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Aziz N, Stafoggia M, Stephansson O, Roos N, Kovats S, Chersich M, Filippi V, Part C, Nakstad B, Hajat S, Ljungman P, de Bont J. Association between ambient air pollution a week prior to delivery and preterm birth using a nationwide study in Sweden. Int J Hyg Environ Health 2024; 262:114443. [PMID: 39159527 DOI: 10.1016/j.ijheh.2024.114443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 08/07/2024] [Accepted: 08/14/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND Air pollution exposure has been linked with increased risk of preterm birth, which is one of the leading causes of infant mortality. Limited studies have attempted to explore these associations in low-polluted areas. In this study, we aimed to assess the association between short-term exposure to ambient air pollution and preterm birth in Sweden. METHOD In this population-based study we included preterm births between 2014 and 2019 from the Swedish Pregnancy Register. We applied a spatiotemporal model to estimate daily levels of particulate matter <2.5 μm (PM2.5), PM < 10 μm (PM10), nitrogen dioxide (NO2), and ozone (O3) at the residential address of each participant. We applied a time-stratified case-crossover design with conditional logistic regression analysis to estimate odds ratios (OR) of preterm birth per 10 μg/m3 (PM10, NO2, O3) and 5 μg/m3 (PM2.5) increase in air pollution exposure at 0-6-day lag. Two-pollutant models were applied to evaluate the independent association of each exposure on preterm birth. We also stratified by maternal characteristics to identify potential effect modifiers. RESULTS 28,216 (4.5%) preterm births were included. An increase in O3 exposure was associated with increased odds of preterm birth [OR = 1.06 per 10 μg/m3 (95% CI, 1.02; 1.10]. PM2.5 and PM10 were not significantly associated with preterm birth, and NO2 displayed a negative nonlinear association with preterm birth. We did not observe any notable effect modification, but we found suggestive larger associations between O3 and preterm birth when stratifying by male sex, spontaneous delivery, and spring season. CONCLUSIONS Increased O3 exposure one week before delivery was associated with an increased risk of preterm birth in Sweden, a country with levels of air pollution below the current World Health Organization air quality guidelines. Increases in O3 levels with climate change make these findings especially concerning.
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Affiliation(s)
- Nabeel Aziz
- Institute of Environmental Medicine, Karolinska Institutet, Sweden
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Sweden; Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Italy
| | - Olof Stephansson
- Department of Women's Health, Division of Obstetrics, Karolinska University Hospital, Stockholm, Sweden; Department of Obstetrics and Gynecology, Karolinska University Hospital, Solna, Sweden
| | - Nathalie Roos
- Department of Women's Health, Division of Obstetrics, Karolinska University Hospital, Stockholm, Sweden; Department of Obstetrics and Gynecology, Karolinska University Hospital, Solna, Sweden
| | - Sari Kovats
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, UK
| | - Matthew Chersich
- Wits Reproductive Health and HIV Institute, Faculty of Health Science, University of the Witwatersrand, South Africa
| | - Veronique Filippi
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, UK; Faculty of Epidemiology and Population Health, Department of Infectious Diseases (International Health), Maternal and Newborn Health Group, LSHTM, UK
| | - Cherie Part
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, UK
| | - Britt Nakstad
- Department of Paediatric and Adolescent Health, University of Botswana, Botswana; Division of Paediatric and Adolescent Medicine, Institute of Clinical Medicine, University of Oslo, Norway
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, UK
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Sweden; Department of Cardiology, Danderyd Hospital, Sweden
| | - Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Sweden.
