National Children s Study Queens Vanguard Center

Transcription

1 National Children s Study Queens Vanguard Center Philip J. Landrigan, MD, MSc, Principal Investigator Leo Trasande, MD, MPP, Queens and Nassau Location Principal Investigator

2 Queens Vanguard Center A Consortium of Five Distinguished Institutions and Key Community Partnerships

3 Why is the NCS needed? Rates of chronic disease in American children are increasing- asthma, cancer, certain birth defects, learning disabilities and obesity The environment is changing The chemical environment The built environment Growing evidence that environmental factors are linked to disease in children Disease of environmental origin is expensive Environmental disease is preventable

4 Why is the NCS needed? Increasing Chronic Disease Asthma (now affects 250,000 NY children) Lead poisoning (10896 NY children in 2001) Obesity (21% of NYC kindergartners are obese) Cancer (second leading cause of death) Birth defects (30% increase in male reproductive defects in NY from ) Injury (NY: 445 deaths, hospitalizations in ) Mental retardation, autism, ADHD, behavioral and psychiatric disorders (5-10% of NYS children) Learning disorders (206,000 NY children) Source: Trasande et al J Urban Health 2006, Landrigan et al Pediatrics 2006, Thorpe et al AJPH 2005, NYC Bureau of Vital Statistics, NYC Bureau of Lead Poisoning and Prevention

5 Why is the NCS needed? Increasing Scope of Environmental Exposures Now more than 80,000 synthetic chemicals 1-3,000 new chemicals are registered each year Children especially at risk of exposure to 2,800 high production volume (HPV) chemicals Total air releases of toxins in NYS decreased by 69% from 1998 to 2001, but: total water releases increased by 370% in that same time period, and land releases increased by 29% 90 Superfund National Priorities List sites in NYS and 235 schools in NYS located within a ½ mile 430,000 housing units with high risk of lead hazards Source: EPA Data Availability Study, 1998; Jacobs et al 2004; EPA Superfund Website; EPA Toxic Release Inventory

6 Why is the NCS needed? Increasing Evidence for the Role of the Environment At least 28% percent of developmental disabilities in children dyslexia, attention deficit disorder and mental retardation are due to at least in part environmental causes. (NAS 2000) Outdoor air pollutants, mold and volatile organic compounds contribute to the causation of asthma and other respiratory diseases in children. Exposures of pregnant women to toxic drugs and smoke released to the environment by the attacks on the World Trade Center on September 11, 2001 caused a doubling in the number of babies who were small for gestational age.

7 Why is the NCS needed? Gaps in Knowledge about the Toxicity of Widely Distributed Environmental Chemicals Fewer than half (43%) of HPV chemicals have been tested for their potential toxicity to humans Only 7% of these chemicals have been tested for their developmental toxicity or toxicity to children (EPA 1996, 1997)

8 Why is the NCS needed? Environmentally Mediated Diseases are Expensive Cost of Environmentally Mediated Diseases in New York State, 2000 (2000 dollars) Disease Lead poisoning Asthma Neurodevelopmental Disorders Childhood cancer Total Estimated Cost $3.66 billion $ billion $ billion $ billion $ billion Trasande et al, unpublished data

9 Why is the NCS needed? The Role of Studies in Documenting Impacts Estimated economic benefit: $110 to $319 billion per year Grosse et al Environ Health Perspect June; 110(6): Annest, Pirkle, Makuc, et al., Chronological trend in blood lead levels between 1976 and NEJM 1983; 308;

10 National Children s Study A prospective epidemiological study of 100,000 American children -- from conception to adulthood Largest long-term study of children s health and development ever to be conducted in the U.S. Longitudinal study of children, their families, and their environment Examples of questions the NCS will seek to answer: What are the health effects of low level chemical exposures? How is asthma influenced by early life infection and air pollution? Does impaired maternal glucose metabolism during pregnancy cause obesity in children? Does television exposure in infancy affect development and behavior?

11 NCS Visit Schedule Trasande et al Environ Health Perspect 117: (2009).

12 NCS Measurements through Pregnancy Regarding Obesity Trasande et al Environ Health Perspect 117: (2009).

13 A Life Course Approach to Obesity Trasande et al Environ Health Perspect 117: (2009).

14 National Probability Sample QUEENS: 1 of 7 Vanguard Centers 1 of 2 Sentinel Sites Field Start Date: January 13, 2009

15 Queens Sample All Births in Nation ~4 million births per year in 3,141 counties Sample of Study Locations 105 Locations Sample of Study Segments Selection of neighborhoods Study Households All or a sample of households within neighborhoods Study Women All eligible women in the household

16 Queens Vanguard Center Community Engagement Goal: To ensure that the communities of Queens are aware and familiar with the NCS and that their perspectives, interests, and needs are represented and used in the planning and implementation of the NCS. Community Partners & Engaged Organizations Queens Borough President Helen Marshall Queens Community Boards Northern Queens Health Coalition Queens Comprehensive Prenatal Perinatal Services Network Clergy United for Community Empowerment Joseph P. Addabbo Family Health Center, Inc. Eastern Queens Alliance