels of chlorpyrifos exposure and structural changes in their brains that are consistent with lower IQ scores in the exposed children In addiƟon, gender differences between the male and female brain appeared to be disrupted Similar results were obtained by scienƟsts at the EPA/ NIEHS Center for Children’s Environmental Health at Columbia University In that study, high cord-blood measures of the OP pesƟcide chlorpyrifos were linked to lowered IQ and deficits in working memory in children at age seven Studies from the UC Berkeley/ CERCH Children’s Center, in collaboraƟon with other Children’s Center researchers, have shown that there can be significant geneƟc differences between individuals in the ability to detoxify OP pesƟcides in the body through differing effi ciency and quanƟty of an enzyme called paraoxonase (PON) They also found that unƟl the age of nine, children in general have lower capacity than adults to detoxify OP pesƟ cides And in the third study, scienƟsts at the EPA/NIEHS Children’s Center at the Mount Sinai School of Medicine found that prenatal exposure to OP pesƟcides was associated with deficits in mental and perceptual reasoning among six- to nine-year-old children Although the studies are not directly comparable, all three studies in three different groups of children show similar results linking prenatal exposure to OP pesƟcides with adverse effects on cogniƟve funcƟ on in childhood The results add to the weight of evidence that prenatal exposure to OP pesƟcides can have detrimental effects on children’s cogniƟ ve development Subsequent studies have conƟnued to build on the work Researchers at the Columbia Children’s Center followed up their analysis by looking at MRI brain scans of some of the children in the original study Results, published in 2012 in the Proceedings of the NaƟ onal Academy of Sciences, revealed links between children whose | 16 Breathing Easier Another part of EPA’s research on prenatal exposures is looking at the potenƟal future health effects that may result from air polluƟon exposure Two recent publicaƟons from that work provide important clues into two potenƟal effects: weight gain and neurobehavioral problems EPA researchers collaborated with partners from Duke University Medical Center on a laboratory study that explored how prenatal exposure to diesel exhaust might be linked to obesity later in life To conduct the study, researchers exposed a group of pregnant laboratory mice to air containing diesel exhaust at levels similar to those found in some U.S ciƟes Another group of pregnant mice was exposed to clean (filtered) air The researchers then evaluated the offspring, recording weight as the mice grew Half the mice in each group were raised on a regular diet and half on a high fat diet While all the offspring weighed roughly the same at birth, male offspring whose mothers had been exposed to diesel exhaust became much heavier once they reached adulthood, whether or not they were fed a high fat diet Male offspring from the diesel exposed group also developed insulin resistance, a risk factor for diabetes and heart disease In contrast, female offspring from the diesel group only gained more weight, as compared to the female control group, when fed high-fat diets “PrevenƟng such diesel exposures to pregnant women may be one strategy, along with beƩer diet and more exercise, to combat the obesity epidemic,” said Sally Perreault Darney, PhD, coordinator of children’s health research for EPA (Also see Closing the Asthma Gap in this issue.) To further advance the research, EPA scienƟsts are now exploring clues that will help explain the observed obesity-inducing eff ect of diesel exhaust EPA’s Ian Gilmour, Ph.D, the co-author of the study, said it’s possible that prenatal exposures to diesel exhaust produces inflammatory reacƟons in the developing brain that prime mice for weight gain as they get older In the second study, scienƟsts at the EPA/NIEHS-funded Columbia Center for Children’s Environmental Health showed that prenatal exposure to air polluƟon can make children more likely to develop behavioral problems The study focused on substances called polycyclic aromaƟc hydrocarbons (PAHs), a group of structurally-similar chemical compounds commonly found in vehicle and other exhaust During the study, non-smoking expectant women living in New York City were fiƩed with air monitors to passively measure PAH levels from the surrounding air as they went about their daily rouƟnes throughout the third trimester of pregnancy The scienƟsts also measured PAH levels in the mothers’ cord-blood aŌer their babies were born Both the ambient air and cordblood measures were combined to esƟmate how much PAH the growing babies were exposed to The researchers conƟnued to follow the children aŌer birth and about 250 children from the cohort, then six to seven years of age, were evaluated for neurobehavioral and other problems by having their mothers fill out a detailed quesƟonnaire Published in the June 2012 issue of Environmental Health PerspecƟ , the fi ndings ves showed a link between higher levels of PAH exposure and increased symptoms of anxiety, depression, and aƩ Ɵ en on problems The new results