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Khosravipour M, Golbabaei F. Short-term ambient temperature variations and incidence of preterm birth: A systematic review and meta-analysis. Int J Hyg Environ Health 2024; 256:114319. [PMID: 38171266 DOI: 10.1016/j.ijheh.2023.114319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/18/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024]
Abstract
This study aimed to determine the short-term effects of ambient temperature variations exposures on the incidence of preterm birth (PTB) for each single lag day (lag0 to lag6) and cumulative lag days (lag0-1 to lag0-6) up to a week before birth. To find relevant publications, online databases, including Web of Science, PubMed, and Scopus were searched with appropriate keywords and Mesh terms from their inception to October 25, 2023. Overall, the number of 39 observational studies with 12.5 million pregnant women and 700.000 cases of PTB met our eligibility criteria. The associations of temperature variations with the incidence of PTB were investigated with two different meta-analyses, including the percentile meta-analysis (comparing different percentiles (P1 to P99) with a referent percentile (P50)), and the linear meta-analysis (per 5 °C increment of the temperature levels). For the percentile meta-analysis, we observed both extreme cold (P1, only lag 0) and heat (P95 and P99 with the highest risk at lag1 and lag0-6) exposures can be significantly associated with a higher risk of PTB. The pooled RR (95 % CI) per 5 °C increase in the temperature levels at lag0-6 was estimated as 1.038 (1.018, 1.058) for the overall analysis. Subgroup analysis based on the season shows a significant association in the warm season (RR = 1.082 and 95 % CI = 1.036, 1.128) at all lag days but not the cold season. For the single lag day, we observed the risk of PTB is the highest at lag1 and decreased with moving to lag6. In sum, we suppose there is a nearly V-shape non-linear association between air temperature levels and the incidence of PTB with the linear relationship for each unit increase (also decrease) in the temperature levels above (also below) moderate temperature limits. Future studies should investigate possible association of occupational heat and cold exposure during pregnancy on the incidence of adverse birth outcomes such as PTB.
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Affiliation(s)
- Masoud Khosravipour
- Occupational Health Engineering Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Farideh Golbabaei
- Occupational Health Engineering Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Yüzen D, Graf I, Tallarek AC, Hollwitz B, Wiessner C, Schleussner E, Stammer D, Padula A, Hecher K, Arck PC, Diemert A. Increased late preterm birth risk and altered uterine blood flow upon exposure to heat stress. EBioMedicine 2023:104651. [PMID: 37355458 PMCID: PMC10363435 DOI: 10.1016/j.ebiom.2023.104651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Climate change, in particular the exposure to heat, impacts on human health and can trigger diseases. Pregnant people are considered a vulnerable group given the physiological changes during pregnancy and the potentially long-lasting consequences for the offspring. Evidence published to date on higher risk of pregnancy complications upon heat stress exposure are from geographical areas with high ambient temperatures. Studies from geographic regions with temperate climates are sparse; however, these areas are critical since individuals may be less equipped to adapt to heat stress. This study addresses a significant gap in knowledge due to the temperature increase documented globally. METHODS Birth data of singleton pregnancies (n = 42,905) from a tertiary care centre in Hamburg, Germany, between 1999 and 2021 were retrospectively obtained and matched with climate data from the warmer season (March to September) provided by the adjacent federal meteorological station of the German National Meteorological Service to calculate the relative risk of heat-associated preterm birth. Heat events were defined by ascending temperature percentiles in combination with humidity over exposure periods of up to 5 days. Further, ultrasound data documented in a longitudinal prospective pregnancy cohort study (n = 612) since 2012 were used to identify pathophysiological causes of heat-induced preterm birth. FINDINGS Both extreme heat and prolonged periods of heat exposure increased the relative risk of preterm birth (RR: 1.59; 95% CI: 1.01-2.43; p = 0.045; RR: 1.20; 95% CI: 1.02-1.40; p = 0.025). We identified a critical period of heat exposure during gestational ages 34-37 weeks that resulted in increased risk of late preterm birth (RR: 1.67; 95% CI: 1.14-1.43; p = 0.009). Pregnancies with a female fetus were more prone to heat stress-associated preterm birth. We found heat exposure was associated with altered vascular resistance within the uterine artery. INTERPRETATION Heat stress caused by high ambient temperatures increases the risk of preterm birth in a geographical region with temperate climate. Prenatal routine care should be revised in such regions to provide active surveillance for women at risk. FUNDING Found in acknowledgements.
