title: Ethical issues in measuring biomarkers in children's environmental health.
abstract: BACKGROUND
  Studying the impact of environmental exposures is important in children because they are more vulnerable to adverse effects on growth, development, and health. Assessing exposure in children is difficult, and measuring biomarkers is potentially useful. Research measuring biomarkers in children raises a number of ethical issues, some of which relate to children as research subjects and some of which are specific to biomarker research.
  
  
  OBJECTIVE
  As an international group with experience in pediatric research, biomarkers, and the ethics of research in children, we highlight the ethical issues of undertaking biomarker research in children in these environments.
  
  
  CONCLUSIONS
  Significant issues include undertaking research in vulnerable communities, especially in developing countries; managing community expectations; obtaining appropriate consent to conduct the research; the potential conflicts of obtaining permission from an ethics review board in an economically developed country to perform research in a community that may have different cultural values; returning research results to participants and communities when the researchers are uncertain of how to interpret the results; and the conflicting ethical obligations of maintaining participant confidentiality when information about harm or illegal activities mandate reporting to authorities.
  
  
  CONCLUSIONS
  None of these challenges are insurmountable and all deserve discussion. Pediatric biomarker research is necessary for advancing child health.
authors: WHO Collaborating Centre for Research on Children's Environmental Health, Curtin University of Technology, Perth, Australia. peters@ichr.uwa.edu.au
authors: Peter D
authors: PD
authors: Sly
authors: Brenda
authors: B
authors: Eskenazi
authors: Jenny
authors: J
authors: Pronczuk
authors: Radim
authors: R
authors: Srám
authors: Fernando
authors: F
authors: Diaz-Barriga
authors: Diego Gonzalez
authors: DG
authors: Machin
authors: David O
authors: DO
authors: Carpenter
authors: Simona
authors: S
authors: Surdu
authors: Eric M
authors: EM
authors: Meslin
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure; D004782:Environmental Health / Q000941:ethics*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D055815:Young Adult
chemical_list: D015415:Biomarkers