School of Public Health and Community Medicine - University of Washington - Autumn 2007

Our department's leadership in children’s environmental health was recognized this fall with four national awards. Professor Elaine Faustman received a $26 million, five-year grant as part of the new National Children’s Study. The Northwest Pediatric Environmental Health Specialty Unit (PEHSU) won a Children’s Environmental Health Excellence Award from the Environmental Protection Agency. And Professor Richard Fenske, who has done so much work on pesticide exposures in children, was honored with two major awards.

National Children's Study
Crossing the frontier for child health and development

The new study will track children from before birth to adulthood. Photo by Suzanne Gleason.

A new study is being launched, but unlike other scientific studies, the participants have not yet been conceived. Neither have all the questions scientists will be poised to ask in the future.

The National Children’s Study (NCS), now on the brink of implementation, is a first of its kind in the United States, tracking children’s health from womb to adulthood. Departmental researchers will play a key role in this unprecedented undertaking by leading the Pacific Northwest Center, one of 22 study centers recently announced. The National Institutes of Health (NIH) grant to this center totals roughly $26 million over five years.

NCS, which will track 100,000 children across the country from before birth to age 21, will be the largest long-term study of children’s health and development ever conducted in the US. A study of this magnitude is necessary to begin unraveling the largely unknown means by which diseases unfold, said Elaine Faustman, director of the study center and professor in our department. The study will also help tease apart the complex interplay between environmental factors and genetic influences that affect health.

"What we learn will help children and families across Washington and throughout the US and shape child health guidance, interventions, and policy for generations to come," Faustman said.

The UW's Role

The Pacific Northwest Center will manage data collection and recruitment of local participants and, with Public Health–Seattle & King County, will facilitate community involvement. The center will also collaborate with Fred Hutchinson Cancer Research Center. UW and its collaborators will recruit participants for the project, starting in 2009. A later phase of the study will include Oregon Health Sciences University and Marion County, Oregon, communities as an additional study location in the Pacific Northwest.

Professor Tom Burbacher of our department and Shirley Beresford of the Department of Epidemiology are codirectors of the center, which will be housed in the UW School of Public Health and Community Medicine.

The UW is a national leader in child health research, with many established researchers and centers. For example, this new study will build on the successes of our department’s current EPA/NIEHS funded Children’s Environmental Health Risk Research Center that has followed children in agricultural communities for more than eight years through community-based research partnerships.

On the national level, NCS is led by a consortium of agencies, including the National Institute of Child Health and Human Development, the National Institute of Environmental Health Sciences, the Centers for Disease Control and Prevention, and the US Environmental Protection Agency.

Why Study Children's Health?

A newborn child reflects a complex mix of genetic and environmental factors. Photo by Lisa Younglove.

The major disorders and diseases affecting children today are markedly different from several generations ago. In the past, infectious diseases dominated, while today, children face mainly chronic conditions that researchers believe arise at the intersection of environmental exposure and genetic makeup.

NCS—initiated in response to the Children’s Health Act of 2000—aims to reduce the public health burden of childhood chronic diseases and disorders. This burden includes not only pain and suffering, but also missed school days, health care expenses, and other costs to children, their families, and society at large.

Congress specified that the study must be longitudinal (long-term) in design and gauge not only chemical, biological, and physical exposures, but also psychosocial factors such as public policy. The study’s hypotheses were designed around areas identified during the planning process: pregnancy outcomes, neurodevelopment and behavior, asthma, obesity and growth, injury, and reproductive development. Additionally, data gathered can be used to answer questions that arise in the future. Researchers will also be able to assess health disparities and differences in disease occurrence between groups of people.

Recruitment and Sampling

The study will be carried out in 105 study locations (counties or groups of counties) across the US. The probability-based approach used to select locations means that the study sample will reflect demographic and geographic diversity, and will represent a balance of rural and metropolitan areas.

The study will follow pregnant women and their partners, couples planning pregnancy, and women of childbearing age who are not planning pregnancy. The children of these participants will comprise the main focus of the NCS. Recruitment will occur primarily through household sampling, but also through prenatal care providers, hospitals, and birthing centers. During women’s pregnancies, study researchers will collect information regarding diet, exposures, environment, and stress. From the first trimester of pregnancy through the child’s 21st year of life, researchers will conduct at least 15 in-person visits, including home visits, visits in clinical settings, and one visit where the child is delivered.

Environmental samples—such as air, water, food, dust, and soil—will be collected at home visits, and researchers will also collect information via telephone and mail-in questionnaires. Biological samples will include hair, urine, blood, saliva, and nail clippings, as well as cord blood and placental tissue collected at the time of delivery. Mothers will provide breast milk samples, and biological fathers who accept invitations to participate will provide semen samples. In addition, the study will include a pre-pregnancy cohort of women determined to be at high probability of pregnancy. Biological and environmental samples will also be collected from these women.

The Future

A toddler explores his environment. Photo by Jennifer Gill.

Because the study will follow the children from before birth to adulthood, findings may not only shed light on the root causes of many childhood and adult diseases, but may provide new preventions, cures, and treatments that could benefit all Americans. Researchers anticipate that study results will inform child health and environmental policy for the next century. According to the projected timeline, the first results will become available in 2010.

The data will provide an unparalleled resource and will yield an invaluable database to help researchers address current hypotheses—and even formulate ones we cannot dream of today— about child health and development.

-Alison Scherer and Elaine Faustman

For Further Reading

The National Children's Study

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