Prenatal WTC Chemical Exposures, Birth Outcomes and Cardiometabolic Risks-Resubmission-1

项目摘要 纽约大学医学院、梅尔曼公共卫生学院、纽约大学沃兹沃斯实验室 卫生部和辛辛那提儿童医院医疗中心对PAR-16-098做出回应，提议 利用两个独特的和同时代的队列来检查化学和心理社会应激源 与WTC地点的接近程度和自我报告的暴露，以及评估出生和神经发育的关系 心脏新陈代谢的结果。第一个是由在以下三个地区分娩的母亲组成的 曼哈顿医院在灾难发生后的几个月里，另一家是位于曼哈顿北部的哥伦比亚医院 儿童环境健康中心(NM)队列。NM队列包括在此之前出生的儿童和 2001年9月11日之后，允许对与压力相关的暴露进行嵌套评估。除了 心脏代谢结果，数据已经可用，包括新获得的持久性有机污染物的测量， 我们将扩展到包括具有NIOSH支持的PFC。在这两个群体中，神经发育结果 都是通过6-7岁进行评估的。利用时间和地理上的差异 在这些队列中，我们将比较心理社会暴露和化学暴露及其与结果的关系 在产前暴露于WTC灾难和没有暴露于WTC灾难的儿童中。这项研究利用 先前测量的生物标记物和前瞻性收集的心理社会压力数据。此外，我们还将 第一个检查子宫内暴露在WTC灾难下的青少年的身体健康状况。而其他人 研究检查了中心动脉和外周动脉僵硬的非侵入性测量，我们的研究是 第一个检查与青春期这些终点有关的化学暴露。临床前措施 建议的项目中可能包括更敏感的心血管终点，以反映环境 在同质人群中的影响，如幼儿和青少年。这项研究由一位 国际儿童环境健康领导者，进行了唯一深入的身体健康 对暴露在灾难中的儿童的研究(Trasande)，两个大出生队列的领导人，其中一个包括 在曼哈顿下城的三家医院出生的儿童；以及曼哈顿上城儿童的另一家将作为 比较(Herbstman，Perera和Rauh)。如果WTC的化学物质暴露与这些结果有关， 这项研究结果有助于采取前瞻性干预措施，如降压药物治疗。 已有文献证明，这些药物可以延长心血管状况不佳的成年人的生存时间。

Project Summary NYU School of Medicine, the Mailman School of Public Health, the Wadsworth Laboratories of the NYS Department of Health, and Cincinnati Children's Hospital Medical Center respond to PAR-16-098, proposing to leverage two unique and contemporaneous cohorts to examine chemical and psychosocial stressors in relationship to proximity to the WTC site and self-reported exposures, and evaluate birth, neurodevelopment and cardiometabolic outcomes. The first is comprised of mothers who delivered in one of three lower Manhattan hospitals in the months after the disaster, and the other is the northern Manhattan-based Columbia Children's Environmental Health Center (NM) cohort. The NM cohort includes children born just before and after September 11, 2001 permitting nested evaluations of stress-related exposures. Except for cardiometabolic outcomes, the data are already available including freshly obtained measurements of POPs, which we will extend to include PFCs with NIOSH support. In both populations, neurodevelopmental outcomes have been assessed through 6-7 years of age. Taking advantage of temporal and geographic differences in these cohorts, we will compare both psychosocial and chemical exposures and their association with outcomes among children who were and were not prenatally exposed to the WTC disaster. This study leverages previously measured biomarkers and prospectively collected data on psychosocial stress. In addition, we will be the first to examine physical health of adolescents exposed in utero to the WTC disaster. While other studies have examined non-invasive measurements of central and peripheral arterial stiffness, ours is one of the first to examine chemical exposures in relation to these endpoints in adolescence. Preclinical measures included in the proposed project may be more sensitive cardiovascular endpoints reflecting environmental influences in homogeneous populations such as young children and adolescents. The study is led by an international leader in children's environmental health who has conducted the only in-depth physical health studies of children exposed to the disaster (Trasande) with leaders of two large birth cohorts, one including children born in three lower Manhattan hospitals; and another of upper Manhattan children that will serve as a comparison (Herbstman, Perera, and Rauh). If WTC chemical exposures are associated with these outcomes, the study findings could facilitate proactive interventions such as treatment with antihypertensive medications which have been documented to prolong survival among adults with suboptimal cardiovascular profile.