The Michigan PBB Registry was established in order to study the health of thousands of people exposed to brominated flame retardants as a result of the largest agricultural disaster in US history. Previous research by this team has shown significant health effects associated with exposure to polybrominated biphenyls (PBB) including earlier menarche, increased risk of miscarriages and lower estrogen levels among women, and more urogenital problems among men. Over the past few years, Emory researchers have conducted over a dozen community meetings throughout Michigan, collaborated with community partners, shared research findings with the community, responded to community needs, and sought community input for future research plans. This proposed study, collaboratively developed by scientists, community partners, and public health officials, addresses several major concerns expressed by the PBB community. Specifically, affected individuals have expressed interest in a possible treatment to remove PBBs from their bodies, concern about heritable effects from PBB on their children and grandchildren, continuing health concerns beyond those related to reproduction, and frustration that local health-care providers seem unaware of the statewide PBB exposure and/or its possible health effects. To address these concerns, the proposed study has four specific aims. The first is to evaluate the utility of nutritional supplement, a non-absorbable artificial fat, as a potential means of accelerating the elimination of PBB by conducting a randomized double-blind trial. The second aim will explore the heritability of changes in the epigenome associated with PBB exposure by studying 25 families across three generations. The epigenome of parents, their children, and their grandchildren will be examined to determine if epigenetic patterns associated with direct exposure to PBB of parents are apparent in the children and grandchildren. Aim three will address community concerns regarding additional health effects beyond reproductive outcomes. Participants, including 575 new enrollees, will complete health questionnaires and provide serum samples for analysis to determine if PBB exposure is associated with neurodegenerative diseases, joint pain/disorder, cancer, immune function and liver/pancreatic problems. If any of the self-identified adverse outcomes are associated with PBB exposure, additional funding will be sought to further explore these associations. Finally, the public health action plan will seek t raise environmental health awareness in Michigan. Educational programs will be developed for healthcare providers, policy-makers, and citizens to increase local capacity to address exposure concerns. ExpandCollapse Abstract