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Chen J, Fang J, Zhang Y, Xu Z, Byun HM, Li PH, Deng F, Guo X, Guo L, Wu S. Associations of adverse pregnancy outcomes with high ambient air pollution exposure: Results from the Project ELEFANT. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 761:143218. [PMID: 33190892 DOI: 10.1016/j.scitotenv.2020.143218] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/18/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Investigations on the potential effects of high air pollution exposure before pregnancy on adverse pregnancy outcomes are limited, and it is unknown whether air quality standards looser than that set by World Health Organization (WHO) still can provide sufficient protection pregnant women from adverse pregnancy outcomes. OBJECTIVES To evaluate the potential effects of high ambient air pollution around pregnancy on preterm birth (PTB) and low birth weight (LBW), and assess the risk of PTB and LBW associated with air pollutants with reference to different air quality standards of WHO and China. METHODS Our study leveraged 10,960 pregnant women from the Project ELEFANT. Daily average particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) and ≤10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone (O3) concentrations were collected based on Chinese Air Quality Reanalysis datasets. Hazard ratios (HR) of PTB and LBW were estimated for maternal PM2.5, PM10, NO2, SO2, CO and O3 exposures and related proportions of days with daily average air pollution concentrations exceeding air quality standards of WHO and China around pregnancy using Cox proportional hazards regression models with adjustment for potential confounders. RESULTS Ambient PM2.5, PM10, NO2, SO2 and CO exposure during the before pregnancy and pregnancy period were both significantly and positively associated with increased risk of PTB, PTB subtypes and LBW. A 10% increase in proportion of days with daily average PM2.5 exceeding 25 μg/m3 over the entire pregnancy was most apparently associated with risk of PTB (HR, 12.66; 95% CI, 8.20-19.53) and LBW (HR, 17.42; 95% CI, 6.88-44.10) among all PM2.5 proportion variables based on different air quality standards. CONCLUSION Air quality standards of WHO are necessary to be implemented to control for risks of adverse pregnancy outcomes associated with ambient air pollution in areas with high air pollution levels.
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Affiliation(s)
- Juan Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Junkai Fang
- Tianjin Institute of Medical & Pharmaceutical Sciences, Tianjin, China
| | - Ying Zhang
- Medical Genetic Laboratory, Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhouyang Xu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Hyang-Min Byun
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Peng-Hui Li
- School of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Liqiong Guo
- Institute of Disaster Medicine, Tianjin University, Tianjin, China.
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China; Key Laboratory of Molecular Cardiovascular Sciences, Peking University, Ministry of Education, China.
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Lee KS, Kim HI, Kim HY, Cho GJ, Hong SC, Oh MJ, Kim HJ, Ahn KH. Association of Preterm Birth with Depression and Particulate Matter: Machine Learning Analysis Using National Health Insurance Data. Diagnostics (Basel) 2021; 11:diagnostics11030555. [PMID: 33808913 PMCID: PMC8003604 DOI: 10.3390/diagnostics11030555] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 12/30/2022] Open
Abstract
This study uses machine learning and population data to analyze major determinants of preterm birth including depression and particulate matter. Retrospective cohort data came from Korea National Health Insurance Service claims data for 405,586 women who were aged 25–40 years and gave births for the first time after a singleton pregnancy during 2015–2017. The dependent variable was preterm birth during 2015–2017 and 90 independent variables were included (demographic/socioeconomic information, particulate matter, disease information, medication history, obstetric information). Random forest variable importance was used to identify major determinants of preterm birth including depression and particulate matter. Based on random forest variable importance, the top 40 determinants of preterm birth during 2015–2017 included socioeconomic status, age, proton pump inhibitor, benzodiazepine, tricyclic antidepressant, sleeping pills, progesterone, gastroesophageal reflux disease (GERD) for the years 2002–2014, particulate matter for the months January–December 2014, region, myoma uteri, diabetes for the years 2013–2014 and depression for the years 2011–2014. In conclusion, preterm birth has strong associations with depression and particulate matter. What is really needed for effective prenatal care is strong intervention for particulate matters together with active counseling and medication for common depressive symptoms (neglected by pregnant women).
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Affiliation(s)
- Kwang-Sig Lee
- AI Center, Korea University Anam Hospital, Seoul 02841, Korea; (K.-S.L.); (H.-I.K.)
| | - Hae-In Kim
- AI Center, Korea University Anam Hospital, Seoul 02841, Korea; (K.-S.L.); (H.-I.K.)
- School of Industrial Management Engineering, Korea University, Seoul 02841, Korea
- Department of Obstetrics & Gynecology, Korea University Anam Hospital, Seoul 02841, Korea;
| | - Ho Yeon Kim
- Department of Obstetrics & Gynecology, Korea University Ansan Hospital, Ansan 15355, Korea; (H.Y.K.); (H.J.K.)
| | - Geum Joon Cho
- Department of Obstetrics & Gynecology, Korea University Guro Hospital, Seoul 08308, Korea; (G.J.C.); (M.J.O.)
| | - Soon Cheol Hong
- Department of Obstetrics & Gynecology, Korea University Anam Hospital, Seoul 02841, Korea;
| | - Min Jeong Oh
- Department of Obstetrics & Gynecology, Korea University Guro Hospital, Seoul 08308, Korea; (G.J.C.); (M.J.O.)
| | - Hai Joong Kim
- Department of Obstetrics & Gynecology, Korea University Ansan Hospital, Ansan 15355, Korea; (H.Y.K.); (H.J.K.)
| | - Ki Hoon Ahn
- Department of Obstetrics & Gynecology, Korea University Anam Hospital, Seoul 02841, Korea;
- Correspondence: ; Tel.: +82-02-920-6777
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Air pollution and pregnancy outcomes based on exposure evaluation using a land use regression model: A systematic review. Taiwan J Obstet Gynecol 2021; 60:193-215. [PMID: 33678317 DOI: 10.1016/j.tjog.2021.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 11/20/2022] Open
Abstract
This review systematically assessed those studies investigating the association between air pollution and birth outcomes using land use regression (LUR) models for exposure assessment. Fifty-four studies were identified which were published between 2007 and 2019. Most of these were conducted in America, Spain and Canada, while only five were conducted in China. One hundred and ninety-seven LUR models were developed for different pollutants. The main pollutants that these studies assessed were NO2 and PM2.5, and the main pregnancy outcomes investigated were preterm birth (PTB), small for gestational age (SGA) and birth weight. Studies consistently found that NO2 exposure during pregnancy was associated with reduced fetal growth and development. The effect of NO2 on other adverse pregnancy outcomes is unclear. In addition, it was found that increased PM2.5 (aerodynamic equivalent diameter ≤ 2.5 um) exposure during pregnancy reduced birth weight. The effect of PM2.5 on other adverse pregnancy outcomes is also unclear. The relationship between other pollutants and adverse pregnancy outcomes is uncertain based on the existing research. Exposure assessment with LUR modeling has been widely used in Europe and North America, but used less in China. Future studies are recommended to use LUR modeling for individual exposure evaluation in China to better characterize the relationship between air pollution and adverse pregnancy outcomes. In addition, further research is required given that a lot of the associations looked at in the review were inconclusive.
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Wang Q, Miao H, Warren JL, Ren M, Benmarhnia T, Knibbs LD, Zhang H, Zhao Q, Huang C. Association of maternal ozone exposure with term low birth weight and susceptible window identification. ENVIRONMENT INTERNATIONAL 2021; 146:106208. [PMID: 33129003 DOI: 10.1016/j.envint.2020.106208] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/09/2020] [Accepted: 10/10/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Ozone pollution keeps deteriorating in the context of climate change. Maternal ozone exposure may be associated with low birth weight (LBW), but the results are still inconsistent. The identification of the critical exposure windows, a specific period of particular susceptibility during pregnancy, remains unresolved. We aimed to evaluate whether ozone exposure was associated with term LBW and further identify the susceptible exposure windows. METHODS A retrospective cohort study was conducted in Guangzhou, a megacity in the most populous and economically developed city clusters in China. We included 444,096 singleton live births between January 2015 and July 2017. From 11 fixed stations, we collected daily 1-h maximum and 8-h maximum moving average ozone level (O3-1 h and O3-8 h) and calculated exposures for each participant based on their district of residence during pregnancy. We used traditional Logistic regression to estimate the trimester-specific association between ozone exposure and term LBW, and further estimated monthly- and weekly association by distributed lag models (DLMs) with Logistic regression. Odds ratios (ORs) and 95% confidence intervals (CIs) of term LBW were calculated for an interquartile range (IQR) increase in ozone exposure. Stratified analyses and heterogeneity tests were conducted by maternal age and infant sex. RESULTS The incidence of term LBW was 1.9%. During the study period, the mean O3-1 h and O3-8 h levels were 112.6 µg/m3 and 84.5 µg/m3, respectively. Increased O3-1 h (IQR: 90 µg/m3) and O3-8 h (73 µg/m3) exposure during the second trimester were associated with increased risk of term LBW. At a monthly level, the term LBW risk was associated with O3-1 h exposure during the 4th-6th month and O3-8 h exposure during the 6th month. By estimating the weekly-specific association, we observed that critical exposure windows were the 15th- 26th gestational weeks for O3-1 h, and the 20th-26th weeks for O3-8 h, respectively. Estimated ORs and 95% CIs ranged from 1.012 (1.000, 1.024) to 1.023 (1.007, 1.039). When examined by subgroups, the effects were present among women ≥ 35 years or < 25 years old and those with female babies. CONCLUSIONS This study provides compelling evidence that exposure to O3 was associated with increased risk of term LBW, and gestational weeks 15th- 26th was found to be particularly susceptible. These findings provide a research basis for further mechanism examination, public health interventions, and targeted environmental policy-making.
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Affiliation(s)
- Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Huazhang Miao
- Department of Healthcare, Guangdong Women and Children Hospital, Guangzhou, China
| | - Joshua L Warren
- Department of Biostatistics, Yale School of Public Health, New Haven, USA
| | - Meng Ren
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, USA; Scripps Institution of Oceanography, University of California, San Diego, USA
| | - Luke D Knibbs
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Huanhuan Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Qingguo Zhao
- Epidemiological Research Office of Key Laboratory of Male Reproduction and Genetics (National Health and Family Planning Commission), Family Planning Research Institute of Guangdong Province/Family Planning Special Hospital of Guangdong Province, Guangzhou, China.
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, China; School of Public Health, Zhengzhou University, Zhengzhou, China; Shanghai Typhoon Institute, China Meteorological Administration, Shanghai, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China.
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Shang L, Huang L, Yang L, Leng L, Qi C, Xie G, Wang R, Guo L, Yang W, Chung MC. Impact of air pollution exposure during various periods of pregnancy on term birth weight: a large-sample, retrospective population-based cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:3296-3306. [PMID: 32914309 PMCID: PMC7788013 DOI: 10.1007/s11356-020-10705-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/01/2020] [Indexed: 06/02/2023]
Abstract
Previous studies have suggested that maternal exposure to air pollution might affect term birth weight. However, the conclusions are controversial. Birth data of all term newborns born in Xi'an city of Shaanxi, China, from 2015 to 2018 and whose mother lived in Xi'an during pregnancy were selected form the Birth Registry Database. And the daily air quality data of Xi'an city was collected from Chinese Air Quality Online Monitoring and Analysis Platform. Generalized additive models (GAM) and 2-level binary logistic regression models were used to estimate the effects of air pollution exposure on term birth weight, the risk term low birth weight (TLBW), and macrosomia. Finally, 321521 term newborns were selected, including 4369(1.36%) TLBW infants and 24,960 (7.76%) macrosomia. The average pollution levels of PM2.5, PM10, and NO2 in Xi'an city from 2015 to 2018 were higher than national limits. During the whole pregnancy, maternal exposure to PM2.5, PM10, SO2, and CO all significantly reduced the term birth weight and increased the risk of TLBW. However, NO2 and O3 exposure have significantly increased the term birth weight, and O3 even increased the risk of macrosomia significantly. Those effects were also observed in the first and second trimesters of pregnancy. But during the third trimester, high level of air quality index (AQI) and maternal exposure to PM2.5, PM10, SO2, NO2, and CO increased the term birth weight and the risk of macrosomia, while O3 exposure was contrary to this effect. The findings suggested that prenatal exposure to air pollution might cause adverse impacts on term birth weight, and the effects varied with trimesters and pollutants, which provides further pieces of evidence for the adverse effects of air pollution exposure in heavy polluted-area on term birth weight.
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Affiliation(s)
- Li Shang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi People’s Republic of China
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi People’s Republic of China
| | - Liyan Huang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi People’s Republic of China
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi People’s Republic of China
| | - Liren Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi People’s Republic of China
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi People’s Republic of China
| | - Longtao Leng
- School of Computer Science & Engineering, University of Electronic Science and Technology of China, Chengdu, Sichuan People’s Republic of China
| | - Cuifang Qi
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi People’s Republic of China
| | - Guilan Xie
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi People’s Republic of China
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi People’s Republic of China
| | - Ruiqi Wang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi People’s Republic of China
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi People’s Republic of China
| | - Leqian Guo
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi People’s Republic of China
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi People’s Republic of China
| | - Mei Chun Chung
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts USA
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Air Pollution Measurements and Land-Use Regression in Urban Sub-Saharan Africa Using Low-Cost Sensors—Possibilities and Pitfalls. ATMOSPHERE 2020. [DOI: 10.3390/atmos11121357] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Air pollution is recognized as the most important environmental factor that adversely affects human and societal wellbeing. Due to rapid urbanization, air pollution levels are increasing in the Sub-Saharan region, but there is a shortage of air pollution monitoring. Hence, exposure data to use as a base for exposure modelling and health effect assessments is also lacking. In this study, low-cost sensors were used to assess PM2.5 (particulate matter) levels in the city of Adama, Ethiopia. The measurements were conducted during two separate 1-week periods. The measurements were used to develop a land-use regression (LUR) model. The developed LUR model explained 33.4% of the variance in the concentrations of PM2.5. Two predictor variables were included in the final model, of which both were related to emissions from traffic sources. Some concern regarding influential observations remained in the final model. Long-term PM2.5 and wind direction data were obtained from the city’s meteorological station, which should be used to validate the representativeness of our sensor measurements. The PM2.5 long-term data were however not reliable. Means of obtaining good reference data combined with longer sensor measurements would be a good way forward to develop a stronger LUR model which, together with improved knowledge, can be applied towards improving the quality of health. A health impact assessment, based on the mean level of PM2.5 (23 µg/m3), presented the attributable burden of disease and showed the importance of addressing causes of these high ambient levels in the area.
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Sarovar V, Malig BJ, Basu R. A case-crossover study of short-term air pollution exposure and the risk of stillbirth in California, 1999-2009. ENVIRONMENTAL RESEARCH 2020; 191:110103. [PMID: 32846172 DOI: 10.1016/j.envres.2020.110103] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/15/2020] [Accepted: 08/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Associations between ambient air pollution and stillbirth have recently been explored, but most studies have focused on long-term (trimester or gestational averages) rather than short-term (within one week) air pollution exposures. OBJECTIVE To evaluate whether short-term exposures to criteria air pollutants are associated with increased risk of stillbirth. METHODS Using air pollution and fetal death certificate data from 1999 to 2009, we assessed associations between acute prenatal air pollution exposure and stillbirth in California. In a time-stratified case-crossover study, we analyzed single day and/or cumulative average days (up to a 6 day lag) of exposure to fine (PM2.5) and coarse particles (PM10-2.5), ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO) for mothers estimated to reside within 10 km of a pollution monitor based on reported zip code. We also examined potential confounding by apparent temperature or co-pollutants, and effect modification by maternal demographic factors, fetal sex, gestational age, and cause of stillbirth. RESULTS Stillbirth cases in the primary analyses ranged between 1,203 and 13,018, depending on the pollutant. For an IQR increase in SO2 (lag 4), O3 (lag 4), and PM10-2.5 (lag 2), we found a 2.8% (95% confidence interval (CI) 0.2%, 5.5%), 5.8% (95% CI 1.6%, 10.1%), and 6.1% (95% CI 0.1%, 12.4%) increase in the odds of stillbirth, respectively. Additional adjustment by apparent temperature had little effect on the SO2 association but slightly attenuated O3 (adjusted % change: 4.2% (95% CI -0.2%, 8.9%) and PM10-2.5 (5.7% (95% CI -1.1%, 13.0%)) associations, while other co-pollutants had minimal impact. Associations were observed specifically for stillbirths from obstetric complications and in women with higher educational attainment. CONCLUSIONS This study provides evidence for associations between prenatal short-term air pollution exposure, specifically SO2, O3, and PM10-2.5, and stillbirth in California and warrants replication of findings in other settings.
