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OHSU receives $2 million for study of smoke impacts on child health

Funding for ongoing study will expand investigation into long-term effects of e-cigarettes, marijuana, wildfires, other climate change factors during pregnancy
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Cindy McEvoy studies research participant, Sadie Schweitzer, 15, at the McEvoy lab at OHSU. Alongside a national cohort of researchers, a team at OHSU is investigating the effect of environmental factors on a child’s long-term respiratory health. (OHSU/Christine Torres Hicks)
Cindy McEvoy, M.D., conducts asthma and vitamin C research on Sadie Schweitzer, 15. Alongside a national cohort of researchers, a team at OHSU is investigating the effect of environmental factors on a child’s long-term respiratory health. (OHSU/Christine Torres Hicks)

A team of researchers at Oregon Health & Science University received $2 million in grant funding from the National Institutes of Health to expand its ongoing work investigating respiratory health outcomes in children with the Environmental Influences on Child Health Outcomes program, or ECHO.

ECHO aims to understand the effects of a broad range of early environmental influences on child health and development, and identify opportunities to improve child health and well-being across their lifespan. The program studies the effects of environmental influences on five key areas of health: pregnancy and birth, breathing, body weight, neurodevelopment and well-being.

Since joining ECHO in 2016, OHSU has focused on respiratory health. Researchers have followed 360 mother-child pairs to assess how smoke exposure has affected their lung function and respiratory health.

The additional funding will allow OHSU to continue following the existing cohort of participants until they are 21 years old. Additionally, the funding will enable the addition of new pregnant participants, which will allow the study of new exposures of concern during pregnancy — such as electronic cigarettes, marijuana and the effects of climate change — as well as how outcomes are influenced by societal factors.

Cindy McEvoy, M.D., stands near the grassy knoll at OHSU. (OHSU)
Cindy McEvoy, M.D. (OHSU)

“The ECHO team personifies the concept of team science, which is necessary to advance the needle on child health outcomes,” said Cindy McEvoy, M.D., professor of pediatrics in the OHSU School of Medicine, who leads the ECHO team at OHSU along with Eliot Spindel, M.D., Ph.D., professor of neuroscience at the Oregon National Primate Research Center. “Participation in ECHO allows OHSU the opportunity to leverage a national dataset of more than 50,000 mother and child pairs in all 50 states, which represent people of different socio-economic status, race and ethnicity. This large, diverse cohort is crucial to be able to identify health disparities and implement interventions to improve the health of children in all communities.”

Understanding impacts of smoke

Environmental smoke exposure can be dangerous for a developing baby and is linked to poor health outcomes, including impaired fetal lung development, decreased airway function and an increased risk for wheezing and asthma. Additionally, decreased airway growth early in life causes increased risk for serious lifelong conditions, such as chronic obstructive pulmonary disease, which is now the third leading cause of death worldwide.

Importantly, McEvoy notes that environmental influences adversely affect certain populations.

“There are many factors that can increase a child’s risk for poor respiratory health outcomes. Many of these factors have to do with a child’s environment in-utero, or in the uterus, and throughout their early life,” McEvoy explained. “The environment around you, location of your home or neighborhood, including factors you might not think about — like your home’s proximity to a park or highway — can all affect a child’s health.”

To further investigate these disparities, McEvoy and her team will leverage geocoding, which allows them to track individual patients by location to examine how social, physical and built environmental factors during pregnancy and early childhood influence health outcomes.

They will investigate the effects of exposure to ambient air pollution throughout pregnancy, including small and large size pollution particles, tobacco smoke, cannabis and electronic cigarettes. They’ll then look at the effects of these exposures on the child, including respiratory, cardiovascular, metabolic and behavioral outcomes, which may help identify a critical time period of exposure, and inform future interventions and health care policies to mitigate the risks.

“These tools allow us to be very precise,” McEvoy said. “For example, we can track exposures to pollution directly to a certain house on a certain block at a specific point in time. The possibilities of what we can learn are really exciting.” 

Looking forward, researchers hope their work will potentially lead to better understanding of, and treatments for, the health impacts of other emerging environmental concerns, including wildfires. The team will also focus on the effect of nationwide policies on childhood health outcomes.

Research reported in this publication was supported by the National Institutes of Health (NIH) under Award Number UH3OD023288. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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