The National Children's Study of Environmental Effects on Child Health and Development. (Commentary)
The National Children's Study Interagency Coordinating Committee
Members of the National Children's Study Interagency Coordinating Committee were Amy M. Branum, Infant and Child Health Studies Branch, National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), Hyattsville, MD, USA; Gwen W. Collman, Chemical Exposures and Molecular Biology Branch, Division of Extramural Research and Training, National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, NC, USA; Adolfo Correa, National Center on Birth Defects and Developmental Disabilities, National Center for Environmental Health, CDC, Atlanta, GA, USA; Sarah A. Keim, National Children's Study (NCS) Program Office, National Institute of Child Health and Human Development (NICHD), Rockville, MD, USA; Woodie Kessel, Office of the Secretary, Department of Health and Human Services, Washington, DC, USA; Carole A. Kimmel, National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency (U.S. EPA), Washington, DC, USA; Mark A. Klebanoff, Division of Epidemiology, Statistics, and Prevention Research, NICHD, Rockville, MD, USA; Matthew P. Longnecker, Epidemiology Branch, NIEHS, Research Triangle Park, NC, USA; Pauline Mendola, National Health and Environmental Effects Research Laboratory, Chapel Hill, NC, USA; Marc Rigas, National Exposure Research Laboratory, U.S. EPA, Las Vegas, NV, USA; Sherry G. Selevan, National Center for Environmental Assessment, Office of Research and Development, U.S. EPA, Washington, DC, USA; Peter C. Scheidt, NCS Program Office, NICHD, Rockville, MD, USA; Kenneth Schoendorf, Infant and Child Health Studies Branch, National Center for Health Statistics, CDC, Hyattsville, MD, USA; Eleanor Smith-Khuri, NCS Program Office, NICHD, Rockville, MD, USA; Marshalyn Yeargin-Allsopp, National Center on Birth Defects and Developmental Disabilities, National Center for Environmental Health, CDC, Atlanta, GA, USA
Increasing recognition that children may be more susceptible than adults to environmental exposures and that they experience potentially life-long consequences of such exposures has led to widespread support for a large new cohort study in the United States. In this article, we propose a framework for a new cohort study of children, with follow-up beginning before birth and continuing to age 21 years. We also describe the administrative structure that has been built to develop the proposal further. The structure includes a partnership between federal and nonfederal scientists and relies on a collaborative, interdisciplinary research effort of unprecedented scale in medical research. We discuss briefly how the proposed cohort could be used to examine, among many other things, the effect of chemical contaminants in breast milk on children's health and development. Key words: child, cohort studies, environment, human milk, pregnancy.
Interest in ambitious new research to improve children's health has been spurred by past successes in identifying adverse effects of environmental exposures on children, coupled with growing awareness of the mechanisms underlying children's susceptibility and the current exposures and risks they undergo. During certain periods of development, or "critical windows," exposure to a toxic agent can have much more severe consequences than would a similar exposure in adulthood (Selevan et al. 2000). In addition, infants have immature mechanisms for metabolism (Balisteri 2000) and excretion (Kleinman 1982) of toxicants. Newborns also have a higher surface area and respiratory minute ventilation per unit body weight; therefore, a given external exposure can result in larger intake of an agent compared with that of adults (Snodgrass 1992). Furthermore, children's behavior can result in a higher exposure and internal dose given the same environment as that of adults (Freeman et al. 2001). …