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Volume 3 | Number 4 | October 2012

Children’s Health Research

About this Issue:

Picking food up from the fl oor,

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

From an environmental health

perspecƟve, the behavior of

children may increase their risk of

exposure to potenƟ ally harmful

chemicals What’s more,

pound-for-pound children eat, drink,

and breathe more than adults

And because their bodies and

internal systems are sƟ ll growing

and developing, the earliest

stages of life are periods when

the potenƟally harmful eff ects of

environmental exposures can be

most pronounced

Keeping children safe is the focus

across the government during

October: Children’s Health Month

President Obama marked Child Health Day on October 1, 2012 with a ProclamaƟon that states:

A safe environment in which our children can live and grow

is also essenƟal to their being Because clean water

well-is the foundaƟon for healthy communiƟes, we are working

to reduce contaminants in our drinking water by updaƟng standards and beƩer 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 bronchiƟs, asthma, cancer, and impaired development

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 specifi cally

on advancing children’s health Today, EPA research conƟ nues to provide a beƩ er 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 MaƩers to learn more

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

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1

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 fi eld 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

Link: hƩ p://bit.ly/GreenwireOlden

EPA Increasing the Effi ciency of Chemical

Toxicity Tests

An effi cient way to find out if a chemical could

harm an unborn child is by running the mouse

embryonic stem cell test (EST) The ScienƟst

interviewed EST experts about the best ways

to use the test and about EST variaƟ ons 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 arƟcle

Stemming the Toxic Tide

Link: hƩp://bit.ly/TheScien Ɵ stEPA

BPA Linked to Thyroid Hormones in Pregnant Women and Newborn Boys

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 PerspecƟves , found a correlaƟon between increased

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 Ɵns cans, in hard plasƟcs, and on thermal receipts Link: hƩ p://bit.ly/BerkeleyBPA

Read the study: hƩ p://bit.ly/EHP_BerkeleyBPA

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: hƩ p://bit.ly/VanderbiltP3 More about EPA’s P3 Program: hƩ p://epa.gov/ncer/ p3/

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 fl oor, 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 beƩ er

science-based knowledge about how

kids are exposed to harmful

things in their environments,

it’s possible to reduce their risks

and take acƟon to beƩ er 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 rouƟnes

“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-Specific Exposure Factors Handbook,

which provides informaƟon

on various physiological and behavioral factors commonly used in assessing children’s exposure to environmental chemicals It is used by scienƟ sts, economists, health assessors, and others within and outside EPA conducƟ ng 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, scienƟ sts need

to understand aspects of exposure, such as how much

| 3

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 informaƟon

and recommendaƟ ons 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

to the ground Understanding these differences is criƟ cal for evaluaƟ ng potenƟal environmental hazards from

EPA is using the informaƟ on 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 informaƟon

to support scienƟfi cally defensible exposure and risk assessments to inform decisions to protect human health

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

EPA scienƟsts and their partners are working to beƩer understand why asthma disproporƟ onately 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 aƩ ack, chances are the paƟent will be a poor, minority child

According to the Centers for Disease Control and PrevenƟon (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

| 5

for asthma and respiratory

illnesses Air polluƟ on and

other challenges are having

serious health eff ects, 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 dispariƟes

A major part of that eff ort 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 prevenƟon and intervenƟ on 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 aƩ acks

EPA researchers and their partners are leading the eff ort to develop new scienƟfi c 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 NaƟonal

Photograph of the 2008 wildfire in No

Ambient Air Quality Standards (NAAQS) (see sidebar):

ozone and parƟ culate maƩer (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 AcƟ on Plan

In May 2012, the President’s Task Force on Environmental Health Risks and Safety Risks to Children released the Coordinated Federal AcƟ on 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 collaboraƟ ve 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 aff ord medicaƟon

AddiƟonally, they face higher levels of environmental exposure to allergens

orth Carolina

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 polluƟ on, affect

asthma control in vulnerable

populaƟ ons.”

To advance that work, EPA

researchers and their partners

took advantage of a 2008 lightning strike that occurred in Pocosin Lakes NaƟ onal Wildlife Refuge in North Carolina The 40,000-acre (16,000-hectare), smoldering peat fi re sparked

by the lightning sent thick, billowing clouds of smoke waŌing into the air

In collaboraƟ on 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 counƟ es had significantly more visits than more affl uent counƟ es, even though air quality and exposure levels were the same

“EPA studies suggest that children and others living in

and pollutants that exacerbate

asthma and lack community

level acƟvi Ɵes to reduce

outdoor air polluƟon

The acƟon plan, in which EPA is

a major partner, focuses on the

following four strategies:

• Reduce barriers to the

be documented semi-annually and made public at www.epa

gov/childrenstaskforce

| 7

Science to Support NaƟonal Ambient Air Quality Standards

ProtecƟng the health of children and other vulnerable life stages and populaƟons is a key consideraƟon

in seƫ ng the NaƟ onal 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 specifi c examples include reviewing the body of research about pollutants through Integrated Science Assessments (ISAs) and making children’s acƟvity data easily available to decision makers through the Consolidated Human AcƟvity Database (CHAD):

