DRAFT. CHILDREN S ENVIRONMENTAL HEALTH EHSC-GA 2051 Thursdays, 4:55-7:35 PM Bobst Library, Lower Level Room 151. SYLLABUS, Spring 2014

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1 DRAFT CHILDREN S ENVIRONMENTAL HEALTH EHSC-GA 2051 Thursdays, 4:55-7:35 PM Bobst Library, Lower Level Room 151 SYLLABUS, Spring 2014 Michael Weitzman MD, Professor of Environmental Medicine and Pediatrics New York University School of Medicine CLASSES 1 AND 2. Course Overview, Rationale and Current Understanding and Controversies on How Children Differ from Adults in Response to Environmental Exposures---Michael Weitzman MD These two classes present (a) an overview of child health in the US and what the major measures and markers of child health status are; and (b) what is and is not known about how the fetus and children differ from adults in terms of their vulnerabilities to, and absorption and metabolism of common environmental exposures. It provides examples of exposures for which children are at heightened vulnerability and others for which children of different ages appear to be protected from exposure relative to adults. These classes set the stage for comprehending how environmental exposures alter child physical, cognitive, and socio-emotional health and functioning. CLASS 3. Childhood Lead Poisoning Michael Weitzman MD Childhood lead poisoning is probably the most ubiquitous negative environmental health exposure of children in the US and is a major global health problem. Over the past 25 years there have been profound decreases in US children s exposure to this potent neurotoxin. At the same time, a parallel research literature has demonstrated subtle, but serious neurocognitive decrements and disabilities 1

Course Overview, Rationale and Current Understanding and Controversies on How Children Differ from Adults in Response to Environmental Exposures---Michael Weitzman MD These two classes present (a) an

2 associated with levels of exposure previously believed to be safe. This class reviews the epidemiology of childhood lead exposure, the sources and pathways of exposure, the extensive body of research on lead s negative effects, and public health and clinical approaches to preventing exposure and treating exposed children. CLASS 4. Ethical Issues in Children s Environmental Health Research: The Case of Johns Hopkins/Kennedy Krieger Lead Paint Housing Study and the Institute of Medicine Response William Ruddick, PhD, Department of Bioethics, NYU Child lead exposure is in large part a problem of children living in poverty in substandard, old housing. Efforts to prevent lead exposure often involve housingbased interventions and policies. This class uses the Kennedy Krieger Study (a Baltimore-based study of the effectiveness of different levels of housing remediation to test cost-effectiveness of various interventions) and the profound public outcry it created to discuss ethical issues in interventional environmental research involving children and impoverished populations. Observational and interventional environmental research often poses unique ethical concerns for which Institutional Review Boards may not be well versed. Part of these unique concerns arise from dealing with research in community settings, often involving impoverished and minority communities and the fact that researchers often must deal with multiple regulatory constraints on collecting samples and needing to act on abnormal findings. CLASS 5. The Roles of the EPA, CDC, OSHA, HUD, NIH and State and Local Government in Children s Environmental Health David Jacobs, PhD, former Director of the HUD Lead Paint Prevention Branch and current Director of Research for the National Center for Healthy Homes. Multiple federal agencies play crucial roles in regulating the public s exposure to potential environmental toxins. Dr. Jacobs is one of the leading researchers and advocates for healthy housing of children and families. He has played many roles 2

approaches to preventing exposure and treating exposed children. CLASS 4.

