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Your Environment. Your Health.

Pediatric Epidemiology Group

Environmental Toxins & Child Development

Walter J. Rogan, M.D.
Walter J. Rogan, M.D.
Principal Investigator
Tel (919) 541-4578
walter.rogan@nih.gov
P.O. Box 12233
Mail Drop A3-05
Research Triangle Park, NC 27709

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Succimer Found Ineffective for Removing Mercury

Walter Rogan, M.D.,

Speaker:
Walter Rogan, M.D.,
Principal Investigator, Pediatric
Epidemiology Group

Research Summary

Walter Rogan, M.D., leads the Pediatric Epidemiology Group, and currently holds a secondary appointment in the NIEHS Reproductive & Developmental Biology Laboratory. As an epidemiologist, he studied the effects of environmental chemicals on the growth and development of children for almost 40 years.

Rogan and colleagues in North Carolina did one of the earliest studies of infants’ exposure to polychlorinated biphenyls (PCBs) and DDT. They followed about 850 North Carolina children born between 1978 and 1982, showed that transplacental exposure to polychlorinated biphenyls (PCBs) produced small delays in motor development detectable from birth to age two years (J Pediatr 119: 58-63, 1991), and saw some evidence for differences in growth and pubertal development (J Pediatr 136: 490-496, 2000). In the same study, women with higher exposure to DDT (measured by the metabolite DDE in their milk) weaned their children earlier. That finding was replicated in Mexico (Am J Pub Health 85: 504-508, 1995), and the investigators speculated that this was due to the estrogenicity and persistence of DDE. Rogan pursued the public health implications in an analysis of the use of DDT to prevent infant deaths from malaria (Emerging Infect Dis 9: 960-964, 2003).

In 1985, Rogan and his colleagues studied a complex food poisoning episode in Taiwan, in which children were exposed transplacentally to PCBs and polychlorinated dibenzofurans (PCDFs) that their mothers ate in contaminated cooking oil. The children had a syndrome of ectodermal defects, global persistent developmental delay and disordered behavior (Science 241: 334-336, 1988).

Rogan was one of the principal investigators for the four-site, randomized, controlled clinical trial of oral chelation therapy (with succimer) to prevent lead-induced disorders of growth, behavior and cognitive development in toddlers. The Treatment of Lead-exposed Children (TLC) trial randomized 780 children between 13-33 months of age with blood lead levels of 20-45 µg/dl and followed them after treatment with tests of cognitive ability, behavior and neuropsychological function. Despite lowering of their blood lead levels and relatively few drug side effects, the children given succimer scored no better than the children given placebo on any of the tests at about age 5 years (N Engl J Med 344: 1421-1426, 2001) or 7 years (Pediatr 114:19-26, 2004).

Rogan returned to his interest in infant nutrition and environmental estrogens by doing a series of pilot studies in which he and colleagues at the Children’s Hospitals in Boston and Philadelphia developed methods to evaluate infants for exposure to estrogen (Environ Health Perspect 116: 416-420, 2008; Pediatr Radiol 41: 633-642, 2011; PLoS One October 16, 2013 10.1371/journal.pone.0077061) and showed that infants fed soy formula excrete unexpectedly large amounts of the plant estrogen genistein in their urine (J Expo Sci Environ Epidemiol 19: 223-234, 2009, with CDC).  Using those results, he and colleagues at the Children’s Hospital of Philadelphia have completed  a new study, the Infant Feeding and Early Development study (IFED),  looking for evidence of the infants’ response to the estrogen exposure from soy as well as other putative “endocrine disrupting” chemicals.  

Rogan received a B.A. from LaSalle College, an M.D. from University of California, San Francisco and an M.P.H. from University of California, Berkeley. He is licensed in North Carolina and Board Certified in General Preventive Medicine. Rogan came to NIEHS in 1976, and has served as Epidemiology Branch Chief, Associate Director in the Division of Biometry and Risk Assessment, and Acting Clinical Director in his years at NIEHS. Recent recognition includes the presidency of the American Epidemiological Society in 2011 and honorary fellowship in the American Academy of Pediatrics in 2012. He retired from full time employment in 2013, but is completing work on the IFED study part-time.

