From nonstick PFAS compounds to lead in water to soot and smog, Michigan residents are exposed to more industrial contaminants than most states, and those contaminants are known to cause adverse health effects, including cancer. But how much exposure, for how long, causes those illnesses? When will the warning signs arise, and how will changes occur over time? How do race, nutrition and other factors influence health outcomes?
One of the largest studies of human health’s connections to environmental exposures ever conducted in Michigan is underway to attempt to get some of those answers.
The Michigan Cancer and Research on the Environment Study, or MI-CARES, is being conducted by the University of Michigan School of Public Health through a grant of more than $13 million from the National Cancer Institute. The study will enroll at least 100,000 people from diverse racial and ethnic backgrounds from throughout Michigan — especially from known areas of environmental injustice, where people of color are disproportionately burdened with pollutant exposures.
Looking for early biological changes that could indicate cancer
Participants will provide researchers with answers to detailed health questionnaires as well as blood and saliva samples. Researchers will then assess what environmental contaminants the participants are exposed to and track over time, through additional questioning and sampling, how their bodies change.
“We are recruiting participants between the ages of 25 and 44 – not really the demographic that you think of as getting cancer,” said Lilah Khoja, a Ph.D. student in UM’s Department of Epidemiology.
“However, it is in that age range that you can start to see some biological changes that indicate that someone might be developing cancer.”
The study is making extra effort to recruit participants from environmental justice hot spots including metro Detroit, Flint, Grand Rapids, Kalamazoo, Saginaw and Lansing.
“A lot of the cancer cohorts that exist are predominantly white people, so this is a big push from the National Cancer Institute to get a more diverse representation of the US population,” said Justin Colacino, a MI-CARES co-investigator and UM associate professor.
More:Study: Water leaving wastewater treatment plants has more detectable PFAS than going in
More:Climate change is already hurting Michigan’s cherry, apple crops — and it could get worse
The study will break ground in its examination of the health and exposures of residents of Middle Eastern and North African descent, said MI-CARES co-investigator and UM associate professor of epidemiology Alison Mondul.
“It’s one of the reasons that doing this in Michigan is a really great opportunity — partly because Michigan is disproportionately affected compared to other states by some of these environmental exposures; but also we have one of the largest Arab American populations in the country in Dearborn It’s a population that really hasn’t been studied in terms of cancer risk in a meaningful way previously,” Mondul said.
Traditionally, researchers studied the effects of one chemical at a time on human health, but that’s not how people are exposed to contaminants. Taking a holistic view of past, present and future exposures on people’s health, tracked over time, will provide new insights, the researchers said.
The six-year study funded under the National Cancer Institute Grant includes milestones that MI-CARES have 10,000 enrollees within two years, working its way up to 100,000 and perhaps beyond. Starting in June, the group has already recruited more than 1,300 participants.
“We are really trying to engage with community leaders and are taking the cue from them on how to engage with their communities,” Khoja said.
Understanding the vulnerabilities of pregnancy
The findings of such a large cohort, tracked over time, are expected to provide greater understanding into the connection between environmental exposures and cancer and other health problems. The spinoff research possibilities are almost endless.
“We all have ideas of different things we want to do,” said Celeste Leigh Pearce, a co-investigator for MI-CARES and a cancer epidemiologist at UM.
“A critical window of susceptibility is pregnancy, for example. When a person is pregnant, are they differentially affected by environmental exposures? So top on my priority list … I want very much to establish a pregnancy sub-cohort. When a person becomes pregnant, we will do some additional work with them to be able to understand the impact of exposures during that time.”
Those ages 25 to 44 interested in participating in the health study can go to micares.health for information on enrolling.
Bhramar Mukherjee is the UM School of Public Health’s chair of biostatistics, a self-professed “data dreamer.”
“I have long been looking for all of these clues for where to find the needle in the haystack for what causes some of the early cancers,” she said.
“This is a unique opportunity to really study a diverse cohort of a large number of people, with very many facets of data … it’s an unprecedented, dream opportunity in our state.”
Added Pearce, “Our ultimate goal is to actually prevent disease. It’s super important to understand how it develops, why it develops, people’s experiences once it develops.”
Contact Keith Matheny: email@example.com.