New Center Focuses on Children’s Environmental Health Hazards in Philadelphia

The new Philadelphia Regional Center for Children's Environmental Health will address environmental health hazards facing children in the region's most vulnerable communities.

mccannn [at] chop.edu (By Nancy McCann)

Children living in Philadelphia, the poorest large city in the country, face a number of environmental threats to their health every day — from lead poisoning and air pollution to exposure to asbestos and endocrine disrupting chemicals, the compounds found in household products and the environment that have been linked to preterm birth, obesity, diabetes, and neurodevelopmental disorders.

In an energized effort to address these hazards and identify and protect the children who live in the region's most vulnerable communities, researchers from Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania are joining forces by integrating their expertise in the new Philadelphia Regional Center for Children's Environmental Health (PRCCEH). With funding from the National Institute of Environmental Health Sciences — a first for the region — the Center is one of six locations nationwide contending with the concerns of children's environmental health.

Rebecca Simmons, MD

Leading the charge are the new Center's Director Rebecca Simmons, MD, professor of Pediatrics and a CHOP neonatologist; Co-Director Aimin Chen, MD, PhD, professor of Epidemiology at Penn; Deputy Director Marilyn Howarth, MD, director of community engagement at Penn's Center of Excellence in Environmental Toxicology; and Translation Core Co-Director Tyra Bryant-Stephens, MD, senior director of CHOP's Center for Health Equity.

They aim to increase awareness by disseminating children's environmental health knowledge to healthcare providers, community members, and policy makers. The team, which includes colleagues from Drexel University, Temple University, Thomas Jefferson University, Lehigh University, Franklin & Marshall College, Villanova University, and University of Delaware, will develop, test, and implement new programs, as well as engage researchers and community partners to make policy, practice, and behavioral changes to reduce environmental exposures in early life.

"The disparities in environmental justice are profound in Philadelphia," Dr. Simmons said. "This Center will build on years of extensive research in environmental toxicology and pediatric health at both Penn and CHOP to make real, positive change in the lives of children throughout the region. We already have many established connections within communities throughout Philadelphia, Delaware, and other counties, and this grant will allow us to strengthen and expand on those partnerships."

Key Areas of Research and Translation

With the goal of improving children's health by reducing environmental exposures in early life, the Center will focus on four areas of research that are considered the biggest targets and environmental exposure load in the Philadelphia region, in order to translate the science into prevention measures.

• Asthma Prevention: Building on CHOP's successful Community Asthma Prevention Program, designed and launched more than 20 years ago by its medical director Dr. Bryant-Stephens to support families of children with asthma in Philadelphia, the Center will expand the initiative to Chester, Pennsylvania, an environmental justice community. PRCCEH will work with local primary care providers to identify and recruit participants to the program and then provide education and supplies to help these families mitigate asthma triggers in the home to improve asthma outcomes in children.
• Lead Exposure and Harm Reduction: With old housing stock, schools, pipes, and historic use of leaded paint and gasoline, Philadelphia has a heavy burden of lead. Research out of CHOP and Penn has revealed some of the harmfulness of lead exposure, such as reduced cognitive function and increased behavioral problems, a significant disparity in elevated blood lead levels in children depending on zip code, and disturbances in sleep and circadian rhythms in early childhood. Projects at the new Center will expand on this research and apply evidence-based solutions to reduce lead poisoning in children, including a collaboration with Clean Water Action to enhance lead paint evaluation and remediation efforts, provide drinking water testing kits to home inspectors, and test residential water samples for lead.
• Air Pollution: The Center will work with the research findings of Heather Burris, MD, MPH, a neonatologist at CHOP and primary investigator of a large Penn Medicine birth cohort study, GeoBirth, in which preterm births are rigorously phenotyped and linked to area-level exposures. By identifying neighborhoods with higher levels of air pollution/higher levels of preterm births, the Center can inform policy makers to make meaningful policy changes to reduce emissions in the identified areas.
• Reduction of Exposure to Endocrine Disrupting Chemicals: PRCCEH will build on research from Dr. Simmons, Sara Pinney, MD, MS, and others, that shows exposure to low levels of endocrine disrupting chemicals causes obesity during pregnancy, and causes obesity and the development of diabetes later in life in animal models. The new Center will establish the Academy for Environmental Exposure Reduction, a program for high-school students that will engage them in an eight-week exploration of endocrine disrupting chemicals and their effects.

"We have a responsibility to try to minimize exposure because we now know through our research that these effects not only affect the offspring, but they also affect the second generation," Dr. Simmons said. "This has profound implications for children's health as well as future generations."

Other CHOP doctors involved with the Center include Lisa Biggs, MD; Kevin Osterhoudt, MD, MSCE; Kathryn Hamilton, PhD; Sharon McGrath-Morrow, MD, MBA; Scott Lorch, MD, MSCE; Jessica Rice, DO, MHS; and Todd Kilbaugh, MD.