The Environmental Influences on Child Health Outcomes (ECHO) Program will evaluate environmental factors affecting children’s health (perinatal, neurodevelopmental, obesity, respiratory, and positive health outcomes) by pooling cohorts composed of >50,000 children in the largest US study of its kind. Our objective was to identify opportunities for studying chemicals and child health using existing or future ECHO chemical exposure data. We described chemical-related information collected by ECHO cohorts and reviewed ECHO-relevant literature on exposure routes, sources, and environmental and human monitoring. Fifty-six ECHO cohorts have existing or planned chemical biomonitoring data for mothers or children. Environmental phenols/parabens, phthalates, metals/metalloids, and tobacco biomarkers are each being measured by ≥15 cohorts, predominantly during pregnancy and childhood, indicating ample opportunities to study child health outcomes. Cohorts are collecting questionnaire data on multiple exposure sources and conducting environmental monitoring including air, dust, and water sample collection that could be used for exposure assessment studies. To supplement existing chemical data, we recommend biomonitoring of emerging chemicals, nontargeted analysis to identify novel chemicals, and expanded measurement of chemicals in alternative biological matrices and dust samples. ECHO’s rich data and samples represent an unprecedented opportunity to accelerate environmental chemical research to improve the health of US children.
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The authors thank David Balshaw (National Institute of Environmental Health Sciences) for insightful contributions and Emma Alquist and Timothy Shields (ECHO Data Analysis Center, Johns Hopkins Bloomberg School of Public Health) for technical assistance.
Research reported in this publication was supported by the ECHO program, Office of The Director, NIH, under award numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center, JPB, GBH, EDP, MZ), UG3OD023305, UH3OD023305, UG3OD023271, UH3OD023271, and UG3OD023349, UH3OD023349 (ESB), UG3OD023282 (PIB), UG3OD023365, UH3OD023365 (DHB), UG3OD023316 (MSB), U2CES026544 (TRF), UG3OD023348, UH3OD023348 (RCF), U24OD023319-01 (Person-Reported Outcomes Core, WEF, RI), 3U2CES026533-01S1-3 (SSH), U2CES026542-01 (KK, PJP), UG3OD023275, UH3OD023275 (MPK, AJS-P), UG3OD023342, UH3OD023342 and 1U2COD023375-02 (KL), UG3OD023248, UH3OD023248 (APS), UG3OD023251, UH3OD023251 (DJW), UG3OD023272, UH3OD023272 (AW, TJW). This research was also supported by NIEHS P01ES022841 (TJW), NIEHS R01ES027051 (TJW), US EPA RD 83543301 (TJW), U2CES026542-01 (KK, PJP), P30 ES006694 (PIB), NIEHS P30 ES005022 (ESB), NIDDK R01DK076648 (APS), NIEHS R00ES025817 (APS), NIEHS P01ES022832 (MRK), and US EPA RD-83544201 (MRK). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Conflict of interest
WEF is a founding partner in EnMed MicroAnalytics, a company that provides heavy metal screening for newborns and children. MSB has worked for ICF International as a paid consultant on the US EPA “IRIS Draft Toxicological Review of PCBs: Effects Other Than Cancer.” All other authors declare they have no actual or potential competing financial interests.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Members of the ECHO are listed in Appendix.
The authors wish to thank our ECHO colleagues, the medical, nursing and program staff, as well as the children and families participating in the ECHO cohorts. We also acknowledge the contributions of the ECHO program collaborators.
ECHO components: Coordinating Center: Duke Clinical Research Institute, Durham, North Carolina: P. B. Smith, K. L. Newby, D. K. Benjamin. Data Analysis Center: Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland: L. P. Jacobson; Research Triangle Institute, Durham, North Carolina: C. B. Parker. Person-Reported Outcomes Core: Northwestern University, Evanston, IL, USA: R. Gershon, D. Cella. Children’s Health and Exposure Analysis Resource: Icahn School of Medicine at Mount Sinai, New York City, NY, USA: S. L. Teitelbaum, R. O. Wright; Wadsworth Center, Albany, NY, USA: K. M. Aldous. RTI International, Research Triangle Park, NC, USA: T. Fennell; University of Minnesota, Minneapolis, MN, USA: S. S. Hecht, L. Peterson; Westat, Inc., Rockville, MD, USA: B. O’Brien. Idea States Pediatric Clinical Trials Network (ISPCTN): University of Arkansas for Medical Sciences, Little Rock, AR, USA: J. Y. Lee, J. Snowden. ISPCTN Data Coordinating and Operations Center: University of Arkansas for Medical Sciences, Little Rock, AR, USA. Pediatric Cohorts: See below under ECHO cohort awardees and cohort sites. ECHO Cohort Awardees
Albert Einstein College of Medicine, Bronx, NY, USA: J. L. Aschner
Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA: B. Poindexter
Icahn School of Medicine at Mount Sinai, New York, NY, USA: S. L. Teitelbaum, A. Stroustrup, C. Grennings, S. Andra, M. Arora
University of Buffalo, Buffalo, NY, USA: A. M. Reynolds
University of Florida, Gainesville, FL, USA: M. Hudak
