Perinatal Environmental Health
The COEC is involved in a number of community and research projects to increase and evaluate perinatal environmental health. A brief description of these efforts is below; please contact the COEC to learn more.
The COEC focuses on outreach, education, and prevention. For clinical concerns about environmental exposures before or during pregnancy, call Dr. Richard Miller with the Perinatal Environmental and Drug Consultation Service at (585) 275-3839.
Environmental Risks and Children's Health
The COEC partnered with Dr. Ann Dozier of the University of Rochester’s Department of Public Health Sciences. Dr. Dozier included several environmental health questions in local implementation of the Perinatal Risk Assessment and Monitoring System (PRAMS) survey. They found that PRAMS has great potential for monitoring environmental health knowledge, but that existing PRAMS environmental health questions are inadequate. They also found that providers do not effectively educate pregnant women about environmental health. This project was supported by a mini-pilot grant from the Integrative Health Sciences Facility Core.
Korfmacher, Katrina Smith, Barbara J. Suter, Xueya Cai, Susan A. Brownson, and Ann M. Dozier. "Environmental Risks and Children’s Health: What can PRAMS Tell Us?" Maternal and Child Health Journal (2013): 1-14.
Environmental Health in Group Pregnancy Care
Reflecting the work of EHSC researchers on prenatal environmental exposures, the COEC has increasingly focused on outreach to pregnant women and prenatal health care providers. These projects involve developing environmental health education messages for pregnant women, provider outreach to increase discussion of these topics, and piloting innovative ways of delivering these messages through group prenatal visits.
Group prenatal care is rapidly expanding in the Rochester area. Prenatal groups provide more extensive discussion of health, well-being, and prevention than can be included in short individual visits. This provides an opportunity for group visit facilitators to introduce environmental health topics. We developed discussion guides to help group facilitators incorporate discussions of lead and asthma triggers into their prenatal groups. We also developed a hands-on asthma activity kit to help guide group discussions about identifying and controlling common asthma triggers in the home; the kit includes a description of the items and how they relate to asthma. The kit includes additional visual aids for topics that may be brought up by participants.
Draft Group Facilitation Guide
Draft Asthma Activity Kit Description
periFACTS® Lead Case (2014)
The periFACTS® OB/GYN Academy offers a wide range of continuing education credit courses for doctors, nursing staff and midwives. Based at University of Rochester, this fee-based service offers additional resources such as reference books, videos and fetal monitoring resources. In 2014, periFACTS® included a case featuring an update on research on the impacts of lead during pregnancy, authored by COEC staff. This summary highlighted research conducted by Dr. Cory-Slechta’s lab, among others. After a year, this case is now available free of charge:
Case 1108 - Perinatal Environmental Health Focusing on Lead: Discussion, Clinical Case Study, and Fetal Heart Rate Interpretation
Perinatal Environmental Health Literacy
Dr. Shaw-Ree Chen partnered with Dr. Bernard Weiss in 2012 to interview pregnant women about their motivations for healthy behaviors during pregnancy and knowledge about common environmental hazards. They focused on endocrine disrupting chemicals (EDCs) in particular. EDCs such as Bisphenol-A (BPA) and phthalates are ubiquitous in the environment; a growing body of research indicates EDCs may adversely affect human development. Their results suggested that detailed and comprehensive education about the potential health effects of EDCs is needed in order for women to conduct their own risk assessment and inform their behaviors.
One finding from the Weiss and Chen study suggested that because EDCs are so prevalent in the environment, participants believed their exposure could not be influenced by personal behaviors. Several dietary intervention studies in high exposure groups (for example, individuals who ate a lot of canned foods), have suggested that dietary changes could reduce exposure. However, there is little information about the effectiveness of dietary intervention in women with average diets. Dr. Chen and Dr. Emily Barrett conducted a pilot study to explore whether a dietary intervention consisting of fresh foods can reduce levels of phthalate metabolites. Importantly, the team also assessed women's willingness to follow such a diet. Their results suggested that for many women, phthalate exposure is not reduced by eating fresh foods rather than their normal diet. The study also revealed that most women were unwilling to change their diet in the long-term. Although further studies are warranted, such a result suggests that recommendations to eat fresh foods in order to reduce exposure to phthalates are not a simple solution, particularly for women who are not in high-exposure groups.
In 2013, Dr. Chen partnered with Dr. Marti Lindsey (University of Arizona COEC Director) on a collaborative administrative supplement “Defining Environmental Health Literacy” to conduct a mixed method study aimed to identify skills and knowledge that are needed for an individual's Environmental Health Literacy (EHL). Although this study did not focus on women, the results may help inform environmental health outreach to pregnant women in addition to informing the development of a measure of EHL.
Administrators of the NIH-funded junior faculty training program, Women's Health over the Entire Lifespan (WHEEL), include several EHSC faculty members. The program hosts annual workshops that "provide a forum for experts and new investigators to share research results that explore the biological basis for gender differences in health and disease." The COEC has helped moderate, evaluate and recruit participants since the first meeting, Researching Women's Environmental Health, in 2010. Dr. Shaw-Ree Chen also produced a Workshop Report for the 2010 event.