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Affiliation(s)
- Dennis Yüzen
- Department of Obstetrics and Fetal Medicine, Laboratory for Experimental Feto-Maternal Medicine, University Medical Centre of Hamburg-Eppendorf, Germany; Institute of Immunology, University Medical Centre of Hamburg-Eppendorf, Germany
| | - Isabel Graf
- Department of Obstetrics and Fetal Medicine, Laboratory for Experimental Feto-Maternal Medicine, University Medical Centre of Hamburg-Eppendorf, Germany
| | - Ann-Christin Tallarek
- Department of Obstetrics and Fetal Medicine, University Medical Centre of Hamburg-Eppendorf, Germany
| | - Bettina Hollwitz
- Department of Obstetrics and Fetal Medicine, University Medical Centre of Hamburg-Eppendorf, Germany
| | - Christian Wiessner
- Institute of Medical Biometry and Epidemiology, University Medical Centre of Hamburg-Eppendorf, Germany
| | | | - Detlef Stammer
- Centre for Earth System Research and Sustainability (CEN), University Hamburg, Germany
| | - Amy Padula
- Division of Maternal-Fetal Medicine, Department of Obstetrics, University of California, San Francisco, USA
| | - Kurt Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Centre of Hamburg-Eppendorf, Germany
| | - Petra Clara Arck
- Department of Obstetrics and Fetal Medicine, Laboratory for Experimental Feto-Maternal Medicine, University Medical Centre of Hamburg-Eppendorf, Germany.
| | - Anke Diemert
- Department of Obstetrics and Fetal Medicine, University Medical Centre of Hamburg-Eppendorf, Germany
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Ming X, He Z, Li Y, Hu Y, Yang Y, Chen H, Chen Q, Yang H, Zhou W. The short-term effects of air pollution exposure on preterm births in Chongqing, China: 2015-2020. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:51679-51691. [PMID: 36810823 PMCID: PMC10119072 DOI: 10.1007/s11356-023-25624-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Accumulating evidence suggested that the risk of preterm births (PTBs) following prenatal exposure to air pollution was inconclusive. The aim of this study is to investigate the relationship between air pollution exposure in the days before delivery and PTB and assess the threshold effect of short-term prenatal exposure to air pollution on PTB. This study collected data including meteorological factors, air pollutants, and information in Birth Certificate System from 9 districts during 2015-2020 in Chongqing, China. Generalized additive models (GAMs) with the distributed lag non-linear models were conducted to assess the acute impact of air pollutants on the daily counts of PTB, after controlling for potential confounding factors. We observed that PM2.5 was related to increased occurrence of PTB on lag 0-3 and lag 10-21 days, with the strongest on the first day (RR = 1.017, 95%CI: 1.000-1.034) and then decreasing. The thresholds of PM2.5 for lag 1-7 and 1-30 days were 100 μg/m3 and 50 μg/m3, respectively. The lag effect of PM10 on PTB was very similar to that of PM2.5. In addition, the lagged and cumulative exposure of SO2 and NO2 was also associated with the increased risk of PTB. The lag relative risk and cumulative relative risk of CO exposure were the strongest, with a maximum RR at lag 0 (RR = 1.044, 95%CI: 1.018, 1.069). Importantly, the exposure-response curve of CO showed that RR increased rapidly when the concentration exceeded 1000 μg/m3. This study indicated significant associations between air pollution and PTB. The relative risk decreases with day lag, while the cumulative effect increases. Thus, pregnant women should understand the risk of air pollution and try to avoid high concentration exposure.
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Affiliation(s)
- Xin Ming
- Women and Children's Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children), Longshan Road 120, Chongqing, 401147, China
| | - Ziyi He
- Women and Children's Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children), Longshan Road 120, Chongqing, 401147, China
| | - Yannan Li
- Women and Children's Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children), Longshan Road 120, Chongqing, 401147, China
| | - Yaqiong Hu
- Women and Children's Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children), Longshan Road 120, Chongqing, 401147, China
| | - Yunping Yang
- Women and Children's Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children), Longshan Road 120, Chongqing, 401147, China
| | - Hongyan Chen
- Women and Children's Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children), Longshan Road 120, Chongqing, 401147, China
| | - Qin Chen
- Institute of Toxicology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Huan Yang
- Institute of Toxicology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Wenzheng Zhou
- Women and Children's Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children), Longshan Road 120, Chongqing, 401147, China.