ISAs: Two pollutants of parƟcular

concern for asthma are parƟ culate maƩer (PM) and ozone To provide the scienƟfic basis for the NAAQS for PM, EPA scienƟsts assessed the latest research on the eff ects PM has on public health and welfare The findings were published in the Integrated Science Assessment (ISA) for ParƟ culate MaƩer (available at hƩ p://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 AcƟvity Database (CHAD) CHAD provides informaƟon on the acƟvi Ɵes

of children and adults Using this informaƟ on, scienƟ sts and engineers can simulate children’s acƟvi Ɵes and breathing rates to see how much of a pollutant a child inhales during daily acƟvi Ɵes This informaƟon ensures that the NAAQS protect children as well as adults

EPA and the NaƟ onal InsƟ tute

of Environmental Health

low-income counƟes could be

less resilient to air polluƟon,

possibly because of social factors

such as inadequate nutriƟon

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 naƟonal

mulƟ -disciplinary organizaƟon

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 beƩ er intervenƟ ons 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 MaƩ ers” 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:

hƩ p://bit.ly/SOT6a5

Tackling Asthma DispariƟes at the Children’s

Environmental Health Centers

Science (NIEHS) jointly fund

the Children’s Environmental

Health and Disease PrevenƟon

Research Centers, a network

of university-based research

programs exploring how to

reduce the impact of adverse

environmental factors on

children’s health—including

asthma

The research has improved

asthma intervenƟons in New

York City

Based on their research

results, health scienƟ sts

at Columbia University’s

Children’s Environmental

Health Center helped

implement an integrated

pest management (IPM) plan

for controlling rodents and

cockroaches, which carry allergens that can trigger asthma aƩ acks

“The EPA/NIEHS funding helped us to carry out an exciƟ ng intervenƟ on that reduces pests that carry asthma allergens while at the same Ɵme reducing the use

of toxic pesƟcides,” said the Center’s director, Frederica Perera, DrPH, a professor of environmental health sciences

at Columbia University “And these intervenƟ ons were carried out in low-income populaƟons at most risk from asthma.”

The National Children’s Study

EPA researchers contribute

to the largest federal study ever undertaken to examine environmental infl uences on the health and development of children

The U.S Environmental ProtecƟon Agency and a consorƟ um of federal partners, led by the Eunice Kennedy Shriver NaƟ onal InsƟ tute

of Child Health and Human Development and also including the Centers for Disease Control and PrevenƟon, and the NaƟonal InsƟtute of Environmental Health Sciences, are working together to conduct The NaƟ onal Children’s Study, an ongoing, long-term study

of environmental and geneƟc influences on children’s health During the study, researchers plan to follow 100,000 children from before birth through their 21st birthdays to learn how environmental infl uences affect children’s health, their growth, and their development Data from the study are expected to inform research into a host of diff erent condiƟ ons, including birth defects and pregnancy-related problems, injuries, asthma, obesity, diabetes, and behavior problems, learning disabiliƟes, and mental health disorders UlƟ mately, findings from the Study will help to ensure a brighter and healthier future for America’s children

For more informaƟon, please visit: hƩ p://www

naƟ onalchildrensstudy.gov/

| 9

The latest Science MaƩ ers

podcast features Dr Peter

GrevaƩ, the director of EPA’s

Office of Children’s Health

ProtecƟon

Below are a few highlights of

the conversaƟon To listen to

the enƟ re conversaƟ on, please

visit: hƩ p://www.epa.gov/

sciencemaƩ ers/sciencemaƩ ers_

podcasts.htm

Science MaƩ ers: Can you give

us an overview of the work EPA

does to protect our children and

help give them a safer future?

Dr GrevaƩ: EPA’s mission is

to protect human health and

the environment, and our goal

is to focus on the protecƟon

of children in everything we

do that affects human health

Our children’s health agenda

includes three key prioriƟes

First, to use the best science

on children’s environmental

health as we implement

environmental laws Second,

to protect children through

the safe use of chemicals And third, to implement effec Ɵ ve, community-based programs

to reduce threats to children’s health

A few examples of EPA’s work under these prioriƟ es include the recently fi nalized mercury and air toxics standards that will prevent 130,000 asthma aƩacks every year The value

of air quality standards such as these total between $37 and $90 billion each year - and those are just health-related savings

Another example of the work EPA does to protect children’s health is partnerships with other government agencies and nonprofi t organizaƟons

to improve environments where children spend most of their Ɵme, such as homes and schools And earlier this year, EPA partnered with Health and Human Services and the Department of Housing and Urban Development to release

a coordinated federal acƟon plan to reduce racial and ethnic asthma dispariƟes

Science MaƩ ers: Thats an impressive amount of work EPA

is doing to protect our children

All of these effects are supported

by science, correct?

