USC and partner institutions awarded $6 million children’s environmental health grant from NIH

Research to look at prenatal and early life environmental influences on lifetime health related to asthma and obesity

Staff Report

Media Coverage: Press Enterprise, Daily News, The Washington Times,, Daily Breeze, Pasadena Star News

LOS ANGELES – September 21, 2016 – Researchers at the Keck School of Medicine of USC have been awarded a 2 year $6 million grant, as the first phase of a large seven-year National Institutes of Health, Environmental Influences on Child Health Outcomes (ECHO) initiative involving more than 30 research entities. The USC based research team will investigate health issues related to asthma and obesity. Continue reading “USC and partner institutions awarded $6 million children’s environmental health grant from NIH”

AirPollBrain and CEHC Presents: “Perinatal Metal Exposure and Neurodevelopment: Identifying Windows of Susceptibility”

The SCEHSC Seminar Series presents

“Perinatal Metal Exposure and Neurodevelopment: Identifying Windows of Susceptibility”

11:00 a.m.-12:00 p.m.

AirPollBrain Mini-Symposium: “Air Pollution and Adolescent Brain Development”

12:00 p.m.-1:30 p.m.

Megan Horton, PhD

Assistant Professor
Department of Environmental Medicine and Public Health
Icahn School of Medicine at Mount Sinai

Tuesday, August 23, 2016

Soto Street I Building, Room 116
2001 North Soto Street
Los Angeles, CA 90032

If you would like to attend the FREE seminar, please email

Dr. Horton earned her doctoral degree in Environmental Health Sciences at Mailman School of Public Health, Columbia University. During her doctoral training, she gained expertise in the development and use of biological markers to measure prenatal and early life exposures to environmental toxicants, focusing mainly on residential exposure to pesticides. Subsequently, she completed a postdoctoral fellowship at the Sergievsky Center for the Epidemiologic Study of Neurologic Diseases. The focus of this postdoc was to explore the use of brain imaging to investigate the impact of prenatal exposure to pesticides and secondhand smoke on neuropsychological and behavioral function throughout childhood. Dr. Horton was recently awarded an NIH career transition award and accepted a position as an Assistant Professor of Preventive Medicine at Icahn School of Medicine at Mount Sinai. Her current work combines her experience with biomarker development and neuroimaging to understand the mechanisms of neurodevelopmental toxicity following exposure to chemical mixtures.

Visitor parking at the Soto Street Building is limited. If you are planning to park at the Soto building during the seminar please contact Marissa Jacy ( for more information. If you are a USC employee, please plan to take the free USC shuttle to our seminars whenever possible. Information about the USC shuttle can be found at

Event update: The air out there: Traffic, pollution and children’s health

View event video, live tweet feed, questions, answers and more about air pollution and children’s health.

On Sunday April 24, 2016 the SC-CEHC co-sponsored the event: The air out there: Traffic, pollution and children’s health with southern california public radio station KPCC. USC Keck Professor Jim Gauderman participated in the panel discussion lead by KPCC Early Childhood Development correspondent Deepa Fernandez. This time provided many great questions and insights into the health effects of air pollution as well as community perspectives and experiences as awareness about how pollution affects health continues to grow in the Southern California region.

KPCC live tweeted the event via @KPCCInPerson. The event can be viewed in full below, including a question/answer session from the audience.


New Research published from the CHS: Less pollution = improvement in children’s respiratory health

Bronchitic symptoms on the decline as pollution levels drop in Los Angeles region over the past two decades  #CleanAir

PRESS COVERAGE: Press Enterprise, New York Times, U.S.News, HealthDay, United Press International, Medical News Today, Eureka Alert
JAMA Coverage:  News Release and VideoAuthor Interview Video

A USC study that tracked Southern California children over a 20 year period has found they now have significantly fewer respiratory symptoms as a result of improved air quality.

The finding expands on the landmark USC Children’s Health Study, which a year ago reported that kids’ lungs had grown stronger over the past 20 years as pollution levels in the Los Angeles Basin declined. In the current study, USC researchers examined a health issue that makes many parents anxious while pulling at their pocketbooks: bronchitic symptoms that could land otherwise healthy children in a doctor’s office or hospital.

The research appears in the April 12, 2016 issue of the Journal of the American Medical Association.

To assess respiratory symptoms, USC scientists studied children in eight California communities and defined bronchitic symptoms over the preceding year as a daily cough for at least three consecutive months, congestion or phlegm not related to a cold, or inflammation of the mucous membranes, according to Kiros Berhane, lead author and a professor of preventive medicine at the Keck School of Medicine of USC.

