Allen Dearry

Creating healthy communities, healthy homes, healthy people: initiating a research agenda on the built environment and public health.

Mounting evidence suggests physical and mental health problems relate to the built environment, including human-modified places such as homes, schools, workplaces, parks, industrial areas, farms, roads and highways. The public health relevance of the built environment requires examination. Preliminary research demonstrates the health benefits of sustainable communities. However, the impact of mediating and moderating factors within the built environment on health must be explored further. Given the complexity of the built environment, understanding its influence on human health requires a community-based, multilevel, interdisciplinary research approach. The authors offer recommendations, based upon a recent conference sponsored by the National Institute of Environmental Health Sciences (NIEHS), for research and policy approaches, and suggest interagency research alliances for greater public health impact.

Incorporating Environmental Health into Pediatric Medical and Nursing Education

Pediatric medical and nursing education currently lacks the environmental health content necessary to appropriately prepare pediatric health care professionals to prevent, recognize, manage, and treat environmental-exposure–related disease. Leading health institutions have recognized the need for improvements in health professionals’ environmental health education. Parents are seeking answers about the impact of environmental toxicants on their children. Given the biologic, psychological, and social differences between children and adults, there is a need for environmental health education specific to children. The National Environmental Education and Training Foundation, in partnership with the Children’s Environmental Health Network, created two working groups, one with expertise in medical education and one with expertise in nursing education. The working groups reviewed the transition from undergraduate student to professional to assess where in those processes pediatric environmental health could be emphasized. The medical education working group recommended increasing education about children’s environmental health in the medical school curricula, in residency training, and in continuing medical education. The group also recommended the expansion of fellowship training in children’s environmental health. Similarly, the nursing working group recommended increasing children’s environmental health content at the undergraduate, graduate, and continuing nursing education levels. Working groups also identified the key medical and nursing organizations that would be important in leveraging these changes. A concerted effort to prioritize pediatric environmental health by governmental organizations and foundations is essential in providing the resources and expertise to set policy and provide the tools for teaching pediatric environmental health to health care providers.

The National Institute of Environmental Health Sciences' research program on children's environmental health.

This article highlights the wide array of research programs supported by the National Institute of Environmental Health Sciences (NIEHS) that address issues related to childrens environmental health. Special attention is given to the interagency, collaborative Centers for Childrens Environmental Health and Disease Prevention Research program. A brief description of each of the eight centers highlights scientific foci and research efforts to date. In addition to discussing NIEHS-supported research programs, the article emphasizes the NIEHS commitment to the promotion of translating basic research findings into public health knowledge so that culturally sensitive and applicable interventions may be developed.

Environmental Health Promotion: Progress and Future Opportunities

Health promotion seeks to provide practitioners of medicine and public health as well as members of the public with the information, resources, and tools that they can use to improve health and well-being. This goal is consonant with that of the National Institutes of Health (NIH), namely, to improve public health outcomes via research, intervention, and education. To accomplish this goal, significant effort has been devoted by the NIH toward understanding disease mechanisms and developing clinical tools to alleviate the burden of disease. In the past decade, however, there has been a more concerted move toward creating university-community partnerships that can affect public health and health policy. This trend has been further enhanced by the growing knowledge that health is affected by multiple, interconnected factors at multiple levels. Such influences originate not only at the individual (biological and genetic) level but also at the familial, as well as community and societal levels. Currently, this emphasis on advancing universitycommunity partnerships has received further impetus from the NIH Roadmap Initiative (see http://nihroadmap.nih.gov) that seeks to support technology development related to disease mechanisms, prevention, diagnosis, or treatment and to build partnerships to address these challenges among communities, universities, and health care professionals. Health promotion efforts targeted specifically at environmentally related disease have made significant progress. By fostering community-university partnerships, the National Institute of Environmental Health Sciences (NIEHS) and other public and private funders have been successful in promoting healthful lifestyles and behaviors at both individual and community levels. Using examples from NIEHS-supported projects, this article will describe some of the basic features and achievements of the environmental health promotion process, its challenges, and its future prospects.