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Affiliation(s)
- Varada Sarovar
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA; Division of Biostatistics, School of Public Health, UC Berkeley, Berkeley, CA, USA
| | - Brian J Malig
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA.
| | - Rupa Basu
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
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Li C, Yang M, Zhu Z, Sun S, Zhang Q, Cao J, Ding R. Maternal exposure to air pollution and the risk of low birth weight: A meta-analysis of cohort studies. ENVIRONMENTAL RESEARCH 2020; 190:109970. [PMID: 32763280 DOI: 10.1016/j.envres.2020.109970] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/07/2020] [Accepted: 07/16/2020] [Indexed: 05/14/2023]
Abstract
Previous studies have evaluated the relationship between prenatal air pollution exposure and low birth weight, but the results are inconsistent. The purpose of this meta-analysis is to quantitatively analyze the relationship between maternal air pollutant exposure and low birth weight (LBW). PubMed and Web of Science databases were searched to obtain the studies on the relationship between the prenatal exposure of air pollutants and LBW that published as of June 2020. The pooled effects of air pollutant exposure and LBW were calculated using random-effect model (for studies with significant heterogeneity) or fixed-effect model (for studies without significant heterogeneity). Totally, 54 studies were included in this meta-analysis. The pooled effect of PM2.5, PM10, NO2, CO, SO2, and O3 exposure on LBW were 1.081 (95% CI: 1.043, 1.120), 1.053 (95% CI: 1.030, 1.076), 1.030 (95% CI: 1.008, 1.053), 1.007 (95% CI: 1.001, 1.014), 1.125 (95% CI: 1.017, 1.244), and 1.045 (95% CI: 1.005, 1.086), respectively. NO2 (per 10 ppb increase) and CO (per 100 ppb increase) exposure in the first trimester were positively correlated with LBW, of which the pooled effect was 1.022 (95% CI: 1.009, 1. 035) and 1.008 (95% CI: 1.004, 1.012), respectively. PM2.5 (per 10 μg/m3 increase) exposure in the third trimester significantly affected the LBW, of which the pooled effect was 1.053 (95% CI: 1.010, 1.097). In addition, PM10 (per 10 μg/m3 increase) exposure in the second trimester also significantly affected the LBW, with the pooled effect of 1.011 (95% CI: 1.005, 1.017). Prenatal exposure of the major air pollutants during the entire pregnancy could increase the risk of LBW, while the susceptible window of the pollutants varied.
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Affiliation(s)
- Changlian Li
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Mei Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Zijian Zhu
- Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Shu Sun
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Qi Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Jiyu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China; Department of Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Rui Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
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Qiu X, Fong KC, Shi L, Papatheodorou S, Di Q, Just A, Kosheleva A, Messerlian C, Schwartz JD. Prenatal exposure to particulate air pollution and gestational age at delivery in Massachusetts neonates 2001-2015: A perspective of causal modeling and health disparities. Environ Epidemiol 2020; 4:e113. [PMID: 33154990 PMCID: PMC7595249 DOI: 10.1097/ee9.0000000000000113] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/23/2020] [Indexed: 11/26/2022] Open
Abstract
There is a lack of evidence on causal effects of air pollution on gestational age (GA) at delivery. METHODS Inverse probability weighting (IPW) quantile regression was applied to derive causal marginal population-level GA reduction for GA percentiles associated with increased ambient particulate matter with diameter <2.5 μm (PM2.5) levels at maternal residential address for each trimester and the month preceding delivery using Massachusetts birth registry 2001 to 2015. Stratified analyses were conducted for neonatal sex, maternal age/race/education, and extreme ambient temperature conditions. RESULTS For neonates at 2.5th, 10th, 25th, 50th, 75th, and 97.5th percentiles of GA at delivery, we estimated an adjusted GA reduction of 4.2 days (95% confidence interval [CI] = 3.4, 5.0), 1.9 days (1.6, 2.1), 1.2 days (1.0, 1.4), 0.82 days (0.72, 0.92), 0.74 days (0.54, 0.94), and 0.54 days (0.15, 0.93) for each 5 μg/m3 increment in third trimester average PM2.5 levels. Final gestational month average exposure yielded a similar effect with greater magnitude. Male neonates and neonates of younger (younger than 35 years) and African American mothers as well as with high/low extreme temperature exposure in third trimester were more affected. Estimates were consistently higher at lower GA percentiles, indicating preterm/early-term births being more affected. Low-exposure analyses yielded similar results, restricting to areas with PM2.5 levels under US ambient annual standard of 12 μg/m3. CONCLUSIONS Prenatal exposure to PM2.5 in late pregnancy reduced GA at delivery among Massachusetts neonates, especially among preterm/early-term births, male neonates, and neonates of younger and African American mothers. Exposure to extremely high/low temperature amplifies the effect of PM2.5 on GA.
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Affiliation(s)
- Xinye Qiu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kelvin C Fong
- School of the Environment, Yale University, New Haven, Connecticut
| | - Liuhua Shi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Stefania Papatheodorou
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Qian Di
- School of Medicine, Tsinghua University, Beijing, China
| | - Allan Just
- Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Anna Kosheleva
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Carmen Messerlian
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Li L, Du T, Zhang C. The Impact of Air Pollution on Healthcare Expenditure for Respiratory Diseases: Evidence from the People's Republic of China. Risk Manag Healthc Policy 2020; 13:1723-1738. [PMID: 33061706 PMCID: PMC7522429 DOI: 10.2147/rmhp.s270587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/03/2020] [Indexed: 12/02/2022] Open
Abstract
Background Air pollution is an important factor in health outcomes and health-care expenditure. It has become an important issue of global concern. The objective of this study was to explore the influence of air pollution on the economic burden of respiratory diseases using different levels of PM2.5. Methods Starting from the demand side, we took the 3,546 patients in the Respiratory and Critical Care Department of a tertiary hospital in Beijing between 2013 and 2015 as examples, combining daily air-quality data using a generalized linear regression–analysis model to explore the impact of air pollution on health-care expenditure on a microindividual level. Results We found that PM2.5 had a significant impact on health-care expenditure on respiratory diseases. It had a positive impact on total health-care expenditure, drug expenditure, and antibiotic expenditure. The impact of different levels of air pollution on the health care–expenditure burden of disease was heterogeneous. As the air-pollution index increased, health care–expenditure burden of respiratory diseases also gradually raised. The impact of PM10 and air-quality index had a positive impact on health-care expenditure for respiratory diseases. Air pollution had a significant impact on health care–expenditure burden of respiratory diseases. The effect of length of stay on various health-care expenditure was significantly positive. Conclusion The impact of mortality-risk classification on various health-care expenditure is significant. Therefore, policy-making must take into account both the supply side and the demand side of health-care services. Furthermore, the government should strengthen environmental governance, pay attention to the heterogeneity of the health care–expenditure burden affected by environmental pollution, improve the medical insurance system, and improve the health of residents to reduce the health care–expenditure burden.
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Affiliation(s)
- Lele Li
- School of Public Policy and Management, Tsinghua University, Beijing 100084, People's Republic of China
| | - Tiantian Du
- Institute for Hospital Management, Tsinghua University, Shenzhen 518055, People's Republic of China
| | - Chi Zhang
- Chinese Academy of Fiscal Sciences, Beijing 100142, People's Republic of China
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Wang L, Guo P, Tong H, Wang A, Chang Y, Guo X, Gong J, Song C, Wu L, Wang T, Hopke PK, Chen X, Tang NJ, Mao H. Traffic-related metrics and adverse birth outcomes: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2020; 188:109752. [PMID: 32516633 DOI: 10.1016/j.envres.2020.109752] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 05/09/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
Given the inconsistency of epidemiologic evidence for associations between maternal exposures to traffic-related metrics and adverse birth outcomes, this manuscript aims to provide clarity on this topic. Pooled meta-estimates were calculated using random-effects analyses. Subgroup analyses were conducted by study area, study design, and Newcastle-Ottawa quality score (NOS). Funnel plots and Egger's test were conducted to evaluate the publication bias, and Fail-safe Numbers (Fail-safe N) were measured to evaluate the robustness of models. From the initial 740 studies (last search, July 11, 2019), 26 studies were included in our analysis. The pooled odds ratio for the change in small for gestational age associated with per 500 m decrease in the distance to roads was 1.016 (95% CI: 1.004, 1.029). Subgroup analyses revealed significant positive associations between term low birth weight and traffic density in higher-quality literatures with higher NOS [1.060 (95% CI: 1.002, 1.121)], cohort studies [1.020 (95% CI: 1.006, 1.033)], and studies in North America [1.018 (95% CI: 1.005, 1.131)]. The buffer of traffic density made no difference in the effect size. Traffic density seemed to be a better indicator of traffic pollution than the distance to roads.
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Affiliation(s)
- Lijun Wang
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Pengyi Guo
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Key Laboratory of Environment, Nutrition and Public Health, 300070, Tianjin, China
| | - Hui Tong
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Anxu Wang
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Ying Chang
- Tianjin Center Hospital of Obstetrics and Gynecology, Tianjin Key Laboratory of Human Development and Reproductive Regulation, China
| | - Xuemei Guo
- University Library, Tianjin Medical University, Tianjin, 300070, China
| | - Junming Gong
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Key Laboratory of Environment, Nutrition and Public Health, 300070, Tianjin, China
| | - Congbo Song
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Lin Wu
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Ting Wang
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Philip K Hopke
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China; Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Key Laboratory of Environment, Nutrition and Public Health, 300070, Tianjin, China.
| | - Nai-Jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Key Laboratory of Environment, Nutrition and Public Health, 300070, Tianjin, China.
| | - Hongjun Mao
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China.
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Zhang M, Wang X, Yang X, Dong T, Hu W, Guan Q, Tun HM, Chen Y, Chen R, Sun Z, Chen T, Xia Y. Increased risk of gestational diabetes mellitus in women with higher prepregnancy ambient PM 2.5 exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 730:138982. [PMID: 32388108 DOI: 10.1016/j.scitotenv.2020.138982] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Air pollution is a serious environmental problem in China. This study was designed to investigate whether exposure to particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5) before pregnancy is associated with gestational diabetes mellitus (GDM) and fasting glucose in China. METHODS We recruited subjects and collected clinical data from the Nanjing Maternity and Child Health Care Hospital from July 2016 to October 2017. A series of validated land-use regression (LUR) models were built to assess individual exposure to PM2.5 in a 1 × 1 km area at both work and home addresses following a time-weighted pattern. Multiple linear regression and logistic regression analyses were performed to examine the association between PM2.5 exposure and GDM and fasting glucose. RESULTS In total, 11,639 of 16,995 women were included in the final analysis. Among the 11,639 women, 2776 (23.85%) had GDM. Individual exposure to PM2.5 within three months before pregnancy ranged from 21.58 to 85.92 μg/m3. Positive associations were observed among the interquartile ranges (IQRs) of exposure to PM2.5 within three months before pregnancy and GDM (OR = 2.61, 95% CI: 1.40-4.93, p < .01) as well as fasting glucose levels (β = 0.57, 95% CI: 0.45-0.68, p < .01). The diabetogenic effects of PM2.5 gradually increased from the first month before pregnancy, peaked in the second month and then gradually decreased until the third month when the week-specific exposure were analyzed to identify the sensitive time window. CONCLUSION Our study confirmed that higher exposure to PM2.5 within three months before pregnancy is significantly associated with increased risk of GDM and elevated fasting glucose levels, reflecting the importance of preconceptional environmental exposure in the development of maternal GDM.
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Affiliation(s)
- Mingzhi Zhang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xu Wang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xu Yang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Tianyu Dong
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Weiyue Hu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Quanquan Guan
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Hein M Tun
- HKU-Pasteur Research Pole, School of Public Health, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yi Chen
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, China
| | - Rui Chen
- School of Public Health, Capital Medical University, China
| | - Zhiwei Sun
- School of Public Health, Capital Medical University, China
| | - Ting Chen
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Hospital, Nanjing, China.
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
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Seposo X, Ueda K, Sugata S, Yoshino A, Takami A. Short-term effects of air pollution on daily single- and co-morbidity cardiorespiratory outpatient visits. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 729:138934. [PMID: 32371210 DOI: 10.1016/j.scitotenv.2020.138934] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 04/14/2023]
Abstract
Several studies have noted that the existence of comorbidities lead to an increase in the risk of premature mortality and morbidity. Most of the studies examining the effects of air pollution on comorbidity visits were from Northern American countries, with scarce literature from Asia. This study contributes to existing, yet limited understanding of air pollution-comorbidity by examining the effects of daily air pollutants on outpatient single morbidity and comorbid cardiorespiratory visits in Japan. A total of 1,452,505 outpatient cardiorespiratory visits were recorded among the 21 Japanese cities from 2013 to 2016. Daily outpatient cardiorespiratory visit data were obtained from a health insurance claims database managed by the Japan Medical Data Center Co., Ltd. (JMDC). A time-stratified case crossover analysis coupled with Generalized Additive Mixed Model was used to analyze the association of daily air pollutants (particulate matter 2.5 μm or less in diameter, ozone and nitrogen dioxide) on daily single (respiratory and cardiovascular) and comorbidity health outcomes. We further examined single and cumulative effects for 0-3 and 0-14 lag periods. Ozone, NO2, and PM2.5 were positively associated with cardiorespiratory visits in either shorter or longer lags, with more apparent comorbidity associations with NO2 exposure. A 10-unit increase in NO2, after adjusting for ozone, was associated with a 2.24% (95% CI: 1.34-3.15) and 6.49% (95% CI: 5.00-8.01) increase in comorbidity visit at Lag 0 (of Lag 0-3) and cumulative lag 0-3, respectively. Our results contribute to existing evidence suggesting that short-term and extended exposure to air pollution elicit health risks on cardiovascular, respiratory and comorbid clinic visits. Exposure to NO2, in particular, was associated with increase in the risk of single and comorbidity cardiorespiratory visits. Results can be potentially utilized for both individual health (e.g. risk population health management) and health facility management (e.g. health visit influx determination).