3 in shaping and enforcing public environmental regulations. This class will focus on the roles of the major federal agencies in (a) regulating and (b) advising the public health and clinical communities and the public at large about prudent policies and practices. It also addresses the use of research to support the development and implementation of current policies and regulations. CLASS 6 Children s Environmental Justice David Frank, PhD, Department of Bioethics, NYU Health disparities and child health inequities are of grave concern worldwide. Environmental Justice, which deals with such inequities, is an emerging field. This class will cover health disparities among children in the US and the world that are due to environmental exposures and the ethical dilemmas that these disparities cause. CLASS 7 The Childhood Obesity Epidemic and the Changing Nutritional and Physical Environment of Children Alan Meyers, MD, Professor of Pediatrics, Boston University School of Medicine The obesity epidemic is unprecedented in the history of humankind. This class, taught by an eminent food policy advocate, will discuss changes in agriculture, food additives, advertising, public subsidies and policies and the built environment that contribute to this widespread change in the nutritional status of children and adults. CLASS 8 The Role of Environmental Exposures such as PCBs and Endocrine Disruptors and Child Obesity Leonardo Transande MD, MPH Associate Professor of Population Health, Environmental Medicine and Pediatrics, the NYU School of Medicine and Associate Professor at The Wagner School There is increasing concern that childhood exposure to a large number of manmade substances, such as PCBs, Endocrine Disruptors, and Phthalates are significantly contributing to the obesity epidemic. Similarly, there is concern 3

practices. It also addresses the use of research to support the development and implementation of current policies and regulations.

4 about the potential role of altered bacterial flora and early exposure to antibiotics in this global epidemic. These issues will be the focus of this class. CLASS 9 Environmental exposures and asthma in children Thomas Matte MD, MPH, Assistant Commissioner for Environmental Surveillance and Policy, NYC Department of Health and Mental Hygiene. About one in eight New York City children have asthma, which is a common cause of school absence, emergency department visits and hospital admission. This class will consider pediatric asthma variation by time, place, and demographic characteristics, how a range of environmental factors in the home and community environment influence asthma in individuals and how these same factors relate to the descriptive epidemiology of asthma. Dr. Matte is an environmental epidemiologist with more than 25 years of experience in public health practice and research with the CDC and the New York City Health Department. CLASS 10 Prenatal Exposures and Child and Adult Disease Judith Zelikoff PhD, Professor of Environmental Medicine, The NYU School of Medicine This class will focus on the mounting evidence that prenatal exposures to such agents as mercury, PCBs, BPA and tobacco have long-term effects on child and adult health. Even malnutrition in pregnancy and being born small for gestational age have been linked to later overweight and risk of Diabetes. Moreover, there is growing concern that prenatal exposures are tied to increasing rates of congenital malformations of the penis, autism, and the earlier onset of puberty in girls. Similarly, prenatal exposure to varying intensities and types of stress result in lifelong or even multigenerational changes in health and function. Dr. Zelikoff is a highly accomplished environmental scientist who has made significant contributions in this area. CLASS 11 Children s Prenatal and Secondhand Smoke Exposure, and the Emergence of Alternative Tobacco Products such as Water Pipes and E- Cigarettes Michael Weitzman MD 4

About one in eight New York City children have asthma, which is a common cause of school absence, emergency department visits and hospital admission.

5 It is only in the past 25 years that a robust research literature has emerged on the effects of prenatal tobacco and secondhand smoke on child health, and this class will cover the role of prenatal tobacco and childhood secondhand smoke exposure and asthma, Sudden Infant Death Syndrome, recurrent ear infections, tooth decay, the Metabolic Syndrome, sensorineural hearing loss, and child and family mental health and child development. It also will cover the emerging worldwide epidemic of use of alternative tobacco and nicotine products, such as water-pipes and e- cigarettes, that threaten the health and longevity of literally hundreds of millions of individuals. CLASS 12 Community Participatory Environmental Health Research Beverly Xaviera Watkins, PhD This class builds on the class on ethical issues by expanding the discussion of the need for community participation in environmental health research conducted in their communities, and will use as an example housing related research involving the elderly in Chinatown and the Lower East side, aimed at improving energy efficiency and protecting the elderly from untoward exposure to heat and cold in their homes. Dr. Watkins in the principal investigator on this NIEHS funded study. CLASS 14 Putting It All Together: Children s Environmental Health Today and Tomorrow Michael Weitzman MD This class will synthesize materials presented over the course of the semester as well as briefly discuss emerging issues and controversies, and the overlap of environmental health, public health and clinical medicine. REQUIREMENTS: Students are expected to attend all classes, complete the assigned readings before class meets each week, participate in class discussions on a regular basis, and produce a term paper. 5

family mental health and child development.

6 FOR FURTHER INFORMATION: Contact Dr. Weitzman at

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