NEW RESEARCH from our MADRES Center

A new research article published in May 2019 provides an in-depth overview of the study design, protocol, and profile of our Maternal And Developmental Risks from Environmental and Social Stressors (MADRES) pregnancy cohort.

The full text of the article and more information can be found here.

The overarching goal of the “Maternal And Developmental Risks from Environmental and Social Stressors (MADRES)” cohort study is to better understand the increased risk for childhood obesity and maternal obesity outcomes among underserved women and children in Los Angeles.

The burden of childhood and adult obesity disproportionately affects certain racial and ethnic groups and groups with lower income and education levels. These same groups are often disproportionately affected by environmental pollution. Pregnancy is a critical developmental period where maternal environmental exposures and stress may have significant impacts on infant and childhood growth as well as the future health of the mother.

The ongoing MADRES study is a prospective pregnancy cohort of 1000 women-child pairs in Los Angeles, CA. Enrollment in the MADRES cohort is initiated prior to 30 weeks gestation from partner community health clinics in Los Angeles. Cohort participants are followed through their pregnancies, at birth, and during the infant’s first year of life through a series of in-person visits with interviewer-administered questionnaires, anthropometric measurements and biospecimen collection as well as telephone interviews conducted with the mother.

In addition to describing the study design of the cohort, this newly published study provides an overview of the cohort characteristics for 291 participants who have delivered their infants, out of 523 participants enrolled in the study from November 2015 to October 2018 from four community health clinics in Los Angeles.

“Future results from the MADRES cohort could be used by community organizations, policy makers, health providers, to better understand the risk of chemical exposures during pregnancy as well as the importance of psychosocial stress on important health outcomes in women and children,” said lead author Tracy Bastain.

Funding

This work was supported by the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) Center (grant #s P50ES026086, 83615801–0) funded by the National Institute of Environmental Health Sciences, the National Institute for Minority Health and Health Disparities and the Environmental Protection Agency; the Southern California Environmental Health Sciences Center (grant # P30ES007048) funded by the National Institute of Environmental Health Sciences, and the Lifecourse Approach to Developmental Repercussions of Environmental Agents on Metabolic and Respiratory health (LA DREAMERs) (grant #s UH3OD023287) funded by the National Institutes of Health Office of the Director ECHO Program.

NEW RESEARCH: Improved air quality leads to fewer kids developing asthma in nation’s most-polluted region

By LEIGH HOPPER, USC

PRESS COVERAGE: National Public Radio, Reuters,

Improved air quality in the Los Angeles region is linked to roughly 20 percent fewer new asthma cases in children, according to a USC study that tracked Southern California children over a 20-year period.

The findings appear in the May 21 issue of the Journal of the American Medical Association.

The research expands on the landmark USC Children’s Health Study, which found that children’s lungs had grown stronger in the previous two decades and rates of bronchitic symptoms decreased as pollution declined throughout the region.

“While the findings show a clear benefit of lower air pollution levels, there must be continued efforts to reduce pollution in our region,” said first author Erika Garcia, a postdoctoral scholar in the Department of Preventive Medicine at the Keck School of Medicine of USC. “We’re not in a place where we can stop and say, ‘Hey, we’ve arrived’.”

USC Infographic: Lower air pollution = less asthma
Graphic by Wendy Gutschow — Full study related infographic and printable PDF can be found here.

Los Angeles remains the nation’s most-polluted region, but air quality improvements between 1993 and 2006 cut nitrogen dioxide pollution by 22 percent and fine particulate matter by 36 percent.

Nitrogen dioxide can cause airway inflammation and airway hyper-responsiveness. Particulate matter — tiny particles of soot, smoke dust, etc. — can penetrate deep into the lungs and cause serious health problems.

read related editorial

To assess new-onset cases of asthma, USC scientists used data from 4,140 children in nine California communities: Alpine, Lake Elsinore, Lake Gregory, Long Beach, Mira Loma, Riverside, San Dimas, Santa Maria and Upland. Parents or guardians completed questionnaires regarding their children’s health. New-onset asthma was defined as a newly reported, physician-diagnosed case of asthma on an annual questionnaire during follow-up.