extend findings from an earlier study with the same children that linked high PAH exposure to lower IQ and developmental delays “Neurobehavioral problems can affect a child’s ability to succeed in school so they can have lifelong impacts,” said the study’s lead author, Frederica Perera, DrPH, a professor of environmental health at Columbia University, who said the effects of PAHs are comparable to those of lowlevel lead exposure “Therefore, research aimed at understanding the role of prenatal exposure to air polluƟon is a key to prevenƟng behavioral and cogniƟve problems that can have long-term effects on children and impose a major burden on society.” | 17 Ask a Scientist: Q&A with Sally Perreault Darney, PhD Sally Perreault Darney, PhD, is an Associate NaƟonal Program Director for EPA’s Chemical Safety for Sustainability research program She is also the coordinator of children’s health and environmental jusƟce research With 25 years of research experience, she has published over a hundred papers on various topics related to reproducƟon, development, epidemiology, and toxicology Earlier this year, she helped create the Coordinated Federal AcƟon Plan to Reduce Racial and Ethnic Asthma DispariƟ es as part of the President’s Task Force on Environmental Health Risks and Safety Risks to Children and represents EPA on the Interagency CoordinaƟng CommiƩee for the NaƟonal Children’s Study Science MaƩers: Can you give us a brief overview of how protecƟng the environment and supporƟng healthy communiƟ es helps protect children’s health? exposed and more suscepƟ ble to environmental contaminants than adults child’s community partly determines the potenƟally dangerous substances to which a child may be exposed If you look at environmental protecƟon from a community standpoint, you say, “Here is a community where children grow up, where they play, where they learn Now, how features of the community affect their health?” So, the community is a very important factor It determines how acƟve their lifestyle is It determines the kinds of buildings and outdoor areas in which they live, learn, and play, and these in turn determine what contaminants they may encounter These same factors also determine what their mothers are exposed to during pregnancy, which can affect prenatal development and lead to health problems later in life We know that children are disproporƟonately vulnerable to environmental exposures because they eat more and drink more, pound for pound, than adults When they are really little, they like to crawl around on the floor where they are more exposed, and toddlers put anything they can in their mouths We know that no maƩer where children live, they are more There are many factors that affect a child’s health, from air quality to socioeconomics to transportaƟon paƩerns We need a balanced understanding among the factors that contribute to their social environment, preserve the natural environment, provide healthy economies, and offer our children a sustainable and healthy community in which to thrive Sally Perreault Darney: A | 18 SM: What is EPA’s role in the Coordinated Federal AcƟon Plan to Reduce Racial and Ethnic Asthma DispariƟ es? SPD: EPA’s role in the Federal AcƟon Plan is to determine the environmental causes of asthma and the extent to which environmental triggers, such as air polluƟon and house dust, contribute to asthma aƩacks For example, an asthma aƩack could be triggered by exposure to high levels of diesel fumes while riding on an old school bus, by high ozone levels while playing outside, or by mold or dust inside the home or school We also need to understand the causes of asthma dispariƟ es We need to understand why poor and minority children are more likely to have asthma and to suffer from more severe and frequent asthma aƩacks than non-minority, higher income children Knowing the factors that lead to these health dispariƟes helps us design intervenƟ ons Sally Perreault Darney, PhD is photographed on a playground at First Environments Early Learning Center This nonprofit child care facility is located in Research Triangle Park, NC, and exemplifies a healthy environment for children Learn more about First Environments’ sustainable pracƟces at hƩp://www firstenvironments.org to reduce them so that some children not suffer more than others because they are poor or disadvantaged A holisƟc approach to children’s health considers all the different factors: children’s suscepƟ bility, children’s exposures, and children’s environment and community These all play into how healthy our children are and whether all children are provided with clean and healthy environments SM: How does EPA science and research help protect and promote children’s health? SPD: Science helps us understand the many factors that affect our children’s health and informs the regulaƟons that ensure the safety of the air our children breathe and water our children drink EPA research also helps local governments make decisions about where to put schools and how to operate them, as well as how to make them safe and walkable for children Finally, scienƟfi c informaƟon helps parents make informed decisions about what products to bring into the