NIEHS/EPA Children’s Environmental Health 

and Disease Prevention Research Centers:

Protecting Children’s Health for a Lifetime

National Institutes of Health • U.S. Department of Health and Human Services
Protecting Children’s Health

We all want our children to thrive and grow into a healthy and productive adult population. 

Since 1998, the NIEHS/EPA Children’s Environmental Health and Disease Prevention Research 

Centers (Children’s Centers) have studied individual, regional, national, and global environmental 

exposures and children’s health. Contributions from this unique coordinated national network 

of research centers are leading to long-term economic and social benefits, along with 

improved health.

Advancing Research Through Collaboration and Training

The Children’s Centers connect basic scientists, social scientists, pediatricians, public health 

professionals, and community organizations, all working together to improve the health and 

environments of children. To keep breakthrough discoveries coming and maintain a pipeline 

of experienced environmental health scientists, the Children’s Centers are also dedicated to 

developing the next generation of researchers.

What We’ve Learned: A Good Start Lasts a Lifetime

Pound for pound, children have increased risks from environmental exposures, because their 

bodily systems — cardiovascular, digestive, immune, nervous, and others — are still developing. 

Environmental health researchers now recognize that low level exposures, especially during 

early developmental growth periods, such as in utero or neonatal, can have long-lasting effects. 

This research evolution demonstrates that environmental health effects are complex — not 

a simple relationship between a particular type and amount of exposure and disease. New 

science shows that combined chemical exposures affect growth and development 

in ways not previously recognized.

All Children’s Centers produce important insights about children’s health and social conditions. 

Examples provided represent some of the work but don’t tell the whole story. More information 

on the research and findings can be found on the EPA and NIEHS websites.

Pregnancy and Birth Outcomes

An adverse pregnancy outcome is an event that reduces the chance of having a healthy baby, 

such as miscarriage, pre term birth, or impaired fetal growth. Nearly a half million babies — 

one out of every nine — are born premature and too small, costing the U.S. health care system 

more than $26 billion a year. 1

n Low birth weight in infants is linked to exposures to low-level arsenic during pregnancy. 2

n	Low thyroid-stimulating hormone levels during pregnancy, in both the mother and baby, 

are associated with exposure to polybrominated diphenyl ethers (PBDEs), commonly used 

as flame retardants.3

 Thyroid hormones regulate metabolism, and are critical to normal 

development of the baby’s brain and nervous system.

Epidemiologic literature also suggests associations of prenatal exposures to heavy metals, 

including mercury, lead, and arsenic, with increased risk for brain damage, neurodevelopmental 

problems, congenital malformations, and miscarriage. 

M I S S I O N :

Jointly funded by 

the National Institute 

of Environmental Health 

Sciences (NIEHS) and the 

U.S. Environmental 

Protection Agency (EPA), 

the mission of the 

Children’s Centers is to 

reduce health risks, protect 

children from environmental 

threats, and promote their 

health and well-being in the 

communities where they live, 

learn, and play. Beginning 

with passage in 1997 of 

Executive Order 13045, 

Protection of Children From 

Environmental Health Risks 

and Safety Risks, our activities 

and research have increased 

scientific knowledge of 

children’s environmental 

health from preconception 

to young adulthood.

 Children’s Centers:

Previous and current institutions that have contributed to improving our understanding of children’s environmental health through this include:

Brown University

Cincinnati Children’s Hospital

 Medical Center

Columbia University

Dartmouth College

Duke University

Harvard University

Johns Hopkins University

Icahn School of Medicine 

 at Mount Sinai

National Jewish Health

University of California, Berkeley

University of California, Davis

University of California, 

 San Francisco

University of Illinois

University of Iowa

University of Medicine and 

 Dentistry of New Jersey

University of Michigan

University of Southern California

University of Washington
Neurodevelopmental and Neurobehavioral Disorders

Over the last 12 years, the prevalence of all developmental disabilities increased 17 percent, 

with the prevalence of learning disabilities found to be 7.6 percent from 1997-2008.4 

The Children’s Centers are conducting research to assess how a wide range of chemicals, 

including certain pesticides; air pollutants, such as polycyclic aromatic hydrocarbons (PAHs); 

and metals, such as lead, mercury, and manganese; lead to learning and behavioral deficits. 