Researchers looked at rates of new-onset asthma alongside air pollution data collected from monitoring stations in each of those communities during three different periods: 1993-2001, 1996-2004 and 2006-2014. Using statistical methods, they separately examined four air pollutants and found that two were associated with reductions in new-onset asthma. They estimated that the nitrogen dioxide reductions achieved between 1993 and 2006 led to a 20 percent lower rate of asthma, while fine particulate matter reductions led to a 19 percent lower rate.

The findings add to the increasing scientific evidence supporting the role of air pollution in the development of new cases of asthma. Asthma is the most common chronic disease in children, affecting about 14 percent of children around the world, and a major contributing factor to missed time from school and work.

“This is encouraging news as it shows the number of new cases of asthma in children can be reduced through improvements in air quality,” said Kiros Berhane, a professor of preventive medicine at the Keck School of Medicine of USC and one of the study’s authors. “This is very likely a direct result of the science-based environmental policies that have been put in place.”

In addition to Garcia and Berhane, the study’s other authors are Talat Islam, Rob McConnell, Robert Urman, Zhanghua Chen and Frank Gilliland, all of the Department of Preventive Medicine at the Keck School of Medicine.

The research was supported by the National Institute of Environmental Health Sciences (grants P30ES007048, P01ES009581, R01ES021801, and R01ES025786), the National Heart, Lung and Blood Institute (grant R01HL118455), the United States Environmental Protection Agency (grants R826708 and RD831861), and the Hastings Foundation.

EDITORIAL: New research findings show that children are exposed to lead in the womb

My team compared the levels of lead in teeth to lead levels in the soil. We discovered a significant trend. The more lead in the soil in residential neighborhoods, the higher the levels in the teeth – both prenatally and during the first year of life.
We continue to collaborate with the community to work toward prevention of lead exposure and cleanup of the contaminated soil.
Jill Johnston

The following editorial by the Truth Fairy Project’s lead researcher appears in The Conversation in full.

The environmental tragedy in Flint, Michigan, in which drinking water contaminated with lead raised fears of potential health effects for exposed children, revealed the failure of a regulatory system to protect residents from lead exposure.

Until 2015 the Exide Technologies lead-acid battery smelter, in southeast Los Angeles County, California, recycled approximately 11 million lead acid batteries per year while operating on temporary state permits. This violated multiple federal environmental regulations and exposed over 100,000 residents to lead and other toxic metals. The result was large-scale environmental disaster with lead contamination of the air and soil in largely Latino communities.

As an environmental scientist and epidemiologist, I sought to understand lead pollution in children growing up in this area. For my research I collaborated with local community organizations and relied on an archive of biological samples that families often save: baby teeth.

Read the full story on The Conversation’s website here.

The research study associated with this editorial can be found here.

A statement regarding this research project and the ongoing work to assure the communities around the lead smelter in Los Angeles are cleaned up can be found on the website of community partner: East Yard Communities for Environmental Justice.

Infographic: USC Environmental Health Centers summarizing the research study results from the Truth Fairy Project

NEW RESEARCH: Lead contamination found in baby teeth of children living near battery smelter

By LEIGH HOPPER, USC

Blood tests for lead only reflect recent exposure, but past exposures detected in teeth may be important indicator of harm

PRESS COVERAGE: KPCC, NBC Los Angeles, CBS Los Angeles, ABC Los Angeles, KTLA, Daily News, Science Daily, KCET, Telemundo, Business Insider, KQED

Airborne lead from recycled car batteries at the Exide plant in Vernon ended up in the baby teeth of children living nearby, a USC study shows.

“We found the higher the level of lead in the soil, the higher the amount of lead in baby teeth,” said first author Jill Johnston, an assistant professor of preventive medicine at the Keck School of Medicine of USC. “There’s no safe level of lead; it’s a potent neurotoxin. Our study provides insight into the legacy of the impact of industrial contamination on children.”

