21-Year Study of Children Set to Begin
After nearly a decade of planning, researchers will begin recruiting pregnant women in January for an ambitious nationwide study that will follow more than 100,000 children from before birth until age 21.
The goal of the federally financed project, the National Children’s Study, is to gain a better understanding of the effects of a wide array of factors on children’s health.
“What we are doing is bold and needs to be bold in order to answer some pressing questions,” said the study’s director, Dr. Peter C. Scheidt, a pediatrician on the staff of the child-health division of the National Institutes of Health.
Investigators hope to find explanations for the rising rates of premature births, childhood obesity, cancer, autism, endocrine disorders and behavioral problems. To that end, they will examine factors like genetics and child rearing, geography, exposure to chemicals, nutrition and pollution.
While few quarrel with the goal, some experts worry that the expansive project will take resources away from smaller and more focused perinatal and pediatric research, particularly when budgets are certain to be strained by the financial crisis. The total cost is estimated to be $2.7 billion.
Participating mothers and children (fathers will be encouraged but not required to take part) will be given periodic interviews and questionnaires. They will further be asked to submit samples of blood, urine and hair. Air, water and dust from their environments will also be sampled and tested.
“Something like this has never been done in this country,” said a principal investigator for the study, Dr. Philip J. Landrigan, professor and chairman of community and preventive medicine at Mount Sinai School of Medicine in Manhattan. “It’s past time for us to do this.”
Studies of comparable size and scope are under way in Britain, Denmark and Norway.
Conceived during the Clinton administration and authorized by the Children’s Health Act of 2000, the National Children’s Study is being led by a group of federal agencies. Besides the health institutes, they are the Department of Health and Human Services, the Centers for Disease Control and Prevention, the Environmental Protection Agency and the Department of Education.
Since 2000, more than 2,400 health care, environmental and technology professionals have met in panels for hundreds of hours to work out such details as sampling methodology, data collection and privacy protection.
Subjects will be chosen from 105 counties to achieve a representative mix of racial, ethnic, religious, social, cultural and geographic characteristics. Forty regional centers will administer the study — mostly well-known medical institutions like Mount Sinai, the University of North Carolina School of Medicine and the University of Texas Health Science Center-Houston.
Dr. Russ Hauser, a professor of environmental and occupational epidemiology at the Harvard School of Public Health who served on a National Academy of Sciences committee that reviewed the study’s design, said the study would be “worthy and feasible” as long as it was properly financed.
But other experts questioned whether it was worth the cost. “The question isn’t whether the goals can be accomplished,” said Dr. Arthur Reingold, professor of epidemiology at the School of Public Health at the University of California, Berkeley. “It’s more a question of is this the best use of almost $3 billion, particularly when it will inevitably take funding from other research, especially with the economy falling to pieces.”
Researchers involved in the study counter that it will more than pay for itself by leading researchers to the causes or contributing factors for so many childhood disorders. Dr. Landrigan said a “dress rehearsal” of the study, which began in 2001 with 1,500 subjects from New York and California, has already shown that pregnant women exposed to organophosphates in pesticides were more likely to have babies with small brains and impaired cognition.
Another concern is that the study’s advisory board — which is choosing the chemical exposures to be studied — includes scientists from 3M and Pfizer, who have apparent conflicts of interest.But Richard Wiles, executive director of the nonprofit Environmental Working Group, said that since there were only 2 such scientists among the board’s 33 members, he hoped they would not have undue influence.