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Affiliation(s)
- Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Japan.
| | - Kayo Ueda
- Environmental Health Division, Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Japan; Environmental Health Sciences, Department of Global Ecology, Graduate School of Global Environmental Studies, Kyoto University, Japan
| | - Seiji Sugata
- Center for Regional Environmental Research, National Institute for Environmental Studies, Japan
| | - Ayako Yoshino
- Center for Regional Environmental Research, National Institute for Environmental Studies, Japan
| | - Akinori Takami
- Center for Regional Environmental Research, National Institute for Environmental Studies, Japan
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64
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Falkner B. Maternal and gestational influences on childhood blood pressure. Pediatr Nephrol 2020; 35:1409-1418. [PMID: 30790042 DOI: 10.1007/s00467-019-4201-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/11/2019] [Accepted: 01/15/2019] [Indexed: 01/25/2023]
Abstract
Exposures that contribute to a sub-optimal intrauterine environment can have an effect on the developing fetus. Impaired fetal growth that results in low birth weight is an established risk factor for cardio-metabolic disorders later in life. Recent epidemiologic and prospective cohort studies that include the maternal and gestational period have identified maternal and gestational conditions that confer increased risk for subsequent cardio-metabolic disorders in the absence of low birth weight. Maternal pre-conception health status, including chronic obesity and type 2 diabetes, increase risk for childhood obesity and obesity-related higher blood pressure (BP) in child offspring. Maternal gestational exposures, including gestational diabetes, gestational hypertension, and preeclampsia, are associated with higher BP in offspring. Other maternal exposures such as cigarette smoke and air pollution also increase risk for higher BP in child offspring. Recent, but limited, data indicate that assisted reproductive technologies can be associated with hypertension in childhood, despite otherwise normal gestation and healthy newborn. Gestational exposures associated with higher BP in childhood can be related to familial lifestyle factors, genetics, or epigenetic modification of fetal deoxyribonucleic acid (DNA). These factors, or combination of factors, as well as other adverse intrauterine conditions, could induce fetal programing leading to health consequences in later life. Current and developing research will provide additional insights on gestational exposures and fetal adjustments that increase risk for higher BP levels in childhood.
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Affiliation(s)
- Bonita Falkner
- Department of Medicine and Pediatrics, Thomas Jefferson University, 833 Chestnut St. Ste. 7000, Philadelphia, PA, 19107, USA.
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Nielsen CC, Amrhein CG, Shah PS, Stieb DM, Osornio-Vargas AR. Space-time hot spots of critically ill small for gestational age newborns and industrial air pollutants in major metropolitan areas of Canada. ENVIRONMENTAL RESEARCH 2020; 186:109472. [PMID: 32298842 DOI: 10.1016/j.envres.2020.109472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 05/06/2023]
Abstract
We assessed the association of spatiotemporal hot spots of critically ill small for gestational age (ciSGA) newborns and industrial air emissions. Using neonatal admission data from the Canadian Neonatal Network between 2006 and 2010 (n = 32,836 infants), we aggregated maternal residential postal codes from nineteen census metropolitan areas (CMA) into space-time cubes and applied emerging hot spot analyses. Using National Pollutant Release Inventory data (n = 161 chemicals) and Environment Canada weather station data (n = 19 sites), we estimated monthly wind-dispersion of air emissions and calculated hot spots. We associated the patterns using logistic regression, with covariates for low socioeconomic status, NO2 pollution, and number of infants. A total of 5465 infants were identified as ciSGA and the larger CMAs had more and larger hot spots (i.e. accumulation of events in space and time). Seventy-eight industrial chemical hot spots were associated with ciSGA hot spots. The highest number of positive associations were for 28 different pollutants, which differed by CMA. Twenty-one were known or suspected developmental toxicants, such as particulate matter, carbon monoxide, heavy metals, and volatile organic compounds. Associations with hot spots of industrial chemical emissions were geographically specific and may help explain the space-time trends of ciSGA.
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Affiliation(s)
- Charlene C Nielsen
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada; Department of Earth and Atmospheric Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Carl G Amrhein
- Department of Earth and Atmospheric Sciences, University of Alberta, Edmonton, Alberta, Canada; Faculty of Arts and Sciences, Aga Khan University, Nairobi, Kenya, Karachi, Pakistan
| | - Prakesh S Shah
- Department of Pediatrics and Institute of Health Policy, Management, and Evaluation, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - David M Stieb
- Environmental Health Science and Research Bureau, Health Canada, Government of Canada, Vancouver, British Columbia, Canada
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Testing the Multiple Pathways of Residential Greenness to Pregnancy Outcomes Model in a Sample of Pregnant Women in the Metropolitan Area of Donostia-San Sebastián. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124520. [PMID: 32586011 PMCID: PMC7345127 DOI: 10.3390/ijerph17124520] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 12/16/2022]
Abstract
Residential greenness may positively impact diverse human health indicators through the reduction of air pollution, the improvement of psychological health, and the promotion of physical activity. Previous studies indicate a weak but positive association with pregnancy outcomes. Our aim was to test the multiple pathways from residential greenness to pregnancy outcomes model, using residential NO2 concentrations, psychological health, and moderate-to-vigorous physical activity (MVPA) during the first trimester of pregnancy, in a sample of 440 pregnant women residing in Donostia, Spain. Three metrics of residential greenness were calculated around each participant’s home address: normalized difference vegetation index (NDVI) within 300 m, and green space (>5000 m2) availability within 300 and 500 m. Residential NO2 concentrations, psychological health, and MVPA were explored as mediators of the associations between these metrics and the following pregnancy outcomes: birth weight (BW), low birth weight (LBW), prematurity, small for gestational age (SGA), and large for gestational age (LGA). Educational attainment, parity, and body mass index (BMI) were treated as covariates. Counterfactual mediation analyses showed very low to null statistical support for an association between any of the greenspace metrics and pregnancy outcomes in the full sample. Green space availability (300 m) was associated with lower BW and showed a marginal protective effect against LGA.
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Shashar S, Kloog I, Erez O, Shtein A, Yitshak-Sade M, Sarov B, Novack L. Temperature and preeclampsia: Epidemiological evidence that perturbation in maternal heat homeostasis affects pregnancy outcome. PLoS One 2020; 15:e0232877. [PMID: 32421729 PMCID: PMC7234374 DOI: 10.1371/journal.pone.0232877] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/22/2020] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION This study aims to determine the association between temperature and preeclampsia and whether it is affected by seasonality and rural/urban lifestyle. METHODS This cohort study included women who delivered at our medical center from 2004 to 2013 (31,101 women, 64,566 deliveries). Temperature values were obtained from a spatiotemporally resolved estimation model performing predictions at a 1×1km spatial resolution. In "Warm" pregnancies >50% of gestation occurred during the spring-summer period. In cold pregnancies >50% of gestation occurred during the fall and winter. Generalized estimating equation multivariable models were used to estimate the association between temperature and incidence of preeclampsia. RESULTS 1) The incidence of preeclampsia in at least one pregnancy was 7% (2173/64,566); 2) during "warm" pregnancies, an elevation of one IQR of the average temperature in the 1st or the 3rd trimesters was associated with an increased risk to develop preeclampsia [patients with Jewish ethnicity: 1st trimester: relative risk (RR) of 2.38(95%CI 1.50; 3.80), 3rd trimester 1.94(95%CI 1.34;2.81); Bedouins: 1st trimester: RR = 2.91(95%CI 1.98;4.28), 3rd trimester: RR = 2.37(95%CI 1.75;3.20)]; 3) In "cold" pregnancies, an elevation of one IQR of average temperature was associated with a lower risk to develop preeclampsia among patients with Bedouin-Arab ethnicity RR = 0.68 (95% CI 0.49-0.94) for 1st trimester and RR = 0.62 (95% CI 0.44-0.87) for 3rd trimester. CONCLUSIONS 1) Elevated averaged temperature during the 1st or 3rd trimesters in "warm" pregnancies confer an increased risk for the development of preeclampsia, especially in nomadic patients; 2) Of interest, during cold pregnancies, elevated averaged temperature was associated with a lower risk to develop preeclampsia for nomadic patients. 3) These findings suggest temperature might be associated with perturbations in maternal heat homeostasis resulting in reallocation of energy resources and their availability to the fetus that may increase the risk for preeclampsia. This observation is especially relevant in the context of global warming and its effects on maternal/fetal reproductive health.
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Affiliation(s)
- Sagi Shashar
- Clinical Research Center, Soroka University Medical Center, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben Gurion University, Beersheba, Israel
| | - Offer Erez
- Division of Obstetrics and Gynecology, Maternity Department "D", Soroka University Medical Center, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Alexandra Shtein
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben Gurion University, Beersheba, Israel
| | - Maayan Yitshak-Sade
- Department of Environmental Health Exposure, Epidemiology, and Risk Program Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Batia Sarov
- Department of Public Health, Faculty of Heath Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Lena Novack
- Clinical Research Center, Soroka University Medical Center, Ben-Gurion University of the Negev, Beersheba, Israel
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Sarizadeh R, Dastoorpoor M, Goudarzi G, Simbar M. The Association Between Air Pollution and Low Birth Weight and Preterm Labor in Ahvaz, Iran. Int J Womens Health 2020; 12:313-325. [PMID: 32440227 PMCID: PMC7211085 DOI: 10.2147/ijwh.s227049] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 02/20/2020] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Pregnant women and fetuses are sensitive to air pollution due to physiological changes in pregnancy. The aim of this study was to determine the relationship between exposure to air pollution, low birth weight and preterm labor in Ahvaz. METHODS This research was a time-series study. The research sample consisted of all data about low birth weight and preterm labor pregnant women from Imam Khomeini Hospital and Razi Hospital in Ahvaz city. Air pollutant data including O3, NO, NO2, SO2, CO, PM10 and PM2.5 and climate data were collected from the Environmental Protection Agency and the Khuzestan Province during a 10-year period from 2008 to 2018. The generalized additive models (GAMs) with different air pollutant lags up to 6 days were used. RESULTS The results of multiple GAM model have shown that there is a direct and significant relationship between exposure to PM10 at 0-6-day lag, SO2 at 2- and 3-day lag and low birth weight. In addition, there was a direct and significant correlation between exposure to NO2, NO, CO and PM2.5 at 0-6-day lag and preterm labor. CONCLUSION The results indicate the effect of air pollutants on low birth weight and preterm labor. Therefore, pregnant women should be informed about the negative consequences of air pollution and avoid exposure to polluted air during pregnancy.
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Affiliation(s)
- Reihaneh Sarizadeh
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholamreza Goudarzi
- Department of Environmental Health Engineering, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran
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Liu W, Zhou Y, Qin Y, Yu L, Li R, Chen Y, Xu Y. Effects of PM 2.5 exposure during gestation on maternal gut microbiota and pregnancy outcomes. CHEMOSPHERE 2020; 247:125879. [PMID: 31935575 DOI: 10.1016/j.chemosphere.2020.125879] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/06/2020] [Accepted: 01/08/2020] [Indexed: 06/10/2023]
Abstract
A number of studies have reported that fine particulate matter (PM2.5) exposure is associated with adverse pregnancy outcomes. Moreover, PM2.5 exposure contributes to changes of gut microbiota. However, influences of PM2.5 exposure during gestation on maternal gut microbiota and pregnancy outcomes were not well understood. Here we performed a study using mice models. Dams were exposed to PM2.5 suspension by intratracheal instillation on gestational day (GD) 3, 6, 9, 12 and 15. Pregnancy outcomes, maternal gut microbiota and short chain fatty acids on GD 18 were all measured. The fetal body weight of PM2.5 group was significantly lower than that of control group (p < 0.05). Meanwhile, the fetal body length of PM2.5 group was significantly shorter than that of control group (p < 0.05). The Shannon or Simpson index of PM2.5 group were higher than that of control group (p < 0.05). At the phyla level, compared to dams in control group, mice in the PM2.5 group had higher ratio of phyla Proteobacteria, Candidatus Saccharibacteria and Fusobacteria and lower ratio of phyla Acidobacteria, Gemmatimonadetes and Deferribacteres in the gut. Compared with control group, the concentration of isobutyric acid was higher in PM2.5 group, but butyric acid concentration was lower in PM2.5 group (p < 0.05). These findings suggested that prenatal exposure to PM2.5 had an effect on birth weight of fetus. Meanwhile, PM2.5 tracheal exposure during gestation caused changes in the distribution and structure of gut microbiota of dams.
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Affiliation(s)
- Wei Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, 100083, China
| | - Yalin Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, 100083, China
| | - Yong Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, 100083, China
| | - Lanlan Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, 100083, China
| | - Ruijun Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, 100083, China
| | - Yuhan Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, 100083, China
| | - Yajun Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, 100083, China; Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing, 100083, China.
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Elten M, Donelle J, Lima I, Burnett RT, Weichenthal S, Stieb DM, Hystad P, van Donkelaar A, Chen H, Paul LA, Crighton E, Martin RV, Decou ML, Luo W, Lavigne É. Ambient air pollution and incidence of early-onset paediatric type 1 diabetes: A retrospective population-based cohort study. ENVIRONMENTAL RESEARCH 2020; 184:109291. [PMID: 32120123 DOI: 10.1016/j.envres.2020.109291] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/17/2020] [Accepted: 02/21/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Studies have reported increasing incidence rates of paediatric diabetes, especially among those aged 0-5 years. Epidemiological evidence linking ambient air pollution to paediatric diabetes remains mixed. OBJECTIVE This study investigated the association between maternal and early-life exposures to common air pollutants (NO2, PM2.5, O3, and oxidant capacity [Ox; the redox-weighted average of O3 and NO2]) and the incidence of paediatric diabetes in children up to 6 years of age. METHODS All registered singleton births in Ontario, Ca nada occurring between April 1st, 2006 and March 31st, 2012 were included through linkage from health administrative data. Monthly exposures to NO2, PM2.5, O3, and Ox were estimated across trimesters, the entire pregnancy period and during childhood. Random effects Cox proportional hazards models were used to assess the relationships with paediatric diabetes incidence while controlling for important covariates. We also modelled the shape of concentration-response (CR) relationships. RESULTS There were 1094 children out of a cohort of 754,698 diagnosed with diabetes before the age of six. O3 exposures during the first trimester of pregnancy were associated with paediatric diabetes incidence (hazard ratio (HR) per interquartile (IQR) increase = 2.00, 95% CI: 1.04-3.86). The CR relationship between O3 during the first trimester and paediatric diabetes incidence appeared to have a risk threshold, in which there was little-to-no risk below 25 ppb of O3, while above this level risk increased sigmoidally. No other associations were observed. CONCLUSION O3 exposures during a critical period of development were associated with an increased risk of paediatric diabetes incidence.
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Affiliation(s)
- Michael Elten
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario Canada; Air Health Science Division, Health Canada, Ottawa, Ontario, Canada
| | | | - Isac Lima
- ICES UOttawa, Ottawa, Ontario, Canada
| | - Richard T Burnett
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Scott Weichenthal
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - David M Stieb
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario Canada; Environmental Health Science and Research Bureau, Health Canada, Vancouver, British Columbia, Canada
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, USA
| | - Hong Chen
- ICES UOttawa, Ottawa, Ontario, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada; Public Health Ontario, Toronto Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Eric Crighton
- ICES UOttawa, Ottawa, Ontario, Canada; Department of Geography, Environment and Geomatics, University of Ottawa, Ottawa, Ontario, Canada
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, USA
| | - Mary Lou Decou
- Maternal & Infant Health Section, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Wei Luo
- Maternal & Infant Health Section, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Éric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario Canada; Air Health Science Division, Health Canada, Ottawa, Ontario, Canada.
