Understanding Risk Gradients from Environment on Native American Child Health Trajectories: Toxicants, Immunomodulation, Metabolic syndromes, & Metals Exposure

了解环境对美国原住民儿童健康轨迹的风险梯度：毒物、免疫调节、代谢综合征、

• 批准号: 9355734
• 负责人: Johnnye L Lewis
• 金额: $ 364.2万
• 依托单位: UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-21 至 2019-06-13
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9355734
• 关键词: 4 year old; Address; Adolescent; Affect; Age; Antibodies; Area; Autoantibodies; Autoimmune Responses; Behavioral; Biological Monitoring; Birth; Brain; Caring; Characteristics; Child; Child Development; Child Rearing; Child health care; Cohort Studies; Communicable Diseases; Complex; Congenital Abnormality; Data; Data Sources; Development; Disease; Employee Strikes; Enrollment; Environment; Environmental Exposure; Environmental Impact; Exposure to; Extended Family; Fathers; Funding; Health; High Prevalence; Home environment; Immune; Infant Mortality; Inflammation; Knowledge; Lead; Lymphocyte; Measurement; Measures; Meconium; Mediation; Metabolic syndrome; Metal exposure; Metals; Mothers; Native Americans; Navajo; Nutrition Surveys; Nutritional; Obesity; Outcome; Participant; Pattern; Policies; Population; Postpartum Period; Poverty; Predisposition; Pregnancy; Prevalence; Protocols documentation; Recruitment Activity; Research; Research Infrastructure; Risk; Rivers; Serum; Sioux Indians; Social Interaction; Specimen; Surveys; Testing; Time; Tribes; Unemployment; United States; United States National Institutes of Health; Uranium; Urine; Work; base; clinical care; clinical development; cohort; cytokine; development policy; drinking water; early childhood; early life exposure; fetal; follow-up; genetic analysis; immune function; immunoregulation; mortality; neurodevelopment; obesity in children; offspring; postnatal; prenatal; programs; resilience; response; screening; social; suicide rate; toxicant; toxicant interaction; tribal Nation; tribal community; tribal lands; virtual; wasting

Summary The URGENT Native American ECHO Cohort will build on the active Navajo Birth Cohort Study (NBCS), extending the follow up period beyond the current 12 month protocol, and adding two additional tribes, the Cheyenne River and Oglala Sioux Tribes, to assess the impact of environmental exposures to abandoned mine waste on birth outcomes and child development. The study, the first large-scale assessment of environmental exposures and children’s health in tribal populations is conducted in partnership with tribal communities and will help to build both research capacity within the tribes as well as capacity of tribal staff to conduct detailed developmental assessments. The study will follow development of the enrolled children until age 5 to track trajectories or patterns of neuro- and physical development with respect to environmental exposures to metal mixtures from abandoned hard rock and uranium mines on or near tribal lands. There are 161,000 such abandoned mines in the Western US, 4,000 of them abandoned uranium mines which are often unfenced, unmarked and accessible to children. On Navajo Nation alone, more than 500 abandoned uranium mines remain un-remediated more than 30 years since the closing of the last mine. The proposed research will address two of the key health outcome focus areas identified by the ECHO program through study of the effects of prenatal and early childhood exposure on 1) neurodevelopment, and 2) obesity. Based on the team’s preliminary findings, the research will focus on dysregulation of immune function as a result of exposure to metal mixtures during gestation, and mechanisms by which this dysregulation can lead to neurodevelopmental delays and obesity. The work will be conducted as part of the NIH Consortium to study Environmental Influences on Child Health Outcomes (ECHO) which will attempt to bring together as many as 50,000 children from existing birth cohort studies to understand the complex interactions of toxicant, social, nutritional, and cultural environments on developmental trajectories. Inclusion of the Native American Cohort will bring to the Consortium the first in-depth look at how normal child development progresses in Native populations in addition to how environmental adversity affects that course. Native Americans have far greater rates of poverty and unemployment, lack much essential infrastructure including clean drinking water and sewers, and have lower educational completion rates. However, they also have strong cultural identities, strength in child- rearing from extended families, and differences in appreciation of significant developmental milestones that have been associated with the development of resilience that helps in overcoming adversity. Therefore, their inclusion in this effort to understand the effects of exposure on these important health outcomes will bring a perspective that will serve not only to inform our understanding of development in the US through inclusion of the diversity represented by the sovereign tribal nations, but will also be of benefit to the tribes in informing the development of policies and clinical care that enhances the ability of children to reach their maximum potential.

概括 紧急美国原住民 ECHO 队列将以活跃的纳瓦霍出生队列研究 (NBCS) 为基础， 将后续期限延长到当前 12 个月协议之后，并增加两个额外的部落， 夏安河和奥格拉拉苏族部落，评估废弃环境暴露的影响 矿山废物对出生结果和儿童发育的影响。该研究是首次大规模评估 与部落合作开展部落人口的环境暴露和儿童健康研究 社区，并将有助于建设部落内部的研究能力以及部落工作人员的能力 进行详细的发展评估。该研究将跟踪登记儿童的发育情况，直到 5 岁，追踪与环境相关的神经和身体发育轨迹或模式 接触部落土地上或附近废弃的硬岩矿和铀矿的金属混合物。有 美国西部有 161,000 个此类废弃矿井，其中 4,000 个废弃铀矿，这些矿井经常被废弃 无围栏、无标记且可供儿童进入。仅纳瓦霍族保留地就有 500 多个废弃的铀矿 自最后一个矿井关闭以来，已有 30 多年未对地雷进行修复。拟议的研究将 通过研究，解决 ECHO 计划确定的两个关键健康成果重点领域 产前和儿童早期暴露对 1) 神经发育和 2) 肥胖的影响。根据团队的情况 初步发现，该研究将重点关注因暴露于环境而导致的免疫功能失调 妊娠期间的金属混合物，以及这种失调可能导致神经发育障碍的机制 延迟和肥胖。这项工作将作为 NIH 联盟的一部分进行，以研究环境 对儿童健康结果的影响 (ECHO) 将尝试将多达 50,000 名儿童聚集在一起 从现有的出生队列研究中了解毒物、社会、营养和环境之间复杂的相互作用 文化环境对发展轨迹的影响。将美洲原住民群体纳入其中将带来 联盟首次深入研究了原住民儿童正常发育的进展情况 除了环境逆境如何影响该过程之外。美洲原住民的比例要高得多 贫困和失业，缺乏许多必要的基础设施，包括清洁饮用水和下水道，以及 教育完成率较低。然而，他们也有很强的文化认同，在儿童方面的实力 来自大家庭的抚养，以及对重要发展里程碑的理解上的差异 与有助于克服逆境的复原力的发展有关。因此，他们的 参与这项努力以了解暴露对这些重要健康结果的影响将带来 这种观点不仅有助于我们通过包容性来了解美国的发展 主权部落国家所代表的多样性，但也有利于部落了解情况 制定政策和临床护理，增强儿童发挥最大潜力的能力。