The NIEHS is a much stronger institution than it was five years ago, according to a January 1998 report by the NIEHS External Review Working Group. The group is made up primarily of representatives from academia, many of whom are current or former members of external review or advisory panels to the institute, and a third of whom have had no prior association with the NIEHS. Kenneth Olden, director of the NIEHS, convened the panel in December 1996 to evaluate the overall direction and organization of the institute.
The group worked on its review over the course of a year, meeting six times between December 1996 and May 1997 and finalizing its report in January 1998. Group members interviewed many current and former staff members of the NIEHS, as well as representatives from other federal agencies. The report focuses on five areas of the NIEHS: the extramural research program, the intramural research program, the National Toxicology Program (NTP), the clinical research program, and interactions with other federal agencies.
Because of the progress that has been achieved over the past few years, the group did not recommend that any major changes be made in the operation or direction of the NIEHS. "The crux of the report is that the institute is in fact on a good track and that it is a viable, well-functioning institution," says Sheila Newton, director of the NIEHS Office of Policy Planning and Evaluation, who provided assistance to the working group.
The group does make some recommendations for additional activities to improve the quality of NIEHS extramural and intramural research programs, but notes that these activities would require additional funding. The group acknowledges that the current NIEHS budget is too small to support its mandate. According to the report, "NIEHS's budget represents only 6 percent of the federal budget for environmentally related research and development, but it provides what is estimated as more than 50 percent of the data on which environmental regulations are based in this country." Overall, the report is positive. "The main recommendations involved improving communications, and small organizational issues here and there," Newton says. In response to the report, the NIEHS has since developed an action plan to address the recommendations made by the group.
Extramural Research Program
The working group makes several recommendations to improve the Division of Extramural Research and Training (DERT). In examining the institute's means of attracting new investigators to environmental health sciences, the group notes that, unlike the National Institutes of Health (NIH) as a whole, the NIEHS has received a significantly increased number of grant applications since Fiscal Year 1991. The group recommends that DERT work with the director of the Center for Scientific Review and other NIH entities to improve the referral process for proposals sent to the NIEHS. The NIEHS action plan notes that DERT staff and directors are working to incorporate the needs and scientific directions of the NIEHS research portfolio into the referral process, and will continue to do so. "The diseases and disorders that are important to the NIEHS mission overlap extensively with those that are important to other agencies," Newton says.
The working group also evaluated the DERT Centers Program. While it states that the program is operating efficiently overall, the group believes that the number of centers in the program may be too high for the institute's budget to support. The report also recommends that DERT eliminate the Developmental Centers Program, because it appears to be ineffective in both serving its function of promoting institutions to full center status and reaching its goal of focusing on underserved communities, an area that could be shifted to the Environmental Justice Program. The NIEHS currently plans to curtail the Developmental Centers Program following the current round of competition, according to the action plan. The NIEHS will also monitor the quality and effectiveness of its Centers Program to ensure that the program objectives are being met.
The NIEHS extramural training program is in need of fine-tuning, states the working group, which recommends that a more comprehensive review of the program be conducted. For instance, the group's report points out that there is a high ratio of predoctoral fellowships to postdoctoral fellowships, and states that the NIEHS should work to attain a balance between the two. Anne Sassaman, director of DERT, says that an evaluation of the DERT training program has been planned, and she is pleased that the report supports an evaluation.
The group also suggests that more input from the National Advisory Environmental Health Sciences Council (an external chartered committee that provides overall review of the NIEHS's programs) and improved communication with the Division of Intramural Research (DIR) would result in stronger extramural program planning. "The group offers some helpful suggestions," says Sassaman. However, she says the report overstates the communications issue between the divisions. In response, a more formal communications system is being established.
Intramural Research Program
The working group report praises the quality of researchers in the DIR, which conducts research relevant to the institute's mission within the NIEHS. "Overall, the scientific credentials and prestige of the research scientists at the NIEHS are outstanding, as good or better than those in the other NIH intramural programs," states the report.
The group commends the scientific peer-review process of the intramural program, as well as the personnel organization. However, the report states concerns that the scientific staff is becoming top-heavy with senior scientists, and recommends that the DIR work to recruit junior investigators, such as those on the assistant professor level. According to the action plan, the DIR is currently conducting three national searches for junior-level scientists, and the division intends to have more tenure-track recruitments in future years. In addition, the group observes that there are few clinically trained physician-scientists on staff, and that there are insufficient in-house training opportunities for medical students interested in environmental health sciences. The action plan says that the NIEHS supports this recommendation and agrees that there needs to be additional efforts devoted to training medical students. The plan does cite the NIEHS Medical Student Training Program, which was developed last year and was recently opened to all medical students, rather than just the third-year students for which it was originally intended.