home environment EPA research looks at all of the factors that impact children’s environmental exposures and the health risks that may be associated with them We research on chemicals and other kinds of contaminants, like nanomaterials, that could aff ect children’s health And we also conduct and support crosscutƟng research on how all these factor come together to aff ect children’s health The Children’s Centers, funded jointly by EPA and the NaƟonal InsƟtute for Environmental Health Sciences (NIEHS) provide a good example Crosscuƫng by design, the Children’s Centers address a variety of contaminants, chemicals, air polluƟon, toxic substances, and water polluƟon They look at children’s health from a community perspecƟve and consider how different environments, say a rural and an urban environment, have different infl uences on exposures and health SM: What is the overall impact of EPA’s research efforts in children’s environmental health? SPD: By understanding the social, behavioral, biological, environmental, and economic factors that affect a child’s health, we can take informed acƟ ons to prevent environmental risks and create safer and healthier communiƟes for our children Healthy children are the foundaƟon of sustainability A sustainable and healthy community both protects and enhances children’s health and wellbeing in all dimensions | 19 Protecting Growth and Development EPA research is developing the tools and informaƟon needed to beƩ er understand the potenƟal risks posed by endocrine disrupƟng chemicals Normal growth and development, from concepƟ on and throughout pregnancy, to childhood and adolescence, depends on hormones These chemical messengers are produced by the body’s endocrine system and regulate growth, maturaƟon, and reproducƟ on ScienƟsts have learned that some exposures to excess hormones or hormone-like substances in the environment— what toxicologists refer to as endocrine disrupƟng chemicals (EDCs)—can be especially disrupƟve for normal health and development and lead to potenƟally serious disease, reproducƟve issues, and other abnormaliƟes later in life EDCs can be found in many everyday products, including some plasƟ c boƩles and containers, food from cans with certain kinds of liners, pesƟcides, detergents, and even some types of toys | 20 Because their bodies and internal systems are sƟll forming, developing fetuses, infants, and children can be parƟ cularly vulnerable to the adverse health effects of EDCs Those risks can be compounded by the fact that, in proporƟon to their body size, babies and children drink, eat, and breathe more than adults and thus are likely to take in relaƟvely more of these substances ProtecƟng children and others from exposures to endocrine disrupƟng chemicals has been an EPA priority since the 1990s, when scienƟsts hypothesized that “humans and wildlife species have suffered adverse health effects aŌer exposure to endocrine-disrupƟ ng chemicals,” as outlined in the paper Research Needs for the Risk Assessment of Health and Environmental Effects of Endocrine Disruptors: A Report of the U.S EPA-sponsored Workshop, (Environmental Health PerspecƟves 1996 August, 104(4)) Since then, EPA researchers and grantees in universiƟ es have worked to understand the potenƟal risks of EDCs to human health and wildlife in the environment The work includes prioriƟzing chemicals for tesƟng through EPA’s innovaƟve Endocrine Disruptors Screening Program and developing models to predict the biological pathways that can lead to endocrine disrupƟ on The work also includes assessing the cumulaƟve risk of chemical mixtures found in food, products, and drinking and source water This work on chemical mixtures is parƟcularly important because the combined effects of different chemicals may be addiƟve, even at low concentraƟons that would not be of individual concern By developing the tools and informaƟon needed to learn EPA-supported Research Partners Advance EDC Science Research conducted by scienƟsts at the Centers for Children’s Environmental Health and Disease PrevenƟon, funded by both EPA and the NaƟ onal InsƟtute of Environmental Health Sciences, are making important scienƟfic discoveries regarding the potenƟal effects of endocrine disrupƟng chemicals on children’s growth, development, and health behavioral problems at age three Examples include: more about EDCs and their potenƟal impacts on human health, Agency researchers and their University partners are helping to protect the health of children, adults, and wildlife The knowledge from the research has a variety of important impacts: it is valuable to manufacturers so they can ensure the safety of their products; it provides informaƟon to expectant mothers so that they can avoid EDC exposures before and during pregnancy; it offers parents, public health professionals, and decision makers at EPA and elsewhere science-based data and tools to make informed choices that will protect children, adults, and wildlife in the environment • University of Illinois FRIENDS Children’s Environmental Health Center scienƟsts are developing novel approaches for examining how phthalates and Bisphenol-A (another chemical with potenƟ al endocrine disrupƟ ng