Birth cohort study on environment and health in Flanders

Subtitle:Feasibility study with the drawing up of a plan of action and cost analysis of such a method.

Exposure to environmental factors during the first stages of life has the potential to have long-term effects on life long term health. Such factors exert their effects during or even before fetal development, on the young child and during later life years. Many conditions that manifest themselves later can somehow be associated with early (and also later) exposures. Examples are cardiovascular diseases, different types of cancer, and cognitive decline. Birth cohort studies are an investment in the present and the future. This principle requires some generosity from society and from the current generation of epidemiologists, because the results of this type of research are usually not clear in the very short term. In the call for this feasibility study (LNE/OL200800113/8068/M&G), it is stated that on the basis of a birth cohort study, the calculation of the degree of association between possible causal factors and health conditions in mother and child is possible. One of the objectives of this study is to evaluate the following alternatives: (1) a birth cohort specific to asthma and allergy (new cohort or continuation of the PIPO study - 'Prospective Project on the Influence of Perinatal Factors on the Occurrence of Asthma and Allergies'); (2) birth cohort on the most relevant environmental conditions; (3) extended birth cohort monitoring the full development of the child, including diseases other than environmental conditions. We have opted to consider also among the alternatives (2) and (3) the options 'new cohort' or 'continuation (and possible extension) of the PIPO study'. The study of multiple 'endpoints' within the same population by means of cohort studies has advantages and disadvantages, but in any case provides valuable information for public health and in terms of future guidelines, and this at relatively limited additional costs. After all, it cannot be ruled out that some exposures at the same time increase the risk of one disorder and reduce the risk of another. Clear disadvantages of cohort studies in general, including birth cohort studies, are their long duration and high total price. The fact remains, however, that much of what is known about major diseases comes from epidemiological studies in general and from cohort studies in particular. Birth cohort studies have a special place here. In a first phase of the study, we conducted a thorough search for relevant, ongoing European and non-European birth cohort studies. To support this, the scientific literature was also examined in a selective way. In addition, an overview is given of a number of important measurement networks. The results of these three sections are presented in Chapter III. The six treated variants (1A, 1B, 2A, 2B, 3A and 3B) are discussed in Chapter IV and evaluated in Chapter V. The willingness of a number of parents of children who have ever participated in the PIPO birth cohort study to participate further is tested through qualitative research and the results are presented in Chapter VI. Finally, important points of attention and recommendations are formulated in Chapter VII.

Publication year:2009

Accessibility:Open