“This is one of the few times that we have been able to report good news, and this is very likely a direct result of the science-­‐‑based policies that have been put in place,” Berhane said. “The message that clean air leads to better health in children should be taken seriously because it has implications for how we live and how productive we become.”

The study, published April 12 in the Journal of the American Medical Association, followed 4,602 children in three cohorts as they aged from 5 to 18. During 1993 to 2012, children and their parents from Long Beach, San Dimas, Upland, Riverside, Mira Loma, Lake Elsinore, Alpine and Santa Maria answered questionnaires about children’s health. Air quality was continuously monitored in each community.

“Because of the wide variations in ambient pollution levels among the eight California communities we analyzed, these findings are applicable to other parts of the United States and maybe other parts of the world as well,” Berhane said, adding the results could help with asthma management and the overall respiratory health of children.

How much children’s respiratory health improved

Because bronchitic symptoms are usually about four times higher in children with asthma, the scientists examined associations of air pollution reduction with bronchitic symptoms separately for kids with and without asthma. Researchers also adjusted their analyses for age, gender, race or ethnicity, secondhand tobacco smoke and presence of cockroaches in the home.

“It is important to note that while reductions in bronchitic symptoms were larger in children with asthma, they were still substantial and significant in children without asthma as well — indicating that all children have benefited from the improvement in air quality over the past 20 years,” Berhane said.

The study found that tiny particles called particulate matter 2.5 (PM 2.5) — which can penetrate deep into lungs and cause serious health problems — dropped by 47 percent from 1992 to 2011 in the study region. USC researchers were able to associate cleaner air with improved children’s respiratory health. Kids with asthma were 32 percent less likely to suffer from bronchitic symptoms, and children without asthma experienced a 21 percent reduction in these respiratory problems.

Moreover, nitrogen dioxide, which can reduce resistance to respiratory infections, decreased by 49 percent in the same two decades. USC researchers linked the drop in nitrogen dioxide with a 21 percent decrease of bronchitic symptoms in children with asthma and a 16 percent decline of bronchitic symptoms in kids without asthma.

“This type of data is important for policymaking and for how clinicians would advise their patients,” Berhane said.

The cost of asthma and sick children

About 1 in 10 children in the United States had asthma in 2009, according to the Centers for Disease Control and Prevention. Medical expenses associated with asthma amounted to $50.1 billion in 2007 and cost the nation about $3,300 per person each year.

“Changes in children’s respiratory health have a ripple effect,” Berhane said. “A child may stay home because of severe bronchitic symptoms. That could mean parents have to call in sick or arrange for a caregiver. Beyond quality of life, childhood asthma and bronchitic symptoms take a toll on children’s school attendance, parental productivity and society in general.”

Asthma is the cause for almost 2 million emergency room visits each year, according to the Asthma and Allergy Foundation of America. Each year, this respiratory condition is the reason for more than 14 million doctor visits and about 439,000 hospital stays.

Frank Gilliland, senior author and a professor of preventive medicine at Keck Medicine of USC, said the USC Children’s Health Study is a unique examination because it has been able to follow children for so many years.

“Asthma is the most common chronic disease of childhood, so the reduction of these symptoms by 16 to 32 percent is a big deal,” Gilliland said. “We studied longitudinal cohorts of children for 20 years using consistent methods and found that decreased levels of air pollutants were associated with a marked decrease in bronchitic-­‐‑related symptoms in children both with and without asthma. No other study has been able to accomplish this.”

Pollution and policy

California cities have consistently topped the American Lung Association’s annual list of most polluted cities by ozone or particulate matter pollution. Historically, Southern California has reported high levels of ambient air pollution because of emissions from vehicles, industrial sources and two of the nation’s largest ports.

“While the reduction in ambient air pollution has been observed during the past 20 years, it was most marked after 2000 and is very likely due to policies that were put in place,” Berhane said. “Even though this is very encouraging, there is still room for improvement. We must recognize that in some cases, the ozone and particulate matter levels in Southern California are still in violation of federal standards.”

Some California regulatory policies that have been implemented include the Low-Emission Vehicle Program, a risk-reduction plan for diesel fueled engines and vehicles, and pollution controls at the ports of Los Angeles and Long Beach.

For many years, environmental epidemiologists have reported adverse health effects associated with increasingly polluted air. So the ability to report that Southern California has been on the path to cleaner air and that this reduction in air pollution has led to significant improvement in children’s health is a welcome change, Gilliland said.

Berhane added: “But we must not get complacent. We expect more cars on the road, more ships at our ports and more economic activities in the region. Even if we maintain the current policies and practices in environmental protection, pollution levels could start to rise again because of more cars and economic activities. We have to stay vigilant so that we do not lose current gains in air quality and the associated improvements in our children’s health.”