properƟes) affect childhood development • Researchers at the Columbia Center for Children’s Environmental Health are exploring the links between prenatal exposure to EDCs and health effects such as obesity and cogniƟ ve problems later in life One recent study found a link between prenatal exposure to phthalates—a class of chemicals that are known to disrupt the endocrine system—and decreased mental and motor development and increased • Researchers at the University of California at Berkeley Center for Children’s Environmental Health are tesƟng the hypothesis that geneƟc suscepƟbility of children to certain chemicals can vary by age and gender This may contribute to health impacts associated with prenatal and early life exposures to the endocrine disrupƟng chemicals PBDE (flame retardants) and DDT/E (insecƟcides), and may aff ect the onset of puberty | 21 Protecting Children’s Health for a Lifetime EPA and the NaƟonal InsƟtute of Environmental Health Sciences support a network of research centers working to improve children’s health and prevent disease Did you know that organic brown rice syrup may be a source of arsenic exposure? That children living near busy roads may be at higher risk for asthma? And that obese mothers may be 67% more likely to have a child with AuƟ sm Spectrum Disorder (ASD) as compared to normal-weight mothers who not have diabetes or hypertension? The above facts are just three of the many findings from a children’s environmental health research program supported by EPA and the NaƟonal InsƟtute of Environmental Health Sciences (NIEHS) For more than 14 years, EPA and NIEHS have partnered to invest more than $150 million to expand knowledge about children’s environmental health through the EPA/NIEHS Children’s Environmental Health and Disease PrevenƟon Research Program (Children’s Centers) Since the program began, more than 20 mulƟ disciplinary Children’s Health Research Centers have been funded, engaging some of the naƟon’s | 22 leading children’s environmental health researchers Through the collaboraƟ ve network, research scienƟsts, pediatricians, epidemiologists, and local community representaƟves seek ways to reduce children’s health risks, protect them from environmental threats, and promote their health and wellbeing in the communiƟes where they live, learn, and play “The Children’s Centers are really cross-cuƫng by design in that they address all kinds of contaminants, chemicals, air polluƟon, toxic substances, and water They look at children’s health from a community perspecƟve so they consider urban and rural environments and how they have different influences on health In that sense, they are serving a broad and important funcƟon,” said Sally Perreault Darney, PhD, the coordinator of EPA’s children’s environmental health research Center researchers are invesƟ Ɵng how environmental, ga geneƟc, and epigeneƟ c components, as well as how social and cultural factors, may be linked to many of today’s most pressing children’s health concerns, including diseases such as asthma, auƟsm, aƩ Ɵon defi cit en In 2013, EPA and NIEHS expect to fund addiƟonal Children’s Centers to build upon the foundaƟon of research on children’s environmental health To learn more about EPA’s Children’s Environmental Health and Disease PrevenƟon Research Centers, including how to sign up for the monthly webinar series presenƟng the latest research findings, please visit: www.epa gov/ncer/childrenscenters/ Long-term Research to Protect Children Some of the Children’s Environmental Health Centers have been following children before they were born, collecƟ ng environmental measurements over several years and across different developmental stages The work has proved to be a tremendous resource and conƟnues to support ongoing research hyperacƟvity disorder (ADHD), neurodevelopmental defi cits, childhood leukemia, diabetes, and obesity EPA/NIEHS Children’s Centers researchers have published a host of important fi ndings on diverse research subjects important to protecƟ ng children’s health (See sidebar: Advancing Children’s Environmental Health Science.) “Children’s Centers researchers have pioneered new ways of thinking about how to understand and address children’s environmental health Because the program includes mentoring of new invesƟgators, the impact of the Centers program reaches well into the next generaƟ on of children’s environmental health researchers,” said Rich Callan, MPH, one of EPA’s project officers for the program The Centers also emphasize community engagement and the importance of translaƟ ng research findings to make them accessible and useful to doctors, nurses, public health officials, and local communiƟ es Many of the Centers include focused research, outreach, and intervenƟon efforts within at-risk populaƟons, such as children whose parents are agricultural workers or from low-income families Recent examples include findings by Children’s Centers at Columbia, Mount Sinai, and UC Berkeley/Center for Environmental Research and Children’s Health (CERCH) showing that prenatal exposure to higher levels of organophosphate (OP) pesƟcides, commonly used on agricultural crops, can lower a child’s Intelligence QuoƟent (IQ) and performance on memory and behavioral tests The Columbia study also found altered brain structure in children with higher prenatal OP exposures The structural alteraƟons observed are consistent with those seen in the brain structures of children found to have IQ defi cits | 23 In addiƟon, research from UC Berkeley/CERCH Children’s Center showed that unƟl age nine, children have lower levels of the enzyme paraoxonase (PON) than adults Because this enzyme can detoxify OP pesƟcides, lower levels of the enzyme can put children at greater risk for adverse health effects, such as behavioral and learning disorders, from exposure SupporƟng Healthy and Sustainable CommuniƟ es The community-focused fi ndings | 24 of a study on pest control by researchers at the Columbia Children’s Center are a prime example of the posiƟve impact that the EPA/NIEHS Children’s Centers have in supporƟ ng children’s health Researchers there demonstrated that integrated pest management (IPM), which incorporates a suite of pracƟces such as sealing indoor cracks and crevices and storing food in sealed containers, can be more eff Ɵve than ec tradiƟonal control measures that rely primarily on the use of pesƟ cides Based on those findings, the New York City Department of Health and Mental Hygiene and the New York City Housing Authority adopted an IPM intervenƟon as part of the standard pest control protocol for public housing in New York City Advancing Children’s Environmental Health Science “The highly significant work from the Centers is a tesƟmony to the conƟnuing success of the Children’s Centers program in promoƟng children’s health and the ongoing partnership between EPA and NIEHS that began in 1998,” said Nica Louie, MS, an EPA project officer for the Centers program Just a few of the many important research fi ndings that are improving the lives and health of children today include: • Children who ate mostly organic fruits and vegetables and drank organic juices had significantly lower levels of pesƟcide byproducts in their urine than children who ate non-organic produce (Center for Child Environmental Health Risks Research at the University of Washington.) • Children’s Centers researchers conducted the first study to invesƟgate the relaƟonship between exposure to the chemical Bisphenol A (BPA) and thyroid funcƟon in pregnant women and neonates Researchers found an associaƟon between levels of BPA and lower levels of thyroid hormones in pregnant women and newborn boys Thyroid hormone during pregnancy and the neonatal period is criƟcal to proper brain development • Researchers found that children with exposures to two types of phthalates (chemicals found in personal care and plasƟc products) have elevated risk of asthma-related airway infl amma Ɵon (Columbia University’s Center for Children’s Environmental Health.) • EPA/NIEHS Children’s Center research has shown that children living in close proximity to major roadways are at higher risk for asthma and are more likely to have reduced lung funcƟ on compared with children living farther away • Air monitoring in homes of children living in innercity BalƟmore, Maryland by researchers at the Johns Hopkins Children’s Center revealed levels of parƟculate maƩer (PM) exceeding the EPA annual limit for ambient PM These levels were associated with increased asthma diagnosis and more frequent respiratory symptoms The researchers also found that using HEPA air filters helped lower PM levels • Prenatal exposure to air pollutants called polycyclic aromaƟc hydrocarbons (PAHs) can lower a child’s IQ, and in one study were found to be related to cogniƟ ve delay at age three (The Columbia Children’s Center.) • Center research has shown an associaƟon of auƟsm with proximity to a freeway and a larger volume of traffic in California (UC Davis Center) For the latest and addiƟ onal research findings from Children’s Center researchers, visit the “Newsroom” at: www.epa.gov/ ncer/childrenscenters/news/ Learn More! Grants and Funding OpportuniƟ es EPA supports the naƟon’s leading scienƟsts and engineers through compeƟƟve grant programs and fellowships to support the Agency’s mission to protect human health and the environment For informaƟon about EPA grants and funding opportuniƟes, please visit: hƩp://www.epa.gov/ncer 25 Volume | Number | October 2012 United States Environmental Protection Agency Office of Research and Development (8101R) Washington, DC 20460 Stay Connected: Follow us on Twitter - @EPAresearch Read our blog - blog.epa.gov/science PRINTED ON 100% POST-CONSUMER, PROCESS CHLORINE FREE, RECYCLED PAPER ... for children’s health, and this is why a conƟ nued robust children’s health research program is so important A good example of science and research that help protect children’s health is the Children’s. .. disciplinary Children’s Health Research Centers have been funded, engaging some of the naƟon’s | 22 leading children’s environmental health researchers Through the collaboraƟ ve network, research. .. important fi ndings on diverse research subjects important to protecƟ ng children’s health (See sidebar: Advancing Children’s Environmental Health Science.) ? ?Children’s Centers researchers have pioneered