University of Rochester, Rochester, NY, USA: G. Pryhuber
Vanderbilt University Medical Center, Nashville, TN, USA: P. Moore
Wake Forest University Health Sciences, Winston Salem, NC, USA: L. Washburn, J. Helderman
Avera McKennan Hospital and University Health Center, Sioux Falls, SD, USA: A. J. Elliott
The Trustees of Columbia University, New York, NY, USA: W. Fifer, J. Isler, M. Myers, M. Perzanowski, V. Rauh
Brigham & Women’s Hospital, Boston, MA, USA: A. A. Litonjua, S. T. Weiss
Columbia University, New York, NY, USA: F. P. Perer, J. B. Herbstman
Dartmouth College, Hanover, NH, USA: M. R. Karagas
Pennsylvania State University, State College, PA, USA: C. J. Newschaffer
Children’s Hospital of Philadelphia, Philadelphia, PA, USA: R. T. Schultz
Johns Hopkins University, Baltimore, MD, USA: H. E. Volk
Kaiser Permanente, Oakland, CA, USA: L. A. Croen
Kennedy Krieger Institute, Baltimore, MD, USA: R. J. Landa
University of California, Davis, Davis, CA, USA: R. J. Schmidt, S. Ozonoff
University of North Carolina, Chapel Hill, Chapel Hill, NC, USA: J. Piven
University of Washington, Seattle, WA, USA: S. R. Dager, D. Mayock
Emory University, Atlanta, GA, USA: A. L. Dunlop, P. A. Brennan, E. J. Corwin
Harvard Pilgrim Health Care, Boston, MA, USA: E. Oken, K. P. Kleinman
Icahn School of Medicine at Mount Sinai, Boston, MA, USA: R. J. Wright, R. O. Wright
Boston Children’s Hospital, Boston, MA, USA: M. B. Enlow
Kaiser Permanente, Oakland, CA, USA: A. Ferrara, L. A. Croen
Massachusetts General Hospital, Boston, MA, USA: C. A. Camargo
Michigan State University, East Lansing, MI, USA: N. Paneth, M. R. Elliott, P. McKane, J. M. Kerver, D. M. Ruden
Henry Ford Health System, Detroit, MI, USA: C. Barone
Wayne State University, Detroit, MI, USA: R. M. Douglas
Memorial Hospital of Rhode Island, Pawtucket, RI, USA: S. Deoni, V. A. D’Sa
Brown University, Providence, RI, USA: J. Braun
Johns Hopkins University School of Medicine, Baltimore, MD, USA: S. Carnell
The Translational Genomics Research Institute, Phoenix, AZ, USA: M. Huentelman
University of California, Davis, Davis, CA, USA: H. G. Mueller, J. L. Wang
University of Colorado Boulder, Boulder, CO, USA: M. LeBourgeois
Wellesley College, Wellesley, MA, USA: V. Klepac-Ceraj
Women & Infants Hospital, Providence, RI, USA: K. Matteson
New York State Psychiatric Institute at Columbia University, New York, NY, USA: C. S. Duarte, G. J. Canino, C. E. Monk, J. E. Posner
New York University, New York, NY, USA: C. B. Blair
New York University School of Medicine, New York, NY, USA: L. Trasande
Northeastern University, Boston, MA, USA: A. N. Alshawabkeh
Oregon Health & Science University, Portland, OR, USA: C. T. McEvoy, E. R. Spindel
University of California, Davis, CA, USA: I. Hertz-Picciotto, D. H. Bennett, J. B. Schweitzer
University of Colorado Anschutz Medical Campus, Aurora, CO, USA: D. Dabelea
University of Illinois, Urbana, Champaign, IL, USA: S. L. Schantz
University of California, San Francisco, CA, USA: T. Woodruff
University of New Mexico, Albuquerque, NM, USA: J. L. Lewis
University of North Carolina, Chapel Hill, Chapel Hill, NC, USA: M. O’Shea, R. Fry
University of Oregon, Eugene, OR, USA: L. D. Leve
George Washington University, Washington, DC, USA: J. M. Ganiban
Penn State, University Park, PA, USA: J. M. Neiderhiser
University of Pittsburgh, Pittsburgh, PA, USA: A. E. Hipwell, K. E. Keenan
University of Rochester, New York, NY, USA: T. G. O’Connor, C. Buss, R. K. Miller, P. D. Wadhwa
Magee-Women’s Hospital, University of Pittsburgh, Pittsburgh, PA, USA: H. N. Simhan
University of Southern California, Los Angeles, CA, USA: F. D. Gilliland, C. V. Breton
University of Utah, Salt Lake City, UT, USA: J. B. Stanford, E. B. Clark, C. Porucznik
University of Washington, Seattle, WA, USA: C. Karr, S. Sathyanarayana
University of California, San Francisco, CA, USA: K. Z. Lewinn, N. R. Bush
University of Tennessee Health Sciences Center, Memphis, TN, USA: F. A. Tylavsky
University of Wisconsin-Madison, Madison, WI, USA: J. Gern
Boston University, Boston, MA, USA: G. O’Connor
Brigham & Women’s Hospital, Boston, MA, USA: D. Gold
Columbia University, New York, NY, USA: R. Miller
Henry Ford Health System, Detroit, MI, USA: C. Johnson, D. Ownby, E. Zoratti
Johns Hopkins University, Baltimore, MD, USA: R. Wood
Marshfield Clinic Research Foundation, Marshfield, WI, USA: C. Bendixsen
University of Cincinnati, Cincinnati, OH, USA: G. K. Hershey
Vanderbilt University Medical Center, Nashville, TN, USA: T. Hartert
Washington University, St. Louis, MO, USA: L. Bacharier
Women & Infants Hospital of Rhode Island, Providence, RI, USA: B. Lester
Emory University, Atlanta, GA, USA: C. J. Marsit
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Buckley, J.P., Barrett, E.S., Beamer, P.I. et al. Opportunities for evaluating chemical exposures and child health in the United States: the Environmental influences on Child Health Outcomes (ECHO) Program. J Expo Sci Environ Epidemiol 30, 397–419 (2020). https://doi.org/10.1038/s41370-020-0211-9
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