The Exide plant, located just southeast of downtown Los Angeles, recycled 11 million auto batteries per year and released 3,500 tons of lead until it closed in March 2015 as part of a legal settlement for hazardous waste violations.

As many as 250,000 residents, mostly working-class Latinos, face a chronic health hazard from exposure to airborne lead and arsenic that subsequently settles into the soil, according to a 2013 health risk assessment by the South Coast Air Quality Management District.

For USC’s “Truth Fairy” study, published in the XX edition of Environmental Science & Technology, researchers collected 50 baby teeth from 43 children in five communities: Boyle Heights, Maywood, East L.A., Commerce and Huntington Park. They recruited families through churches, schools and door-to-door visits. A local organization, East Yard Communities for Environmental Justice, coined the name, “Truth Fairy.”

Using laser ablation and an analytical technique for molecular-level information, the researchers were able to look at the teeth layer by layer and assign time points for lead contamination, such as the second trimester of pregnancy, when teeth are starting to form in the mother’s womb.

During second trimester, teeth start to form in the mother’s womb. During the third trimester the baby is growing rapidly and incorporates nutrients and toxins to which the mother is exposed. After a child is born, they can be exposed to toxic metals in their environment. Infants are at higher risk because they crawl and put their hands and toys in their mouths. Infographic: USC Environmental Health Centers

Dr. Rima Habre contributes to international panel on performance standards for low-cost air pollution sensors

*Rima Habre holds an ultrafine particle monitor monitor while a plane flies overhead. Photo courtesy of Something in the Air documentary.*

In June 2018, USC Environmental Health Centers exposure assessment expert Rima Habre, ScD, contributed to a two-day workshop hosted by the U.S. Environmental Protection Agency. Habre discussed essential features, design recommendations and performance targets specifically for wearable personal PM_2.5 deployed in health research studies to assess personal exposures and investigate relationships with health outcomes in population studies. Dr. Habre’s presentation discussed her work in the UCLA/USC Los Angeles PRISMS center led by Dr. Alex Bui (UCLA Medical Imaging Informatics) where researchers are developing a multi-sensor informatics platform to enable mHealth studies of pediatric asthma. The platform, called BREATHE (Biomedical REAl-Time Health Evaluation for Pediatric Asthma) allows researchers to monitor environmental exposures, behaviors, medications and symptoms using Bluetooth-enabled wearable sensors in real-time and in context, to ultimately help predict and prevent asthma attacks in children. Dr. Habre’s presentation focused on ‘real-life compatibility’ design and performance needs for low-cost PM_2.5 sensors deployed as part of an informatics ecosystem, including flexible wear options, battery life, communication needs, but also calibration well-suited for mobile deployments on humans moving in and across microenvironments in daily life.

Proceedings from the meeting that focused on performance targets for low cost sensors that measure fine particulate matter and ozone, are summarized in a research paper of which Habre is a co-author, published in April 2019 in the Atmospheric Environment journal.

Williams, R., Duvall, R., Kilaru, V., Hagler, G., Hassinger, L., Benedict, K., Habre, R. … Ning, Z. (2019). Deliberating performance targets workshop: Potential paths for emerging PM2.5 and O3 air sensor progress. Atmospheric Environment: X, 2, 100031. https://doi.org/10.1016/J.AEAOA.2019.100031

For more information about the workshop, including links to all presentations, click here.

Learn more about Dr. Habre’s recent research here.

Children’s Health Study featured in new book

The following article on CityLab’s website, and can be read in full on the website. The article is an excerpt from the new book Choked: Life and Breath in the Age of Air Pollution (University of Chicago Press, $27.50).

How Scientists Discovered What Dirty Air Does to Kids’ Health

BETH GARDINER APRIL 22, 2019

The landmark Children’s Health Study tracked thousands of children in California over many years—and transformed our understanding of air pollution’s harms.

Across Southern California, in school gyms and libraries and lunchrooms, the children filed in, one by one, to put their lips around a plastic tube and blow with all their might. Thousands of them, year after year, in rich neighborhoods and poor ones, from the breezy towns along the Pacific coast to the hot, smoggy valley locals know as the Inland Empire.

