Bonny Specker, Ph.D.

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National Childrens Study

• Bonny Specker, Ph.D.
• South Dakota State University

Brookings, Yellow Medicine, Pipestone Lincoln
Counties (BYPL) Vanguard Center
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What is the National Childrens Study (NCS)?

• Largest nationwide study of childrens health
• Authorized by the Childrens Health Act of 2000
• Supported by the National Institutes of Health
  (NIH), Centers for Disease Control Prevention
  (CDC), and the Environmental Protection Agency
  (EPA)

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Outline of Talk The National Childrens Study
(NCS)

• Reason for doing the study
• Important facts about how the Study will work
• Background on the Vanguard Centers
• Things about the BYPL Vanguard Center that might
  be of interest
  
• Timeline of events
• BYPL Brookings, Yellow Medicine, Pipestone,
  Lincoln counties

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Some Childhood Conditions are Increasing
of Children with Asthma 1981-2003
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Some Childhood Conditions are Increasing
of Children Overweight 1963-2002
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Some Childhood Conditions are Increasing

• We suspect that the environment plays a part in
  these childhood conditions
  
• Birth defects
• Prematurity
• Autism
• Cerebral palsy
• Type I diabetes
• Mental retardation
• Obesity
• Asthma
• Injuries

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Children are NOT Little Adults

• Children behave differently
• Children are physically different
• Harm is more possible at certain times in
  development

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Children Behave Differently

• Explore the world through touch and taste
• Spend more time outdoors
• Diet and eating habits differ

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Children are Physically Different

• Pound-for-pound, kids
• Breathe more air than adults
• Drink more water than adults
• Eat more food than adults

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Children are NOT Little Adults

• Most chemicals to which children are exposed have
  not been tested
  
• 80,000 chemicals in commerce
• Danger to growing children is known for less than
  20 of these chemicals

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Some Things Partly to Blame for Childhood Diseases

• Mothers infections during pregnancy ?
  prematurity
  
• Heavy metals (lead in paint, mercury in fish) ?
  developmental problems
  
• Mothers exposure to pesticides ? developmental
  problems
  
• Stress during pregnancy ? childhood asthma
• Child television watching super-size me
  portions ? obesity

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Why Do We Need the NCS?

• The NCS will identify what is
• Harmful
• Harmless
• Helpful
• to child development

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Facts about the NCS

• Focuses on priority areas
• National in scope (105 U.S. counties) and the
  group enrolled will provide a snapshot of all
  U.S. families
  
• Families followed from before conception or in
  early pregnancy until age 21 years
  
• Many different aspect of environment will be
  studied chemical, physical, social behavioral
  
  
• Biological specimens will be stored so scientists
  can use these to answer health questions in the
  future

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How Will Families be Identified?

• 105 study locations were drawn from the full list
  of about 3,000 counties in the U.S.
  
• Certain neighborhoods in these counties will be
  selected.
  
• We will go door-to-door looking for women to
  enroll.
  
• We also will ask for help from doctors caring for
  pregnant women.

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Vanguard Locations

• Precede other Study locations by two years
• Finalize exactly what information will be
  collected
  
• Pilot testing
• 7 Vanguard Sites
• BYPL Counties, South Dakota Minnesota
• Duplin County, North Carolina
• Montgomery County, Pennsylvania
• Orange County, California
• Queens County, New York
• Salt Lake County, Utah
• Waukesha County, Wisconsin

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NCS Locations
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Vanguard Center Comparisons
in 2003 LBWLow Birth Weight (less than 5½
pounds) Each site will contribute 1,250 births to
NCS
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Types of Data Collected

• Questionnaires Interviews medical history,
  dietary intake, product use
  
• Environmental Samples Observations air, dust,
  soil, water, home observations
  
• Physical Examinations fetal ultrasound
  measures, height, weight, blood pressure
  
• Observation of Behavior mother-child
  interactions
  
• Biological Samples blood, urine, umbilical cord
  blood, placenta, breast milk

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Schedule of Visits
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Large Size of the NCS

• The NCS is large, long, and extensive because
  most studies
  
• do not enroll enough children need large
  numbers to pull apart all the effects of
  different environmental influences
  
• last for short periods of time do not follow
  the children as they get older and cannot see
  diseases resulting from long-term exposure to
  something harmful
• are only done in one place may not represent
  all U.S. children

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Associations Interactions in the NCS
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Expected Benefits of the NCS
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The National Childrens Study

• What might be interesting about the BYPL counties?

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The BYPL Communities

• Land Area 2,555 square miles
• Population 21 people/square mile
• 44 live in urban clusters (2,500-5,000 people)
• 56 live in rural areas (12 are actively
  farming)
  
• 85 are high school graduates
• 19 elementary schools
• 17 high schools
• 23 have a 4-year college degree
• 12 live below poverty
• 77 are affiliated with a church (137 churches)

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Births in the BYPL Counties
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Environmental Exposures in the BYPL Communities

• Agricultural-related exposures
• Pesticides
• Accidents injuries
• Significant number of older housing units ?
  possible increased lead exposure
  
• In 2002, Brookings County ranked among the
  dirtiest/worst 20 of all counties in the U.S. in
  terms of air releases of recognized developmental
  toxicants.

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BYPL NCS Vanguard Center Collaborators

• South Dakota State University
• EAM Program in Human Nutrition, Nursing,
  Engineering, Exercise Physiology, Human
  Development, Rural Sociology
  
• Cincinnati Childrens Hospital Medical Center
• Childrens Environmental Research Center
• University of Cincinnati
• Department of Environmental Health
• Numerous local hospitals, clinics and physicians

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BYPL Vanguard Center

• 11 segments will be identified 7 of these
  randomly chosen
  
• All women in these 7 segments will be approached
  (4,000 enrolled)
  
• Expect 250 births/y for 5 years (N1,250)

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Timeline
BYPL Contract awarded to SDSU
1st Annual CEH Seminar
Community Outreach and Engagement Activities BEGIN
20 Additional Centers Funded
Listing Training Site Visit
Media Event
Recruitment BEGINS!!
Healthcare Meetings BEGIN
NOV
DEC
FEB
JUL
DEC
JUN
OCT
NOV
AUG
2005
2006
2007
2008
CAC Initiation Meeting
2nd Annual CEH Seminar
FY 07 Funding issues
Pilot Listing Completed
Hypotheses / Planning / Study Development- ONGOING
County Assessment Research - ONGOING
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A Healthy Environment Means Healthier Children
NCS Website www.nationalchildrensstudy.gov