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Communities Actively Researching Exposure Study CARES Data Collection

To date CARES has collected data from more than 500 children and their primary caregivers, many of whom we have followed for over a decade. On this page we outline the data that is currently available from the CARES cohort. If you are interested in learning more about the CARES data, please contact Dr. Haynes at erin.haynes@uky.edu.

Questionnaires

The following questionnaires were administered to the primary caregivers of the CARES participants at 7-9 years of age (2008-2013).

  • Main Questionnaire
    • Collected information regarding the child’s home, drinking water sources, residential history, daily activities, health history, tobacco exposure, sleep, and demographic information.
  • Prenatal and Early Life Questionnaire
    • Includes questions surrounding maternal health during pregnancy, smoking and alcohol consumption during pregnancy, child birth weight, and infant feeding.
  • Food Frequency Questionnaire
    • Asks about the type of foods and frequency that the children ate the foods during the last 7 days as well as multivitamin, vitamin, mineral, and supplement usage.

The following questionnaires were administered during the second phase of the original CARES which continued the work of the initial research. Only those who participated in the original study were included (2017 – present).

  • CARES2 Main Questionnaire
    • Completed by the child’s primary caregiver and collected information regarding the child’s home, school, residential history, health history, and demographic information.
  • Tobacco Usage Questionnaire
    • Collected information from the participants regarding their history of using tobacco products such as cigarette, cigar, chewing tobacco, electronic cigarettes, etc.

Environmental Measures, Collected at Ages 7-9 Years

Environmental Sample Analyzed for: Methods Relevant Publications
Air- Personal Aluminum, Arsenic, Cadmium, Chromium, Mercury, Manganese, Nickel, Lead, PM2.5 Personal air samples were collected on a subset of CARES participants (N=40) for a 48-hour period using a backpack equipped with an air sampling pump and a two-stage personal modular impactor capable of measuring particulate matter (PM)2.5 and PM2.5–10 Fulk, 2016; Haynes 2012
Air - Stationary Aluminum, Arsenic, Cadmium, Chromium, Mercury, Manganese, Nickel, Lead, PM2.5 A stationary air sampler was positioned on the rooftop of a Marietta College building approximately 8 km from the ferromanganese refinery. Three 48-hour samples were collected each week. Stationary air sampling was conducted over a 2-year time frame from October 2008–September 2010. Haynes, 2012
Dust - Home Aluminum, Arsenic, Cadmium, Chromium, Magnesium, Manganese, Nickel, Lead, Vanadium Composite dust samples were collected from three locations in the home: front entrance, kitchen, and the child’s primary activity room. Samples were collected using a wet wipe method. Fulk, 2017
Soil - Home Aluminum, Arsenic, Cadmium, Chromium, Magnesium, Manganese, Nickel, Lead, Vanadium Composite soil samples were collected from six random locations in the home yard. Onehalf inch of bare soil was transferred to a plastic sample bag using a stainless-steel spatula while wearing protective gloves. Fulk, 2017
Water - Home Aluminum, Arsenic, Cadmium, Chromium, Magnesium, Manganese, Nickel, Lead, Vanadium Water samples were collected according to EPA guidelines. Briefly, water was collected from the kitchen faucet after a 2-3-minute flush. Samples were acidified (HNO3) and analyzed for metal content by ICP-MS.  

Biological Sample Collection

Biological Matrix Analyzed for: Analytic Laboratory 7-9 Years 13-17 Years Relevant Publications
Whole Blood Cadmium, Mercury, Manganese, Lead The Laboratory of Inorganic and Nuclear Chemistry at the New York State Department of Health’s Wadsworth Center in Albany, New York ✓ ✓ Haynes, 2015; Haynes, 2018; Vollet Martin, 2021
Hair Arsenic, Cadmium, Lead, Manganese Channing Trace Metals Laboratory, Brigham and Women’s Hospital, Harvard T.H. Chan School of Public Health in Boston, Massachusetts and the Molecular Environmental Health Laboratory at the Mount Sinai Hospital ✓ ✓ Haynes, 2015; Fulk, 2017; Haynes, 2018; Vollet Martin, 2021
Serum Cotinine, Ferritin, Iron, Total iron-binding capacity, Unsaturated iron-binding capacity, Iron Saturation Serum Cotinine: The Laboratory of Inorganic and Nuclear Chemistry at the New York State Department of Health’s Wadsworth Center in Albany, New York

