2004 Progress Report: Markers of Individual Susceptibility and Outcome Related to Fetal and Infant Growth and Development

EPA Grant Number: R830827
Title: Markers of Individual Susceptibility and Outcome Related to Fetal and Infant Growth and Development
Investigators: Berkowitz, Gertrud S. , Canfield, Richard L , Engel, Stephanie M. , Wetmur, James G. , Wolff, Mary S. , Yehuda, Rachel
Current Investigators: Wolff, Mary S. , Berkowitz, Gertrud S. , Canfield, Richard L , Engel, Stephanie M. , Wetmur, James G. , Yehuda, Rachel
Institution: Mount Sinai School of Medicine
EPA Project Officer: Hahn, Intaek
Project Period: August 1, 2002 through July 31, 2005 (Extended to July 31, 2006)
Project Period Covered by this Report: August 1, 2003 through July 31, 2004
Project Amount: $748,512
RFA: Biomarkers for the Assessment of Exposure and Toxicity in Children (2002) RFA Text |  Recipients Lists
Research Category: Children's Health , Health Effects , Human Health , Health


The fire and collapse of the World Trade Center (WTC) was the largest acute environmental disaster that has ever befallen New York City. The objective of this research project is to evaluate whether exposures to the resulting toxicants or the associated stress are related to impaired fetal growth or other adverse pregnancy outcomes. To accomplish this objective, we established a prospective epidemiologic study of 187 women who were pregnant and within or near the WTC on or about September 11, 2001.

Progress Summary:

Baseline assessments were completed on 187 women, 2 of which were lost to followup and 3 miscarried, leaving 182 women eligible to continue the study protocol. An integral component of this project was the creation of a specimen bank for assessment of biological markers of exposure and for genotyping of selected polymorphisms. Maternal blood and urine were obtained as well as a sample of breast milk, if available, at the time of the baseline visit. The participants also completed four psychological screening instruments to determine levels of post-traumatic stress and depression following the WTC attacks. At the 1-year anniversary of the 9/11 attacks, mothers were mailed a second set of psychological screening instruments, which included two additional trauma history screening instruments.

We completed neurodevelopmental assessments on 159 infants when they were 9 months of age. The 9-month interview included questionnaires, infant buccal cells for genotyping, and saliva collection. A manuscript describing the relationships between maternal post-traumatic stress and infant development is in revision, and another paper on maternal and infant cortisol levels and their association with this disorder has just been submitted.

We also have completed follow-up neurodevelopmental assessments on 132 children at 2 years of age. The assessments included questionnaires about the children’s health and environment, urine collection, and a third set of psychological screening instruments.

A paper describing the environmental exposure data is in press and available on the Environmental Health Perspectives Web Site. This paper describes maternal dust exposures in the month after 9/11, based on an elaborate WTC-plume reconstruction performed by colleagues at University of Medicine and Dentistry of New Jersey, combined with detailed diary information provided by each participant, on each day’s location in the first month after 9/11. In addition, biologic markers of exposure, measured for 80 specific chemicals, also are described in the paper.

We previously reported that the WTC cohort had a two-fold increased risk of small-for-gestational age (SGA) infants. SGA is a potential marker for intrauterine growth restriction, which has been linked to maternal exposures to particulate air pollution. Other investigations have linked air pollution to preterm births. Prenatal exposure to cigarette smoke, which contains polycyclic aromatic hydrocarbons (PAH) and other toxins, is a well-established risk factor for SGA. Thus, it is possible that prenatal exposures to particulates as well as to PAH at the WTC impair fetal growth, although we have not made this link directly. The long-term effects of these exposures on infant development are unknown and will be evaluated during continuing prospective followup.

Future Activities:

We are finishing the 2-year follow-up evaluations of the infants that include assessment of childhood growth, the Bayley Scales of Infant Development, a brief follow-up questionnaire, and the Home Inventory (which assesses the quality of the home environment and parent/child interaction). We also are collecting infant urine at this visit. We have begun the 3-year follow-up visit with the same assessments as the 2-year follow-up.

A control group of 9-month old infants currently is being recruited. The control group is being recruited from two private pediatric groups near Mount Sinai Medical Center. The sociodemographic characteristics of the mothers of these infants appear to be similar to those of the WTC mothers. The same questionnaires, stress instruments, growth assessments, and neurodevelopment tests will be administered.

We will complete the 3-year assessments for the WTC cohort, and the 2-year assessments for the control group. Additional data analyses are ongoing, including the examination of the exposure biomarker data with respect to pregnancy; the examination of longitudinal psychopathology among the women exposed to the WTC; and the examination of the relationship between exposure and developmental and behavioral outcomes at 9-months and 2-years of age.

Journal Articles on this Report : 3 Displayed | Download in RIS Format

Other project views: All 27 publications 6 publications in selected types All 6 journal articles
Type Citation Project Document Sources
Journal Article Berkowitz GS, Wolff MS, Janevic TM, Holzman IR, Yehuda R, Landrigan PJ. The World Trade Center disaster and intrauterine growth restriction. Journal of the American Medical Association 2003;290(5):595-596. R830827 (2003)
R830827 (2004)
R830827 (Final)
  • Abstract from PubMed
  • Full-text: JAMA-Full Text HTML
  • Other: SemanticsScholar-Full Text PDF
  • Journal Article Landrigan PJ, Lioy PJ, Thurston G, Berkowitz G, Chen LC, Chillrud SN, Gavett SH, Georgopoulos PG, Geyh AS, Levin S, Perera F, Rappaport SM, Small C, NIEHS World Trade Center Working Group. Health and environmental consequences of the World Trade Center disaster. Environmental Health Perspectives 2004;112(6):731-739. R830827 (2004)
    R830827 (Final)
    R827351 (2003)
    R827351 (Final)
    R831711 (2007)
    R831711C002 (2004)
    R832141 (2005)
    R832141 (2007)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Journal Article Wolff MS, Teitelbaum SL, Lioy PJ, Santella RM, Wang RY, Jones RL, Caldwell KL, Sjodin A, Turner WE, Li W, Georgopoulos P, Berkowitz GS. Exposures among pregnant women near the World Trade Center site on 11 September 2001. Environmental Health Perspectives 2005;113(6):739-748. R830827 (2004)
    R830827 (Final)
    R831711 (2005)
    R831711 (2007)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Supplemental Keywords:

    exposure, effects, infants, children, polymorphisms, toxicants, particulates, PAH, psychological, epidemiology, genetics, New York, NY, toxics, infant growth, infant neurodevelopment, genetic polymorphisms, disasters, in utero, exposure assessment, biomarker, prenatal exposure, in utero exposure, pregnant women, World Trade Center, WTC, 9/11, cortisol, buccal cells, neurodevelopmental assessment,, RFA, Health, Scientific Discipline, ENVIRONMENTAL MANAGEMENT, Environmental Chemistry, Health Risk Assessment, Risk Assessments, Susceptibility/Sensitive Population/Genetic Susceptibility, Biochemistry, Children's Health, genetic susceptability, Risk Assessment, environmental triggers, health effects, adolescence, infants, exposure, genetic predisposition, airway disease, endocrine disrupting chemicals, air pollution, children, Human Health Risk Assessment, assessment of exposure, growth and development, childhood respiratory disease, children's vulnerablity, stress, human exposure, children's environmental health, human susceptibility, harmful environmental agents, biomarker

    Relevant Websites:

    http://www.mssm.edu/cpm/superfund/wtc_supp.shtml Exit

    Progress and Final Reports:

    Original Abstract
  • 2003 Progress Report
  • 2005
  • Final Report