Why do kids get sick?
A massive new study aims to find out what's ailing America's children
Air. Water. Dust. Dirt. Body fluids. Genes. Food. Television. To see how they all interact in ways that sicken or protect children, researchers next year will begin fanning out across the country. They'll fill vials with tap water and capture samples of air. They'll scoop up soil, take note of lawns and outdoor plants. In rural Wisconsin and New York City, they will ask mothers for samples from umbilical cords and placentas. Babies and toddlers will contribute samples of urine, feces, and saliva. Mothers and fathers from the desert Southwest and small towns in Pennsylvania will sit down to answer detailed questions on their health, their illnesses, and their family histories of illness. Researchers will ask about exercise, diet, and how much TV kids watch.
In all, 100,000 children and their parents will be enrolled in the largest ever study of youngsters. Called the National Children's Study, it will be a 21-year odyssey of discovery, following children from the uterus to the threshold of adulthood. By carefully watching and waiting, researchers hope to gain a better understanding of major diseases that strike children, some of which are spreading alarmingly fast. The study will involve scientists from the National Institute of Child Health and Human Development, the National Institute of Environmental Health Sciences, the Centers for Disease Control and Prevention, and the Environmental Protection Agency.
Watching--and waiting. After four years in which the details of the study design were hammered out, it has garnered the support of groups ranging from the March of Dimes to the American Chemistry Council. The study has $12 million, enough to launch the first phase by selecting three to eight sites, which will each enroll 250 newborns a year for five years. The initial centers will serve as models, and eventually 96 locations will be chosen, reflecting the diversity of America. But with a price tag that could go as high as $2.7 billion over two decades, it's uncertain whether Congress, which called for the study in 2000, will continue to fund it. Researchers hope that success at the initial sites will prompt Congress to come through. The greatest hope is that medicine will find answers to questions about childhood diseases, including the growing childhood epidemics of diabetes, obesity, asthma, and autism.
Other long-term observational studies have paid off in countless lives saved. The Framingham Heart Study, for example, followed an initial 5,209 residents of the Massachusetts town since 1948. It is now recruiting the third generation of volunteers, the grandchildren of the original participants, and is credited with discovering the risk factors--such as hypertension, high levels of blood cholesterol, smoking, and lack of exercise--that contribute to heart disease.
Like heart disease, many of the childhood disorders afflicting growing numbers of children are likely to have more than one cause. They are the result of genetics interacting with environment, biology triggered by social circumstance. "You have to measure exposures early in life," says Peter Scheidt, the director of the study, "and follow the same individuals long enough for the condition to develop in order to understand."
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