Collaborative Research and Action: Empowering an Exposed Community

项目摘要/摘要： 密歇根州PBB登记处的建立是为了研究数千名接触过铅的人的健康状况 美国历史上最大的农业灾难导致溴化阻燃剂。之前的研究，由 该研究小组已经证明，暴露在多溴联苯(PBB)中会对健康产生重大影响。 包括月经初潮提前，流产风险增加，女性雌激素水平降低，以及更多 男性中的泌尿生殖系统问题。在过去的几年里，埃默里的研究人员已经进行了20多次 密歇根州各地的社区会议，与社区合作伙伴合作，分享研究成果 与社区合作，回应社区需求，并为未来的研究计划寻求社区意见。 这项拟议的研究由科学家、社区合作伙伴和公共卫生官员共同开发， 解决了PBB社区表达的几个主要关切。具体地说，受影响的个人 表达了对可能的治疗方法从体内清除多溴联苯的兴趣，对遗传影响的担忧 来自PBB的儿童和孙子，持续的健康担忧，除了与 生殖，以及当地医疗保健提供者似乎没有意识到全州范围内的多溴联苯暴露的挫败感 和/或其可能的健康影响。为了解决这些担忧，拟议的研究有四个具体目标。这个 首先是评估营养援助作为加速消除多溴联苯的潜在手段的效用，方法是 进行随机双盲临床试验。第二个目标将探索变化的遗传性。 通过研究三代人的家庭，表观基因组与多溴联苯的暴露有关。表观基因组 将对父母、他们的子女和他们的孙子进行检查，以确定表观遗传模式 父母直接暴露于多溴联苯的相关性在子女和孙辈中很明显。目标三 将解决社区对生殖结果以外的额外健康影响的关切。 参与者将完成健康问卷并提供血清样本进行分析，以确定是否存在PBB 暴露与神经退行性疾病、关节疼痛/疾病、癌症、免疫功能和 肝脏和胰腺都有问题。如果任何自我确定的不良后果与多溴联苯暴露有关， 将寻求更多资金来进一步探索这些联系。最后，公共卫生行动计划将 寻求提高密歇根州的环境健康意识。将为以下人员制定教育方案 卫生保健提供者、政策制定者和公民提高当地能力，以解决暴露问题。

Project Summary/Abstract: The Michigan PBB Registry was established in order to study the health of thousands of people exposed to brominated flame retardants as a result of the largest agricultural disaster in US history. Previous research by this team has shown significant health effects associated with exposure to polybrominated biphenyls (PBB) including earlier menarche, increased risk of miscarriages and lower estrogen levels among women, and more urogenital problems among men. Over the past few years, Emory researchers have conducted over two dozen community meetings throughout Michigan, collaborated with community partners, shared research findings with the community, responded to community needs, and sought community input for future research plans. This proposed study, collaboratively developed by scientists, community partners, and public health officials, addresses several major concerns expressed by the PBB community. Specifically, affected individuals have expressed interest in a possible treatment to remove PBBs from their bodies, concern about heritable effects from PBB on their children and grandchildren, continuing health concerns beyond those related to reproduction, and frustration that local health-care providers seem unaware of the statewide PBB exposure and/or its possible health effects. To address these concerns, the proposed study has four specific aims. The first is to evaluate the utility of a nutritional aid as a potential means of accelerating the elimination of PBB by conducting a randomized double-blind clinical trial. The second aim will explore the heritability of changes in the epigenome associated with PBB exposure by studying families across three generations. The epigenome of parents, their children, and their grandchildren will be examined to determine if epigenetic patterns associated with direct exposure to PBB of parents are apparent in the children and grandchildren. Aim three will address community concerns regarding additional health effects beyond reproductive outcomes. Participants will complete health questionnaires and provide serum samples for analysis to determine if PBB exposure is associated with neurodegenerative diseases, joint pain/disorder, cancer, immune function and liver/pancreatic problems. If any of the self-identified adverse outcomes are associated with PBB exposure, additional funding will be sought to further explore these associations. Finally, the public health action plan will seek to raise environmental health awareness in Michigan. Educational programs will be developed for healthcare providers, policy-makers, and citizens to increase local capacity to address exposure concerns.