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71
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Zhao B, Wang M, Lü C, Feng L, Ma H, Meng H, Qi M, Fan Q, Wang H, Zhou H, He J. Seasonal response of the synergism of maternal comorbidities and long-term air pollution exposure on birth outcomes. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 191:110232. [PMID: 31986457 DOI: 10.1016/j.ecoenv.2020.110232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/10/2020] [Accepted: 01/17/2020] [Indexed: 06/10/2023]
Abstract
Air pollution has been considered as one of the most important factors associating with various birth outcomes. However, the seasonal response of maternal comorbidities effects associated with air pollution has not been investigated, especially in the city with distinguish seasonal pattern and long heating seasons. In this work, 69,945 live births were investigated from 2013 to 2016, and the seasonal relationship between air pollution and preterm birth and low birth weight were assessed, as well as the synergism of maternal comorbidities. Exposures of six pollutants were assigned to maternal residences during pregnancy. The potential effect modification by maternal comorbidities on the associations was evaluated between prenatal air pollution and preterm birth (PTB), as well as effects of seasons and trimesters. Adjusting for seasonality, all six pollutants presented seasonal relationship with preterm birth, which CO, PM10, NO2, and PM2.5 were with [odds ratio (OR) = 1.035 95% CI: 1.015, 1.055, OR = 1.039 95% CI: 1.034, 1.045, OR = 1.042, 95% CI: 1.029, 1.056 and OR = 1.085 95% CI 1.073, 1.097, respectively] for tenth quartile of 10 μg/m3 range increased in autumn (the beginning of heating season). For O3, it associated with PTB in winter and spring with OR = 1.113 95% CI: 1.104, 1.123, and OR = 1.155 95% CI: 1.145, 1.165, respectively. The OR increase of PTB for exposure to all six pollutants was higher among women with preeclampsia and gestational hypertension. The associations between ambient air pollution and preterm birth were modified by gestational hypertension and preeclampsia. The seasonal patterns of six studied air pollutants increases the risk of PTB in autumn and winter distinguishably, which may due to the sudden increased concentrations of pollutants emitted by traditional heating. The seasonal response of the synergism of maternal comorbidities and long-term air pollution exposure on birth outcomes is supported by the data sets of preterm birth.
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Affiliation(s)
- Boyi Zhao
- School of Ecology and Environment, Inner Mongolia University, 010021, Hohhot, China
| | - Min Wang
- The Affiliated Hospital of Inner Mongolia Medical University, 010050, Hohhot, China
| | - Changwei Lü
- School of Ecology and Environment, Inner Mongolia University, 010021, Hohhot, China; Institute of Environmental Geology, Inner Mongolia University, Hohhot, 010021, China.
| | - Ling Feng
- School of Ecology and Environment, Inner Mongolia University, 010021, Hohhot, China; Institute of Environmental Geology, Inner Mongolia University, Hohhot, 010021, China
| | - Hua Ma
- School of Ecology and Environment, Inner Mongolia University, 010021, Hohhot, China
| | - Haixia Meng
- The Affiliated Hospital of Inner Mongolia Medical University, 010050, Hohhot, China
| | - Muge Qi
- The Affiliated Hospital of Inner Mongolia Medical University, 010050, Hohhot, China
| | - Qingyun Fan
- Environmental Monitoring Center of Inner Mongolia, 010011, Hohhot, China
| | - Haoji Wang
- School of Ecology and Environment, Inner Mongolia University, 010021, Hohhot, China
| | - Haijun Zhou
- College of Geographical Science, Inner Mongolia Normal University, Hohhot, 010022, China
| | - Jiang He
- School of Ecology and Environment, Inner Mongolia University, 010021, Hohhot, China; Institute of Environmental Geology, Inner Mongolia University, Hohhot, 010021, China.
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Starling AP, Moore BF, Thomas DSK, Peel JL, Zhang W, Adgate JL, Magzamen S, Martenies SE, Allshouse WB, Dabelea D. Prenatal exposure to traffic and ambient air pollution and infant weight and adiposity: The Healthy Start study. ENVIRONMENTAL RESEARCH 2020; 182:109130. [PMID: 32069764 PMCID: PMC7394733 DOI: 10.1016/j.envres.2020.109130] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND Prenatal exposures to ambient air pollution and traffic have been associated with adverse birth outcomes, and may also lead to an increased risk of obesity. Obesity risk may be reflected in changes in body composition in infancy. OBJECTIVE To estimate associations between prenatal ambient air pollution and traffic exposure, and infant weight and adiposity in a Colorado-based prospective cohort study. METHODS Participants were 1125 mother-infant pairs with term births. Birth weight was recorded from medical records and body composition measures (fat mass, fat-free mass, and adiposity [percent fat mass]) were evaluated via air displacement plethysmography at birth (n = 951) and at ~5 months (n = 574). Maternal residential address was used to calculate distance to nearest roadway, traffic density, and ambient concentrations of fine particulate matter (PM2.5) and ozone (O3) via inverse-distance weighted interpolation of stationary monitoring data, averaged by trimester and throughout pregnancy. Adjusted linear regression models estimated associations between exposures and infant weight and body composition. RESULTS Participants were urban residents and diverse in race/ethnicity and socioeconomic status. Average ambient air pollutant concentrations were generally low; the median, interquartile range (IQR), and range of third trimester concentrations were 7.3 μg/m3 (IQR: 1.3, range: 3.3-12.7) for PM2.5 and 46.3 ppb (IQR: 18.4, range: 21.7-63.2) for 8-h maximum O3. Overall there were few associations between traffic and air pollution exposures and infant outcomes. Third trimester O3 was associated with greater adiposity at follow-up (2.2% per IQR, 95% CI 0.1, 4.3), and with greater rates of change in fat mass (1.8 g/day, 95% CI 0.5, 3.2) and adiposity (2.1%/100 days, 95% CI 0.4, 3.7) from birth to follow-up. CONCLUSIONS We found limited evidence of an association between prenatal traffic and ambient air pollution exposure and infant body composition. Suggestive associations between prenatal ozone exposure and early postnatal changes in body composition merit further investigation.
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Affiliation(s)
- Anne P Starling
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Brianna F Moore
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Deborah S K Thomas
- Department of Geography and Earth Sciences, University of North Carolina Charlotte, NC, USA
| | - Jennifer L Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Weiming Zhang
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John L Adgate
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Department of Epidemiology, Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA
| | - Sheena E Martenies
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - William B Allshouse
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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73
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Yuan L, Zhang Y, Wang W, Chen R, Liu Y, Liu C, Kan H, Gao Y, Tian Y. Critical windows for maternal fine particulate matter exposure and adverse birth outcomes: The Shanghai birth cohort study. CHEMOSPHERE 2020; 240:124904. [PMID: 31550593 DOI: 10.1016/j.chemosphere.2019.124904] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/02/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Prenatal exposure to ambient levels of air pollution has been reported to adversely affect birth outcomes, yet few studies have investigated refined susceptible windows for adverse birth outcomes. OBJECTIVES The study aimed at estimating associations between maternal exposure to ambient fine particulate matter (PM2.5; particles with an aerodynamic diameter ≤ 2.5 μm) and birth outcomes, including birth weight, low birth weight (LBW) and preterm birth (PTB), and identify specific susceptible windows. METHODS A total of 3692 singleton live births were enrolled between 2013 and 2016 in Shanghai Birth Cohort, China. Based on mothers' residential addresses, weekly mean concentrations of PM2.5 over gestation were estimated based on an incorporated evaluating approach combining satellite-based estimates and ground-level measurements. Distributed lag non-liner models (DLNMs) were fitted by incorporating with multiple liner models and Cox proportional hazard models to evaluate weekly-as well as trimester-exposure-lag-response associations between average PM2.5 level and birth weight, LBW and PTB, and to identify critical windows. RESULTS In this study, gestational exposure to PM2.5 was associated with adverse birth outcomes in infants, and critical windows were identified as 31st-34th gestational weeks for reduced birth weight, 38th-42 nd weeks for LBW and 27th-30th weeks for PTB, respectively. Trimester-specific associations were found for all birth outcomes during the third trimester. CONCLUSIONS Ambient PM2.5 exposure exhibited adverse impacts on multiple outcomes including reduced birth weight, LBW and PTB in the late pregnancy. The study provides further evidence supporting harmful effects of maternal PM2.5 exposure on birth outcomes and identifying critical windows.
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Affiliation(s)
- Lei Yuan
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Zhang
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weidong Wang
- Department of Environmental Health, School of Public Health, Fudan University School of Medicine, Shanghai, China
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Fudan University School of Medicine, Shanghai, China
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Cong Liu
- Department of Environmental Health, School of Public Health, Fudan University School of Medicine, Shanghai, China
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University School of Medicine, Shanghai, China.
| | - Yu Gao
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ying Tian
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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74
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Lu C, Cao L, Norbäck D, Li Y, Chen J, Deng Q. Combined effects of traffic air pollution and home environmental factors on preterm birth in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 184:109639. [PMID: 31525560 DOI: 10.1016/j.ecoenv.2019.109639] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Although mounting evidence have linked traffic-related air pollution (TRAP) with increased risk of preterm birth (PTB), whether it can interact with indoor environmental factors remains unknown, and its window(s) susceptibility at the stage of gestation is unclear. OBJECTIVE To explore PTB risk for prenatal exposure to traffic-related air pollution and home environmental factors during pregnancy, so as to identify critical window(s) in the combined effect of traffic air pollution and main home environmental factor(s) on PTB development. METHODS A retrospective cohort study of 3,509 preschool children was performed in Changsha, China during 2011-2012. The PTB prevalence was reported by the parents based on a questionnaire. We estimated each mother's exposure to traffic-related air pollutant NO2 in different windows of gestation, including conception month, three trimesters, birth month, and whole gestation. Maternal exposure to home environmental factors was considered by renovation (new furniture/redecoration) in pregnancy, and mold/damp stains and window condensation during perinatal period. Associations of PTB with both ambient NO2 and home environmental factors, and their interactions on PTB were evaluated by logistic regression models using odds ratio (OR) with 95% confidence interval (CI). RESULTS Traffic air pollutant NO2 exposure in utero was significantly associated with PTB, with adjusted odds ratio (OR) (95% CI) of 1.41 (1.00-1.98) for an IQR increase in NO2 exposure during whole pregnancy, particularly in the conception month and 1st trimester. We further found a positive relationship between perinatal exposure to mold/damp stains in the homes and PTB, OR (95% CI) = 1.73 (1.04-2.90). Especially, we detected a significant interaction between outdoor NO2 and indoor mold/damp stains on PTB risk. Male and female foetus were respectively more susceptible to perinatal mold/dampness at home and outdoor NO2 exposure in early gestation. CONCLUSION Our finding indicates that both outdoor traffic air pollutant and indoor mold/dampness play key roles in PTB development, and their interaction effect in early pregnancy significantly increases PTB risk.
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, China; Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University, Changsha, China
| | - Lanqin Cao
- Department of Gynecology, XiangYa Hospital, Central South University, Changsha, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Jing Chen
- School of Architecture and Art, Central South University, Changsha, China
| | - Qihong Deng
- XiangYa School of Public Health, Central South University, Changsha, China; Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University, Changsha, China; School of Architecture and Art, Central South University, Changsha, China.
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75
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Patel R, Gupta A, Chauhan S, Bansod DW. Effects of sanitation practices on adverse pregnancy outcomes in India: a conducive finding from recent Indian demographic health survey. BMC Pregnancy Childbirth 2019; 19:378. [PMID: 31651276 PMCID: PMC6813085 DOI: 10.1186/s12884-019-2528-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 09/20/2019] [Indexed: 01/03/2023] Open
Abstract
Background Several risk factors predisposing women and their live-borns to adverse outcomes during pregnancy have been documented. Little is known about sanitation being a factor contributing to adverse pregnancy outcomes in India. The role of sanitation in adverse pregnancy outcomes remains largely unexplored in the Indian context. This study is an attempt to bring the focus on sanitation as a factor in adverse pregnancy outcome. Along with the sanitation factors, few confounder variables have also been studied in order to understand the adverse pregnancy outcomes. Methods The study is based on the fourth round of National Family Health Survey (NFHS-IV) covering 26,972 married women in the age-group 15–49. The study variables include the mother’s age, Body Mass Index (BMI), education, anemia, and Antenatal care (ANC) visits during their last pregnancy. The household level variable includes place of residence, religion, caste, wealth index, access to toilet, type of toilet, availability of water within toilet premises, and facility of hand wash near the toilet. Children study variables include Low Birth Weight (LBW), the order of birth (Parity), and the death of the children of the women in the last 5 years. The target variable Adverse Pregnancy Outcome (APO) was constructed using children born with low birth weight or died during the last pregnancy. Results We calculated both adjusted as well as unadjusted odds ratios for a better understanding of the association between sanitation and adverse pregnancy outcomes. Findings from the study showed that women who did not have access to a toilet within the house had a higher risk of adverse pregnancy outcome. In the multivariable model, no association was observed for adverse pregnancy outcome among women who did not have access to toilet and women who used shared toilet. Teenage (15–19 years), uneducated, underweight and anemic mothers were more likely to face APO as compare to other mothers in similar characteristics group. Conclusions Our findings contribute to the decidedly less available literature on maternal sanitation behaviour and adverse pregnancy outcomes. Our results support that sanitation is a very significant aspect for women who are about to deliver a baby as there was an association between sanitation and adverse pregnancy outcome. Education on sanitation practices is the need of the hour as much as it needs to follow.
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Affiliation(s)
- Ratna Patel
- International Institute for Population Sciences, Govandi station Road, Deonar, Mumbai, 400088, India
| | - Ajay Gupta
- International Institute for Population Sciences, Govandi station Road, Deonar, Mumbai, 400088, India
| | - Shekhar Chauhan
- International Institute for Population Sciences, Govandi station Road, Deonar, Mumbai, 400088, India.
| | - Dhananjay W Bansod
- International Institute for Population Sciences, Govandi station Road, Deonar, Mumbai, 400088, India
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Nabizadeh R, Yousefian F, Moghadam VK, Hadei M. Characteristics of cohort studies of long-term exposure to PM 2.5: a systematic review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:30755-30771. [PMID: 31494855 DOI: 10.1007/s11356-019-06382-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 08/29/2019] [Indexed: 06/10/2023]
Abstract
This study systematically reviewed all the cohort studies investigating the relationship between long-term exposure to PM2.5 and any health outcome until February 2018. We searched ISI Web of Knowledge, Pubmed, and Scopus databases for peer-reviewed journal research articles published in English. We only extracted the results of the single-pollutant main analysis of each study, excluding the effect modifications and sensitivity analyses. Out of the initial 9523 articles, 203 articles were ultimately included for analysis. Based on the different characteristics of studies such as study design, outcome, exposure assessment method, and statistical model, we calculated the number and relative frequency of analyses with statistically significant and insignificant results. Most of the studies were prospective (84.8%), assessed both genders (66.5%), and focused on a specific age range (86.8%). Most of the articles (78.1%) had used modeling techniques for exposure assessment of cohorts' participants. Among the total of 317 health outcomes, the most investigated outcomes include mortality due to cardiovascular disease (6.19%), all causes (5.48%), lung cancer (4.00%), ischemic heart disease (3.50%), and non-accidental causes (3.50%). The percentage of analyses with statistically significant results were higher among studies that used prospective design, mortality as the outcome, fixed stations as exposure assessment method, hazard ratio as risk measure, and no covariate adjustment. We can somehow conclude that the choice of right characteristics for cohort studies can make a difference in their results.