Researchers have also discovered that prenatal exposures, not just those that occur after birth, 

lead to neurological deficits in children.

n High prenatal PAH exposure is associated with a lower mental development index score at 

age 3 (Bayley Scale) and with increased odds of cognitive developmental delay. 5 In children 

6-7, high PAH exposure was associated with symptoms of anxiety, depression, and 

attention problems.6

n Women with higher phthalate exposures during pregnancy report more disruptive 

behaviors in their children. 7 Phthalates are chemical compounds used in many plastics 

and some personal care products.

n Children exposed prenatally to high levels of chlorpyrifos, a pesticide, show both enlargement 

and thinning of certain brain areas, and have lower intelligence testing scores.8

Asthma

One in 11 children has asthma, an inflammatory lung disease. Asthma prevalence more than 

doubled over the past two decades, especially among urban populations, and cost the 

U.S. $56 billion annually, with a yearly cost of more than $1,000 for a child with the disease.11

Discovering asthma triggers will help development of prevention strategies. For example, in 

the past decade, several researchers, have found that living near dense traffic is associated with 

asthma or long-lasting problems with lung function in children.

n Specifically, diesel soot particulate matter is the component of air pollution most 

responsible for several respiratory problems among inner-city children.12

n Children living in moldy homes are three times more likely to develop asthma 

by age 7.13

n Early childhood exposure to the chemical bisphenyl A (BPA) is associated with 

an elevated risk for asthma in young children.14

What We Want to Learn Next

New and often interconnected areas of research to be addressed include:

n Obesity: What is the role of environmental factors in the epidemic of childhood obesity?

n Endocrine Disrupting Chemicals: How are widespread exposures to these chemicals 

affecting children, particularly during vulnerable windows of development?

n Epigenetics: How do modifications to DNA, resulting from diet, aging, stress and 

environmental exposures, affect our children or our grandchildren?

n Microbiome: How do helpful microorganisms in the gastrointestinal tract affect children’s 

health? How is the microbiome affected by environmental exposures, including diet, 

antibiotic use, and chemicals?

n Immune System: What is the role of environmental triggers in autoimmune diseases? 

How do early life exposures affect immune responses?

n Cumulative Exposures: Recognizing that people are not exposed to one chemical at 

a time and are exposed to many chemicals over time, how can assessment be improved?

Environment and Autism 

Risk: More Than Genetics

The prevalence of autism increased 

289.5 percent over the last 12 years.9

Autism is a developmental disorder 

long attributed to genetic factors. 

While changes in diagnostic criteria 

and increased awareness have been 

thought to contribute to the rising 

incidence of the disorder, these 

factors alone cannot explain the 

dramatic increase in the number 

of children affected. 

Researchers have found evidence 

that links certain environmental 

exposures with autism risk. For 

example, living near a freeway 

may be associated with increased 

risk of autism, according to a 

study by a team from the 

Children’s Hospital Los Angeles, 

University of Southern California, 

and University of California, Davis.10

Researchers are investigating 

chemicals in air pollution, 

such as PAHs, that may affect 

neurodevelopment and contribute 

to autism risk. Further research is 

needed to understand potential 

gene-exposure interactions and to 

identify autism prevention strategies. 

Childhood Leukemia 

and Benzene

Leukemia is the most common 

type of childhood cancer, placing 

considerable stress and financial 

burden on affected families. 

Environmental causes of childhood 

cancer, although long suspected, 

are difficult to pin down. But, in a 

breakthrough discovery, benzene, 

known to be a human carcinogen, 

was linked to leukemia by the 

University of California, Berkeley. 

Benzene’s association with childhood 

leukemia stems from its toxicity to 

certain cells. Researchers say there 

is probably no safe level of exposure 

to benzene, and all exposures 

constitute some risk.15
Community Engagement is Essential

Many parents are eager to learn about simple steps they can take to minimize harmful exposures 

for their children. To this end, the Children’s Centers apply community-based participatory research 

techniques, in which community partners play a vital role in informing, implementing, and sharing 

what the findings mean. Additionally, each center has a designated physician-scientist to ensure 

research is translated into practical information for health care providers. 

Policy Advances Based on Science

Concerns about the health effects of hazardous environmental exposures have led to federal 

and local policies designed to inform and protect the public. 

n	Nationally, the Mercury and Air Toxics Standards limit air pollutants emitted from utilities. 

This policy will help avoid 130,000 asthma attacks every year.16

n	In New York City, the passage of two landmark bills in 2005 was bolstered by the testimony 

of Columbia University researchers, who linked smaller birth size and prenatal pesticide exposure. 

The bills reduce exposure to certain pesticides through better notification and a reinforced 

commitment to adopting integrated pest management strategies.

n	In any locality, reduction in children’s air pollution exposures can be achieved by considering 

local ]traffic volume, not just regional air quality, when siting schools, sports fields, or new 

homes.18 Some jurisdictions have called for less idling in school bus operations, as a way 

to reduce diesel fume exposures at minimal cost.

For More Information

NIEHS: http://www.niehs.nih.gov/research/supported/dert/sphb/programs/prevention/index.cfm

EPA: http://epa.gov/ncer/childrenscenters

Watch past and upcoming webinars at http://epa.gov/ncer/childrenscenters/multimedia/index.html

1 CDC (Centers for Disease Control and Prevention). 2013. Reproductive Health. Available: http://www.cdc.gov/reproductivehealth/MaternalInfantHealth/PretermBirth.htm [accessed 30 September 2013].

2 Fei DL, Koestler DC, Li Z, Giambelli C, Sanchez-Mejias A, Gosse JA, Marsit CJ, Karagas MR, Robbins DJ. 2013. Association between in utero arsenic exposure, placental gene expression, and infant birth weight: 

 a U.S. birth cohort study. Environmental Health 12:58. 