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Sakali AK, Papagianni M, Bargiota A, Rasic-Markovic A, Macut D, Mastorakos G. Environmental factors affecting pregnancy outcomes. Endocrine 2023; 80:459-469. [PMID: 36729371 DOI: 10.1007/s12020-023-03307-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 01/10/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Pregnancy represents a fragile period in the life of a woman, vulnerable to hazardous environmental substances which might affect maternal and fetal metabolism. The possible influence of environmental factors, including endocrine disrupting chemicals (EDCs), upon the mother and the fetus before and/or during pregnancy might be associated directly and/or indirectly to deleterious pregnancy outcomes. Because the existence of such associations would be, to our view, of major importance to the scientific community, their investigation is the scope of this critical review. METHODS This critical review includes in vivo animal and human studies regarding the role of environmental factors, including EDCs, on pregnancy outcomes complying with the SANRA (a scale for the quality assessment of narrative review articles) questions for narrative reviews. Studies were identified by searching the MEDLINE (PubMed and PubMed Central), the Cochrane library and the Google Scholar databases till October 2022 with the combinations of the appropriate key words (detailed environmental factors including EDCs AND detailed negative pregnancy outcomes) as well as by scanning references from already included articles and relevant reviews manually. Because environmental factors and EDCs have been associated to epigenetic alterations, special care has been given to EDC-induced transgenerational effects on pregnancy outcomes. RESULTS The existing evidence suggests positive associations between specific environmental factors and negative pregnancy outcomes such as ectopic pregnancies, pregnancy losses, gestational diabetes, hypertensive disorders of pregnancy, preterm births, birth defects, intrauterine growth restriction, and small or large for gestational age babies. CONCLUSION Environmental factors and EDCs may have a catalytic effect on the course and the outcomes of pregnancy.
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Affiliation(s)
- Anastasia-Konstantina Sakali
- Department of Endocrinology and Metabolic Diseases, Larissa University Hospital, University of Thessaly, Larissa, Greece
| | - Maria Papagianni
- Department of Nutrition and Dietetics, School of Physical Education and Sport Science and Dietetics, University of Thessaly, Trikala, Greece
- Endocrine Unit, 3rd Department of Pediatrics, Hippokration Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandra Bargiota
- Department of Endocrinology and Metabolic Diseases, Larissa University Hospital, University of Thessaly, Larissa, Greece
| | - Aleksandra Rasic-Markovic
- Institute of Medical Physiology, Faculty of Medicine, University of Belgrade, Visegradska 26, 11000, Belgrade, Serbia
| | - Djuro Macut
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - George Mastorakos
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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de Bont J, Stafoggia M, Nakstad B, Hajat S, Kovats S, Part C, Chersich M, Luchters S, Filippi V, Stephansson O, Ljungman P, Roos N. Associations between ambient temperature and risk of preterm birth in Sweden: A comparison of analytical approaches. ENVIRONMENTAL RESEARCH 2022; 213:113586. [PMID: 35671796 DOI: 10.1016/j.envres.2022.113586] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/24/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence indicates that high temperatures are a risk factor for preterm birth. Increasing heat exposures due to climate change are therefore a concern for pregnant women. However, the large heterogeneity of study designs and statistical methods across previous studies complicate interpretation and comparisons. We investigated associations of short-term exposure to high ambient temperature with preterm birth in Sweden, applying three complementary analytical approaches. METHODS We included 560,615 singleton live births between 2014 and 2019, identified in the Swedish Pregnancy Register. We estimated weekly mean temperatures at 1-km2 spatial resolution using a spatiotemporal machine learning methodology, and assigned them at the residential addresses of the study participants. The main outcomes of the study were gestational age in weeks and subcategories of preterm birth (<37 weeks): extremely preterm birth (<28 weeks), very preterm birth (from week 28 to <32), and moderately preterm birth (from week 32 to<37). Case-crossover, quantile regression and time-to-event analyses were applied to estimate the effects of short-term exposure to increased ambient temperature during the week before birth on preterm births. Furthermore, distributed lag nonlinear models (DLNM) were applied to identify susceptibility windows of exposures throughout pregnancy in relation to preterm birth. RESULTS A total of 1924 births were extremely preterm (0.4%), 2636 very preterm (0.5%), and 23,664 moderately preterm (4.2%). Consistent across all three analytical approaches (case-crossover, quantile regression and time-to-event analyses), higher ambient temperature (95th vs 50th percentile) demonstrated increased risk of extremely preterm birth, but associations did not reach statistical significance. In DLNM models, we observed no evidence to suggest an increased effect of high temperature on preterm birth risk. Even so, a suggested trend was observed in both the quantile regression and time-to-event analyses of a higher risk of extremely preterm birth with higher temperature during the last week before birth. CONCLUSIONS In Sweden, with high quality data on exposure and outcome, a temperate climate and good quality ante-natal health care, we did not find an association between high ambient temperatures and preterm births. Results were consistent across three complementary analytical approaches.