Dr GrevaƩ: Yes, all of these acƟons, and others, rely on the use of the latest science on children’s environmental health

Science MaƩ ers: Can you tell

us a bit more about how EPA’s science and research support your efforts to protect children?

Dr GrevaƩ: EPA simply cannot

be fully successful in fulfi lling our children’s health mission without

a strong research program We know there are unique windows

of vulnerability for children developing in the womb and early in their lifeƟmes We also know that children are exposed

to a myriad of chemicals during development, many of which have very liƩle toxicity data available, and we know that children are much more highly exposed to these compounds than adults We oŌen do not yet know the implicaƟon of these factors for children’s health, and this is why a conƟnued 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 Health Research Centers,

jointly sponsored by EPA and NIEHS, that foster research collaboraƟons among clinical and behavioral scienƟ sts with parƟcipa Ɵon from local communiƟes These centers contribute to understanding the complex interacƟ ons between the environment, geneƟ cs, and other factors, and how those interacƟ ons aff ect children’s health from preconcepƟon through young adulthood

Science MaƩ ers: In your opinion, what area of children’s

health research has had the

biggest impact on EPA protecƟng

children?

Dr GrevaƩ: Some of the

most important emerging areas

from the Children’s Health

Research Centers include

endocrine disrupƟ ng chemicals,

epigeneƟcs, and implicaƟ ons for

pesƟcide exposure in children

Another important area of

research includes having

addiƟonal toxicity studies of

developmental endpoints These

have helped the agency develop

more health assessments that

address potenƟ al childhood

concerns Some of the newer

IRIS assessments have included

criƟ cal effects for developmental

outcomes

Also, comprehensive children’s

exposure factors have been

criƟcally important because

we now understand how

much more children’ eat and

drink , pound for pound, than

adults We also much beƩer

understand the unique behaviors

like breasƞeeding and puƫng

non-food objects in children’s

mouths and how this makes

children more vulnerable to

environmental factors

Science MaƩ ers: In your

opinion, what area of children’s

health research has had the

biggest impact on EPA protecƟng

children?

Dr GrevaƩ: It is really difficult

to idenƟfy just one type of

research that has had the biggest

impact and that’s because

all lines of children’s health

research support EPA’s efforts

to protect children So, I gave

you examples of epidemiology

research, toxicology, health

assessments, and children’s exposure factors We need data from all of these lines of research to help make sure we’re protecƟng children’s health

Science MaƩ ers: Looking back over the past ten years, what kind of overall progress do you think we’ve made as a result

of EPA’s children’s environmental health research?

Dr GrevaƩ: SubstanƟal progress has been made toward advancing children’s environmental health over the past ten years The unique vulnerabiliƟes of children have increasingly become an essenƟal part of the naƟ onal discussion

on policy, science, and educaƟon

For example, ten years ago

we certainly understood that lead impacts children’s IQs, but through addiƟonal research, we now understand that even low levels of lead exposure can affect children’s health This increased understanding of lead’s effects led to the development of a revised NaƟonal Ambient Air Quality Standard (NAAQS) that substanƟ ally strengthened protecƟons for children from lead exposures in air

Science MaƩ ers: Going forward, what would you say

is the greatest challenge we face in the field of children’s’ environmental health?

Dr GrevaƩ: One of the greatest challenges we face is how to address the many stark dispariƟes in children’s chronic health outcomes that we see in America today For example, the naƟonal prevalence of asthma in children is slightly less than 10%, but in African American children it’s nearly 16% There is a very high prevalence of asthma in Puerto Rican neighborhoods as well

If we want to address these issues and help protect all of the children in America, we must build on the progress that’s been made in pediatric care, medical research, and community involvement We need to expand the conversaƟon on children’s health by geƫ ng messages out to parents and health care providers about basic, simple steps they can take to help to protect children from potenƟally dangerous exposures

Another major challenge is understanding the vulnerabiliƟes during both the prenatal and postnatal periods of a child’s development There’s sƟ ll more

we need to know in this area

to determine how we can best protect pregnant mothers to have healthier children at these criƟcal stages of life

A strong children’s health research program has laid the foundaƟon for the progress that we’ve made to date I’m confident that a robust children’s health research program will lead to conƟnued progress in EPA’s work on children’s health

in the future

| 11

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 PrevenƟon,

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,

potenƟ ally 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 beƩer

determine how prenatal

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 eff ects of

a variety of prenatal exposures

Virtual Embryo simulates how chemicals and pesƟcides, including those that disrupt the

endocrine system (see ProtecƟng Growth and Development in this

issue), interact with important biological processes that could disrupt fetal development The chemicals used in simulaƟons are idenƟfied by EPA’s Toxicity Forecaster (ToxCast - see sidebar)

as having the potenƟal to affect development

The predicƟons from the computer simulaƟons need to

be further tested against virtual observaƟ ons However, the models provide scienƟ sts with a powerful tool for screening and prioriƟzing the chemicals that need to be more closely