exploratory behaviors increase their likelihood of exposure (Bearer, 1995). In addition, the effects of exposure may be magnified by their smaller size and developmental immaturity (Bearer, 1995).
Among children, those in minority and low-income households are at greatest risk for health hazards in the home because of the generally poorer quality of their housing. Homes occupied by African Americans and low-income residents are 1.7 and 2.2 times more likely, respectively, to have a severe physical problem than other homes (Krieger and Higgins, 2002, citing American Housing Survey data). Children in low-income families are more likely to live in overcrowded households. Fatal residential injuries occur more frequently among African American children (Nagaraja et al., 2005). Evidence suggests that the higher prevalence of asthma and asthma morbidity among children in low-income families is at least partly attributable to housing conditions (Rauh, Chew, and Garfinkel, 2002; Huss et al., 1994). Lead poisoning is concentrated among poor, black children in older, poorly maintained homes in inner cities (Cummins and Jackson, 2001). In agricultural communities, particularly among the children of migrant farm workers, pesticide exposure is common (Bradman et al., 2005).
Research with children inevitably raises ethical concerns. First, unlike adults, children cannot directly avoid or mitigate the risks of research because of their lack of experience and lack of control of their environment. Second, young children cannot provide informed consent on their own behalf: their parents or guardians must give permission for them to be enrolled in research. Exposing humans to research risks to which they have not consented always calls for close ethical scrutiny.
The goal of research by definition is the advancement of generalizable knowledge. As such, research interventions primarily benefit society as a whole, or future generations of children, not necessarily the children enrolled in the research and exposed to any risks that may be associated with the research. The federal regulations that govern research with children recognize that children have unique vulnerabilities; the regulations are accordingly designed to provide special protections. Although additional guidance is needed on some aspects of these regulations (discussed in this report), the current regulatory framework provides a solid framework for conducting ethical research with children. However, the particular characteristics of housing health hazards research introduce ethical issues not fully addressed by the current regulations: those additional issues are the focus of this report. Although some of the same characteristics are present in other types of research, and the additional protections proposed could apply in these cases, the focus of this report is specifically on housing health hazards research.