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Affiliation(s)
- Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Sweden.
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Sweden; Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Italy
| | - Britt Nakstad
- Division Paediatric Adolescent Medicine, Inst Clinical Medicine, University of Oslo, Oslo, Norway; Department Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana
| | - Shakoor Hajat
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, UK
| | - Sari Kovats
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, UK
| | - Chérie Part
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, UK
| | - Matthew Chersich
- Wits Reproductive Health and HIV Institute, Faculty of Health Science, University of the Witwatersrand, South Africa
| | - Stanley Luchters
- Centre for Sexual Health and HIV/AIDS Research, CeSHHAR, Harare, Zimbabwe; Department of Public Health and Primary Care, Ghent University, Belgium; Liverpool School of Tropical Medicine, UK
| | - Veronique Filippi
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, UK
| | - Olof Stephansson
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Sweden; Department of Cardiology, Danderyd University Hospital, Sweden
| | - Nathalie Roos
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Sweden
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Cushing L, Morello-Frosch R, Hubbard A. Extreme heat and its association with social disparities in the risk of spontaneous preterm birth. Paediatr Perinat Epidemiol 2022; 36:13-22. [PMID: 34951022 DOI: 10.1111/ppe.12834] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 10/21/2021] [Accepted: 10/24/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Climate change is increasing the frequency and intensity of heatwaves. Prior studies associate high temperature with preterm birth. OBJECTIVES We tested the hypotheses that acute exposure to extreme heat was associated with higher risk of live spontaneous preterm birth (≥20 and <37 completed weeks), and that risks were higher among people of colour and neighbourhoods with heat-trapping landcover or concentrated racialised economic disadvantage. METHODS We conducted a retrospective cohort study of people giving birth between 2007 and 2011 in Harris County, Texas (Houston metropolitan area) (n = 198,013). Exposures were daily ambient apparent temperature (ATmax in 5°C increments) and dry-bulb temperatures (Tmax and Tmin >historical [1971-2000] summertime 99th percentile) up to a week prior for each day of pregnancy. Survival analysis controlled for individual-level risk factors, secular and seasonal trends. We considered race/ethnicity, heat-trapping neighbourhood landcover and Index of Concentration at the Extremes as effect modifiers. RESULTS The frequency of preterm birth was 10.3%. A quarter (26.8%) of people were exposed to ATmax ≥40°C, and 22.8% were exposed to Tmax and Tmin >99th percentile while at risk. The preterm birth rate among the exposed was 8.9%. In multivariable models, the risk of preterm birth was 15% higher following extremely hot days (hazard ratio [HR] 1.15 (95% confidence interval [CI] 1.01, 1.30) for ATmax ≥40°C vs. <20°C; HR 1.15 (95% CI 1.02, 1.28) for Tmax and Tmin >99th percentile). Censoring at earlier gestational ages suggested stronger associations earlier in pregnancy. The risk difference associated with extreme heat was higher in neighbourhoods of concentrated racialised economic disadvantage. CONCLUSIONS Ambient heat was associated with spontaneous preterm birth, with stronger associations earlier in pregnancy and in racially and economically disadvantaged neighbourhoods, suggesting climate change may worsen existing social inequities in preterm birth rates.
