Navajo Birth Cohort Study (NBCS)

June 2011; revised July 2011

 

Background:

In October 2007, the U.S. House Committee on Oversight and Government Reform held hearings on the environmental effects of uranium mining on the Navajo Nation.  The Navajo Nation was heavily mined for uranium to support development of the atomic bomb and subsequent cold-war weapons production from 1942 through the late-1960s.  The last mines operating on or next to the Navajo Nation closed in the mid-1980s, leaving 1,100 mine waste sites associated with 520 discrete mines, most of which have never been fully remediated.  In spite of the potential for long-term, low-level chronic exposures to community members, no comprehensive health studies have been conducted to assess the impact to the Navajo people from exposures to these wastes.  The Committee directed five federal agencies to come up with a plan to remediate abandoned uranium mines (AUMs), remediate or replace homes made with mine wastes, locate and replace water sources contaminated with uranium and other hazardous substances, and support or conduct health studies in uranium-impacted communities. Congress subsequently appropriated funds for the studies referenced in the 2009 budget, and in Fall 2009, staff of the Agency for Toxic Substances and Disease Registry (ATSDR) held meetings with community members, Navajo Nation agencies, NAIHS staff and academic institutions doing environmental health research on the Navajo Nation to determine how to best to meet the congressional  mandate. ATSDR and its parent agency, the Centers for Disease Control and Prevention (CDC), determined that investigating the possible effects of environmental exposures to uranium wastes on Navajo pregnancies and birth outcomes would appropriately respond to both the community concerns and to the congressional mandate.

 

Objective and Benefits:

In August 2010, CDC awarded a cooperative agreement to UNM-CEHP (University of New Mexico Community Environmental Health Program) to work with CDC/ATSDR, Navajo Area Indian Health Service (NAIHS) and the Navajo Nation to design and conduct a study to determine whether uranium exposures affect birth outcomes and child development on the Navajo Nation. In addition to this primary research goal, the project should also provide broad public health benefits for Navajo communities through education on environmental prenatal risks and earlier assessment and referral for identified developmental delays. Finally, the results of this study will provide the first Navajo Nation-wide documentation of birth outcomes and developmental delays.  Information gathered and analyzed will be provided to the Navajo Nation and NAIHS to improve future birth outcomes and services and to inform policy on clean-up of environmental hazards.

 

Implementation of the Plan:

A plan for the research was developed by the UNM Team in consultation with Navajo Nation agencies, community members and NAIHS staff, and has been submitted to both the UNM and Navajo Nation human research review boards for approval. The planned research involves recruiting 1,000 to 1,500 pregnant women living on the Navajo Nation, evaluating the environment where they live, monitoring them during their pregnancy, and upon delivery, following the infants through their first year.  Environmental monitoring, biological sample analysis, surveys, and developmental screenings will be performed during the research cycle for each participant.  Because the planned research is dependent on so many agencies, the UNM Team will play the key role of coordinating the study and facilitating the cooperation of all agencies.  The UNM Team will conduct the study under the moniker of the Diné Network for Environmental Health (DiNEH) Project, a long-term partnership of UNM-CEHP, Southwest Research and Information Center (SRIC) and other organizations, that has been assessing health impacts of exposure to uranium and other environmental contaminants in 20 chapters of the Eastern Navajo Agency since 2004.  The DiNEH Team is working with the partnering agencies to identify “best practices” for implementing the study plan.  An Interagency Agreement (IAA) executed between NAIHS and the Navajo Nation Division of Health (NNDOH) in August 2010 sets forth the responsibilities of these organizations in working with the DiNEH Team to conduct the study.  CDC is providing funds to UNM to coordinate and carry out the research and to NAIHS and NNDOH to collaborate with the DiNEH Team.  The funds will allow NAIHS and NNDOH to hire new professional positions dedicated to the implementing the research plan over a three-year period. Additional funds may be identified and sought by the cooperating agencies to continue the prospective study after the initial three years. Contact information for key study personnel appears on the back of this sheet.

 

 

 

Navajo Birth Cohort Key Personnel

 

 

DiNEH Project (UNM) Team (Core Members)

 

·         Johnnye Lewis, PhD, DABT, principal investigator: 505-272-4853; jlewis@cybermesa.com

·         David Begay, PhD, co-investigator: 928-607-0365; dbegay@gmail.com

·         Chris Shuey, MPH, co-investigator: 505-262-1862; sric.chris@earthlink.net

·         Mary Woodruff, program manager: 505-272-0459; mwoodruff@salud.unm.edu

 

Toll Free Number: 1-877-545-6775

 

Navajo Nation Division of Health (Lead Contact)

 

·         Mae-Gilene Begay, MSW, Community Health Representative Program director: 928-871-6782; mgbegay@yahoo.com.

 

Navajo Area Indian Health Service (Principal Contact)

 

·         Douglas Peter, MD, Area Medical Director: 928-871-4811; Douglas.Peter@ihs.gov.

·         Lisa Allee, CNM, coordinator, Community Uranium Exposure-Journey To Healing: 505-368-6311; Lisa.Allee@ihs.gov

 

Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry (Principal Contact)

 

·         Steve Dearwent, Ph.D.: 770-488-3665; sed7@cdc.gov.