NIH - Environmental Exposures and Health: Exploration of Non-Traditional Settings (R01, R21 Clinical Trial Optional)

The following description was taken from the R01 version of this FOA:

It has been well established that environmental exposures, to common and hazardous pollutants, contribute to the development of many human illnesses including asthma, cancers such as breast and lung, Parkinson’s disease, and reproductive disorders in both men and women. The possible association between environmental pollutant exposure and obesity continues to be investigated. Research has led to the development of prevention strategies; health and safety guidelines; and potential treatments for asthma, cardiovascular and pulmonary diseases, cancer, and other environmentally-related diseases. A growing body of research evidence supports the role of indoor and outdoor pollutants in aggravating chronic diseases such as asthma and allergic-type reactions, and suggests that these pollutants have a role in the development of diseases, and symptoms associated with disease(s), and increases in health care costs. Environmental factors have also been associated with an increased number of children diagnosed with attention deficit/hyperactivity disorder (ADHD), pervasive developmental disorder (PDD), autism, and developmental impairment. Chemical stressors may be considered as single chemicals, or as mixtures and aggregates as may be found in consumer products used by children and environments and microenvironments frequented by children. Non-chemical stressors include mediating and modifying factors such as economic deprivation, discrimination, poverty, lack of health care, fear of crime, diet and nutrition, physical activity, psychosocial factors, and the design of the built environment (e.g., settings: home, school, and play areas) from birth through young adulthood. Non-chemical stressors, social and cultural factors, and settings cannot be considered alone, but they may be included as modifier variables to the primary environmental stressor(s). Mathematical models that incorporate children and older adult susceptibility to environmental health hazards are scant and must continue to be developed. Developing and comparing interventions aimed at reducing environmental health risks and symptoms through research focused on treatment or prevention strategies to determine interventions that are most effective in “real-world” settings, is also important in expanding the knowledge base and improving health. Interventions aimed at reducing environmental risks and symptoms in individuals, families, or communities are starting to be supported. However, few of these interventions have been examined in a systematic way and most have not been evaluated relative to cost analysis.

There is evidence that air pollution, allergens, and environmental toxic exposures are associated with adverse health consequences in adults, and especially older adults. For example, the first American Heart Association report (2004) concluded that short-term exposure to particulate matter (PM) air pollution contributes to acute cardiovascular morbidity and mortality and long-term exposure reduces life expectancy. Moreover, the World Health Organization (WHO) stated that over the last 10 years, there has been a substantial increase in findings that particular matter pollution is not only exerting a greater impact on established health endpoints, but is also associated with a broader number of disease outcomes. A growing body of scientific evidence has linked fine PM (>2.5 µm) (PM2.5), particulates derived chiefly from combustion processes in transportation, manufacturing, and power generation, with increased risk of respiratory and allergic diseases such as asthma, chronic obstructive lung disease, chronic rhinitis and cardiovascular disorders such as stroke, cardiac arrhythmia, heart failure exacerbation, and myocardial infraction. Ultrafine particulates (UFPs) (<0.1 µm, gaseous co-pollutants), particulates found in ozone, nitrogen oxides (NO2) and pollutants (e.g., traffic), have been linked to increased blood pressure, prothrombotic and coagulant changes, systemic inflammatory and oxidative stress responses, endothelial vasoconstriction and dysfunction, and autonomic imbalance and progression to atherosclerosis. Relative to fine PM (> 2.5), UFPs more readily penetrate indoors, are transported over longer distances, and tend to be more uniform within communities, resulting in highly ubiquitous exposure. As researchers and scientists become more sensitive to the need to focus studies on common and/or hazardous environmental pollutants, consideration must also be given to the unequal distribution of exposure within the population as well as understudied settings where exposure occurs.

Young children are likely to be more susceptible than older children and adults to environmental toxins, pollutants, and chemical exposures because of their immature organ development, rapid physical development, greater surface-to-volume ratios, higher metabolic and ventilation rates, and greater and different physical activities/behaviors. For very young children (i.e., those attending day care and pre-school), environmental risks may also occur because they often explore new objects through a variety of senses including taste which adds additional threats from plastics and the leaching of phthalates. Risk assessment of inhaled toxicants has typically focused on adults, with modeling used to extrapolate dosimetry and risks from lab animals to humans. However, behavioral factors such as time spent playing outdoors and/or having closer proximity to the ground may lead to greater exposure to inhaled and systemic toxicants in children. Research demonstrates that depending on the inhaled agent and the age and size of the child, children may receive a greater internal dose than adults because of greater ventilation rate per body weight or lung surface area. Also, metabolic differences may result in different tissue burdens. Other research has demonstrated that there may be child-adult dosimetry differences for inhaled toxicants that are systemically absorbed. Thus, modeling techniques need to be adapted to children in order to estimate inhaled and systemic dose and risk in this potentially susceptible life stage.