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Affiliation(s)
- Lara Cushing
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy & Management, University of California, Berkeley, California, USA.,School of Public Health, University of California, Berkeley, California, USA
| | - Alan Hubbard
- School of Public Health, University of California, Berkeley, California, USA
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Chersich MF, Pham MD, Areal A, Haghighi MM, Manyuchi A, Swift CP, Wernecke B, Robinson M, Hetem R, Boeckmann M, Hajat S. Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis. BMJ 2020; 371:m3811. [PMID: 33148618 PMCID: PMC7610201 DOI: 10.1136/bmj.m3811] [Citation(s) in RCA: 173] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess whether exposure to high temperatures in pregnancy is associated with increased risk for preterm birth, low birth weight, and stillbirth. DESIGN Systematic review and random effects meta-analysis. DATA SOURCES Medline and Web of Science searched up to September 2018, updated in August 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Clinical studies on associations between high environmental temperatures, and preterm birth, birth weight, and stillbirths. RESULTS 14 880 records and 175 full text articles were screened. 70 studies were included, set in 27 countries, seven of which were countries with low or middle income. In 40 of 47 studies, preterm births were more common at higher than lower temperatures. Exposures were classified as heatwaves, 1°C increments, and temperature threshold cutoff points. In random effects meta-analysis, odds of a preterm birth rose 1.05-fold (95% confidence interval 1.03 to 1.07) per 1°C increase in temperature and 1.16-fold (1.10 to 1.23) during heatwaves. Higher temperature was associated with reduced birth weight in 18 of 28 studies, with considerable statistical heterogeneity. Eight studies on stillbirths all showed associations between temperature and stillbirth, with stillbirths increasing 1.05-fold (1.01 to 1.08) per 1°C rise in temperature. Associations between temperature and outcomes were largest among women in lower socioeconomic groups and at age extremes. The multiple temperature metrics and lag analyses limited comparison between studies and settings. CONCLUSIONS Although summary effect sizes are relatively small, heat exposures are common and the outcomes are important determinants of population health. Linkages between socioeconomic status and study outcomes suggest that risks might be largest in low and middle income countries. Temperature rises with global warming could have major implications for child health. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD 42019140136 and CRD 42018118113.
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Affiliation(s)
- Matthew Francis Chersich
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Hillbrow, Johannesburg 2001, South Africa
| | - Minh Duc Pham
- Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ashtyn Areal
- Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Marjan Mosalam Haghighi
- The Children's Hospital at Westmead, Cardiology Centre, University of Sydney, Sydney, NSW, Australia
| | - Albert Manyuchi
- Global Change Institute, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Bianca Wernecke
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa
- Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, South Africa
| | | | - Robyn Hetem
- School of Animal, Plant and Environmental Sciences, Faculty of Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Melanie Boeckmann
- Department of Environment and Health, School of Public Health, Bielefeld University, Germany
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, and the Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
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Adverse Birth Outcomes Related to NO 2 and PM Exposure: European Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218116. [PMID: 33153181 PMCID: PMC7662294 DOI: 10.3390/ijerph17218116] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 12/27/2022]
Abstract
There is a growing number of international studies on the association between ambient air pollution and adverse pregnancy outcomes, and this systematic review and meta-analysis has been conducted focusing on European countries, to assess the crucial public health issue of this suspected association on this geographical area. A systematic literature search (based on Preferred Reporting Items for Systematic reviews and Meta-Analyses, PRISMA, guidelines) has been performed on all European epidemiological studies published up until 1 April 2020, on the association between maternal exposure during pregnancy to nitrogen dioxide (NO2) or particular matter (PM) and the risk of adverse birth outcomes, including: low birth weight (LBW) and preterm birth (PTB). Fourteen articles were included in the systematic review and nine of them were included in the meta-analysis. Our meta-analysis was conducted for 2 combinations of NO2 exposure related to birth weight and PTB. Our systematic review revealed that risk of LBW increases with the increase of air pollution exposure (including PM10, PM2.5 and NO2) during the whole pregnancy. Our meta-analysis found that birth weight decreases with NO2 increase (pooled beta = −13.63, 95% confidence interval (CI) (−28.03, 0.77)) and the risk of PTB increase for 10 µg/m3 increase in NO2 (pooled odds ratio (OR) = 1.07, 95% CI (0.90, 1.28)). However, the results were not statistically significant. Our finding support the main international results, suggesting that increased air pollution exposure during pregnancy might contribute to adverse birth outcomes, especially LBW. This body of evidence has limitations that impede the formulation of firm conclusions. Further studies, well-focused on European countries, are called to resolve the limitations which could affect the strength of association such as: the exposure assessment, the critical windows of exposure during pregnancy, and the definition of adverse birth outcomes. This analysis of limitations of the current body of research could be used as a baseline for further studies and may serve as basis for reflection for research agenda improvements.