3 Chevrier J, Harley KG, Bradman A, Gharbi M, Sjodin A, Eskenazi B. 2010. Polybrominated diphenyl ether (PBDE) flame retardants and thyroid hormone during pregnancy. Environ Health Perspect 118(10):1444-1449.

4 CDC (Centers for Disease Control and Prevention). 2011. CDC Developmental Disabilities Increasing in U.S. Available: http://www.cdc.gov/features/dsdev_disabilities [accessed 30 September 2013]. 

5 Perera FP, Rauh V, Whyatt RM, Tsai WY, Tang D, Diaz D, Hoepner L, Barr D, Tu YH, Camann D, Kinney P. 2006. Effect of prenatal exposure to airborne polycyclic aromatic hydrocarbons on neurodevelopment in the first 3 years 

 of life among inner-city children. Environ Health Perspect 114(8):1287-1292.

6 Perera FP, Tang D, Wang S, Vishnevetsky J, Zhang B, Diaz D, Camann D, Rauh V. 2012. Prenatal polycyclic aromatic hydrocarbon (PAH) exposure and child behavior at age 6-7 years. Environ Health Perspect 120(6):921-926.

7 Engel SM, Miodovnik A, Canfield RL, Zhu C, Silva MJ, Calafat AM, Wolff MS. 2010. Prenatal phthalate exposure is associated with childhood behavior and executive functioning. Environ Health Perspect 118(4):565-571.

8 Rauh VA, Perera FP, Horton MK, Whyatt RM, Bansal R, Hao X, Liu J, Barr DB, Slotkin TA, Peterson BS. 2012. Brain anomalies in children exposed prenatally to a common organophosphate pesticide. Proc Natl Acad Sci U S A 

 109(20):7871-7876.

9 CDC (Centers for Disease Control and Prevention). 2012. Autism Spectrum Disorders: Data & Statistics. Available: http://www.cdc.gov/ncbddd/autism/data.html [accessed 30 September 2013].

10 Volk HE, Hertz-Picciotto I, Delwiche L, Lurmann F, McConnell R. 2011. Residential proximity to freeways and autism in the CHARGE study. Environ Health Perspect 119(6):873-877.

11 CDC (Centers for Disease Control and Prevention). 2010. Asthma’s Impact on the Nation. Available: http://www.cdc.gov/asthma/impacts_nation/asthmafactsheet.pdf [accessed 30 September 2013].

12 Spira-Cohen A, Chen LC, Kendall M, Lall R, Thurston GD. 2011. Personal exposures to traffic-related air pollution and acute respiratory health among Bronx schoolchildren with asthma. 2011. Environ Health Perspect 

 119(4):559-565. 

13 Reponen T, Vesper S, Levin L, Johansson E, Ryan P, Burkle J, Grinshpun SA, Zheng S, Bernstein DI, Lockey J, Villareal M, Khurana Hershey GK, LeMasters G. 2011. High environmental relative moldiness index during infancy 

 as a predictor of asthma at 7 years of age. Ann Allergy Asthma Immunol 107(2):120-126. 

14Donohue KM, Miller RL, Perzanowski MS, Just AC, Hoepner LA, Arunajadai S, Canfield S, Resnick D, Calafat AM, Perera FP, Whyatt RM. 2013. Prenatal and postnatal bisphenol A exposure and asthma development among 

 inner-city children. J Allergy Clin Immunol 131(3):736-742.

15 Smith MT. 2010. Advances in understanding benzene health effects and susceptibility. Annu Rev Public Health 31:133-148.

16 EPA (Environmental Protection Agency). 2013. America’s Children and the Environment, Third Edition. Available: http://www.epa.gov/ace/publications/ACE3_2013.pdf [accessed 30 September 2013]. 

17Gilliland FD. 2009. Outdoor air pollution, genetic susceptibility, and asthma management: opportunities for intervention to reduce the burden of asthma. Pediatrics 123 Suppl 3:S168-S173.

Contacts

NIEHS

Kimberly Gray, Ph.D. 

Health Scientist Administrator

Division of Extramural 

Research and Training 

gray6@niehs.nih.gov

EPA

Richard Callan, M.P.H. 

Environmental Health Scientist

National Center for 

Environmental Research

callan.richard@epa.gov

Nica Louie, M.S. 

Environmental Scientist 

National Center for 

Environmental Research

louie.nica@epa.gov

National Institutes of Health

U.S. Department of Health and Human Services

NIEHS: 111 TW Alexander Drive, PO Box 12233, 

Research Triangle Park, NC 27709

919-541-3345

www.niehs.nih.gov

USEPA: 1200 Pennsylvania Avenue NW

Mail Code 8723P, Washington, D.C. 20460 

703-347-8051 or 703-347-8125

www.epa.gov/ncer

Printed on 30% post-consumer 

content using soy-based inks

October 2013