Erika Fields was one of them, back in the 1990s, when she was in high school at Long Beach Poly, just outside Los Angeles. Even now, she’s the kind of person who raises her hand, who steps forward when volunteers are needed, and she liked being the only one called out of her class, walking down the hall to the quiet room where the breathing machine sat on a desk. She liked, too, the sense of being part of something bigger than herself, something that might really matter in the world.

In the empty classroom, the woman from the University of Southern California would hand her a sterile mouthpiece, attached by a tube to the spirometer ready to gauge the power of her lungs. Erika would give it a couple of practice puffs to get comfortable before the one that counted. “I remember her saying ‘Push, push, push. Blow all the air out.’ And then she would show me on her laptop, and I could see on a graph where I pushed the most,” and watch the line edge downward as her breath tailed off.

After that, there was a survey to fill out, a couple of pages about her health and her family, about smoking in the home and pets and diet and exercise, and then Erika would walk back down the hall, back to her classmates and the ordinary rhythms of the school day.

She didn’t know it then, but those brief, once-a-year interruptions to her routine helped lay the foundation for insights that would ultimately change scientists’ understanding of what air pollution does to the human body. In the vast stacks of accumulating numbers—results from Erika Fields’s breath tests and thousands of others— a team of patient researchers would discern the outlines of a threat that had, until then, been hard to see.

Photo/Courtesy of the South Coast Air Quality Management District

Ed Avol was one of those scientists. He grew up breathing the foul air of 1960s L.A., and he remembers well the hacking coughs that filled the playgrounds of his childhood. An engineer by training, he worked early in his career on hospital-based studies that examined the effects of dirty air as researchers had for decades, by pumping pollution into small rooms and watching volunteers exercise inside.

The team he was part of wasn’t allowed to make conditions in their smog chambers any worse than what Angelenos would experience outdoors, but in the 1980s that still gave them plenty of latitude. The researchers would monitor subjects as they pedaled, measuring their heart rates and oxygen levels, making note of their coughing, their shortness of breath, and their red, watery eyes.

By that time, it was clear to scientists that ozone—the main ingredient in the smog that still plagues L.A. and so many other cities—had an immediate effect on those who breathed it. And the impact could be far more serious than the discomfort Avol saw so plainly: When ozone blankets a city, asthmatics wheeze, emergency room visits spike, and even in healthy people, the lungs can grow inflamed and struggle to do their job.

Read the rest of this article, including more of the history of the Children’s Health Study, and interviews from CHS investigators including Ed Avol and Jim Gauderman here on CityLab’s website.

This article from CityLab is an excerpt from the new book Choked: Life and Breath in the Age of Air Pollution (University of Chicago Press, $27.50).

Work of SCEHSC member and UCLA researcher Beate Ritz featured in new book

The work of longtime Southern California Environmental Health Sciences Center member and UCLA researcher Beate Ritz, will be featured in a chapter of an upcoming book, an excerpt was published recently in Environmental Health News, is found below.

Dirty air wreaks harm long before birth

BETH GARDINER, APRIL 29, 2019

The changes pollution inscribes in pregnancy haunt us not just during childhood, but throughout life

In chunky black glasses and a patterned scarf, her dark hair pulled back, Beate Ritz still looks more the sophisticated European than the casual Californian, even after decades in America.

Sunshine streams through a window into her home in the Santa Monica Mountains, above Los Angeles, as we speak on Skype, and she pours herself a cup of tea.

Ritz is an epidemiologist at UCLA, and she knows it can be nearly impossible to link one individual’s health problem to a specifc environmental cause. But the work that would shape her career began with a nagging, personal worry. The smog blanketing L.A. came as a foul shock when she arrived from her native Germany.

Los Angles skyline. Photo: Shutterstock.com

Read the rest of the article on Environmental Health News here.
The article is an excerpt from the new book Choked: Life and Breath in the Age of Air Pollution (University of Chicago Press, $27.50).