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Association of Summer Heat Waves and the Probability of Preterm Birth in Minnesota: An Exploration of the Intersection of Race and Education. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176391. [PMID: 32887349 PMCID: PMC7503599 DOI: 10.3390/ijerph17176391] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/24/2020] [Accepted: 08/28/2020] [Indexed: 11/17/2022]
Abstract
Preterm birth (PTB) is common and has negative impacts on infant health. While some maternal risk factors have been identified, including age under 20 or over 40, substance abuse, low BMI, and racism, less is known about the impact of environmental exposures like high heat. We combined 154,157 records of live births occurring in Minnesota between 2009 and 2015 with hourly weather records collected from the Minneapolis–St. Paul airport. We tested if maternal heat wave exposure (a seven-day period with a mean daily high temp of 37 °C) immediately prior to birth leads to a higher risk of preterm birth. Additional covariates included maternal age, race/ethnicity, educational status, and residence in the seven-county Minneapolis–St. Paul metro area. Pregnant women exposed to a seven-day heat wave of 37 °C or higher experienced a higher relative risk of PTB compared to women who did not experience a heat wave (1.14 risk ratio (RR), 1.0–1.3 95% confidence interval (CI)). The result is robust to controls for a woman’s age, race/ethnicity, educational attainment, place of residence, and year of the birth. Children born to Black women with college degrees who are exposed to heat waves experience a higher relative risk of PTB compared to White women with college degrees in a heat wave (2.97 RR, 1.5–6.1 95% CI). Summer heat waves are associated with higher risk of PTB in late-term pregnancies in Minnesota.
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Li L, Ma J, Cheng Y, Feng L, Wang S, Yun X, Tao S. Urban-rural disparity in the relationship between ambient air pollution and preterm birth. Int J Health Geogr 2020; 19:23. [PMID: 32563251 PMCID: PMC7305583 DOI: 10.1186/s12942-020-00218-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/15/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Some studies have reported that air pollution exposure can have adverse effects on pregnancy outcomes. However, the disparity between urban and rural areas in the risk of preterm birth (PTB) has yet to be elucidated. Considering geographic contexts as homogeneous or ignoring urban-rural differences cannot accurately reveal the disparities in the health effects of air pollution under different geographic contexts. The aims of this study were to examine the disparities in the risks of PTB in three different regions and five urban-rural types and to investigate the extent to which fine particulate matter (PM2.5) exposure during the entire pregnancy can explain the variations. METHODS We collected data on 429,865 singleton newborns born in 2014 in Hubei Province, China, and divided Hubei Province into three regions. Spatial correlation methods were employed to measure the associations between the rate of PTB and air pollution using average annual indexes for the entire province and regions. A series of multilevel logistic models were conducted to examine disparities in the risks of PTB with decreases in urbanity and the effects of air pollution exposure on the occurrence of preterm births. RESULTS The PM2.5 concentration was significantly different across the regions. The eastern region had the most wide-ranged and serious level of pollution, whereas the levels in the middle and western regions weakened. The odds of PTB and air pollution exhibited a positive spatial correlation for the entire province and in the east (BiMoran's I = 0.106 and 0.697, respectively). Significant urban-rural disparities in the risks of PTB were noted in the east and middle regions, and the mean PM2.5 exposure during the entire pregnancy was positively associated with PTB risk. However, in the west, the results showed weak differences in the risks of PTB among the five urban-rural types and an insignificant effect of PM2.5 exposure. The direction of the effect of district/county-level income on PTB varied by region. CONCLUSIONS This study finds that air pollution exposure and PTB have significant and positive spatial relationships in areas with a serious air pollution burden. The risks of PTB in three regions of Hubei Province follow the same W-shaped pattern as urbanity decreases and rurality increases. High levels of air pollution exposure may be an important disadvantage for urban pregnant women in this setting.