A major milestone for the National Children's Study.

In January 2009, after 8 years of planning and development, the National Children’s Study (NCS; http://www.nationalchildrensstudy.gov/Pages/default.aspx) will begin enrollment and data collection at the first of the initial, or Vanguard, locations, in Duplin County, North Carolina, and in Queens, New York. In spring 2009, the remaining five Vanguard locations will join them, followed by 29 additional locations in 2010 and more in the following 2 years. The NCS, a national longitudinal cohort study of 100,000 children to be followed from early pregnancy to adulthood, will examine how environmental exposures, interacting with genetic factors and medical access, affect children’s health and development. Beginning enrollment caps a remarkable journey from a bold vision to a reality that was sometimes unpredictable and cloaked in uncertainty. The NCS began after assertions from both the President’s Task Force on Environmental Health and Safety Risks to Children and the Children’s Health Act of 2000 that a multiagency consortium should carry out a large longitudinal study. Since its inception, the planning and development of the NCS have been led by the National Institute of Child Health and Human Development, along with a consortium of lead agencies that includes the National Institute of Environmental Health Sciences, the Centers for Disease Control and Prevention, and the U.S. Environmental Protection Agency. With broadly defined environmental exposures and all of children’s health and developmental outcomes of concern, the NCS calls for equally broad input by scientific experts, communities, and involved groups. To meet this need, the study has committed to gathering the best input possible through its Federally Chartered Advisory Committee; Interagency Coordinating Committee; over 20 working groups representing > 2,500 clinicians, scientists, and community members; public, peer, and agency reviews; and active participation by the network of Study Centers across the country. The NCS provides opportunities for related investigations by affiliated and nonaffiliated investigators through adjunct studies conducted at NCS study locations or through analysis of data collected in the NCS to address a wide range of additional questions beyond the core study hypotheses. The study can be expanded to cover even broader maternal, fetal, and child health research. The processes for thoroughly considering the development of methods, proposed changes, and ongoing input are being established through working teams composed of scientists at the various Study Centers, federal agencies, and elsewhere. These teams are organized according to the various issues being addressed in the NCS, such as genetics/epigenetics and genomics/epigenomics, health disparities, environmental exposure, neurodevelopment and cognition, nutrition, and physical/clinical measures. The nationally representative sampling strategy is probably the most unique and demanding challenge. A representative sample offers the best opportunity to apply the findings of the NCS to all children in the United States. Enrolling and retaining a representative sample of participants will require full engagement of all of the communities involved. Thus, this national study must also become a community study at the level of participating neighborhoods and counties, with input and ownership by community advisory boards, community organizations and institutions, and local citizens. In spite of the size and the breadth of the NCS, it cannot meet all of the needs and expectations of its supporters. A sample with 100,000 subjects will, by its very size and cost, limit the depth and complexity of many measures. The sample size may prohibit many specialized procedures and technologies, and many questions that investigators want to ask will also be beyond the reach of this study. The advantages of the NCS that other studies cannot do are its capacity to address compelling problems that are uncommon and to examine interactions between various environmental exposures and genetic factors that require a large sample and detailed measures of multiple exposures and outcomes across life stages. The capability to study possible effects and relationships of many exposure factors on multiple outcomes provides both considerable cost-effectiveness and research opportunities not otherwise available. Access to the necessary resources will be an ongoing challenge, dependent upon many factors, especially the ability of the NCS to fulfill its promise. Findings from the NCS will ultimately benefit all Americans by providing researchers, health care providers, and public health officials with information from which to develop prevention strategies, health and safety guidelines, and possibly new treatments and cures for disease. As we mark the true beginning of this ambitious study, it is appropriate to recognize that the NCS belongs to all of us—scientists, communities, and families. Realizing its goals will require our continued effort, investment, and ownership.

Laying a Community-Based Foundation for Data-Driven Semantic Standards in Environmental Health Sciences.