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Affiliation(s)
- Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Yousefian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Kazemi Moghadam
- Department of Environmental Health Engineering, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mostafa Hadei
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
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Sheridan P, Ilango S, Bruckner TA, Wang Q, Basu R, Benmarhnia T. Ambient Fine Particulate Matter and Preterm Birth in California: Identification of Critical Exposure Windows. Am J Epidemiol 2019; 188:1608-1615. [PMID: 31107509 DOI: 10.1093/aje/kwz120] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 05/07/2019] [Accepted: 05/08/2019] [Indexed: 12/17/2022] Open
Abstract
Exposure to ambient fine particulate matter (particulate matter ≤2.5 μm in aerodynamic diameter (PM2.5)) during pregnancy is associated with preterm birth (PTB), a leading cause of infant morbidity and mortality. Results from studies attempting to identify etiologically relevant exposure periods of vulnerability have been inconsistent, possibly because of failure to consider the time-to-event nature of the outcome and lagged exposure effects of PM2.5. In this study, we aimed to identify critical exposure windows for weekly PM2.5 exposure and PTB in California using California birth cohort data from 2005-2010. Associations were assessed using distributed-lag Cox proportional hazards models. We assessed effect-measure modification by race/ethnicity by calculating the weekly relative excess risk due to interaction. For a 10-μg/m3 increase in PM2.5 exposure over the entire period of gestation, PTB risk increased by 11% (hazard ratio = 1.11, 95% confidence interval: 1.09, 1.14). Gestational weeks 17-24 and 36 were associated with increased vulnerability to PM2.5 exposure. We find that non-Hispanic black mothers may be more susceptible to effects of PM2.5 exposure than non-Hispanic white mothers, particularly at the end of pregnancy. These findings extend our knowledge about the existence of specific exposure periods during pregnancy that have the greatest impact on preterm birth.
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Affiliation(s)
- Paige Sheridan
- Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, San Diego, California
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California
| | - Sindana Ilango
- Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, San Diego, California
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California
| | - Tim A Bruckner
- Department of Public Health and Planning, Policy and Design, University of California, Irvine, Irvine, California
| | - Qiong Wang
- School of Medicine, Yale University, New Haven, Connecticut
| | - Rupa Basu
- Air Toxicology and Epidemiology Branch, California Office of Environmental Health Hazard Assessment, Sacramento, California
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, San Diego, California
- Scripps Institute of Oceanography, University of California, San Diego, San Diego, California
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Wang J, Cao H, Sun D, Qi Z, Guo C, Peng W, Sun Y, Xie Y, Liu X, Li B, Luo Y, Pan Y, Li Y, Zhang L. Associations between ambient air pollution and mortality from all causes, pneumonia, and congenital heart diseases among children aged under 5 years in Beijing, China: A population-based time series study. ENVIRONMENTAL RESEARCH 2019; 176:108531. [PMID: 31226628 DOI: 10.1016/j.envres.2019.108531] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 06/06/2019] [Accepted: 06/08/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND Previous studies have mainly focused on the associations between particulate matters and infant mortality. However, evidence regarding the associations between gaseous pollutants and mortality among children aged <5 years remains sparse. OBJECTIVES The aim of this study was to investigate the associations between ambient air pollution and death among children aged <5 years in Beijing, China, and explore the impact of age, gender and specific causes of death on these associations. METHODS Concentrations of ambient air pollution and the number of deaths among children aged <5 years in Beijing from January 2014 to September 2016 were extracted from authoritative electronic databases. The associations were estimated for a single-month lag from the current month up to the previous 5 months (lag0-lag5) and moving averages of the current and previous months (lag01-lag05) using generalized additive Poisson regression (adjusted for time trends, season, meteorological variables and holidays). Subgroup analyses related to age, gender and specific diseases were performed. Two-pollutant models were used to evaluate the possible role of single pollutants. RESULTS Sulfur dioxide (SO2), nitrogen dioxide (NO2) and carbon monoxide (CO) demonstrated the strongest associations with death among children aged <5 years at lag0, and the estimates decreased or even turned negative with the increasing lag periods. For an interquartile range increase in SO2, NO2 and CO at lag0, the odds ratios (OR) were 1.332 (95% CI 1.152-1.539), 1.383 (95% CI 1.113-1.718) and 1.273 (95% CI 1.028-1.575). However, CO lost significance after adjusting for SO2 and NO2, and PM2.5 gained significance (OR 1.548, 95% CI 1.061-2.258) after adjusting for PM10. The ORs for SO2 and NO2 remained the most stable across all two-pollutant models. The associations for children aged 1-5 years were stronger than those reported for infants at lag0 but lower at the other lag months. The pollutant associations were stronger for congenital heart disease-related death than overall and pneumonia-related death. We did not find significant differences in terms of gender. CONCLUSION Exposure to air pollution may increase the incidence of death among children aged <5 years. SO2 and NO2 may be the most stable pollutants reflecting associations between air pollution and death, deserving further attention. Children with congenital heart diseases are more susceptible to air pollution. Therefore, it is urgent to implement the clean air targets established by WHO and reduce the exposure of children to air pollution.
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Affiliation(s)
- Jing Wang
- Department of Children's Health Care, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China; Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Han Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Dianqin Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Zifan Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Chunyue Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Wenjuan Peng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Yanyan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Yunyi Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Xiaohui Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Bingxiao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Ying Pan
- Department of Children's Health Care, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China
| | - Yichen Li
- Department of Children's Health Care, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China.
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China.
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Shen C, Liu J, Zhu F, Lei R, Cheng H, Zhang C, Sui X, Ding L, Yang M, Chen H, Ding R, Cao J. The effects of cooking oil fumes-derived PM 2.5 on blood vessel formation through ROS-mediated NLRP3 inflammasome pathway in human umbilical vein endothelial cells. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 174:690-698. [PMID: 30878009 DOI: 10.1016/j.ecoenv.2019.03.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 03/01/2019] [Accepted: 03/07/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND Cooking oil fumes (COFs), a main pollutant in kitchen air, is a major risk to human health. In our previous research, exposure to COFs-derived PM2.5 could cause umbilical vascular endothelial dysfunction, leading to decreased fetal weight. Here, to test the role of ROS-mediated NLRP3 inflammasome pathway in blood vessel formation of human umbilical vein endothelial cells (HUVECs) caused by COFs-derived PM2.5, the cells were exposed to COFs-derived PM2.5 at different concentrations with and without N-acetyl-L-cysteine (NAC). METHODS MTT assay was used to determine HUVECs viability. Intracellular ROS and mitochondrial ROS levels were assessed with DCFH-DA and MitoSOX™ assay. The levels of proteins and mRNA involved in NLRP3 inflammasome signaling pathway and VEGF were measured by western blot and real-time PCR (RT-PCR). Tube formation in HUVECs was detected by tube formation assay. RESULTS The results revealed that COFs-derived PM2.5 exposure reduced HUVECs viability, increased the intracellular and mitochondrial ROS levels in cells, and up-regulated the levels of proteins and mRNA involved in NLRP3 inflammasome signaling pathway. However, the protein and mRNA expression of VEGF were reduced with the increasing exposure concentrations. In addition, COFs-derived PM2.5 also affected the tube formation. However, co-incubation with NAC effectively rescued the damages caused by COFs-derived PM2.5 exposure. CONCLUSIONS This study proved that COFs-derived PM2.5 could significantly reduce HUVECs viability, induce the overproduction of ROS, lead to inflammation and inhibit VEGF expression, thus affect angiogenesis of HUVECs in vitro. It was revealed that the impact caused by COFs-derived PM2.5 on blood vessel formation through a ROS-mediated NLRP3 inflammasome pathway.
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Affiliation(s)
- Chaowei Shen
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Jie Liu
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Furong Zhu
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Ruoqian Lei
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Han Cheng
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Chao Zhang
- Department of Environmental Health, Center for Disease Control and Prevention, Nanjing, China.
| | - Xinmiao Sui
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Liu Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Mei Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Hongbo Chen
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital Affiliated to Anhui Medical Universit, 15 Yimin Road, Hefei, China.
| | - Rui Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Jiyu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
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Li S, Wang H, Hu H, Wu Z, Chen K, Mao Z. Effect of ambient air pollution on premature SGA in Changzhou city, 2013-2016: a retrospective study. BMC Public Health 2019; 19:705. [PMID: 31174511 PMCID: PMC6555963 DOI: 10.1186/s12889-019-7055-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/27/2019] [Indexed: 11/28/2022] Open
Abstract
Background Air pollution is becoming an increased burden to the world. Previous studies have confirmed its effects on adverse birth outcomes, but few associated with premature small for gestational age (SGA). We report a retrospective cohort study conducted in Changzhou city to evaluate the association between air pollutants (PM2.5, SO2 and NO2) and premature SGA during pregnancy. Methods A total of 46,224 births were collected from January, 2013 to December, 2016, in Changzhou Maternity and Child Health Care Hospital, finally 2709 preterm births were admitted for study. Corresponding air monitoring data were collected from Changzhou Environmental Protection Agency. Generalized estimating equations were used to examine the association between these air pollutants and premature SGA controlling for individual covariates in single- and multi-pollutant models. Results We found that, in the third trimester, every 10 μg/m3 increments in PM2.5 concentration were associated with premature SGA (OR = 1.18, 95% CI: 1.03–2.83; OR = 1.37, 95% CI: 1.03–3.58) in two- and three-pollutants models. In the whole gestation, a 10 μg/m3 increment in PM2.5 concentration in two- and three-pollutant models were related to premature SGA (OR = 1.53, 95% CI: 1.38–2.47; OR = 1.73, 95% CI: 1.18–2.57). The OR (95% CI) of premature SGA were increasing across quintiles of PM2.5, SO2, NO2 concentrations during the whole gestation period adjusting for confounders (Pfor trend < 0.001). Conclusions These results indicated that pregnant women exposed to PM2.5, combined with other pollutants in the third trimester have a higher risk to deliver premature SGA babies, providing further evidence linking PM2.5 and pregnancy outcomes.
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Affiliation(s)
- Shushu Li
- Changzhou Center for Disease Control and Prevention, Changzhou, 213022, Jiangsu, China
| | - Huaiyan Wang
- Changzhou Maternity and Child Health Care Hospital affiliated to Nanjing Medical University, Changzhou, 213003, Jiangsu, China
| | - Haiting Hu
- Changzhou Maternity and Child Health Care Hospital affiliated to Nanjing Medical University, Changzhou, 213003, Jiangsu, China
| | - Zeying Wu
- Changzhou Institute of Technology, Changzhou, 213003, Jiangsu, China
| | - Kejin Chen
- Changzhou Maternity and Child Health Care Hospital affiliated to Nanjing Medical University, Changzhou, 213003, Jiangsu, China
| | - Zhilei Mao
- Changzhou Maternity and Child Health Care Hospital affiliated to Nanjing Medical University, Changzhou, 213003, Jiangsu, China. .,State Key Laboratory of Reproductive Medicine, Center for Global Health, Nanjing Medical University, 101 Longmian Road, Nanjing, 211100, China. .,Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, 101 Longmian Road, Nanjing, 211100, China.
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81
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Li Z, Yuan X, Fu J, Zhang L, Hong L, Hu L, Liu L. Association of ambient air pollutants and birth weight in Ningbo, 2015-2017. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 249:629-637. [PMID: 30933760 DOI: 10.1016/j.envpol.2019.03.076] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/28/2019] [Accepted: 03/18/2019] [Indexed: 06/09/2023]
Abstract
Previous studies have suggested a change of birth weight linked with elevated ambient air pollutant concentrations during the pregnancy. However, investigations of the influence of higher pollutant levels on birth weight change are limited. The goal of this study is to evaluate whether the air pollution of Ningbo is associated with birth weight, and which trimester could be a window period for maternal exposure to air pollution. A total of 170,008 live births were selected in the Ningbo city of Zhejiang, China, from 2015 to 2017. We estimated the association between the decreased birth weight and the increased air pollutant concentrations in the three trimesters and full gestation. The effects of interaction among pollutants were identified using a co-pollutant adjustment model. An interquartile range increases in PM2.5 (10.55 μg/m3), SO2(4.6 μg/m3), CO (125.59 μg/m3), and O3 (14.54 μg/m3) concentrations during the entire gestation were associated with 3.65 g (95% confidence interval: -6.02 g, -1.29 g), 5.02 g (-6.89 g, -3.14 g), 2.64 g (-4.65 g, -0.63 g) and 2.9 g (-4.8 g, 1 g) decreases, respectively, in birth weight. With each interquartile range increment in NO2 concentration was associated with an 8.05 g (6.24 g, 9.85 g) increase in birth weight. In the first trimester, only the PM2.5 exposure seemed to be associated with the greatest decline in birth weight. After adjustment for co-pollutant, both PM2.5 and SO2 were still associated with birth weight, except for CO for O3 adjustment, O3 for SO2 adjustment, and O3 for NO2 adjustment. Maternal exposure to air pollution may be associated with a decrease of birth weight, but the contribution of various pollutants is necessary to verify by future research.
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Affiliation(s)
- Zhen Li
- Department of Preventative Medicine, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China
| | - Xiaoqi Yuan
- Pediatric Surgery Ward, Ningbo Women and Children Hospital, Ningbo, Zhejiang Province 315012, People's Republic of China
| | - Jianfei Fu
- Department of Medical Records and Statistics, Ningbo First Hospital, Ningbo, Zhejiang Province 315010, People's Republic of China
| | - Lingyun Zhang
- Department of Preventative Medicine, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China
| | - Lixia Hong
- Department of Preventative Medicine, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China
| | - Lingjie Hu
- Department of Preventative Medicine, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China
| | - Liya Liu
- Department of Preventative Medicine, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China.
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Yuan L, Zhang Y, Gao Y, Tian Y. Maternal fine particulate matter (PM 2.5) exposure and adverse birth outcomes: an updated systematic review based on cohort studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:13963-13983. [PMID: 30891704 DOI: 10.1007/s11356-019-04644-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 02/19/2019] [Indexed: 04/16/2023]
Abstract
Exposure to ambient air pollutants during pregnancy may be associated with numerous side health effects and adverse birth outcomes. Growing numbers of studies have explored a possible linkage between prenatal exposure to PM2.5 (particulate matter with aerodynamic diameter ≤ 2.5 μm) and impacts on fetal development. We aimed to conduct a systematic review based on published cohort studies to summarize evidence regarding the association between maternal PM2.5 exposure and birth outcomes, including birth weight, low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). Eligible studies meeting the following criterion were selected: PM2.5 exposure during pregnancy and live birth singletons, certain presentation of sample sizes, and quantitative evaluation of the associations between exposure and outcomes. Among the 42 selected studies, 23 evaluated the impact of prenatal PM2.5 exposure on birth weight of infants while 12 of them provided a significantly negative association for exposure and birth weight. Twenty-one studies aimed to identify the possible relationship between maternal exposure and LBW and 8 studies proved significant associations. Among 18 studies that explored the correlation between prenatal exposure and PTB, 9 reached a consistent conclusion that gestational exposure would add to the risk of PTB. Nine studies assessed the impact of PM2.5 on SGA and 5 of them demonstrated a significant effect. So far, linkages between maternal PM2.5 exposure during varied gestational stages and multiple adverse birth outcomes have been observed in many studies. A summary of them will be meaningful for further research on maternal exposure and adverse birth outcomes.
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Affiliation(s)
- Lei Yuan
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai, 200025, China
| | - Yan Zhang
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai, 200025, China
| | - Yu Gao
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai, 200025, China.
| | - Ying Tian
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai, 200025, China.
