Robyn Gilden

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Researcher:

Robyn Gilden, PhD ’10, MS ’01, RN, assistant professor

Areas of expertise:

Gilden is an environmental community researcher who focuses on pesticide exposure and environmental health in early childhood learning environments.

The BIG Idea:

Gilden’s research aims to assess and reduce exposure to pesticides in children and pregnant women. Her most recent work, which was conducted in her role as an UMSON Dean’s Research Scholar 2017 - 19, focused on gestational pesticide exposure and child respiratory health outcomes. In that role, she was awarded $12,000 to pursue her project, “Determining the contribution of pesticides to asthma in children.”

Why does the research matter?

“The hypothesis is that pregnant women in Baltimore City are exposed to certain levels of gestational pesticide that is associated with adverse child respiratory health outcomes, such as risk of wheeze and later development of asthma,” Gilden explains.

Gilden’s research included a secondary data analysis of qualitative data from a birth cohort from the Health Outcomes and Measures of the Environment (HOME) study, conducted by the Cincinnati Children’s Environmental Health Center. From this analysis, Gilden determined that organophosphate (a group of man-made insecticides) exposure, diet (measured by asking about daily fruit and vegetable intake), and certain genetic markers such as the PON1 gene (an enzyme involved with metabolizing pesticides) play a role in children’s respiratory outcomes. Using this information, she convened and followed a birth cohort in Baltimore with 11 women who were recruited during their second trimester of pregnancy.

Gilden identified pyrethroid pesticides 3-PBA (another group of man-made insecticides meant to be less toxic than organophosphates), but no organophosphate exposure during pregnancy among the cohort. At the babies’ one-month follow-up, they were still too young to determine respiratory outcomes, and as this was a pilot study using the Dean’s Research Scholar funds during the grant period, there was not an opportunity to follow the children any further. At the conclusion of the Dean’s Research Scholar period, microbiome and genetic lab data from the babies were used to inform an R01 grant submission to the National Institutes of Health, which would create a larger birth cohort in Baltimore with the ability to follow the children up to age 2.

Gilden is completing a pesticide exposure and children’s respiratory health outcome literature review to provide more data and justification for why researchers must examine prenatal pyrethroid exposure because of gaps in objective measures. “Most studies focus on postnatal exposure and are based off of self-reported questionnaires for both outcomes and exposures,” Gilden says.

Who does the research matter to?

Gilden’s research focuses on pregnant women who are exposed to pesticides and the children born following the exposure. This in turn impacts the nurses taking care of these women and children so they can proactively educate pregnant women on a healthy diet with adequate produce intake and on potential community pesticide exposures before conception and during pregnancy. With the data her research produces, Gilden seeks to impact policy changes aimed at reducing pregnant women’s exposure to pesticides to improve health outcomes for their children.

What are the clinical applications of the research?

“The goal is to develop enough information to show that there is a need for intervention with dietary recommendations to reduce exposure to pesticides and nurse-led technical assistance to implement integrated pesticide management, thereby reducing pesticide exposure to pregnant mothers and their fetuses and hopefully positively affecting the children’s respiratory health outcomes,” Gilden explains. Technical assistance could include having a nurse-led home assessment before pregnancy to assess for commonly used pesticides and suggest safer alternatives.

She also works with environmental health nonprofits to show how research results can provide the objective evidence needed to spur action and improve the health of those around us through policy change.

“I am an environmental community researcher, so my focus is on broader applications. I look at how I can make my work apply to more than just one population,” Gilden says. “How can we make things better through translation of research findings into policy? How can we make it apply to the whole country?”

Gilden credits her broader focus to the national organizations she works with, including the Children’s Environmental Health Network and the Alliance of Nurses for Healthy Environments. “I want to make sure that my research can be translated into action and practice through advocacy and can be used stimulate more research," she says.

More Highlighted Research

Keeping Children Out of Harm's Way

Our Researcher:

By Dan Mezibov

For Robyn Gilden, PhD, RN, a look around her children’s soccer field inspired the research she’d eventually pursue. She noticed that a landscaper had left a flag alerting that pesticides had been applied, and although it was a week after the posted pull date, she wondered about the potential harmful effects.

Her curiosity sparked the subject for her doctoral dissertation and later, a landmark 2012 study by Gilden, University of Maryland School of Nursing assistant professor and director of the Environmental Health Certificate program, and her UMSON colleagues that was the first to assess the potential for pesticide exposure by exploring how chemicals are used on athletic fields. That study focused on fields in parks and schools in central Maryland, and it led to the research team’s call for policy changes to include more widespread and uniform use of “integrated pest management”—approaches to controlling pests through habitat modification, sanitation practices, and organic and other nonchemical methods, with the use of least-toxic pesticides only as a last resort.

Exposure to pesticides has been linked to serious health outcomes, including neurological, reproductive, and immune system disorders, developmental impairment, and certain types of cancers, including both childhood cancers and cancers that develop later in life. Children are exposed in many places, including child care facilities, where pesticides are among a host of potential chemicals to which children can be exposed daily: household cleaners, lead, radon, plastic toys, art supplies, and more. In 2015, in another important first step, Gilden and her colleagues demonstrated the effectiveness of a program to teach child care providers how to check for these hazards, use eco-healthy alternatives, and educate families to adopt better practices at home.

But while studies have documented the rising incidence of respiratory disorders among all age groups, most significantly in children, few investigations have focused on how pesticide exposure may be a contributing factor.

With $12,000 of initial funding from a two-year UMSON Dean’s Research Scholar Award, Gilden is exploring how exposure to pesticides may contribute to asthma and wheezing (a precursor to asthma) in children. She is analyzing data from the ongoing Health Outcomes and Measures of the Environment (HOME) study by the University of Cincinnati and Cincinnati Children’s Hospital Medical Center, which is evaluating how pesticides and other environmental exposures affect children’s health. While that investigation has examined mostly neurodevelopmental effects, Gilden is analyzing HOME study data specifically regarding respiratory health. The HOME study tested for pesticide biomarkers in the urine of pregnant mothers and their children up to age 8 and collected parents’ reports and doctors’ diagnoses of the children’s episodes of wheezing and asthma.

Gilden’s analysis is novel not only because it explores both prenatal and childhood exposures to pesticides, but also because it examines how genetic variations in a particular blood enzyme may influence a child’s susceptibility to developing wheezing or asthma after being exposed.

Following the HOME analysis, Gilden will conduct a pilot study of 10 pregnant Baltimore women that will test for urinary residue of pesticides and analyze the mothers’ prenatal exposures. Her findings will support an application for a five-year, federally funded study to focus on how both prenatal and postnatal exposure to pesticides may contribute to children’s respiratory illnesses.

“Nurses are fierce advocates for patients and clients,” Gilden explains, adding that her research is aimed at “documenting that exposure is occurring and giving nurses ways to intervene to prevent that exposure.” Ultimately, she says, “what my research is really best for is supporting the science-based data to change policy.”

It's not a question, but an assertion: We are who cares.

This was originally published in 2017 as part of a series of profiles highlighting nurse researchers at UMSON.