Impact of environmental chemicals studied

Impact of environmental chemicals studied

From left to right are Celeste Seguin and her 10-month-old baby, Naomi, with Dr. Paul Fredette, principal investigator of the study for the Sudbury site, and Barbara Ward, director, Medicor Research Inc., co-ordinating centre of the study. Celeste was one of the first Sudbury participants in the study.

Sudbury is one of eleven sites across Canada participating in a five-year academic research study to help reduce the levels of chemicals affecting the environment and human health.This proactive Health Canada study called MIREC, short for Maternal-Infant Research on Environmental Chemicals – a national profile of in utero and lactational exposure to environmental contaminants, began in 2007 and has a projected completion date of 2012.  The study is part of the federal government’s Chemicals Management Plan, launched in December 2006 to reduce the impact of environmental chemicals on human health and the environment.

The three main objectives are to measure the extent to which pregnant women and their infants are exposed to chemicals; to measure some of the beneficial elements in human breast milk; and to assess what health risks are associated with the chemical levels measured, especially heavy metals such as lead and mercury.

Co-principal investigators are Dr. Tye Arbuckle, senior epidemiologist and research scientist, Health Canada, and Dr. William Fraser, chair, Department of Obstetrics and Gynecology, University of Montreal and Associate Director of the CHU Sainte-Justine Research Centre in Montreal.

The study is designed to address the limited Canadian information about how environmental chemicals affect pregnant women and their babies. Data obtained will help determine acceptable levels of exposure to environmental chemicals.
Dr. Paul Fredette, family physician and principal investigator for the Sudbury site, said the study is looking at organics, inorganics and genetic data.

“The list of elements being tested is very long and it covers a full breadth of environmental contaminants,” he said.
In addition to testing for chemicals possibly found in food, water, air or on cooking surfaces, vitamin D levels are also being tested.

Barbara Ward, director of Medicor Research Inc. and co-ordinator for the Sudbury site, said the genetic component will examine how exposure levels affect different ethnicities.

Funded by Health Canada, the Canadian Institutes of Health Research and the Ontario Ministry of the Environment, the study is recruiting approximately 2,000 women from cities across Canada, including Sudbury. As of late May, it had
reached its thousandth participant.

Criteria

Participants are women 18 years-of-age and older and less than 13 weeks pregnant, who plan to deliver their baby in one of the study sites.

Sudbury accepted its 89th participant in late May and has a target of 200 participants. Celeste Seguin and her baby-girl, Naomi, were among the first patients to participate when Sudbury began the study in late 2008. For Seguin, the study was her contribution to medical research and finding answers to various childhood disorders.

“It was very personal for me,” she said. “I have an older son diagnosed with autism and, given that they don’t know where it comes from, this might be a step in that direction.”

Seguin said she enjoyed working with the people at Medicor Research and would highly recommend the study.

“It puts things into perspective about what you are putting into your body and what you are exposing yourself to. I am a healthy person, and I do monitor what I put into my body, but it was even more obvious when it is on paper asking specific questions,” she said.

There are six points of contact with the participants. The first three visits occur every trimester, during which blood and urine samples are taken and a questionnaire is filled out. The fourth and fifth visits are in the hospital at the time of delivery. Samples of maternal urine and blood, and umbilical cord blood are taken. About two days postpartum, a sample of the baby’s meconium (first stool) is taken.

The last visit occurs at home two to eight weeks post partum, at which time a sample of the mother’s hair and some breast milk is required. Mothers receive a free Medela breast pump, along with a MIREC hat and bracelet.

In Sudbury, the study will wrap up recruitment in December of this year. Participants will then be followed for 10 months.
Recruitment

One of the biggest challenges to date has been recruitment because of the low funding levels. Fredette and Ward explain that funds primarily go toward manpower for staffing and laboratory fees, and not for promotion.

“Testing for metals is very specialized,” Ward said, explaining that the processed samples go to a central laboratory in Quebec.

Fredette said it is a big commitment on the part of the patient to go to three visits, and that some patients don’t like blood work done. Another challenge is increasing awareness and educating health-care providers about the study. Despite his and Ward’s effort to educate midwives and other health-care providers, many have shunned the study because it was believed that a pharmaceutical company was pushing it.

“It is purely academic research,” with the Northern Ontario School of Medicine as the managing academic site, Fredette said. “Some physicians have discouraged it because the perception is that someone is making money. That is not the case at all.”

Another challenge is having enough time to educate the patient about the study, given the fact that doctors already feel they are stretched too thin.

Fredette presented the next phase of the study, called MIREC ID  (infant development), to the ethics committee at the Sudbury Regional Hospital in early June. Mothers from the first part of the study who are in their third trimester will be accepted to participate in the second phase of the project, which follows infants from birth to six months of age.

The research project has the potential to become multigenerational, as long as funding is available to support it. A subsequent phase of the study will track infants from six months to three years-of-age.

“I’m incredibly excited about this,” Fredette said. “Being a primary care provider in Sudbury, you have a lot of people concerned about the effects of the environment on their health. I’ve been privileged to work with and know patients who have had direct health problems due to environmental exposure. Without that experience, I’m not sure what else would have pushed me in the direction of working with this study.”

For further information, please contact Barb Ward at 705-566-0005 ext. 103 (barb.ward@medicorresearch.com), or Dr. Paul Fredette at 705-222-1888.

www.mirec-canada.ca

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