- MOE and Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Perera F, Ashrafi A, Kinney P, Mills D. Towards a fuller assessment of benefits to children's health of reducing air pollution and mitigating climate change due to fossil fuel combustion. ENVIRONMENTAL RESEARCH 2019; 172:55-72. [PMID: 30771627 DOI: 10.1016/j.envres.2018.12.016] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/20/2018] [Accepted: 12/08/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Fossil fuel combustion by-products, including particulate matter (PM2.5), polycyclic aromatic hydrocarbons (PAH), nitrogen dioxide (NO2) and carbon dioxide (CO2), are a significant threat to children's health and equality. Various policies to reduce emissions have been implemented to reduce air pollution and mitigate climate change, with sizeable estimated health and economic benefits. However, only a few adverse outcomes in children have been considered, resulting in an undercounting of the benefits to this vulnerable population. OBJECTIVES Our goal was to expand the suite of child health outcomes addressed by programs to assess health and economic benefits, such as the Environmental Protection Agency (EPA) Benefits Mapping and Analysis Program (BenMAP), by identifying concentration-response (C-R) functions for six outcomes related to PM2.5, NO2, PAH, and/or PM10: preterm birth (PTB), low birthweight (LBW), autism, attention deficit hyperactivity disorder, IQ reduction, and the development of childhood asthma. METHODS We conducted a systematic review of the literature published between January 1, 2000 and April 30, 2018 to identify relevant peer-reviewed case-control and cohort studies and meta-analyses. In some cases meta-analyses were available that provided reliable C-R functions and we assessed their consistency with subsequent studies. Otherwise, we reviewed all eligible studies published between our search dates. RESULTS For each pollutant and health outcome, we present the characteristics of each selected study. We distinguish between C-R functions for endpoints having a causal or likely relationship (PTB, LBW, autism, asthma development) with the pollutants for incorporation into primary analyses and endpoints having a suggestive causal relationship with the pollutants (IQ reduction, ADHD) for secondary analyses. CONCLUSION We have identified C-R functions for a number of adverse health outcomes in children associated with air pollutants largely from fossil fuel combustion. Their incorporation into expanded assessments of health benefits of clean air and climate mitigation policies will provide an important incentive for preventive action.
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Affiliation(s)
- F Perera
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 W. 168th Street, New York, NY 10032, USA.
| | - A Ashrafi
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 W. 168th Street, New York, NY 10032, USA.
| | - P Kinney
- Boston University School of Public Health, Boston, MA, USA.
| | - D Mills
- Abt Associates, Boulder, CO, USA.
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Arroyo V, Linares C, Díaz J. Premature births in Spain: Measuring the impact of air pollution using time series analyses. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 660:105-114. [PMID: 30639707 DOI: 10.1016/j.scitotenv.2018.12.470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/27/2018] [Accepted: 12/30/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Premature birth (<37 weeks of gestation) is the principal indicator of neonatal death during the first month of life and the second cause of death of children under age five. There are 15 million premature births (PTB) worldwide. Air pollution in cities, primarily the result of urban traffic, greatly impacts PTBs, though there are few studies carried out on this topic at the country level. The objective of this study is to quantify the relative risks (RR) and the population attributable risk (PAR) of concentrations of contaminants on PTBs in Spain, and to analyze the most susceptible trimesters. METHODS For each province average weekly PTBs were calculated (ICD-10: P07.2-P07.3) during the period 2001-2009 as well as weekly average concentrations of PM10, NO2 and O3. Estimations were made of RR and PAR using generalized linear models with link Poisson, controlling for the trend, seasonality, the autoregressive nature of the series and the influence of temperature in periods of heat and/or cold waves. A meta-analysis was carried out to estimate RR and PAR at the global level based on the RR obtained for each of the provinces. RESULTS For all of Spain, the global RR of PTB due to the impact of PM10 was 1.071 (1.049, 1.093) and 1.150 (1.084, 1.220) for NO2, with no detected association for O3. Therefore, with decreases of 10 μg/m3 in the concentrations of PM10 and NO2, around 12.5% and 4.5% of PTBs could have been avoided respectively. CONCLUSIONS Around 1.35% of PTBs that occurred in Spain during the study period can be attributed to air pollution. The adoption of structural measures to reduce these air pollutants should result in a decrease in the number of PTBs in Spain.
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Affiliation(s)
- Virginia Arroyo
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain; Autonomous University of Madrid, Spain
| | - Cristina Linares
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Julio Díaz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
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Han X, Guo Y, Gao H, Ma J, Sang M, Zhou S, Huang T, Mao X. Estimating the spatial distribution of environmental suitability for female lung cancer mortality in China based on a novel statistical method. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:10083-10096. [PMID: 30756355 DOI: 10.1007/s11356-019-04444-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 01/30/2019] [Indexed: 06/09/2023]
Abstract
Lung cancer as one of the major causes of cancer mortality has been demonstrated to be closely related to the ambient atmospheric environment, but little has been done in the synthetic evaluation of the linkage between cancer mortality and combined impact of ambient air pollution and meteorological conditions. The present study determined the environmental suitability for female lung cancer mortality associated with air contaminants and meteorological variables. A novel fuzzy matter-element method was applied to identify the spatial distribution and regions for the environmental suitability for the female lung cancer mortality across China in 2013. The membership functions between the cancer mortality and 6 environmental factors, including PM2.5, NO2, SO2, PM10, the annual mean wind speed, and mean temperature, were generated and the weights of each of the environmental factors were established by the maximum entropy (MaxEnt) model. We categorized the environmental suitability combined with GIS spatial analysis into three zones, including low-suitable, medium-suitable, and high-suitable region where the cancer mortality ranging from low to high rate was identified. These three zones were quantified by the MaxEnt model taking different air pollutants and meteorological variables into consideration. We identified that NO2 was a most significant factor among the 6 environmental factors with the weight of 24.88%, followed by the annual mean wind speed, SO2, and PM2.5. The high-suitable area, mainly in the North China Plain which is a most heavily contaminated region by air pollution in China, covers 1.6195 million square kilometers, accounting for 17.85% of the total area investigated in this study. Identification of the impact of various environmental factors on cancer mortality in the different suitable area provides a scientific basis for the environmental management, risk assessment, and lung cancer control.
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Affiliation(s)
- Xiao Han
- Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Yanlong Guo
- Key Laboratory of Remote Sensing of Gansu Province, Northwest Institute of Eco-Environment and Resources, Chinese Academy of Sciences, Lanzhou, 730000, Gansu, China
| | - Hong Gao
- Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China.
| | - Jianmin Ma
- Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China
- College of Urban and Environmental Science, Peking University, Beijing, 100000, China
| | - Manjie Sang
- Research Center for Eco-Environment Sciences in Shanxi, Taiyuan, 030000, Shanxi, China
| | - Sheng Zhou
- Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Tao Huang
- Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Xiaoxuan Mao
- Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, 730000, Gansu, China
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Li Z, Tang Y, Song X, Lazar L, Li Z, Zhao J. Impact of ambient PM 2.5 on adverse birth outcome and potential molecular mechanism. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 169:248-254. [PMID: 30453172 DOI: 10.1016/j.ecoenv.2018.10.109] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/26/2018] [Accepted: 10/30/2018] [Indexed: 05/20/2023]
Abstract
PM2.5 (particulate matter ≤2.5 µm in aerodynamic diameter) refers to atmospheric particulate matter (PM) with an aerodynamic diameter of equal and less than 2.5 µm that tends to be suspended for long periods of time and travel over long distances in both outdoor and indoor atmospheres. PM2.5, along with the toxic compounds attached on it, may cause a wide range of disorders. The fetus is considered to be highly susceptible to a variety of toxicants including atmospheric pollutants such as PM2.5 through prenatal exposure. To better understand the relationship between maternal exposure to PM2.5 and adverse birth outcomes for reproduction and fetus development, we studied the published data on this issue including case-control studies, cohort studies and meta-analyses studies, and summarized the basic impact of ambient particulate matter on adverse birth outcomes. Research evidence indicates that PM2.5 has a potential to induce low birth weight (LBW), preterm birth (PTB), and stillbirth. A further in-depth analysis shows that oxidative stress, DNA methylation, mitochondrial DNA (mtDNA) content alteration, and endocrine disruptions may all play an important role in PM2.5 induced adverse effects to pregnant women and fetuses. In addition, PM2.5 exposure can cause male reproductive toxicity, leading to associated adverse pregnancy outcomes.
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Affiliation(s)
- Zhou Li
- Department of Preventative Medicine, Zhejiang Key Laboratory of Pathophysiology, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China
| | - Yuqing Tang
- Department of Preventative Medicine, Zhejiang Key Laboratory of Pathophysiology, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China
| | - Xin Song
- Department of Preventative Medicine, Zhejiang Key Laboratory of Pathophysiology, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China
| | - Lissy Lazar
- Department of Preventative Medicine, Zhejiang Key Laboratory of Pathophysiology, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China
| | - Zhen Li
- Department of Preventative Medicine, Zhejiang Key Laboratory of Pathophysiology, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China.
| | - Jinshun Zhao
- Department of Preventative Medicine, Zhejiang Key Laboratory of Pathophysiology, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China.
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87
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Padula AM, Yang W, Lurmann FW, Balmes J, Hammond SK, Shaw GM. Prenatal exposure to air pollution, maternal diabetes and preterm birth. ENVIRONMENTAL RESEARCH 2019; 170:160-167. [PMID: 30579990 PMCID: PMC6373725 DOI: 10.1016/j.envres.2018.12.031] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/03/2018] [Accepted: 12/14/2018] [Indexed: 05/21/2023]
Abstract
Prenatal exposure to ambient air pollution has been associated with preterm birth in several studies. Associations between air pollution and gestational or pre-existing diabetes have been hypothesized but are not well established. We examined the association between air pollution exposure in pregnancy and gestational diabetes and whether the association between air pollution and preterm birth is modified by diabetes (gestational or pre-existing) in a highly polluted area of California. Birth certificates and hospital discharge data from all singleton births from 2000 to 2006 to women living in four counties in the San Joaquin Valley of California were linked to criteria air pollution and traffic density measurements at the geocoded maternal residence. Air pollutants were dichotomized at the highest quartile and compared to the lower three quartiles. Logistic regression models were adjusted for maternal race-ethnicity, age, education, payment of birth expenses, and prenatal care. There were consistent inverse associations between exposure to air pollution during the first two trimesters and gestational diabetes (statistically significant odds ratios (OR) less than 1). When stratified by any diabetes (gestational or pre-existing), associations between air pollution exposure during pregnancy and categories of preterm birth (20-27, 28-31, 32-33, 34-36 weeks) were generally similar with few exceptions of exposures to carbon monoxide (CO) and particulate matter < 2.5 µm (PM2.5). Those with diabetes and exposure higher levels of CO (in first trimester or entire pregnancy) or PM2.5 (in first trimester) had higher risk of extremely preterm birth (20-27 weeks) compared with those without diabetes. The associations between traffic-related air pollution and gestational diabetes were in the unexpected ("protective") direction. Among those with any diabetes, associations were stronger between CO and PM2.5 and extremely preterm birth.
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Affiliation(s)
- Amy M Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Wei Yang
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | | | - John Balmes
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - S Katharine Hammond
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Gary M Shaw
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
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88
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Delnord M, Mortensen L, Hindori-Mohangoo AD, Blondel B, Gissler M, Kramer MR, Richards JL, Deb-Rinker P, Rouleau J, Morisaki N, Nassar N, Bolumar F, Berrut S, Nybo Andersen AM, Kramer MS, Zeitlin J. International variations in the gestational age distribution of births: an ecological study in 34 high-income countries. Eur J Public Health 2019; 28:303-309. [PMID: 29020399 DOI: 10.1093/eurpub/ckx131] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Few studies have investigated international variations in the gestational age (GA) distribution of births. While preterm births (22-36 weeks GA) and early term births (37-38 weeks) are at greater risk of adverse health outcomes compared to full term births (39-40 weeks), it is not known if countries with high preterm birth rates also have high early term birth rates. We examined rate associations between preterm and early term births and mean term GA by mode of delivery onset. Methods We used routine aggregate data on the GA distribution of singleton live births from up to 34 high-income countries/regions in 1996, 2000, 2004, 2008 and 2010 to study preterm and early term births overall and by spontaneous or indicated onset. Pearson correlation coefficients were adjusted for clustering in time trend analyses. Results Preterm and early term births ranged from 4.1% to 8.2% (median 5.5%) and 15.6% to 30.8% (median 22.2%) of live births in 2010, respectively. Countries with higher preterm birth rates in 2004-2010 had higher early term birth rates (r > 0.50, P < 0.01) and changes over time were strongly correlated overall (adjusted-r = 0.55, P < 0.01) and by mode of onset. Conclusion Positive associations between preterm and early term birth rates suggest that common risk factors could underpin shifts in the GA distribution. Targeting modifiable population risk factors for delivery before 39 weeks GA may provide a useful preterm birth prevention paradigm.
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Affiliation(s)
- Marie Delnord
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Laust Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ashna D Hindori-Mohangoo
- Department Child Health, TNO, The Netherlands Organisation for Applied Scientific Research, Leiden, The Netherlands.,Department Public Health, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname.,Perinatal Interventions Suriname (Perisur) Foundation, Paramaribo, Suriname
| | - Béatrice Blondel
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Mika Gissler
- THL National Institute for Health and Welfare, Helsinki, Finland.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennifer L Richards
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Paromita Deb-Rinker
- Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Jocelyn Rouleau
- Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Naho Morisaki
- Department of Lifecourse Epidemiology, Department of Social Medicine, National Center for Child Health and Development, Setagayaku, Tokyo, Japan
| | - Natasha Nassar
- MenziesKids, Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, Australia
| | | | - Sylvie Berrut
- Federal Department of Home Affairs FDHA, Federal Statistical Office FSO, Health Section, Neuchâtel, Switzerland
| | | | - Michael S Kramer
- Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Jennifer Zeitlin
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
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89
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Nobles CJ, Grantz KL, Liu D, Williams A, Ouidir M, Seeni I, Sherman S, Mendola P. Ambient air pollution and fetal growth restriction: Physician diagnosis of fetal growth restriction versus population-based small-for-gestational age. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 650:2641-2647. [PMID: 30296771 PMCID: PMC6203640 DOI: 10.1016/j.scitotenv.2018.09.362] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/24/2018] [Accepted: 09/28/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Ambient air pollution may affect fetal growth restriction (FGR) through several mechanisms. However, prior studies of air pollution and small-for-gestational age (SGA), a common proxy for FGR, have reported inconsistent findings. OBJECTIVE We assessed air pollution in relation to physician-diagnosed FGR and population-based SGA in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Consecutive Pregnancy Study (2002-2010). METHODS Among 50,005 women (112,203 singleton births), FGR was captured from medical records and ICD-9 codes, and SGA determined by population standards for birthweight <10th, <5th and <3rd percentile. Community Multiscale Air Quality models estimated ambient levels of seven criteria pollutants for whole pregnancy, 3-months preconception, and 1st, 2nd and 3rd trimesters. Generalized estimating equations with robust standard errors accounted for interdependency of pregnancies within participant. Models adjusted for maternal age, race/ethnicity, pre-pregnancy body mass index, smoking, alcohol, parity, insurance, marital status, asthma and temperature. RESULTS FGR was diagnosed in 1.5% of infants, and 6.7% were <10th, 2.7% <5th and 1.5% <3rd percentile for SGA. Positive associations of SO2, NO2 and PM10 and negative associations of O3 with FGR were observed throughout preconception and pregnancy. For example, an interquartile increase in whole pregnancy SO2 was associated with 16% (95% CI 8%, 25%) increased FGR risk, 17% for NO2 (95% CI 9%, 26%) and 12% for PM10 (95% CI 6%, 19%). Associations with SGA were less clear. CONCLUSIONS Chronic exposure to air pollution may be associated with FGR but not SGA in this low-risk population.
