Appendix B
National Children’s Study Assembly Meeting
Breakout Session Summary: Environmental Quality-Important Factors in Your Community
December 17, 2003
Sheraton Atlanta Hotel
Atlanta, GA
Facilitator:
James J. Quackenboss, M.S., Office of Research and Development, EPA
Opening Remarks
Mr. Quackenboss introduced himself as the facilitator for the session and stated that the purpose of the session was to gather information concerning what environmental concerns community members feel should be considered during the planning of the National Children’s Study.
Discussion Topics and Important Points
- Urban inner city housing
- Mold/moisture and children’s health
- Sampling--old and all housing stock
- Quantitative PCR--mold/dust
- Remote RHE monitoring
- Links to environmental toxins with ADD and ADHD
- Warning the public and messages sent by the Study
- Occupational environments and the parents
- How does this affect the child
- Preconception (early pregnancy)
- Accurate assessment of the preconception exposures
- Heavy metal exposure and testing techniques
- Impact of the results of the Study on curriculum and competition in the medical profession
- To further study how genes and environmental factors interact
- Mold in buildings (at work)
- Causes of postpartum depression (environmental exposure, such as to paints)
- Birth defects and environmental exposures
- Quality assurance and quality control of community areas and what measures to take to ensure the Study’s integrity
Samples and Results
- Environmental sampling--over time (from infancy to adolescence)
- How often to take samples
- When (season and life stage) and what?
- Mobility: tracking and deciding what/which exposure to relate with the outcomes of interest
- Patterns of transport
- Results: turnaround, informing of hazards
- Local community within time to change source
- Is exposure adverse?
- Something we know? What we might bring to the Study
- What are some of the impacts of informing the public about results of the Study?
- Right-to-know versus over-alarming
- Need plan for responding to the results of the Study (for example, Women’s Health Initiative-stop study if it affects the public)
- Type of sampling-environment at community level or at individual homes
- Biological results
- Talk to physician or other health care provider
- Community advocacy group to inform community
- Notify the public of the change in behavior
- Prioritize what is important to the integrity of the Study
- Known risk-must inform if it is harmful
- Printout and show ranges
- Farming and agriculture: extension agents as field representatives and contacts in each county
- Many have "healthy homes" coordinators
- Trained agents
- In business of providing outreach (building on existing infrastructures)
Important Information and How to Handle the Data
- Information and contacts
- Pediatric Environmental Health Centers (EPA Regional Center--AOEC)
- State and county, city health department
- Aware of community concepts
- Health care school nurses (urban school district spread thin)
- Community health centers interact
- Schools interact
- Teachers know what’s happening with the students.
- Gathering baseline information from the educators of the child participants in the Study
- Records and testing of children in the Study
- Results on a national or local context?
- Local flexibility regarding measures
- National standardization
- Creative and additional local issues
- How do we get folks to buy in on the Study and remain interested?
- Listen locally
- Concern about industry and what they are doing.
- Chemical factory
- Fear of what might be found and the effects that occur.
- The question of power and (the number of cases)
- Could we measure something like this?
- Geography and relocation of the test subjects in the Study
- Sampling errors over time
- Frequency over time
- Size over time
- Changes of homes over time (for example, lead in homes and the decrease of this exposure to the subjects in the Study, or the decrease of the material of lead used in home construction)
- Measures in home
- Questionnaires (history and conditions)
- Individual burden and demands (willingness to participate in the Study)
- Collect samples
- Repositories and the space needed for the data and other record keeping mechanisms
- State building/health codes (available data)
- Questions we should have asked but didn’t--find ways to ask hard questions to get information we need.
- Air sampling
- In home, how?
- VOCs and other things
- Settled dust for biological and microbiological reasons
- Suggestion: Bring in old vacuum cleaner bags in order to measure density of settle dust and the makeup of the particulates in homes.
Summary
Mr. Quackenboss summarized the issues discussed.
In Attendance:
Linda Clark Amankwaa, Ph.D., R.N., Albany State University
Jane L. Browning, Learning Disabilities Association of America
Margaret Byron, M.S., RTI International
Dorr Dearborn, M.D., Ph.D., School of Medicine, Case Western Reserve University
Warren Galke, Ph.D., NICHD, NIH, DHHS
Wayne Garfinkel, P.E., Children’s Environmental Health, EPA
Jana Hildreth, B.A., Blaze Science Industries
Christine E. Kennedy, M.P.H., National Center on Birth Defects and Developmental Disabilities, CDC, DHHS
Marquea D. King, Ph.D., Office of Prevention, Pesticides, and Toxic Substances, EPA
Fatima D. Mili, M.D., Ph.D., RTI International
Barbara J. Porter, B.S., National Institute of Standards and Technology, U.S. Department of Commerce
Christine L. Rosheim, D.D.S., M.P.H., Public Health Practice Program Office, CDC, DHHS
Steven M. Schrader, Ph.D., National Institute for Occupational Safety and Health, CDC, DHHS
Csaba Siffel, National Center on Birth Defects and Developmental Disabilities, CDC, DHHS