Studies

  • DDE and Lactation in Mexican Children
  • Infant Feeding and Early Development (IFED) Study
    The (ongoing) Infant Feeding and Early Development (IFED) Study is designed to test the hypothesis that plant estrogens in soy formula will prolong the physiologic estrogenization of the newborn, and suppress the post-natal production of sex hormones by the infant.
  • NC Infant Feeding Study
  • NC Puberty Followup
  • SEAD Soy Study ("/Rhythmyx/assembler/render?sys_contentid=36114&sys_revision=2&sys_variantid=639&sys_context=0&sys_authtype=0&sys_siteid=&sys_folderid=" sys_dependentvariantid="639" sys_dependentid="36114" inlinetype="rxhyperlink" rxinlineslot="103" sys_dependentid="36114" sys_siteid="" sys_folderid="")
    The Study of Estrogen Activity and Development (SEAD) Soy Study is a series of cross-sectional pilot studies designed to establish methods for future larger studies on the estrogenic effects of soy infant formulas on the developing infant.
  • Taiwan Yucheng Children Study
  • Treatment of Lead-exposed Children Trial
    ("/Rhythmyx/assembler/render?sys_contentid=35392&sys_revision=2&sys_variantid=639&sys_context=0&sys_authtype=0&sys_siteid=&sys_folderid=" sys_dependentvariantid="639" sys_dependentid="35392" inlinetype="rxhyperlink" rxinlineslot="103" sys_dependentid="35392" sys_siteid="" sys_folderid="")The Treatment of Lead-exposed Children (TLC) clinical trial compared the effect of lead chelation with succimer to placebo therapy on a variety of cognitive, behavioral, and neuromotor endpoints in children of school age with baseline blood lead levels of 20-44 µg/dl.


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Selected Publications

  1. Rogan WJ, Dietrich KN, Ware JH, Dockery DW, Salganik M, Radcliffe J, Jones RL , Ragan NB, Chisolm JJ Jr, Rhoads GG, Treatment of Lead-Exposed Children Trial Group. The effect of chelation therapy with succimer on neuropsychological development in children exposed to lead. New England Journal of Medicine 344: 1421-1426, 2001.[Abstract][Full Text][PDF]
  2. Lai TJ, Liu X, Guo NW, Yu ML, Hsu CC, Guo YL, Rogan WJ. A cohort study of behavioral problems and intelligence in children with high prenatal PCB exposure. Arch Gen Psychiatr 59: 61-66, 2002.[Abstract][Full Text][download the PDF]
  3. Chen A, Rogan WJ. Nonmalarial infant deaths and DDT use for malaria control. Emerging Infectious Diseases 9: 960-4, 2003.[Abstract][Full Text][PDF]
  4. Dietrich KN, Ware JH, Salganik M, Radcliffe J, Rogan WJ, Rhoads GG, Fay ME, Davoli CT, Denckla MB, Bornschein RL, Schwarz D, Dockery DW, Adubato S, Jones RL for the TLC investigators. Effect of chelation therapy on the neuropsychological and behavioral development of lead-exposed children following school entry. Pediatr 114: 19-26, 2004.[Abstract][Full Text][download the PDF]
  5. Bernbaum JC, Umbach DM, Ragan NB, Ballard JL, Archer JI, Schmidt-Davis H, Rogan WJ. Pilot studies of estrogen-related physical findings in infants. Environmental Health Perspectives 116:416-420 (2008).
  6. Cao Y, Calafat AM, Doerge DR, Umbach DM, Bernbaum JC, Twaddle NC, Ye X, Rogan WJ. Isoflavones in urine, saliva and blood of infants - data from a pilot study on the estrogenic activity of soy formula. Journal of exposure science & environmental epidemiology 19(2):223-234, 2009.[Abstract]
  7. Adgent MA, Daniels JL, Edwards LJ, Siega-Riz AM, Rogan WJ. Early life soy exposure and gender-role play behavior in children. Environmental health perspectives 2011 119(12):1811-6.[Abstract]
  8. Adgent MA, Daniels JL, Rogan WJ, Adair L, Edwards LJ, Westreich D, Maisonet M, Marcus M. Early Life Soy Exposure and age at Menarche. Paediatric and perinatal epidemiology 2012 26(2):163-75.[Abstract]
  9. Wang Y, Dinse GE, Rogan WJ. Birth weight, early weight gain and pubertal maturation: a longitudinal study. Pediatric obesity 2012 7(2):101-9.[Abstract]
  10. Li MC, Tsai PC, Chen PC, Hsieh CJ, Leon Guo YL , Rogan WJ. Mortality after exposure to polychlorinated biphenyls and dibenzofurans: 30 years after the "Yucheng Accident". Environmental research 2013 120:71-5[Abstract]
  11. Adgent MA, Flake GP, Umbach DM, Stallings VA, Bernbaum JC, Rogan WJ. Urogenital epithelial cells as simple markers of estrogen response in infants: methods and applications. PloS one 8(10):e77061, 2013.[Abstract]
  12. Wang Y, Rogan WJ, Chen PC, Lien GW, Chen HY, Tseng YC, Longnecker MP, Wang SL. Association between Maternal Serum Perfluoroalkyl Substances during Pregnancy and Maternal and Cord Thyroid Hormones: Taiwan Maternal and Infant Cohort Study. Environmental health perspectives 2014 122(5):529-534.[Abstract]
  13. Liu J, Liu X, Wang W, McCauley L, Pinto-Martin J, Wang Y, Li L, Yan C, Rogan WJ. Blood Lead Concentrations and Children's Behavioral and Emotional Problems: A Cohort Study. JAMA pediatrics 2014 168(8):737-745.[Abstract]

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