Children’s Environmental Health: A Systems Approach

ABSTRACT: There is increasing public awareness and concern around the prevalence of children’s health outcomes, and a desire to understand the potential role of chemical exposures on those outcomes. Recent high visibility research publications have identified associations between chemical exposures and risk of diseases, including asthma, autism spectrum disorder, and childhood obesity. To date, research in this area has been limited and the complexity of exposures, disease etiology, and health outcomes make it difficult to evaluate and interpret reported associations.

Understanding the health effects of exposures to chemicals has real implications for public health. The traditional chemical assessment paradigm evaluates risks from exposures to individual or groups of chemicals based on properties of those chemicals. Clearly, removing chemical/pollution stressors is a necessary and essential component of children’s health protection. However, this approach rarely enables policy makers to link increased risk of specific diseases or public health outcomes to chemical management actions. Community planning and development decisions are designed from the holistic perspective of both minimizing risks while at the same time providing an environment that supports and promotes healthy child development. To inform these decisions, information is required on the health impacts of multiple factors in the built and natural environment that contribute to children’s health, and the relative importance of each.

To support the full range of public health objectives and ensure sustainable decisions on chemicals, novel approaches are required to incorporate critical elements of complexity and to compare alternatives and evaluate outcomes. Systems thinking refers to a discipline that examines the relationships between essential parts of a problem, and determines how to manage those relationships to get better outcomes. In this way, decisions can be evaluated in the larger context and potential consequences anticipated. A systems-based approach is presented to conceptually link the source-to-dose framework with the adverse-outcome-pathway (AOP) framework and enable integration of information that supports holistic evaluation of the interactions that deter­mine health impacts. The goal is to extend the scope of considerations that support sustainable chemical management decisions and advance the tools for integrating this more complex information.

BRIEF BIO: Elaine Cohen Hubal has over 25 years of experience in the field of environmental health with broad scientific background in environmental science, human exposure, and chemical safety evaluation. Her primary research interests are in understanding complex systems at the nexus of the natural environment, built environment, and human health with an emphasis on impacts to vulnerable populations and life stages. Dr. Cohen Hubal is the Editor-in-Chief for the Journal of Exposure Science and Environmental Epidemiology. She has also served in a series of science leadership positions in EPA’s Office of Research and Development where she currently works as a Senior Science Advisor in EPA’s National Exposure Research Laboratory. In this capacity, Dr. Cohen Hubal leads the NERL research efforts to build predictive models for Per- and polyfluoroalkyl substances (PFAS). She is also focused on translating EPA exposure information and tools for use by multiple sectors to generate new insights, and working with stakeholders in government, industry and academia to access and apply EPA information and tools to inform decisions on chemicals and products. Previously, she served as Deputy National Program Director for EPA’s Chemical Safety for Sustainability research program. She also served as Acting Director of the Integrated Systems Toxicology and as Acting Director of the Computational Exposure Division. Dr. Cohen Hubal has served as an expert on a variety of scientific panels and committees including the Voluntary Children’s Chemical Evaluation Program (VCCEP) Peer Consultation, the Study Design Working Group for the NCS, and as chair of the WHO IPCS working group on “Identifying Important Life Stages for Monitoring and Assessing Risks from Exposures to Environmental Contaminants.” Currently, she is a core member of the Health Canada and Environment Canada Chemicals Management Plan Science Committee, and is a Member of the California Department of Toxic Substances Control’s Green Ribbon Science Panel. Dr. Cohen Hubal received her Ph.D. and M.S. in Chemical Engineering from North Carolina State University, and a S.B. in Chemical Engineering from Massachusetts Institute of Technology.