Changing Course on Children’s Health

nih.gov

nih.gov

The National Children’s Study, launched by Congress 12 years ago, promised to be the most important study of its kind—a comprehensive look at the lives of 100,000 Americans that would begin with pregnant mothers and follow their children up through age 21. Participants were being recruited from 100 sites across the nation and agreeing to a high level of scrutiny over the years, from detailed questionnaires about their daily habits and alcohol and drug intake, to collection of bodily fluids and the baby’s first feces.

By taking into account environmental exposures—including air and water quality throughout pregnancy and a child’s development, the study promised to provide answers to the question of exposures and health and developmental outcomes that, because of the large sample size, could be considered definitive. Now, an article in Science Magazine reveals that 40 National Children’s Study research sites are being dismantled, with the work being passed to large contractors. The long-term fate of the highly touted study is no longer certain.

Program administrators at the National Institute of Health have cited cost concerns with dismantling the centers and starting over. Early cost estimates for the program indicated that it would be in the range of $2.7 billion over 25 years—it has spent $992 million thus far, including $114 million for one coordinating center that was dismantled. By many accounts, the National Children’s Study has little to show for the large dollars spent.

One prominent epidemiologist who asked not to be named in the article called the study “a national embarrassment.”

Others say it was the natural outcome of a study that was trying to accomplish too much. An advisory committee of some 2,500 experts came up with 28 broad hypotheses that the study would attempt to resolve: whether genetics make children more vulnerable to pesticides, for instance, and whether video games are related to violent behavior.

“The study ‘became the vehicle for most hypotheses related to children’s health,’ says Jonathan Samet, an epidemiologist at the University of Southern California.”

Struggling under bureaucratic inefficiencies and regularly shifting course (i.e., from knocking on doors to recruit women to drawing them from doctors’ offices), the study, in its pared down form, may finally be on track—though not without some disappointment. Instead of 100,000 volunteers, the new study will focus on just 50,000; instead of defining the hypotheses from the outset, it will focus on collecting the data and allowing hypotheses to evolve with emerging science. But though its streamlined, it won’t be as rigorous.

Children’s health expert Philip J. Landrigan, Ph.D. with the Mt. Sinai Hospital whose work connecting lead exposure to diminished brain functioning in children helped to guide the study in its early stages, noted in the article that the new study “has much lower likelihood…of discovering potentially causal associations between toxic chemicals and disease in children.”