Early life exposures to environmental toxicants in air pollution, water, and social stressors can all play a critical role in shaping health outcomes over one’s lifetime. A large group of researchers around the United States have teamed up to understand how these factors contribute to an array of adverse health conditions. The findings from the ECHO study analysis will build the scientific evidence for the protection of children’s health.
Hyunok Choi, an associate professor in the College of Health’s Department of Community and Population Health, has recently been awarded funding from the National Institutes of Health (NIH) to investigate the effects of early environmental influences on child health and development. Choi is part of a multidisciplinary team of researchers from the University of Pennsylvania and the Children’s Hospital of Philadelphia (CHOP) who have joined forces to support the NIH’s Environmental Influences on Child Health Outcomes (ECHO) study.
The ECHO program began in 2016 and seeks to discover how environmental exposures during preconception, pregnancy, and early life affect children’s long-term health. Specifically, the program focuses on five areas of health: pre-, peri-, and postnatal health, upper and lower airways, obesity, brain development, and positive health.
“Childhood developmental markers are hypothesized to set the stage for your well-being for the rest of your life,” said Choi. “Babies and children who endure high prenatal toxicant exposures could be at an elevated risk, not only for obesity but also other diseases, such as asthma. That’s why it’s so critical that we investigate a multitude of exposures and the environmental factors in a large enough sample.”
The research team in Philadelphia is gathering and distributing data to the larger ECHO program, a collection of well over 100 ECHO study sites around the country. The vast study is comprised of about 107,000 participants nationwide.
According to Choi, the study answers some of the key research questions of the NIH, which is not only to understand and to reduce the risks on the nation’s population in terms of prevalent diseases but also to reduce disparity in segments of the population that bear the greater burden of certain outcomes.
Penn Medicine patients in Philadelphia are recruited through their OB-GYN office while pregnant, then infants will be followed into childhood at CHOP. Pregnant women participate in the study during their routine visits and may donate additional biospecimen samples. As the children grow, there may be additional meetings at the researcher’s office, said Choi. About 2,500 subjects will be followed for the seven-year period of the grant.
Currently, the researchers have entered the second phase of the study, and additional maternal–child cohorts have been recruited. Choi is currently analyzing the data from the Phase 1 project.
Through this effort, there is a massive opportunity to impact public health and reduce healthcare costs.
“Asthma alone poses an economic burden of about $5 billion in total in the US alone per year. If you add to that, the burden posed by other neurodevelopmental diseases, as well as obesity, you are considering truly burdensome human suffering,” said Choi.
“If we intervene and understand the extreme risks that influence these outcomes during early childhood,” she continued, “we are looking at reducing not only the human suffering but also the economic cost of caring for people who will during their adulthood, develop multiple billions of dollars in expenditures, in terms of direct and indirect health care. By intervening in newborn babies and children, we have the opportunity to prevent these globally burdensome diseases of human suffering at a global scale.”
