Interactive Effect of Environmental Exposures and Alcohol in the Navajo Birth Coh

环境暴露和酒精对纳瓦霍出生COH的交互影响

• 批准号: 8496240
• 负责人: Ludmila Nicole Bakhireva
• 金额: $ 42.19万
• 依托单位: UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8496240
• 关键词: 1 year old; Address; Affect; Age; Age-Years; Alcohol abuse; Alcohol dependence; Alcohols; American Indian and Alaska Native; Arsenic; Biological Markers; Biological Monitoring; Birth; Child; Cohort Studies; Collaborations; Communities; Congresses; Data; Data Set; Development; Developmental Delay Disorders; Diagnosis; Early Intervention; Early identification; Environmental Exposure; Environmental Pollution; Environmental Risk Factor; Esters; Ethanol; Evaluation; Exposure to; Fatty Acids; Feces; Fetal Alcohol Exposure; Fetal Alcohol Spectrum Disorder; Fetal alcohol effects; Foundations; Funding; Future; Glucuronides; Goals; Gold; Growth; Growth and Development function; Head circumference; Heavy Metals; Height; Home environment; Lead; Learning; Left; Life; Maternal Age; Maternal and Child Health; Measures; Meconium; Metals; Methods; Mining; National Institute on Alcohol Abuse and Alcoholism; Native Americans; Navajo; Neurocognitive; Neurocognitive Deficit; Neurodevelopmental Deficit; Newborn Infant; Outcome; Outcome Study; Parents; Patient Self-Report; Perinatal; Population; Prevalence; Prevention program; Production; Psyche structure; Public Health; Questionnaires; Recommendation; Recording of previous events; Reporting; Reproductive Health; Resources; Risk; Risk Factors; Sensitivity and Specificity; Site; Source; Staging; Surveys; Testing; Toxic Environmental Substances; Toxicant exposure; Tribes; Uranium; Validation; War; Water; Water Pollution; Weight; Wit; Work; cohort; cost effective; diethyl sulfate; disability; disorder prevention; drinking water; experience; health disparity; improved; innovation; modifiable risk; neurodevelopment; neurotoxic; northern plains; novel; operation; population based; prenatal; prenatal environmental exposure; programs; public health relevance; screening; socioeconomics; tribal community; wasting; weapons

DESCRIPTION (provided by applicant): American Indian/Alaska Natives (AI/AN) have historically experienced disparate rates of key reproductive health indicators. In addition, many AI tribes, especially in the western U.S., have been disproportionately affected by exposure to environmental contaminants, including but not limited to non-occupational exposures to uranium and other metal wastes such as arsenic resulting from past mining and milling operations and also from drinking water contamination. In addition, poor socioeconomic conditions affecting many tribal communities often lead to increased rates of alcohol abuse and dependence. While AI/AN are greatly underrepresented in the population-based and targeted screening programs, recent studies among AI of the Northern Plains suggest that the prevalence of the Fetal Alcohol Spectrum Disorder might be 10-fold higher than in the general U.S. population (May et al, 2008). The goal of this project is to partner with the Navajo Birth Cohort Study (NBCS; PI: Lewis) to assess a combined effect of prenatal alcohol, uranium, and arsenic exposure on growth and neurocognitive deficits in 600 Navajo children at 1 year of age. The central hypothesis is that alcohol will synergize with uranium and arsenic co-exposures to increase the risk of early growth and neurodevelopmental deficits at one year of age. The project will employ the state-of-the-art methods to confirm both environmental exposures and prenatal alcohol exposure (PAE) and is supported by Dr. Lewis's extensive preliminary data on uranium and arsenic exposure sources in the Navajo Nation and validation of ethanol biomarkers studies conducted by Dr. Bakhireva. Uranium and arsenic exposures will be determined through in- home environmental assessments, extensive surveys for exposure histories, and through biomonitoring confirmation of recent exposures. In addition to maternal self-report, PAE will be confirmed with a battery of one established (fatty acid ethyl ester [FAEE]) and two novel (ethyl glucuronide [EtG] and ethyl sulfate [EtS]) meconium biomarkers. The presence of FAEE in meconium at birth has been previously reported to be predictive of future mental and psychomotor delays in children, and a battery of three biomarkers is expected to improve sensitivity and specificity of the test. The innovation of the proposed work lies in partnering wit the established NBCS, employing a cost-effective strategy by leveraging NBCS resources, and working within an established, decade-long, community and academic partnership. The proposed study is, to our knowledge, the first attempt to objectively assess prevalence of prenatal alcohol exposure (PAE) and interaction between PAE and environmental toxicants in a Native American population. Both exposures represent potentially modifiable risk factors which might be the key players contributing to health disparities and poor perinatal outcomes in the Native American communities. If the hypothesis is supported by the study outcomes, the findings would have impact beyond the current population.

描述(由申请人提供)：美国印第安人/阿拉斯加原住民(AI/AN)历史上经历了关键生殖健康指标的不同比率。此外，许多人工智能部落，特别是在美国西部，受到环境污染物暴露的不成比例的影响，包括但不限于非职业性接触铀和其他金属废物，如过去采矿和磨矿作业产生的砷，以及饮用水污染。此外，恶劣的社会经济条件影响到许多部落社区，往往导致酗酒和依赖率上升。虽然人工智能/AN在基于人群和有针对性的筛查计划中的比例很低，但最近在北部平原人工智能中的研究表明，胎儿酒精谱系障碍的患病率可能是美国普通人群的10倍(May等人，2008年)。该项目的目标是与纳瓦霍出生队列研究(NBCS；PI：Lewis)合作，评估产前酒精、铀和砷暴露对600名1岁纳瓦霍儿童的生长和神经认知缺陷的综合影响。中心假设是酒精将与铀和砷的共同暴露协同作用，增加一岁时早期生长和神经发育缺陷的风险。该项目将使用最先进的方法来确认环境暴露和产前酒精暴露(PAE)，并得到Lewis博士关于纳瓦霍民族铀和砷暴露来源的广泛初步数据以及Bakhireva博士进行的乙醇生物标记物研究的验证的支持。铀和砷的暴露将通过室内环境评估、对暴露历史的广泛调查以及通过对最近暴露的生物监测确认来确定。除了产妇自我报告外，PAE还将通过一组已建立的胎粪生物标志物(脂肪酸乙酯[FAEE])和两种新的胎粪生物标志物(乙基葡萄糖醛酸乙酯[EtG]和硫酸乙酯[ETS])来确认。此前有报道称，出生时胎粪中FAEE的存在可以预测儿童未来的精神和精神运动延迟，一系列三种生物标志物有望提高测试的敏感性和特异性。拟议工作的创新之处在于与已建立的NBCS合作，通过利用NBCS的资源采用具有成本效益的战略，并在已建立的、长达十年的社区和学术伙伴关系内工作。据我们所知，这项拟议的研究是第一次试图客观评估美国原住民人群中产前酒精暴露(PAE)的患病率以及PAE与环境毒物之间的相互作用。这两种暴露都是潜在的可改变的风险因素，这可能是导致美洲原住民社区健康差距和围产期结局不良的关键因素。如果这一假设得到研究结果的支持，研究结果将产生超出当前人群的影响。