While it is recognized that individuals age differently, gradual changes in cardiovascular and circulatory (e.g., rigidity and dilation of the blood vessels; fibrosis in the conduction system; alteration in cell oxygenation processes); pulmonary (e.g., increased rigidity of the thorax and diaphragm; decreased numbers of alveoli and diffusion ability; decreased strength in breathing/coughing); hematologic (e.g., altered antigen-antibody responses, decreased leukocyte production), immune (decreased T and B cells, slowed immune reaction); inflammatory systems (e.g., alterations in the inflammatory immune cascade; and decline in macrophages, neutrophils and phagocytic activity) in older adults results in increased vulnerability to environmental exposures/pollutants and toxins. These age-related system alterations are further compromised in older adulthood when co-morbid conditions exist. In addition to the above aging system changes, older adults are often unmarried, living alone, have limited informal support, and experience more physical and mental health problems than their age peers who live in traditional home settings. In addition, older adult residents living in low-income housing are particularly vulnerable because they have lower income, may be less educated, suffer more functional impairments, encounter higher levels of stress, relocate more frequently, have higher rates of tobacco and alcohol use, and experience more physical and mental health problems. There is a growing body of research examining the relationship between environmental pollutants and their impact on older adults. However, little research has examined the effects of exposure in non-traditional settings where a growing number of older adults spend their time and/or live.

Regardless of a person’s age, setting/building environmentally-induced health-related symptoms and disorders are multifactorial in origin. Factors for consideration must include building characteristics (e.g., age of the building, water damage and dampness, mold growth and airborne mold spores, and dusts), dose and number of days of environmental exposure, routes of exposure, and current health status (e.g., those with asthma, allergies, or who have immunocompromised health conditions have higher prevalence of building and environmentally-related health symptoms and illness). Because of the increased vulnerability faced by children and older adults to different routes and sources of exposure and levels and length of exposure to environmental risks it is important to gain a more in-depth understanding of: 1) the relationship between environmental exposure factors, symptoms, and health outcomes, and 2) effective strategies that minimize or eliminate environmental health-related risks in children and older adults who spend time or live in non-traditional settings.

Objectives

As this FOA focuses on pre-school and school-age children it is intended to include healthy children, children with known acute and/or chronic diseases, and vulnerable children including those with disabilities. The intended focus on older adults includes healthy older adults, older adults with chronic illnesses and those with developmental disabilities. This FOA is not intended to focus on research with healthy/unhealthy adults in the workplace or living in traditional settings. For children and older adults, locations include, but are not limited to places such as community centers, pre-school and non-traditional school environments (e.g., churches, daycare, home-based schools, dormitories, alternative schools, and playgrounds), child and older adult foster care facilities, older adult day care facilities, half-way homes, assisted living and long-term care facilities. Specific areas of research interest for this interdisciplinary collaborative research include, but are not limited to, the areas listed below.

NINR examples of topics of interest in the area of wellness, self-management, and symptom-management:

Address the possible mechanisms by which environmental risks/exposures cause, modulate, or potentiate already existing conditions
Develop studies conducted in non-traditional settings that evaluate critical windows of susceptibility to environmental pollutants that result in exacerbating or reducing health conditions and their associated symptoms
Develop mathematical and microsimulation models based on non-traditional settings that incorporate children and older adult susceptibility to environmental health hazards and contaminants and their relationship to symptoms and symptom management
Develop new technologies, or use existing ones for early biomarkers of symptoms resulting from exposure to environmental pollutants and toxins to test efficacy of approaches to manage symptoms
Characterize life stage specific environmental exposures (chemical and non-chemical), and related outcomes: in settings of greatest importance for children’s exposures (such as homes, child care centers, schools, and playgrounds) and development of strategies to reduce or prevent adverse exposures in those settings

NINR examples of topics of interest in the area of exposure assessment research:

Examine the relationship between environmental factors/agents in understudied and non-traditional settings that result in the development of symptoms of acute and chronic disorders/diseases including quality of life
Develop exposure assessment models for risk levels specific to non-traditional settings
Develop interventions or adapt existing interventions from other settings to reduce exposure to environmental pollution and toxin exposures in non-traditional settings
Examine environment exposure and dose-responses of children and older adults in the development of illness and/or disease and their related symptoms
Examine the effects of known determinants of health (e.g., demographic, socioeconomic, geographic and rural verses urban) on non-traditional environment exposure(s) and health outcomes of children and/or older adults
Conduct research on different approaches to reduce and/or eliminate environmental risks and symptoms for children and older adults living or spending large amounts of time in non-traditional settings

NIEHS will continue to support and facilitate integrated fundamental, clinical, laboratory, and public health science and examples of topics of interest:

Identify the harmful influences of environmental exposures and changing environments as well as the protective and nurturing impact of healthy environments on normal physiological function of organs and systems of the fetus/child during gestation/childhood/adolescence
Determine the mechanisms of vulnerability to environmental stressors of the fetus and young child at all stages of early development
Consider children’s health from a holistic perspective where the impact of complex environmental exposures may be exacerbated by non-chemical stressors encountered in community settings.

NIEHS will continue to support research that:

Support chemical stressors that may be considered as single chemicals, or as mixtures and aggregates as may be found in consumer products used by children and environments and microenvironments frequented by children
Support non-chemical stressors include mediating and modifying factors such as economic deprivation, discrimination, poverty, lack of health care, fear of crime, diet and nutrition, physical activity, psychosocial factors, and the design of the built environment (e.g., settings: home, school, play areas) from birth through young adulthood
Non-chemical stressors, social and cultural factors, and settings cannot be considered alone, but they may be included as modifier variables to the primary environmental stressor(s)
Characterization of life stage specific environmental exposures (chemical and non-chemical), and related outcomes:
In settings of greatest importance for children’s exposures (such as homes, child care centers, schools, and playgrounds) and development of strategies to reduce or prevent adverse exposures in those settings

Deadlines: standard dates and standard AIDS dates apply

URLs:

Filed Under: Funding Opportunities

NIH – Environmental Exposures and Health: Exploration of Non-Traditional Settings (R01, R21 Clinical Trial Optional)