Understanding Risk Gradients from Environment on Native American Child Health Trajectories: Toxicants, Immunomodulation, Metabolic syndromes, & Metals Exposure

了解环境对美国原住民儿童健康轨迹的风险梯度：毒物、免疫调节、代谢综合征、

• 批准号: 10415881
• 负责人: Johnnye L Lewis
• 金额: $ 424.96万
• 依托单位: UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-21 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10415881
• 关键词: 4 year old; Address; Affect; Age; Antibodies; Area; Autoantibodies; Autoimmune Responses; Behavioral; Biological Monitoring; Birth; Brain; Characteristics; Cheyenne; Child; Child Development; Child Health; Child Rearing; Cohort Studies; Communicable Diseases; Complex; Congenital Abnormality; Data; Data Sources; Development; Disease; Enrollment; Environment; Environmental Exposure; Environmental Impact; Exposure to; Extended Family; Fathers; Funding; Health; High Prevalence; Home; Immune; Infant Mortality; Inflammation; Infrastructure; Knowledge; Lead; Lymphocyte; Measurement; Measures; Meconium; Mediation; Metabolic syndrome; Metal exposure; Metals; Mothers; Native Americans; Navajo; Nutrition Surveys; Nutritional; Obesity; Outcome; Participant; Pattern; Policies; Population; Postpartum Period; Poverty; Predisposition; Pregnancy; Prevalence; Protocols documentation; Recruitment Activity; Research; Risk; Rivers; Serum; Sioux Indians; Specimen; Surveys; Testing; Time; Tribes; Unemployment; United States; United States National Institutes of Health; Uranium; Urine; Work; adolescent suicide; base; clinical care; cohort; cytokine; development policy; diversity and inclusion; drinking water; early childhood; early life exposure; fetal; follow-up; genetic analysis; immune function; immunoregulation; mortality; neurodevelopment; obesity in children; offspring; postnatal; prenatal; programs; resilience; response; screening; social; social determinants; suicide rate; toxicant; toxicant interaction; tribal Nation; tribal community; tribal lands; virtual; wasting

Summary The URGENT Native American ECHO Cohort will build on the active Navajo Birth Cohort Study (NBCS), extending the follow up period beyond the current 12 month protocol, and adding two additional tribes, the Cheyenne River and Oglala Sioux Tribes, to assess the impact of environmental exposures to abandoned mine waste on birth outcomes and child development. The study, the first large-scale assessment of environmental exposures and children’s health in tribal populations is conducted in partnership with tribal communities and will help to build both research capacity within the tribes as well as capacity of tribal staff to conduct detailed developmental assessments. The study will follow development of the enrolled children until age 5 to track trajectories or patterns of neuro- and physical development with respect to environmental exposures to metal mixtures from abandoned hard rock and uranium mines on or near tribal lands. There are 161,000 such abandoned mines in the Western US, 4,000 of them abandoned uranium mines which are often unfenced, unmarked and accessible to children. On Navajo Nation alone, more than 500 abandoned uranium mines remain un-remediated more than 30 years since the closing of the last mine. The proposed research will address two of the key health outcome focus areas identified by the ECHO program through study of the effects of prenatal and early childhood exposure on 1) neurodevelopment, and 2) obesity. Based on the team’s preliminary findings, the research will focus on dysregulation of immune function as a result of exposure to metal mixtures during gestation, and mechanisms by which this dysregulation can lead to neurodevelopmental delays and obesity. The work will be conducted as part of the NIH Consortium to study Environmental Influences on Child Health Outcomes (ECHO) which will attempt to bring together as many as 50,000 children from existing birth cohort studies to understand the complex interactions of toxicant, social, nutritional, and cultural environments on developmental trajectories. Inclusion of the Native American Cohort will bring to the Consortium the first in-depth look at how normal child development progresses in Native populations in addition to how environmental adversity affects that course. Native Americans have far greater rates of poverty and unemployment, lack much essential infrastructure including clean drinking water and sewers, and have lower educational completion rates. However, they also have strong cultural identities, strength in child- rearing from extended families, and differences in appreciation of significant developmental milestones that have been associated with the development of resilience that helps in overcoming adversity. Therefore, their inclusion in this effort to understand the effects of exposure on these important health outcomes will bring a perspective that will serve not only to inform our understanding of development in the US through inclusion of the diversity represented by the sovereign tribal nations, but will also be of benefit to the tribes in informing the development of policies and clinical care that enhances the ability of children to reach their maximum potential.

概括 紧急美国原住民回声队列将建立在主动的纳瓦霍人出生队列研究（NBCS）的基础上 将以下期限延长到当前的12个月协议之外，并增加了两个部落， Cheyenne River和Oglala Sioux部落，以评估环境暴露对废弃的影响 在出生成果和儿童发展方面浪费浪费。这项研究是对 部落人口的环境暴露和儿童健康与部落合作进行 社区，将有助于建立部落内的研究能力以及部落工作人员的能力 进行详细的发展评估。该研究将遵循入学儿童的成长直到 5岁以跟踪有关环境的神经和身体发展的轨迹或模式 在部落土地上或附近的废弃硬石和铀矿的金属混合物暴露。有 在美国西部有161,000个这样废弃的矿山，其中4,000台被遗弃的铀矿经常 没有未经标记的儿童访问。仅在纳瓦霍国家，有500多个废弃的铀 自上一矿关闭以来，地雷仍未被调整30多年。拟议的研究将 通过研究来解决ECHO计划确定的两个关键健康结果重点领域 产前和幼儿暴露对1）神经发育的影响，以及2）肥胖。根据团队的 初步发现，该研究将集中于免疫功能的失调，导致暴露于 妊娠期间的金属混合物以及这种失调可能导致神经发育的机制 延迟和肥胖。这项工作将作为NIH联盟的一部分进行研究 对儿童健康成果的影响（ECHO），该结果将尝试将多达50,000名儿童汇集在一起 从现有的出生队列研究到了解有毒，社会，营养和 关于发展轨迹的文化环境。包括美国原住民队列将带给 财团第一次深入了解正常儿童发展在本地人群中的正常发展如何 除了环境广告如何影响该课程。美洲原住民的比率要高得多 贫困和失业，缺乏重要的基础设施，包括干净的饮用水和下水道，以及 具有较低的教育完成率。但是，他们也具有强大的文化身份，儿童的力量 - 由大家庭饲养，以及对重大发展里程碑的欣赏差异 与有助于克服广告的弹性发展有关。因此，他们 包含在理解暴露对这些重要健康结果的影响的努力中，将带来 观点不仅可以通过包含来告知我们对美国发展的理解 主权部落国家代表的多样性，但也将对部落有益于告知该部落 制定政策和临床护理，增强了儿童发挥最大潜力的能力。