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. 2020 May;30(3):397-419.
doi: 10.1038/s41370-020-0211-9. Epub 2020 Feb 17.

Opportunities for Evaluating Chemical Exposures and Child Health in the United States: The Environmental Influences on Child Health Outcomes (ECHO) Program

Free PMC article

Opportunities for Evaluating Chemical Exposures and Child Health in the United States: The Environmental Influences on Child Health Outcomes (ECHO) Program

Jessie P Buckley et al. J Expo Sci Environ Epidemiol. .
Free PMC article


The Environmental Influences on Child Health Outcomes (ECHO) Program will evaluate environmental factors affecting children's health (perinatal, neurodevelopmental, obesity, respiratory, and positive health outcomes) by pooling cohorts composed of >50,000 children in the largest US study of its kind. Our objective was to identify opportunities for studying chemicals and child health using existing or future ECHO chemical exposure data. We described chemical-related information collected by ECHO cohorts and reviewed ECHO-relevant literature on exposure routes, sources, and environmental and human monitoring. Fifty-six ECHO cohorts have existing or planned chemical biomonitoring data for mothers or children. Environmental phenols/parabens, phthalates, metals/metalloids, and tobacco biomarkers are each being measured by ≥15 cohorts, predominantly during pregnancy and childhood, indicating ample opportunities to study child health outcomes. Cohorts are collecting questionnaire data on multiple exposure sources and conducting environmental monitoring including air, dust, and water sample collection that could be used for exposure assessment studies. To supplement existing chemical data, we recommend biomonitoring of emerging chemicals, nontargeted analysis to identify novel chemicals, and expanded measurement of chemicals in alternative biological matrices and dust samples. ECHO's rich data and samples represent an unprecedented opportunity to accelerate environmental chemical research to improve the health of US children.

Keywords: Chemicals; Children’s health; Environmental exposures; Environmental influences on child health outcomes.

Conflict of interest statement

Conflicts of interest. WEF is a founding partner in EnMed MicroAnalytics, a company that provides heavy metal screening for newborns and children. MSB has worked for ICF International as a paid consultant on the US EPA ‘IRIS Draft Toxicological Review of Polychlorinated Biphenyls (PCBs): Effects Other Than Cancer’. All other authors declare they have no actual or potential competing financial interests.

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