USC strives to conduct research that could have a global impact. This study was supported by the National Institute of Environmental Health Sciences, the Health Effects Institute and the California Air Resources Board.

Press Release: by Zen Vuong, USC Media Relations

# # #
Kiros Berhane, PhD; Chih-Chieh Chang, PhD; RobMcConnell, MD;W. James Gauderman, PhD; Edward Avol, MS; Ed Rapapport, MPH; Robert Urman, PhD; Fred Lurmann, MS; Frank Gilliland, MD, PhD. Association of Changes in Air Quality With Bronchitic Symptoms in Children in California, 1993-2012. JAMA. 2016;315(14):1491-1501. doi:10.1001/jama.2016.3444

USC News: USC, UCLA to develop children’s asthma prediction app

Technology will help young people maximize their health and reduce the burden of the incurable condition

by Zen Voung, USC Media Relations
Link to original article on USC News

USC and UCLA scientists are working on a smartphone app and cloud services platform that will predict the probability of a child’s future asthma attack and provide personalized risk management advice.

The smartphone is a personalized approach that evaluates potential real-time environmental triggers. (Graphic/Alex Bui)

Frank Gilliland, professor of preventive medicine at the Keck School of Medicine of USC, said the integrative Biomedical Real-Time Health Evaluation (BREATHE) platform he and colleagues are developing is a potentially revolutionary approach to managing asthma, one of the most common chronic childhood diseases.

“We think this is the future for asthma care,” said Gilliland, co-principal investigator of the project. “We will use real-time, high-volume information about physiology, symptoms, medication use and environmental exposures. This ‘big data’ will help physicians manage patients better and prevent exacerbations. It is a personalized medicine approach that evaluates potential real-time environmental triggers, genetics and a child’s asthma attack

Data crunch
USC and UCLA researchers will build a platform that will crunch data from children’s wearable devices, smartphones and individual electronic health records as well as real-time reports on weather conditions, air quality, pollen and allergy forecasts, and other “asthma triggers.” The algorithm will supply contextual information in a secure, cloud-based system.

The National Institute of Biomedical Imaging and Bioengineering awarded a $5.25 million grant to co-principal investigators Gilliland and Jose-Luis Ambite, a research assistant professor in the Department of Computer Science at the USC Viterbi School of Engineering. The agency also awarded UCLA a $6 million grant, of which $1.85 million is expected to be subcontracted to USC. The money in both grants will be spread across four years of research and development.

About 6.8 million children in the United States have asthma, according to the Centers for Disease Control and Prevention. The currently incurable respiratory condition cost the United States about $56 billion in medical costs, lost school and work days in 2007.

“Asthma weighs heavily on the nation in terms of public health, medical costs and quality of life,” said Alex Bui, also a principal investigator in this study and professor of radiological sciences at the David Geffen School of Medicine at UCLA. “One of the biggest challenges will be making the smart device user-friendly for young children. Kids like intuitive interfaces with bright colors, simple language, big text and quirky noises. We’re having fun exploring how to build those facets into our design.”

Take a breath
Researchers will test the platform on 8- to 12-year-old children with asthma. The algorithm scientists are developing will analyze data from the landmark USC Children’s Health Study, a litany of contextual data from environmental sensors and a history of previous asthma attacks. When exacerbating conditions arise again, the asthma app may remind a child or caregiver to bring an inhaler or medicine to ward off a future asthma attack.

“We will use technology to help people maximize their health and reduce the burden of childhood asthma,” said Gilliland, director of USC’s Division of Environmental Health. “Privacy is critical. The data has to be encrypted and secure so people could be assured their data will be confidential.”

The smartphone is a personalized approach that evaluates potential real-time environmental triggers. (Graphic/Alex Bui)

Children’s Health Study receives top honors for paper in 2015 from NEJM and NIEHS

In March 2015, as part of the ongoing research of the Southern California Children’s Health Study, a paper documenting improvement in children’s lung function as a direct result of decline in pollutant levels (nitrogen dioxide and fine particles) across Southern California was published in the New England Journal of Medicine (NEJM).

The National Institute of Environmental Health Sciences (NIEHS), one of the funders of the research, recognized the paper as one of the top 25 papers of 2015.

The New England Journal of Medicine recognized the paper as one of the top 12 papers that was published by the journal in 2015.

The direct link to a summary of the article on the NEJM website can be found here.
More: press release and a summary of press coverage of the article.