Iron Profile: Marietta Memorial Hospital in a CLIA-certified clinical laboratory		 ✓ ✓ Yeramaneni, 2015; Haynes, 2015; Haynes, 2018; Vollet Martin, 2021
Toenail Arsenic, Cadmium, Chromium, Lead, Manganese The Microbiology and Environmental Toxicology Department at the University of California Santa Cruz ✓ ✓ Vollet Martin, 2021
Tooth Barium, Copper, Cadmium, Chromium, Lead, Lithium, Magnesium, Manganese, Molybdenum, Nickel, Strontium, Tin, Zinc The Senator Frank R. Lautenberg Environmental Health Science Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA      
Urine Collected and Stored Collected and Stored ✓    
Saliva Markers for Iron and Manganese metabolism University of Kentucky Genomics Core Laboratory   ✓  

Neuromotor Measures

Neuromotor Assessment Brief Description 7-9 Years 13-17 Years Relevant Publications
Halstead-Reitan Finger Oscillation Test (HRFOT) HRFOT is a test of simple motor speed. The participant taps on a finger tapper board as fast as possible with his/her index finger, with the tapping motion occurring only at the index finger joint and not at the wrist or forearm ✓   Yeramaneni, 2015
Purdue Grooved Pegboard Test – Kiddie version (PGPT) PGPT is a test of manual dexterity requiring complex visuo-motor coordination. Each participant was required to match the groove of the peg, which contains a round side and a square side, with the groove of the peg board containing similar round and square holes as quickly as possible using one peg and one hand at a time. ✓   Yeramaneni, 2015
Bruininks-Oseretsky Test of Motor Proficiency 2 - Short form (BOT-2) The BOT-2 is designed to measure several fine and gross motor skills. ✓   Yeramaneni, 2015
Postural Balance Testing with a Computer Force Platform System The tests evaluate the relative roles of various afferents relevant in the maintenance of static postural balance. In addition, semi-dynamic tests were conducted to dynamically challenge all the afferents relevant for postural balance. Each test uses a portable microprocessor-based force platform system, Accusway Plus. The forces and moments obtained from the force plate are used to calculate sway length and sway area. ✓ ✓  
Functional Gait Tests for Assessment of Dynamic Postural Balance The test protocol is designed to examine the normal walking patterns and the functional gait patterns which challenge various neuromotor control systems necessary for maintaining upright balance and at the same time keeping dynamic control of body segments during progression of gait.   ✓  

Neurodevelopmental Outcomes

Neurodevelopmental Test 7-9 Years 13-17 Years Primary Caregiver Relevant Publications
Wechsler Abbreviated Scale of Intelligence (WASI)     ✓ Haynes 2015
Wechsler Intelligence Scale for Children - IV (WISC-IV) ✓     Haynes, 2015;

Haynes, 2018;

Vollet Martin, 2021
Behavior Rating Inventory of Executive Function (BRIEF) ✓      
Behavior Assessment System for Children - 2 (BASC-2) ✓      
California Verbal Learning Test (CVLT-C) ✓      
Kaufman Brief Intelligence Test - 2 (KBIT-2) ✓      
Adolescent Psychopathology Scale - Short Form (APS-SF)   ✓    
Behavior Assessment System for Children - 3 (BASC-3)   ✓    
Conner’s Continuous Performance Test   ✓    
Delis-Kaplan Executive Function System (D-KEFS)   ✓    
Wide Range Achievement Test - 4 (WRAT-4)   ✓    

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