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Affiliation(s)
- Carrie J Nobles
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Katherine L Grantz
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Danping Liu
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Andrew Williams
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Marion Ouidir
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Indulaxmi Seeni
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | | | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
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90
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Wang Q, Benmarhnia T, Li C, Knibbs LD, Bao J, Ren M, Zhang H, Wang S, Zhang Y, Zhao Q, Huang C. Seasonal analyses of the association between prenatal ambient air pollution exposure and birth weight for gestational age in Guangzhou, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 649:526-534. [PMID: 30179811 DOI: 10.1016/j.scitotenv.2018.08.303] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/11/2018] [Accepted: 08/22/2018] [Indexed: 05/16/2023]
Abstract
Ambient air pollution has been linked to small for gestational age (SGA); however, the relationship with large for gestational age (LGA) is unclear and very few studies have investigated seasonal effects on the association between air pollution and SGA or LGA. Using birth registry data of 506,000 singleton live births from 11 districts in Guangzhou, China between January 2015 and July 2017, we examined associations between ambient air pollutants (PM2.5, PM10, NO2, SO2, and O3) and SGA/LGA, and further assessed the modification effect of season. Daily concentrations of air pollutants from 11 monitoring stations were used to estimate district-specific exposures for each participant based on their district of residence during pregnancy. Two-level binary logistic regression models were used to evaluate associations between air pollution and SGA/LGA. Stratified analyses by season and a Cochran Q test were performed to assess the modification of season. Exposure to PM2.5, NO2, SO2, and O3 was significantly associated with increased risk of SGA, especially for exposure during the second and third trimester. For an interquartile range (IQR) increase in PM2.5 (6.5 μg/m3), NO2 (12.7 μg/m3), SO2 (2.8 μg/m3) and O3 (20.8 μg/m3) during the entire pregnancy, SGA risk increased by 2% (OR = 1.02, 95% CI: 1.00-1.04), 8% (OR = 1.08, 95% CI: 1.04-1.12), 2% (OR = 1.02, 95% CI: 1.01-1.03), and 14% (1.14, 1.11-1.17), respectively. A decreased risk of LGA was found for PM2.5, PM10, SO2, and O3 during the first trimester or entire pregnancy. When examined by season, significant associations between air pollutants and SGA were observed for women who conceived during summer or fall, and the patterns were consistent for all pollutants. Our study suggests that conception during different seasons might modify the association between ambient air pollution and SGA.
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Affiliation(s)
- Qiong Wang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Changchang Li
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Luke D Knibbs
- School of Public Health, The University of Queensland, Herston, Australia
| | - Junzhe Bao
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Meng Ren
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Huanhuan Zhang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Suhan Wang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yawei Zhang
- School of Public Health, Yale University, New Haven, CT, USA
| | - Qingguo Zhao
- Key Laboratory of Male Reproduction and Genetics (National Health and Family Planning Commission), Family Planning Research Institute of Guangdong Province, Guangzhou, China; Key Laboratory of Male Reproduction and Genetics (National Health and Family Planning Commission), Family Planning Special Hospital of Guangdong Province, Guangzhou, China.
| | - Cunrui Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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91
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Zhao B, Wang M, Lü C, Meng H, Fan Q, Guo J, Wang W, Wang H, Zhou H, He J. Increasing risk of congenital anomalies associated with seasonal pattern of air pollution: Differences by maternal comorbidities. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 167:317-323. [PMID: 30343146 DOI: 10.1016/j.ecoenv.2018.10.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/12/2018] [Accepted: 10/10/2018] [Indexed: 06/08/2023]
Abstract
To interpret the relationship of the seasonal pattern of air pollution exposure associated with increased risk of congenital anomalies (CA) and the trimester-specific effects. In this work, 55,428 hospital records with 847 doctor-diagnosed CA from July 2013 to December 2016 were collected in Hohhot, China. Maternal exposure to critical air pollutants (SO2, CO, PM10, O3, NO2 and PM2.5) were estimated using an inverse distance weighted (IDW) method on the basis of the ambient air quality monitoring stations. Logistic regression analysis was employed to determine the association of CA (in terms of odds ratio (OR) and 95% confidence interval (CI)) in three trimesters with heating/none heating season exposure. The results showed that CO exposure was found a significant association with ORs (95% CI) 1.58 (1.09, 2.27) changing from IQR2-3 and 1.40 (1.01, 1.93) changing from IQR3-IQR4 in 1st trimester and 1.51 (1.12, 2.04) changing from IQR2-3 in 2nd trimester, respectively. PM10 also presented significant association with ORs (95% CI) 1.42(1.08, 1.86) changing from IQR3-4 in 2nd trimester. Exposure effects were found more obvious in heating season, i.e. CO exposure levels were associated with the risks of CA with IQR changing ORs (95% CI) of 5.21(2.02, 7.44), 2.24 (1.21, 4.15) and 1.84 (1.10, 3.11) in 1st trimester, respectively; PM2.5 exposure levels were associated with the risks of CA with IQR changing ORs (95% CI) of 3.76 (1.48, 6.55), 2.45 (1.10, 5.44) and 3.30 (1.63, 6.67) in 2nd trimester, respectively. Our findings suggested some positive associations of pregnancy and CA with maternal exposure to ambient CO and PM2.5 during the 1st and 2nd trimester after controlling for maternal comorbidities general covariates and other pollutants. PM10 was also found significantly associated with increased risk of CA in 2nd trimester besides seasons. There was no association found in 3rd trimester.
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Affiliation(s)
- Boyi Zhao
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China
| | - Min Wang
- The Affiliated Hospital of Inner Mongolia Medical University, 010050 Hohhot, China
| | - Changwei Lü
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China; Institute of Environmental Geology, Inner Mongolia University, Hohhot 010021, China.
| | - Haixia Meng
- The Affiliated Hospital of Inner Mongolia Medical University, 010050 Hohhot, China
| | - Qingyun Fan
- Environmental Monitoring Center of Inner Mongolia, 010011 Hohhot, China
| | - Jing Guo
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China
| | - Wenqing Wang
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China
| | - Haoji Wang
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China
| | - Haijun Zhou
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China; Environmental Monitoring Center of Inner Mongolia, 010011 Hohhot, China
| | - Jiang He
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China; Institute of Environmental Geology, Inner Mongolia University, Hohhot 010021, China.
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92
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Stieb DM, Lavigne E, Chen L, Pinault L, Gasparrini A, Tjepkema M. Air pollution in the week prior to delivery and preterm birth in 24 Canadian cities: a time to event analysis. Environ Health 2019; 18:1. [PMID: 30606207 PMCID: PMC6318965 DOI: 10.1186/s12940-018-0440-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 12/07/2018] [Indexed: 05/05/2023]
Abstract
BACKGROUND Numerous studies have examined the association between air pollution and preterm birth (< 37 weeks gestation) but findings have been inconsistent. These associations may be more difficult to detect than associations with other adverse birth outcomes because of the different duration of exposure in preterm vs. term births, and the existence of seasonal cycles in incidence of preterm birth. METHODS We analyzed data pertaining to 1,001,700 singleton births occurring between 1999 and 2008 in 24 Canadian cities where daily air pollution data were available from government monitoring sites. In the first stage, data were analyzed in each city employing Cox proportional hazards models using gestational age in days as the time scale, obtaining city-specific hazard ratios (HRs) with their 95% confidence intervals (CIs) expressed per interquartile range (IQR) of each air pollutant. Effects were examined using distributed lag functions for lags of 0-6 days prior to delivery, as well as cumulative lags from two to six days. We accounted for the potential nonlinear effect of daily mean ambient temperature using a cubic B-spline with three internal knots. In the second stage, we pooled the estimated city-specific hazard ratios using a random effects model. RESULTS Pooled estimates across 24 cities indicated that an IQR increase in ozone (O3, 13.3 ppb) 0-3 days prior to delivery was associated with a hazard ratio of 1.036 (95% CI 1.005, 1.067) for preterm birth, adjusting for infant sex, maternal age, marital status and country of birth, neighbourhood socioeconomic status (SES) and visible minority, temperature, year and season of birth, and a natural spline function of day of year. There was some evidence of effect modification by gestational age and season. Associations with carbon monoxide, nitrogen dioxide, particulate matter, and sulphur dioxide were inconsistent. CONCLUSIONS We observed associations between daily O3 in the week before delivery and preterm birth in an analysis of approximately 1 million births in 24 Canadian cities between 1999 and 2008. Our analysis is one of a limited number which have examined these short term associations employing Cox proportional hazards models to account for the different exposure durations of preterm vs. term births.
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Affiliation(s)
- David M. Stieb
- Environmental Health Science and Research Bureau, Health Canada, 101 Tunney’s Pasture Driveway, Ottawa, ON K1A 0K9 Canada
- School of Epidemiology and Public Health, University of Ottawa, Room 101, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3 Canada
| | - Eric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, Room 101, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3 Canada
- Water and Air Quality Bureau, Health Canada, 269 Laurier Avenue W, Ottawa, ON K1A 0K9, Mail Stop 4903B Canada
| | - Li Chen
- Environmental Health Science and Research Bureau, Health Canada, 101 Tunney’s Pasture Driveway, Ottawa, ON K1A 0K9 Canada
| | - Lauren Pinault
- Health Analysis Division, Statistics Canada, 100 Tunney’s Pasture Driveway, Ottawa, ON K1A 0T6 Canada
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, Room 213, 15-17 Tavistock Place, London, WC1H 9SH UK
| | - Michael Tjepkema
- Health Analysis Division, Statistics Canada, 100 Tunney’s Pasture Driveway, Ottawa, ON K1A 0T6 Canada
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Liu Y, Xu J, Chen D, Sun P, Ma X. The association between air pollution and preterm birth and low birth weight in Guangdong, China. BMC Public Health 2019; 19:3. [PMID: 30606145 PMCID: PMC6318948 DOI: 10.1186/s12889-018-6307-7] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 12/05/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND A mountain of evidence has shown that people's physical and mental health can be affected by various air pollutions. Poor pregnancy outcomes are associated with exposure to air pollution. Therefore, this study aims to investigate the association between air pollutions (PM2.5, PM10, SO2, NO2, CO, and O3) and preterm birth/low birth weight in Guangdong province, China. METHOD All maternal data and birth data from January 1, 2014 to December 31, 2015 were selected from a National Free Pre-pregnancy Check-ups system, and the daily air quality data of Guangdong Province was collected from China National Environmental Monitoring Center. 1784 women with either preterm birth information (n = 687) or low birth weight information (n = 1097) were used as experimental group. Control group included 1766 women with healthy birth information. Logistic regression models were employed to evaluate the effects of air pollutants on the risk of preterm birth and low birth weight. RESULTS The pollution levels of PM2.5, PM10, SO2, NO2, CO, and O3 in Guangdong province were all lower than the national air pollution concentrations. The concentrations of PM2.5, PM10, SO2, NO2 and CO had obvious seasonal trends with the highest in winter and the lowest in summer. O3 concentrations in September (65.72 μg/m3) and October (84.18 μg/m3) were relatively higher. After controlling for the impact of confounding factors, the increases in the risk of preterm birth were associated with each 10 μg/m3 increase in PM2.5 (OR 1.043, 95% CI 1.01-1.09) and PM10 (OR 1.039, 95% CI 1.01~1.14) during the first trimester and in PM2.5 (OR 1.038, 95% CI 1.01~1.12), PM10 (OR 1.024, 95% CI 1.02~1.09), SO2 (OR 1.081, 95% CI 1.01~1.29), and O3 (OR 1.016, 95% CI 1.004~1.35) during the third trimester. The increase in the risk of low birth weight was associated with PM2.5, PM10, NO2, and O3 in the first month and the last month. CONCLUSION This study provides further evidence for the relationships between air pollutions and preterm birth/low birth weight. Pregnant women are recommended to reduce or avoid exposure to air pollutions during pregnancy, especially in the early and late stages of pregnancy.
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Affiliation(s)
- Ying Liu
- Institute of Psychology Continuing Education College, University of the Chinese Academy of Sciences, National Research Institute for Family Planning, No.12, Dahuisi Road, Hai Dian District, Beijing, 100081 China
| | - Jihong Xu
- Research Center for Mental Health and Behavior Big Data, National Research Institute for Family Planning, Beijing, China
| | - Dian Chen
- Department of Psychology, Tsinghua University, Beijing, China
| | - Pei Sun
- Department of Psychology, Tsinghua University, Beijing, China
| | - Xu Ma
- Research Center for Mental Health and Behavior Big Data, National Research Institute for Family Planning, Beijing, China
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94
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Sears CG, Braun JM, Ryan PH, Xu Y, Werner EF, Lanphear BP, Wellenius GA. The association of traffic-related air and noise pollution with maternal blood pressure and hypertensive disorders of pregnancy in the HOME study cohort. ENVIRONMENT INTERNATIONAL 2018; 121:574-581. [PMID: 30300815 PMCID: PMC6252254 DOI: 10.1016/j.envint.2018.09.049] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 05/21/2023]
Abstract
Traffic-related air and noise pollution may increase the risk for cardiovascular disorders, especially among susceptible populations like pregnant women. The objective of this study was to evaluate the association of exposure to traffic-related air pollution and traffic noise with blood pressure in pregnant women. We extracted systolic blood pressure (SBP) and diastolic blood pressure (DBP) at ≥20 weeks gestation, as well as hypertensive disorders of pregnancy from medical records in the HOME Study, a prospective pregnancy and birth cohort from Cincinnati, OH (n = 370). We estimated exposure to elemental carbon attributable to traffic (ECAT),1 a marker of traffic-related air pollution, at women's residences at ~20 weeks gestation using a validated land use regression model and traffic noise using a publicly available transportation noise model. We used linear mixed models and modified Poisson regression adjusted for covariates to examine associations of ECAT and traffic noise with blood pressure and hypertensive disorders of pregnancy risk, respectively. In adjusted models, we found a 1.6 (95% CI = 0.02, 3.3; p = 0.048) mm Hg increase in SBP associated with an interquartile range increase in ECAT concentration; the association was stronger after adjusting for traffic noise (1.9 mm Hg, 95% = 0.1, 3.7; p = 0.035). ECAT concentrations were not significantly associated with DBP or hypertensive disorders of pregnancy, and traffic noise was not associated with SBP, DBP, or hypertensive disorders of pregnancy. There was no evidence of a joint effect of traffic noise and ECAT on any outcome. In this cohort, higher residential traffic-related air pollution exposure at ~20 weeks gestation was associated with higher SBP in late pregnancy. It is important for future studies of traffic-related air or noise pollution to jointly consider both exposures and neighborhood characteristics given their correlation and potential cumulative impact on cardiovascular health.
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Affiliation(s)
- Clara G Sears
- Institute at Brown for Environment and Society, Brown University, Providence, RI, USA.
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Patrick H Ryan
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Yingying Xu
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
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95
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Wang Q, Benmarhnia T, Zhang H, Knibbs LD, Sheridan P, Li C, Bao J, Ren M, Wang S, He Y, Zhang Y, Zhao Q, Huang C. Identifying windows of susceptibility for maternal exposure to ambient air pollution and preterm birth. ENVIRONMENT INTERNATIONAL 2018; 121:317-324. [PMID: 30241019 DOI: 10.1016/j.envint.2018.09.021] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 09/02/2018] [Accepted: 09/12/2018] [Indexed: 05/21/2023]
Abstract
Maternal exposure to ambient air pollution has been associated with preterm birth (PTB), however, entire pregnancy or trimester-specific associations were generally reported, which may not sufficiently identify windows of susceptibility. Using birth registry data from Guangzhou, a megacity of southern China (population ~14.5 million), including 469,975 singleton live births between January 2015 and July 2017, we assessed the association between weekly air pollution exposure and PTB in a retrospective cohort study. Daily average concentrations of PM2.5, PM10, NO2, SO2, and O3 from 11 monitoring stations were used to estimate district-specific exposures for each participant based on their district residency during pregnancy. Distributed lag models (DLMs) incorporating Cox proportional hazard models were applied to estimate the association between weekly maternal exposure to air pollutant and PTB risk (as a time-to-event outcome), after controlling for temperature, seasonality, and individual-level covariates. We also considered moderate PTB (32-36 gestational weeks) and very PTB (28-31 gestational weeks) as outcomes of interest. Hazard ratios (HRs) and 95% confidential intervals (95% CIs) were calculated for an interquartile range (IQR) increase in air pollutants during the study period. An IQR increase in PM2.5 exposure during the 20th to 28th gestational weeks (27.0 μg/m3) was significantly associated with PTB risk, with the strongest effect in the 25th week (HR = 1.034, 95% CI:1.010-1.059). The significant exposure windows were the 19th-28th weeks for PM10, the 18th-31st weeks for NO2, and the 23rd-31st weeks for O3, respectively. The strongest associations were observed in the 25th week for PM10 (IQR = 37.0 μg/m3; HR = 1.048, 95% CI:1.034-1.062), the 26th week for NO2 (IQR = 29.0 μg/m3; HR = 1.060, 95% CI:1.028-1.094), and in the 28th week for O3 (IQR = 90.0 μg/m3; HR = 1.063, 95% CI:1.046-1.081). Similar patterns were observed for moderate PTB (32-36 gestational weeks) and very PTB (28-31 gestational weeks) for PM2.5, PM10, NO2 exposure, but the effects were greater for very PTB. We did not observe any association between pregnancy SO2 exposure and the risk of PTB. Our results suggest that middle to late pregnancy is the most susceptible air pollution exposure window for air pollution and PTB among women in Guangzhou, China.