W. James Gauderman, Ph.D., Robert Urman, M.S., Edward Avol, M.S., Kiros Berhane, Ph.D., Rob McConnell, M.D., Edward Rappaport, M.S., Roger Chang, Ph.D., Fred Lurmann, M.S., and Frank Gilliland, M.D., Ph.D. Association of Improved Air Quality with Lung Development in Children.
N Engl J Med 2015; 372:905-913March 5, 2015 DOI: 10.1056/NEJMoa1414123

New study finds that risk of asthma and nasal allergy varies by genetic ancestry in Hispanic children

LOS ANGELES – According to the US Census, the Hispanic or Latino population has experienced the fastest growth in the United States and account for more than half of the population growth between 2000 and 2010.  With such trend in population growth, there is a growing need to investigate causes of common health conditions in Hispanic children, who have diverse environmental, socioeconomic, cultural and ancestral backgrounds.

A new study led by Keck School of Medicine of the University of Southern California (USC) researchers set out to investigate the effect of genetic factors on asthma and rhinitis (defined for this study as a problem with sneezing or a runny or blocked nose, when the child does not have a cold or the ‘flu’ also known as “nasal allergy”), two of the most common illnesses in children. They conducted the study among nearly 1800 Hispanic children between the ages of 5 and 7 years who participated in the Southern California Children’s Health Study in 2003.

For a link to the study, click here.

The research indicates that looking at genetic ancestry may help explain the differences in prevalence of asthma and rhinitis within the spectrum of Hispanic people and the burden of asthma and rhinitis in the fast growing, ethnically diverse Hispanic population in the US.

“Studies in the past have generally included multiethnic population with predominantly non-Hispanic population,” said Muhammad T. Salam, adjunct assistant professor of research in the department of preventive medicine at the Keck School of Medicine, and lead author of the research. “While there are common risk factors that affect everyone, we are just beginning to understand that we need to focus on specific Hispanic populations to better understand the complex interplay of genetic, environmental and cultural factors in the development of common health conditions such as asthma and rhinitis.”

To determine the ancestral (ethnic) background of each child more precisely, the researchers estimated contributions from Amerindian (ancestral background in Latin American people before 15th century), European, African and Asian ancestry using over 200 DNA sequence variations.
Such variations in DNA (human genome) are genetic markers of ancestry. Certain variants occur in one population or another in the human genome (DNA). When DNA is analyzed in this way, ancestry can be determined at a very precise level depending on how many genetic markers are looked at.

The researchers found lower risk of asthma and rhinitis in people with more Amerindian ancestry.  For each 25% increase in Amerindian ancestry, there was an 18% lower risk of asthma and 14% lower risk of rhinitis.  In children with over 75% Amerindian ancestry, only 9% had asthma and 30% had rhinitis. In contrast, Hispanic children who had less than 25% Amerindian ancestry, 21% had asthma and 44% had rhinitis. The study took into account factors in the environment, culture, and economics.

The parents provided information on their children’s health conditions, environmental exposures such as tobacco smoke, allergens, and socioeconomic background. Acculturation is a process by which cultural patterns change when people come in contact with other cultural patterns. The U.S. Hispanic population has undergone such changes over generations. Researchers assessed acculturation based on where the mother was born and what language the parent used to complete the study questionnaire (English or Spanish)

The Southern California Children’s Health Study began in 1993 at USC and was designed to study the chronic effects of air pollution on the developing lungs of Southern California school children.

The research appears in the August 11, 2015 issue of the PLOS ONE. Co-authors include Muhammad T. Salam, M.D., Ph.D. of the Keck School of Medicine of USC, and the Department of Psychiatry, Kern Medical Center; Tigran Avoundjian, M.P.H. of US Department of Veterans Affairs, Center for Health Care Evaluation; Wendy M. Knight MPH, of the Los Angeles County Department of Public Health, Acute Communicable Disease Control Program; and Frank D. Gilliland, M.D., Ph.D. of the Keck School of Medicine of USC

The collaborative study was funded by the National Heart, Lung and Blood Institute (grants 5R01HL61768 and 5R01HL76647); the Southern California Environmental Health Sciences Center (grant 5P30ES007048) funded by the National Institute of Environmental Health Sciences; the Children’s Environmental Health Center (grants 5P01ES009581, R826708-01, and RD831861-01) funded by the National Institute of Environmental Health Sciences and the Environmental Protection Agency; the National Institute of Environmental Health Sciences (grants 5P01ES011627); and the Hastings Foundation.

Article Cited:
Salam, M.T., Avoundjian, T., Knight, W.M., & Gilliland, F.D. (2015). Genetic ancestry and asthma and rhinitis occurrence in Hispanic children: Findings from the Southern California Children’s Health Study. PLOS ONE Published online August 11, 2015; doi: 10.1371/journal.pone.0135384

Contact: Muhammad T. Salam,