文章基本信息

标题：Lessons Learned From the Children’s Environmental Exposure Research Study
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作者：David B. Resnik ; Steven Wing
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2007
卷号：97
期号：3
页码：414-418
DOI：10.2105/AJPH.2005.081729
语种：English
出版社：American Public Health Association
摘要：We examined 5 different ethical concerns about the Children’s Environmental Exposure Research Study and make some recommendations for future studies of exposure to hazardous environmental agents in the home. Researchers should seek community consultation and participation; make participants aware of all the risks associated with the research, including hazards discovered in the home and uncertainties about the risks of agents under investigation; and take steps to ensure that their studies will not have unfair representation of the poor or people of color. Researchers should also avoid even the appearance of a financial conflict of interest in studies that are likely to be controversial and make it clear to all parties that studies will not intentionally expose subjects to hazardous environmental agents. THE CHILDREN’S Environmental Exposure Research Study (CHEERS) became embroiled in controversy in the fall of 2004, when environmental groups charged that the study was unethical. CHEERS’ critics argued that the study had a number of different ethical problems, including: (1) the study intentionally exposed children to pesticides, (2) the study targeted low-income people of color, (3) the incentives to participate in the study amounted to coercion or undue influence, (4) private sources of funding for the study were unacceptable conflicts of interest, and (5) the parents were not provided with enough information about pesticides during the consent process. 5 ^, 6 In response to these accusations, the Environmental Protection Agency (EPA), the main sponsor of CHEERS, suspended the study pending further review by an independent committee of scientists and ethicists. (CHEERS had already been approved by a special EPA committee and institutional review boards at Battelle Memorial Institute, the University of Florida, and the Florida Department of Health; the neurobehavioral part of the study had been reviewed by the University of North Carolina institutional review board.) The EPA’s response did not satisfy special interest groups or politicians, who pressed for the study to end. Senators Barbara Boxer (D, Calif) and William Nelson (D, Fla) grilled EPA administrator nominee Stephan Johnson during his nomination hearing and threatened to derail his confirmation if he did not stop the study. 1 On April 8, 2005, Johnson cancelled CHEERS. In making the decision, Johnson maintained that CHEERS had been grossly misrepresented by the media and advocacy groups. 2 Many scientists were disturbed that Congress had intervened in the peer review process and that the study had become a political football used by politicians to score points among constituencies and special interest groups. This was not the first time in recent years that research on environmental hazards in the home has come under intense scrutiny. In 2001, a Maryland appellate court ruled that researchers from the Kennedy Krieger Institute, who were conducting a study of lead abatement methods in Baltimore homes, had legal duties to warn the plaintiffs of unsafe lead levels detected in the blood of children and to obtain informed consent. The court also rendered opinions about the risks that children are legally permitted to face in research and the scope of researchers’ legal duties toward human subjects in nontherapeutic research. 3 The Kennedy Krieger Institute case, which instigated legal and bioethical debates about environmental health and pediatric research, was prominently featured in a report released by the Institute of Medicine in 2005, Ethical Considerations for Research on Housing-Related Health Hazards Involving Children . 4 We describe the CHEERS protocol, examine these allegations concerning the design and implementation of CHEERS, and make some recommendations for future environmental health research.