As for research planning, the group says in the report that it is concerned about how the NIEHS conducts planning and how the intramural program fits into the overall scheme of national environmental health research. The report suggests that the DIR could support more environment-related research through innovative funding opportunities for postdoctoral fellows and junior investigators, or through awards to two or more investigators to focus their combined expertise on a particular environmental health problem. These efforts are already underway in the DIR, according to Steven Akiyama, the division's associate director for research and training.
The working group report rates the DIR as excellent in evaluating research priorities, but states that the program fails to target several important areas. Specifically, the report recommends that the NIEHS expand its intramural programs in certain areas such as pulmonary biology, neuroscience, and immunology. The report also emphasizes the importance of the NIEHS's role in research on childhood diseases, and recommends that the institute increase its commitment to developmental biology problems. The action plan states that the NIEHS has begun the process of augmenting its program to include these recommended areas of research.
National Toxicology Program
The NTP was established by Congress as a cooperative effort to coordinate the public health efforts of federal agencies that deal with toxicants in the environment, to conduct toxicological research, and to strengthen the science base in toxicology. The NTP is directed under the NIEHS intramural program through the Environmental Toxicology Program. The working group report praises the NTP for its effectiveness and calls the administration "sound and progressive."
The report suggests that the NIEHS should evaluate the quality of grant applications related to NTP objectives, and that the NIEHS should make optimum use of a small grants program to exploit new leads uncovered in the course of formal testing. "We were pleased with the review since we've worked hard to integrate the toxicology program with the intramural program," says George Lucier, director of the NTP. "We agree with the comments that it's important to build upon our interactions with the grants program, and we're exploring ways to expand the small grants program."
Clinical Research Program
The working group also reviewed the NIEHS's plans to expand its clinical research program. The official proposal for the clinical program includes three major goals: to translate advances in understanding of the environmental causes of disease into prevention/intervention strategies; to translate basic research in genetics and molecular biology to better understand the underlying mechanisms and environmental causes of human diseases; and to train clinical researchers in environmental health sciences.
The report is critical of the current status of the clinical research program, stating that there are not sufficient staff to address the issues and there is no infrastructure to support such a program. Furthermore, without additional funding, the program's objectives would be achieved at the expense of existing programs. The group suggests that the NIEHS review the feasibility of the program and look at ways to work with other agencies, for example, by conducting treatment trials at the NIH Clinical Center in Bethesda, Maryland. According to NIEHS scientific director Carl Barrett, the NIEHS is currently reevaluating the mechanism for implementing the program, and the action plan states that the institute will examine ways to undertake prevention trials in partnership with external researchers, and that the institute is actively pursuing possibilities for collaborating on clinical studies at the NIH Clinical Center.
Collaboration with Other Agencies
While the NIEHS director is doing an "outstanding" job of representing the institute to a broad constituency, according to the report, there is a need to address relationships between the NIEHS and other agencies. For example, the report stresses that interagency cooperation is important to the future of environmental health, and that the NIEHS should work to improve agency collaboration where possible under the law. "The NIEHS recognizes the critical importance of collaboration with other NIH institutes in order to fulfill its mission to support environmental health sciences research in cross-disciplinary areas," states the NIEHS action plan. "The NIEHS is working to expand its communication and collaboration with other institutes."
The working group report also recommends that the NIEHS strive to enhance interactions and expand collaborations in areas of common interest with other NIH bodies. For example, the NIEHS could work with the National Institute of Allergy and Infectious Diseases in the areas of waterborne infections, indoor air pollution, and respiratory disease, says the report. In addition, the NIEHS should work with other agencies to identify gaps in databases and exposure assessment. The report encourages the NIEHS to more aggressively seek opportunities to receive funding from other agencies and sources, such as the Department of Energy's environmental management research program. The action plan states that the NIEHS will work to pursue partnerships with other agencies to conduct and fund research of joint interest.
A recurring theme in the working group report is the recommendation that the NIEHS endeavor to improve communications both internally and externally--between the divisions of intramural and extramural research, as well as with other agencies--in order to better coordinate its overall objectives.
NIEHS administrators have begun carrying out the group's recommendations. "We are hoping to continue to improve the quality of the work here as we have in the past,and make the institute even better in the next five years," says Kenneth Olden, director of the NIEHS.
Brandy E. Fisher
Last Updated: July 23, 1998
