Adrienne S. Ettinger, Sc.D., M.P.H.
Principal Investigator/Research Scientist

Education

Sc.D. Environmental Epidemiology
Harvard School of Public Health

Sc.M. Environmental Health
Harvard School of Public Health

M.P.H. Epidemiology & Biostatistics
Boston University School of Public Health

B.A. Independent Concentration in Public Health
Boston University College of Liberal Arts

Research Interests

1) Effects of environmental exposures on reproductive, perinatal, and children's health.

2) Biological markers of fetal exposure and early biologic effects.

3) Genes and nutritional status as modifiers of susceptibility to environmental toxins.

 

Narrative Description of Research:

Epidemiologic and experimental evidence suggest that environmental agents are reproductive toxicants, but relatively little is known about the biological mechanisms of effect. The objective of my work is to understand how common genetic variants, epigenetic events and nutritional status may modify susceptibility to environmental exposures in the maternal-fetal unit and, ultimately, impact toxicant-induced pregnancy and developmental outcomes. My research involves the epidemiologic analysis of exposure to metals and the associated human health effects in several new and ongoing longitudinal birth cohort studies. These studies are being carried out in: Mexico, in collaboration with researchers at the National Institute for Public Health and Oklahoma, at the Tar Creek Superfund site, where we are investigating interactions among several metals (arsenic, cadmium, lead, manganese, zinc). We are working to develop novel approaches for studying complex interactions between environmental exposures and other factors (e.g. nutrition, genetics, hormones, socio-behavioral characteristics). This research is primarily aimed at investigating mechanisms by which environmental contaminants impair maternal, fetal and child health. I am interested in developing and validating new molecular biological markers for use in the characterization of exposure, susceptibility, and toxicity from environmental agents to be applied in studies of human populations, with a particular emphasis on trans-generational effects of environmental exposures. This builds on my doctoral dissertation research evaluating the role of maternal bone lead stores as an endogenous source of exposure to the developing fetus and nursing infant. Currently, I am conducting research to study genetic and epigenetic modifiers of placental and lactational transfer of environmental toxicants & perinatal outcomes (NIEHS 1 K01 ES014907-01A1). This research is aimed at evaluating if specific genes, involved in the regulation of calcium metabolism, modify the relationships between maternal lead biomarkers and physiologic parameters during pregnancy and, ultimately, influence fetal and early infant exposures and birth outcomes. An exploratory aim is investigating genomic imprinting and gene expression in the maternal-fetal unit using evolutionary theories of “gestational conflict” to develop a conceptual epidemiologic framework for understanding these complex interactions at the molecular level. Regulation of gene expression due to metabolic disturbances secondary to environmental exposures during pregnancy could have effects on fetal development that have not yet been fully appreciated or understood. Thus, this research may provide new insights to better understand how risks within and between populations vary with respect to exposure, underlying susceptibility and developmental stage.

Keywords:

Biological markers of fetal exposure and early biologic effects; human biomonitoring; metals in breast milk; prenatal lead exposure; placental and lactational transfer; environmental toxicants; gene-environment interaction; nutrition; calcium metabolism; environmental epidemiology; pediatric and perinatal epidemiology; reproductive epidemiology; molecular epidemiology; birth cohort studies; community-based research; maternal/child health; international health.

 

