Accelerating Research on Chemical Exposures and Child Health Outcomes through ECHO: An Overview

Abstract

Background: The Environmental Influences on Child Health Outcomes (ECHO) program is a seven-year U.S. National Institutes of Health initiative launched in 2016 to advance knowledge of the effects of a broad range of environmental exposures on child health and development.Objective: To provide an overview of the ECHO program as it relates to understanding relationships between early life chemical exposures and child health outcomes.Methods: We overview ongoing efforts related to chemical exposures and child health outcomes in ECHO by describing existing chemical exposure information and plans for new data collection.Results: ECHO’s observational component leverages data from 84 extant longitudinal cohorts with more than 50,000 children from diverse backgrounds across 44 states, Puerto Rico, and the District of Columbia. The earliest cohort enrolled participants beginning in the 1980s while others have ongoing enrollment. Most cohorts began recruitment during gestation and all cohorts follow children longitudinally and collect biospecimens. ECHO includes working groups dedicated to chemical exposures as well as five outcome focus areas: 1) pre-, peri- and postnatal outcomes; 2) obesity and its consequences; 3) upper and lower airway conditions; 4) neurodevelopment; and 5) positive health. Existing chemical exposures data already collected by some ECHO cohorts includes chemical biomonitoring data, estimates of outdoor air pollution or geographic proxies of air pollution, environmental or personal exposure monitoring, and questionnaire data. In addition, all ECHO cohorts will contribute certain existing and new data as part of the ECHO-wide Cohort data collection protocol, including biospecimens and exposure questionnaires at key life stages of development.Conclusion: By combining rich, longitudinal data with team science approaches, ECHO will accelerate novel and policy-oriented research to address complex environmental health questions.