Largest Study of US Child Health Begins

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WASHINGTON – Scientists begin recruiting mothers-to-be in North Carolina and New York this week for the largest study of U.S. children — aiming eventually to track 100,000 around the country from conception to age 21.

"We are embarking on the road to discovering the preventable causes of the major chronic diseases that plague American children today," Dr. Philip Landrigan of the Mount Sinai School of Medicine, one of the lead researchers, declared Tuesday.

Nearly a decade in the planning, the ambitious National Children's Study tackles a major mystery: How the environment — everything from a pregnant woman's diet to a child's exposure to various chemicals — interacts with genetics to affect youngsters' health and development.

Autism, asthma, certain birth defects and other child disorders are on the rise, as is concern about which environmental factors play a role. Plus, many adult diseases take root in childhood.

But while technology has finally advanced enough to separate multichemical and gene-environment interactions, research until now hasn't included enough children to prove why some are more at risk than others. The hope is that the new study can identify both what's harmful and what's not.

Among the big questions: When someone is genetically vulnerable to a disease like diabetes, are there early environmental exposures that push them over the edge? And does simple exposure to common compounds — such as plastics or pesticides found in people's urine — mean they were harmed? If so, are there key periods when exposure is riskiest?

In 2000 Congress ordered the National Institutes of Health to establish the study, but tight budgets delayed the project. Plus, it took years of planning to ensure the 105 locations where families ultimately will participate are a scientifically representative sample of the nation's diverse population.

This week, researchers will fan out in New York's dense and ethnically diverse borough of Queens plus the smaller, rural Duplin County, N.C., to find the first recruits: Women in early pregnancy or who are trying to conceive.

Those who agree to participate will give samples of their blood, hair and urine, let researchers test the water and dust in their homes, and undergo health interviews throughout pregnancy. Their babies' health will be tracked, with periodic exams and checks of their home environment in the first year of life and then about every three years afterward.

The first two sites demonstrate the study's look at diversity in not just population but environmental factors. Sparsely populated Duplin County — where University of North Carolina at Chapel Hill researchers will cover 885 miles of road to recruit — is home to many large hog and turkey farms and their processing factories. Queens mixes a modern urban environment with decades-old industrial sites.

Scientists expect the study's first birth to occur in July. But they won't have to wait for the children to grow up for answers: Data on what influences problems like premature birth and birth defects should come first, as early as 2012, with more details on early childhood diseases within five years.

In April, scientists will begin recruiting in five more locations, in parts of California, Pennsylvania, Utah, South Dakota and Minnesota. The first locations are pilot-testing the study's initial steps, with nationwide enrollment set for summer 2010.

But the NIH issued a gentle warning Tuesday: Don't call up seeking to volunteer. Participants must be from tightly defined geographic locations to avoid skewing the results, and researchers are calling homes or getting prenatal providers to recruit in just those spots.

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