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Affiliation(s)
- Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Huanhuan Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Luke D Knibbs
- School of Public Health, The University of Queensland, Herston, Australia
| | - Paige Sheridan
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA; Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Changchang Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Junzhe Bao
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Meng Ren
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Suhan Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yiling He
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yawei Zhang
- School of Public Health, Yale University, New Haven, CT, USA
| | - Qingguo Zhao
- Epidemiological Research Office of Key Laboratory of Male Reproduction and Genetics (National Health and Family Planning Commission), Family Planning Research Institute of Guangdong Province, Guangzhou, China; Epidemiological Research Office of Key Laboratory of Male Reproduction and Genetics (National Health and Family Planning Commission), Family Planning Special Hospital of Guangdong Province, Guangzhou, China.
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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96
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Klepac P, Locatelli I, Korošec S, Künzli N, Kukec A. Ambient air pollution and pregnancy outcomes: A comprehensive review and identification of environmental public health challenges. ENVIRONMENTAL RESEARCH 2018; 167:144-159. [PMID: 30014896 DOI: 10.1016/j.envres.2018.07.008] [Citation(s) in RCA: 211] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 05/19/2023]
Abstract
There is a growing number of studies on the association between ambient air pollution and adverse pregnancy outcomes, but their results have been inconsistent. Consequently, a comprehensive review of this research area is needed. There was a wide variability in studied pregnancy outcomes, observed gestational windows of exposure, observed ambient air pollutants, applied exposure assessment methods and statistical analysis methods Gestational duration, preterm birth, (low) birth weight, and small for gestational age/intrauterine growth restriction were most commonly investigated pregnancy outcomes. Gestational windows of exposure typically included were whole pregnancy period, 1st, 2nd, 3rd trimester, first and last gestational months. Preterm birth was the outcome most extensively studied across various gestational windows, especially at the beginning and at the end of pregnancy. Particulate matter, nitrogen dioxide, ozone, and carbon monoxide were the most commonly used markers of ambient air pollution. Continuous monitoring data were frequently combined with spatially more precisely modelled estimates of exposure. Exposure to particulate matter and ozone over the entire pregnancy was significantly associated with higher risk for preterm birth: the pooled effect estimates were 1.09 (1.03-1.16) per 10 μg/m3 increase in particulate matter with an aerodynamic diameter of 10 µm or less (PM10),1.24 (1.08-1.41) per 10 μg/m3 increase in particulate matter with an aerodynamic diameter of 2.5 µm or less (PM2.5), and 1.03 (1.01-1.04) per 10 ppb increase in ozone. For pregnancy outcomes other than PTB, ranges of observed effect estimates were reported due to smaller number of studies included in each gestational window of exposure. Further research is needed to link the routine pregnancy outcome data with spatially and temporally resolved ambient air pollution data, while adjusting for commonly defined confounders. Methods for assessing exposure to mixtures of pollutants, indoor air pollution exposure, and various other environmental exposures, need to be developed.
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Affiliation(s)
- Petra Klepac
- National institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia.
| | - Igor Locatelli
- University of Ljubljana, Faculty of Pharmacy, Aškerčeva 7, 1000 Ljubljana, Slovenia.
| | - Sara Korošec
- Department of Obstetrics and Gynecology, Reproductive Unit, University Medical Centre Ljubljana, Zaloška 3, 1525 Ljubljana, Slovenia.
| | - Nino Künzli
- Swiss Tropical and Public Health Institute (SwissTPH), Socinstrasse 57, 4002 Basel, Switzerland; University of Basel, Petersplatz 1, 4001 Basel, Switzerland.
| | - Andreja Kukec
- National institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia; University of Ljubljana, Faculty of Medicine, Vrazov trg 2, 1000 Ljubljana, Slovenia.
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97
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Padula AM, Huang H, Baer RJ, August LM, Jankowska MM, Jellife-Pawlowski LL, Sirota M, Woodruff TJ. Environmental pollution and social factors as contributors to preterm birth in Fresno County. Environ Health 2018; 17:70. [PMID: 30157858 PMCID: PMC6114053 DOI: 10.1186/s12940-018-0414-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 08/21/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND Environmental pollution exposure during pregnancy has been identified as a risk factor for preterm birth. Most studies have evaluated exposures individually and in limited study populations. METHODS We examined the associations between several environmental exposures, both individually and cumulatively, and risk of preterm birth in Fresno County, California. We also evaluated early (< 34 weeks) and spontaneous preterm birth. We used the Communities Environmental Health Screening Tool and linked hospital discharge records by census tract from 2009 to 2012. The environmental factors included air pollution, drinking water contaminants, pesticides, hazardous waste, traffic exposure and others. Social factors, including area-level socioeconomic status (SES) and race/ethnicity were also evaluated as potential modifiers of the relationship between pollution and preterm birth. RESULTS In our study of 53,843 births, risk of preterm birth was associated with higher exposure to cumulative pollution scores and drinking water contaminants. Risk of preterm birth was twice as likely for those exposed to high versus low levels of pollution. An exposure-response relationship was observed across the quintiles of the pollution burden score. The associations were stronger among early preterm births in areas of low SES. CONCLUSIONS In Fresno County, we found multiple pollution exposures associated with increased risk for preterm birth, with higher associations among the most disadvantaged. This supports other evidence finding environmental exposures are important risk factors for preterm birth, and furthermore the burden is higher in areas of low SES. This data supports efforts to reduce the environmental burden on pregnant women.
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Affiliation(s)
- Amy M. Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, 550 16th Street, Mail Stop 0132, San Francisco, CA 94143 USA
| | - Hongtai Huang
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, 550 16th Street, Mail Stop 0132, San Francisco, CA 94143 USA
- Department of Pediatrics, University of California, San Francisco, USA
| | - Rebecca J. Baer
- Department of Pediatrics, University of California, San Diego, USA
| | - Laura M. August
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Sacramento, USA
| | | | | | - Marina Sirota
- Department of Pediatrics, University of California, San Francisco, USA
| | - Tracey J. Woodruff
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, 550 16th Street, Mail Stop 0132, San Francisco, CA 94143 USA
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98
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Svechkina A, Dubnov J, Portnov BA. Environmental risk factors associated with low birth weight: The case study of the Haifa Bay Area in Israel. ENVIRONMENTAL RESEARCH 2018; 165:337-348. [PMID: 29778968 DOI: 10.1016/j.envres.2018.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/15/2018] [Accepted: 05/07/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Low birth weight (LBW) is known to be associated with infant mortality and postnatal health complications. Previous studies revealed strong relationships between LBW rate and several socio-demographic factors, including ethnicity, maternal age, and family income. However, studies of association between LBW rate and environmental risk factors remain infrequent. STUDY METHODS We retrieved a geo-referenced data set, containing 7216 individual records of children born in 2015 in the Haifa Bay Area in Israel. Using this dataset, we analysed factors affecting LBW prevalence by applying two alternative techniques: analysis of LBW rates in small census area (SCAs) and more recently developed double kernel density (DKD) relative risk (RR) estimates. RESULTS In the SCA models, LBW rate was found to be associated with proximity to petrochemical industries (B=-0.26, 95%CI=-0.30, -0.22), road density (B=0.05, 95%CI=0.02, 0.08), distance to the seashore (B=0.17, 95%CI=0.14, 0.22), PM2.5 (B=0.06, 95%CI=0.04, 0.09) and NOx (B=0.10, 95%CI=0.06, 0.13) exposure estimates. Although similar factors emerged in the DKD models as well, in most cases, the effects of these factors in the latter models were found to be stronger: proximity to petrochemical industries (B=-0.48, 95%CI= -0.51, -0.30), road density (B=0.05, 95%CI=0.02, 0.08), distance to the seashore (B=0.24, 95%CI=0.21, 0.27), PM2.5 (B=0.08, 95%CI=0.05, 0.10) and NOx (B=0.20, 95%CI=0.17, 0.23) exposure estimates. In addition, elevation above the sea level was found to be statistically significant in spatial dependence models estimated for both DKD and SCA rates (P < 0.01). CONCLUSION The analysis revealed an excess LBW rate in residential areas located close to petrochemical industries and a protective effect of seashore proximity and elevation above the sea level on the LBW rate. We attribute the latter finding to the moderating effect of elevated seashore locations on outdoor temperatures during the hot summer season.
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Affiliation(s)
- Alina Svechkina
- Department of Natural Resources and Environmental Management, Faculty of Management, University of Haifa, Mount Carmel, Haifa 3498838, Israel
| | - Jonathan Dubnov
- School of Public Health, Faculty of Welfare and Health Sciences, University of Haifa, Mount Carmel, Haifa 3498838, Israel
| | - Boris A Portnov
- Department of Natural Resources and Environmental Management, Faculty of Management, University of Haifa, Mount Carmel, Haifa 3498838, Israel.
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99
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Mendoza-Ramirez J, Barraza-Villarreal A, Hernandez-Cadena L, Hinojosa de la Garza O, Luis Texcalac Sangrador J, Elvira Torres-Sanchez L, Cortez-Lugo M, Escamilla-Nuñez C, Helena Sanin-Aguirre L, Romieu I. Prenatal Exposure to Nitrogen Oxides and its Association with Birth Weight in a Cohort of Mexican Newborns from Morelos, Mexico. Ann Glob Health 2018; 84:274-280. [PMID: 30873792 PMCID: PMC6748222 DOI: 10.29024/aogh.914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The Child-Mother binomial is potentially susceptible to the toxic effects of pollutants because some chemicals interfere with placental transfer of nutrients, thus affecting fetal development, and create an increased the risk of low birth weight, prematurity and intrauterine growth restriction. Objective To evaluate the impact of prenatal exposure to nitrogen oxides (NOx) on birth weight in a cohort of Mexican newborns. Methodology We included 745 mother-child pair participants of the POSGRAD cohort study. Information on socio-demographic characteristics, obstetric history, health history and environmental exposure during pregnancy were readily available and the newborns’ anthropometric measurements were obtained at delivery. Prenatal NOx exposure assessment was evaluated using a Land-Use Regression predictive models considering local monitoring from 60 sites on the State of Morelos. The association between prenatal exposure to NOx and birth weight was estimated using a multivariate linear regression models. Results The average birth weight was 3217 ± 439 g and the mean of NOx concentration was 21 ppb (Interquartile range, IQR = 6.95 ppb). After adjusting for maternal age and other confounders, a significant birthweight reduction was observed for each IQR of NOx increase (ß = –39.61 g, 95% CI: –77.00; –2.21; p = 0.04). Conclusions Our results provides evidence that prenatal NOx exposure has a negative effect on birth weight, which may influence the growth and future development of the newborn.
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Affiliation(s)
- Jessica Mendoza-Ramirez
- Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Santa María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, MX
| | - Albino Barraza-Villarreal
- Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Santa María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, MX
| | - Leticia Hernandez-Cadena
- Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Santa María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, MX
| | - Octavio Hinojosa de la Garza
- Centro de Investigación en Materiales Avanzados S.C., Complejo Industrial Chihuahua, Avenida Miguel de Cervantes 120, C.P. 31109 Chihuahua, Chih, MX.,Facultad de Ingeniería, Universidad Autónoma de Chihuahua, Circuito Universitario Campus II, C.P. 31240 Chihuahua, Chih, MX
| | - José Luis Texcalac Sangrador
- Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Santa María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, MX
| | - Luisa Elvira Torres-Sanchez
- Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Santa María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, MX
| | - Marlene Cortez-Lugo
- Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Santa María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, MX
| | - Consuelo Escamilla-Nuñez
- Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Santa María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, MX
| | - Luz Helena Sanin-Aguirre
- Facultad de Enfermería y Nutriología, Universidad Autónoma de Chihuahua, Circuito Universitario Campus II, C.P. 31240 Chihuahua, Chih, MX
| | - Isabelle Romieu
- Instituto Nacional de Salud Pública, Av. Universidad # 655, Col. Santa María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos, MX
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100
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Lavigne É, Burnett RT, Stieb DM, Evans GJ, Godri Pollitt KJ, Chen H, van Rijswijk D, Weichenthal S. Fine Particulate Air Pollution and Adverse Birth Outcomes: Effect Modification by Regional Nonvolatile Oxidative Potential. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:077012. [PMID: 30073952 PMCID: PMC6108848 DOI: 10.1289/ehp2535] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 07/03/2018] [Accepted: 07/03/2018] [Indexed: 05/05/2023]
Abstract
BACKGROUND Prenatal exposure to fine particulate matter air pollution with aerodynamic diameter ≤2.5 μm (PM2.5) has been associated with preterm delivery and low birth weight (LBW), but few studies have examined possible effect modification by oxidative potential. OBJECTIVES The aim of this study was to evaluate if regional differences in the oxidative potential of PM2.5 modify the relationship between PM2.5 and adverse birth outcomes. METHODS A retrospective cohort study was conducted using 196,171 singleton births that occurred in 31 cities in the province of Ontario, Canada, from 2006 to 2012. Daily air pollution data were collected from ground monitors, and city-level PM2.5 oxidative potential was measured. We used random-effects meta-analysis to combine the estimates of effect from regression models across cities on preterm birth, term LBW, and term birth weight and used meta-regression to evaluate the modifying effect of PM2.5 oxidative potential. RESULTS An interquartile increase (2.6 μg/m3) in first-trimester PM2.5 was positively associated with term LBW among women in the highest quartile of glutathione (GSH)-related oxidative potential [odds ratio (OR)=1.28; 95% confidence interval (CI): 1.10, 1.48], but not the lowest quartile (OR=0.99; 95% CI: 0.87, 1.14; p-interaction=0.03). PM2.5 on the day of delivery also was associated with preterm birth among women in the highest quartile of GSH-related oxidative potential [hazard ratio (HR)=1.02; 95% CI: 1.01, 1.04], but not the lowest quartile [HR=0.97; 95% CI: 0.95, 1.00; p-interaction=0.04]. Between-city differences in ascorbate (AA)-related oxidative potential did not significantly modify associations with PM2.5. CONCLUSIONS Between-city differences in GSH-related oxidative potential may modify the impact of PM2.5 on the risk of term LBW and preterm birth. https://doi.org/10.1289/EHP2535.
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Affiliation(s)
- Éric Lavigne
- Health Canada, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Richard T Burnett
- Health Canada, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - David M Stieb
- Health Canada, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Hong Chen
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | | | - Scott Weichenthal
- Health Canada, Ottawa, Ontario, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
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