Selected Publications

1. Freeman NCG, Ettinger A, Berry MR, Rhoads GG. Hygiene- and food-related behaviors associated with blood lead levels of young children from lead-contaminated homes. J Expo Anal Environ Epidemiol 1997 Jan-Mar;7(1):103-18.
2. Rhoads GG, Ettinger AS, Weisel CP, Buckley TJ, Goldman KD, Adgate JC, Lioy PJ. The effect of dust lead control on blood lead in toddlers: a randomized trial. Pediatrics 1999; 103(3):551-5.
3. Ettinger AS . Chelation therapy for childhood lead poisoning: Does excretion equal efficacy? Harvard Reviews in Pharmacoepidemiology 1999. Available at: http://www.hsph.harvard.edu/organizations/DDIL/chelation.htm
4. Buckley B, Ettinger AS, Hore P, Lioy PJ, Freeman NCG. Using observational information in planning and implementation of field studies with children as subjects. J Expo Anal Environ Epidemiol 2000 Nov-Dec;10(6 Pt 2):695-702.
5. Ettinger AS , Bornschein RL, Farfel M, Campbell C, Ragan NB, Rhoads GG, Brophy M, Wilkens S, Dockery DW. Assessment of cleaning to control lead dust in homes of children with moderate lead poisoning: Treatment of Lead-exposed Children Trial. Env Health Perspect 2002 December; 110(12):A773-A779.
6. Janakiraman V, Ettinger AS, Mercado-Garcia A, Hu H, Hernandez-Avila M. Calcium supplements suppress bone resorption during pregnancy: a randomized crossover trial. Am J Prev Med 2003;24(3):260-264.
7. Ettinger AS , Tellez-Rojo MM, Amarasiriwardena C, Gonzalez-Cossio T, Peterson K, Aro A, Hu H, Hernandez-Avila M. Levels of lead in breast milk and their relation to maternal blood and bone lead levels at one month postpartum. Environ Health Perspect 2004 June; 112(8):926-931.
8. Ettinger AS , Tellez-Rojo MM, Amarasiriwardena C, Bellinger D, Schwartz J, Hu H, Hernandez-Avila M. Effect of breast milk lead on infant blood lead levels at one month of age. Environ Health Perspect 2004 Oct; 112(14):1381-1385.
9. Fenton SE, Condon M, Ettinger AS, Mason A, McDiarmid M, Qian Z, Selevan S, LaKind JS. Collection and use of exposure data from human milk biomonitoring in the U.S. J Tox Env Hlth, Part A 2005; 68(20):1691-1712.
10. Berlin CM, LaKind JS, Fenton SE, Wang R, Bates MN, Brent RL, Condon M, Crase BL, Dourson ML, Ettinger AS, Foos B, Fürst P, Giacoia GP, Goldstein DA, Haynes SG, Hench KD, Kacew S, Koren G, Lawrence RA, Mahaffey KR, Mason A, McDiarmid MA, Moy G, Needham LL, Paul I, Pugh L, Qian Z, Salamone L, Selevan S, Sonawane B, Tarzian AJ, Tully MR, Uhl K. Conclusions and Research Needs of the Expert Panel: Technical Workshop on Human Milk Surveillance and Biomonitoring for Environmental Chemicals in the United States. J Tox Env Hlth, Part A 2005; 68(20):1825-1831.
11. Ettinger AS , Téllez-Rojo MM, Amarasiriwardena C, Schwartz J, Peterson KE, Aro A, Hu H, Hernández-Avila M. Influence of maternal bone lead burden and calcium intake on levels of lead in breast milk over the course of lactation. Am J Epidemiol 2006; 163:48-56.
12. Hu H, Téllez-Rojo MM, Bellinger D, Smith D, Ettinger AS, Lamadrid-Figueroa H, Schwartz J, Schnaas L, Mercado-García A, Hernández-Avila M. Fetal lead exposure at each stage of pregnancy as a predictor of infant mental development. Environ Health Perspect 2006; 114:1730–1735.
13. Hennig B, Ettinger AS, Jandacek RJ, Koo S, McClain C, Seifried H, Silverstone A, Watkins B, Suk WA. Using nutrition for intervention and prevention against environmental chemical toxicity and associated diseases. Environ Health Perspect 2007 April; 115:493–495.
14. Ettinger AS , Hu H, Hernández-Avila M. Dietary calcium supplementation to lower blood lead levels in pregnancy and lactation. J Nutr Biochem. 2007 Mar;18(3):172-8.
15. Arora M, Ettinger AS, Peterson KE, Schwartz J, Hu H, Hernández-Avila M, Tellez-Rojo MM, Wright RO. Maternal dietary intake of polyunsaturated fatty acids modifies the relationship between lead levels in bone and breast milk. J Nutr. 2008 Jan;138(1):73-9.

Link to HSPH webpage:

http://www.hsph.harvard.edu/researchers/aettinge.html