Background: Despite increasing availability of environmental health science (EHS) data, development, and implementation of relevant semantic standards, such as ontologies or hierarchical vocabularies, has lagged. Consequently, integration and analysis of information needed to better model environmental influences on human health remains a significant challenge. Objectives: We aimed to identify a committed community and mechanisms needed to develop EHS semantic standards that will advance understanding about the impacts of environmental exposures on human disease. Methods: The National Institute of Environmental Health Sciences sponsored the “Workshop for the Development of a Framework for Environmental Health Science Language” hosted at North Carolina State University on 15–16 September 2014. Through the assembly of data generators, users, publishers, and funders, we aimed to develop a foundation for enabling the development of community-based and data-driven standards that will ultimately improve standardization, sharing, and interoperability of EHS information. Discussion: Creating and maintaining an EHS common language is a continuous and iterative process, requiring community building around research interests and needs, enabling integration and reuse of existing data, and providing a low barrier of access for researchers needing to use or extend such a resource. Conclusions: Recommendations included developing a community-supported web-based toolkit that would enable a) collaborative development of EHS research questions and use cases, b) construction of user-friendly tools for searching and extending existing semantic resources, c) education and guidance about standards and their implementation, and d) creation of a plan for governance and sustainability. Citation: Mattingly CJ, Boyles R, Lawler CP, Haugen AC, Dearry A, Haendel M. 2016. Laying a community-based foundation for data-driven semantic standards in environmental health sciences. Environ Health Perspect 124:1136–1140; http://dx.doi.org/10.1289/ehp.1510438

Workshop report: Identifying opportunities for global integration of toxicogenomics databases, 26–27 June 2013, Research Triangle Park, NC, USA

A joint US-EU workshop on enhancing data sharing and exchange in toxicogenomics was held at the National Institute for Environmental Health Sciences. Currently, efficient reuse of data is hampered by problems related to public data availability, data quality, database interoperability (the ability to exchange information), standardization and sustainability. At the workshop, experts from universities and research institutes presented databases, studies, organizations and tools that attempt to deal with these problems. Furthermore, a case study showing that combining toxicogenomics data from multiple resources leads to more accurate predictions in risk assessment was presented. All participants agreed that there is a need for a web portal describing the diverse, heterogeneous data resources relevant for toxicogenomics research. Furthermore, there was agreement that linking more data resources would improve toxicogenomics data analysis. To outline a roadmap to enhance interoperability between data resources, the participants recommend collecting user stories from the toxicogenomics research community on barriers in data sharing and exchange currently hampering answering to certain research questions. These user stories may guide the prioritization of steps to be taken for enhancing integration of toxicogenomics databases.

Pioneering Interdisciplinary Research Initiatives for Oceans and Human Health

Following the release of the report From Monsoons to Microbes by the National Research Council in 1999, efforts began to promote federal sponsorship of research and education in a new scientific discipline focusing on how the ocean affects human health. The National Institute of Environmental Health Sciences (NIEHS) and the National Science Foundation (NSF) initiated a joint program to establish and sustain several research Centers for Oceans and Human Health (COHH) at nonfederal institutions. Shortly thereafter, the National Oceanic and Atmospheric Administration (NOAA) mounted a similar initiative to establish intramural centers at existing NOAA facilities as well as an extramural grants program. This profile reviews the history and current state of these developments.

Framework for Examining the Interface of Genetics and the Environment

Exposure to toxic environmental and occupational agents can have different effects in different persons of differing age, socio-economic status (SES), ethnic background, gender, and genetic composition. Technologies that are currently available allow for the identification of susceptibility haplotypes that predispose individuals and/or subpopulations to certain environmentally related pathologies. The ability to analyze gene-environment interactions in response to social and physical environments and identify susceptibility haplotypes may provide opportunities to develop a new paradigm for risk assessment. However, these genomic technologies must be incorporated into a long-term strategy for preventing disease at a population level. Several existing and emerging research programs are highlighted to make the case for developing novel, multidisciplinary, integrative research programs to improve the public health of the nation, especially children and other vulnerable populations.