Center for Research on Early Childhood Exposure and Development in Puerto Rico (CRECE)

 说明(申请人提供)：在胎儿和儿童发育的关键时期接触环境中的多种化学物质是一个重要但研究不足的公共卫生领域，特别是在与可能改变这些暴露影响的心理社会风险因素相结合的情况下。为了弥补这一差距，波多黎各儿童早期接触和发展研究中心将研究环境暴露和改变因素的混合对波多黎各北海岸严重污染的儿童胎儿和儿童早期健康和发育的影响，波多黎各北部海岸是一个服务不足、高度暴露和低收入人口，健康差距很大。 为了实现这一及时而重要的目标，CRECE开发了一个创新的、具有科学特色的项目，该项目利用Protect NIEHS Superfund研究中心正在进行的队列研究；该队列跟踪了1800名波多黎各孕妇分娩过程，以调查地下水污染与该岛极高的早产率之间的关系。CRACE将启动一项对600名受保护队列出生的婴儿的跟踪研究，对这些婴儿来说，已经有丰富的产前数据集和生物样本，跟踪他们从出生到四岁。通过包含三个相互关联的跨学科研究项目和三个核心的独特和全面的源到结果战略，CRCE将1)捕获通过多种暴露途径和生物途径发生的污染物暴露(单独和联合)对胎儿和幼儿健康和发育的影响，2)评估心理社会风险因素(例如社会经济状况和母亲压力)如何改变这些影响，以及3)阐明可能解释机械途径并调节这些关系的生物学机制。CREE跨学科团队包括环境流行病学家、儿科医生、环境科学家/工程师、暴露科学家、社会学家、社会工作者、生物统计学家、毒物学家和通信神经学家(他们中的许多人以前曾通过PROTECT进行过合作)。 CRACE将回答重要的研究问题：在高度暴露的人群中，宫内和儿童早期暴露于多种污染物对儿童健康和发育的综合影响是什么？这些影响发生的机制是什么？心理社会因素如何改变环境化学品暴露的影响？是否可以开发暴露生物标记物来捕捉多污染物和多途径暴露，以进行健康影响调查？对这些问题的回答，以及为回答这些问题而开发的创新工具和方法，将通过提高我们对整个环境对高危人群和有多次接触的普通人群的影响的理解，促进儿童环境健康的科学研究。这项拟议的工作将为未来的临床干预、风险评估和政策制定工作提供信息，既针对这一高危、脆弱人群，也为整个美国。

 DESCRIPTION (provided by applicant): Exposure to multiple chemicals in the environment during critical fetal and childhood development periods is an important yet understudied area of public health, particularly when coupled with psychosocial risk factors that may modify the effects of these exposures. To address this gap, the Center for Research on Early Childhood Exposure and Development in Puerto Rico (CRECE) will study the impact of a mixture of environmental exposures and modifying factors on fetal and early childhood health and development in the children of the heavily-contaminated northern coast of Puerto Rico, an underserved, highly-exposed, and low-income population with significant health disparities. To achieve this timely and significant goal, CRECE has developed an innovative and scientifically distinct program that leverages the ongoing cohort study of the PROTECT NIEHS Superfund Research Center; this cohort is following 1800 pregnant Puerto Rican women through childbirth to investigate the relationship between groundwater contamination and the island's extremely high preterm birth rate. CRECE will initiate a follow-up study of 600 infants born to the PROTECT cohort, for whom a rich prenatal dataset and biological samples already exists, following them from birth to age four. Through a unique and holistic source-to-outcome strategy incorporating three interrelated and transdisciplinary research projects and three cores, CRECE will 1) capture the impacts of pollutant exposures (both alone and in combination) that occur through multiple exposure routes and biological pathways on fetal and early childhood health and development, 2) evaluate how psychosocial risk factors (e.g. socioeconomic status and maternal stress) may modify these effects, and 3) elucidate biological mechanisms that may explain mechanistic pathways and mediate these relationships. The CRECE interdisciplinary team includes environmental epidemiologists, pediatricians, environmental scientists/engineers, exposure scientists, sociologists, social workers, biostatisticians, toxicologists, and communication neuroscientists (many of whom have previously collaborated through PROTECT). CRECE will answer important research questions: What are the combined effects of intrauterine and early childhood exposure to multiple pollutants on children's health and development in a highly exposed population? What are the mechanisms by which these effects occur? How do psychosocial factors modify the effects of environmental chemical exposures? Can exposure biomarkers be developed to capture multi- pollutant and multi-pathway exposures for health effect investigations? The answers to these questions, along with the innovative tools and methods developed to answer them, will advance the science of children's environmental health by improving our understanding of the effects of the total environment on at-risk as well as general populations with multiple exposures. The proposed work will inform future clinical intervention, risk assessment, and policy-setting efforts for both this at-risk, vulnerable population and the U.S. as a whole.