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Affiliation(s)
- Long Li
- Beijing Key Laboratory for Remote Sensing of Environment and Digital Cities, Faculty of Geographical Science, Beijing Normal University, Beijing, 100875, China
| | - Jing Ma
- Beijing Key Laboratory for Remote Sensing of Environment and Digital Cities, Faculty of Geographical Science, Beijing Normal University, Beijing, 100875, China.
| | - Yang Cheng
- Beijing Key Laboratory for Remote Sensing of Environment and Digital Cities, Faculty of Geographical Science, Beijing Normal University, Beijing, 100875, China
| | - Ling Feng
- Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shaoshuai Wang
- Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao Yun
- College of Urban and Environmental Sciences, Peking University, Beijing, 100871, China
| | - Shu Tao
- College of Urban and Environmental Sciences, Peking University, Beijing, 100871, China
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Siddika N, Rantala AK, Antikainen H, Balogun H, Amegah AK, Ryti NRI, Kukkonen J, Sofiev M, Jaakkola MS, Jaakkola JJK. Short-term prenatal exposure to ambient air pollution and risk of preterm birth - A population-based cohort study in Finland. ENVIRONMENTAL RESEARCH 2020; 184:109290. [PMID: 32126375 DOI: 10.1016/j.envres.2020.109290] [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: 08/27/2019] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Previous studies have provided evidence that prenatal exposure to low-level air pollution increases the risk of preterm birth (PTB), but the findings of the effects of short-term exposure have been inconclusive. Moreover, there is little knowledge on potential synergistic effects of different combinations of air pollutants. OBJECTIVES To assess independent and joint effects of prenatal exposure to air pollutants during the week prior to the delivery on the risk of PTB. METHODS The study population included 2568 members of the Espoo Cohort Study, living in the City of Espoo, Finland, born between 1984 and 1990. We assessed individual-level prenatal exposure to ambient air pollutants of interest based on maternal residential addresses, while taking into account their residential mobility. We used both regional-to-city-scale dispersion modelling and land-use regression-based method to estimates the pollutant concentrations. We contrasted the risk of PTB in the highest quartile (Q4) of exposure to the lower exposure quartiles (Q1-Q3) during the specific periods of pregnancy. We applied Poisson regression analysis to estimate the adjusted risk ratios (RRs) with their 95% confidence intervals (CI), adjusting for season of birth, maternal age, sex of the baby, family's socioeconomic status, maternal smoking, and exposure to environmental tobacco smoke during pregnancy, single parenthood, and exposure to other air pollutants (this in multi-pollutant models). RESULTS The risk of PTB was related to exposures to PM2.5, PM10 and NO2 during the week prior to the delivery with adjusted RRs of 1.67 (95%CI: 1.14, 2.46), 1.60 (95% CI: 1.09, 2.34) and 1.65 (95% CI: 1.14, 2.37), from three-pollutant models respectively. There were no significant joint effects for these different air pollutants (during the week prior to the delivery). CONCLUSION Our results provide evidence that exposure to fairly low-level air pollution may trigger PTB, but synergistic effects of different pollutants are not likely.
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Affiliation(s)
- Nazeeba Siddika
- Center for Environmental and Respiratory Health Research, Faculty of Medicine, P.O. Box 5000, 90014, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, P.O. Box 8000, 90014, University of Oulu, Oulu, Finland
| | - Aino K Rantala
- Center for Environmental and Respiratory Health Research, Faculty of Medicine, P.O. Box 5000, 90014, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, P.O. Box 8000, 90014, University of Oulu, Oulu, Finland
| | - Harri Antikainen
- Geography Research Unit, P.O. Box 3000, 90014, University of Oulu, Oulu, Finland
| | - Hamudat Balogun
- Center for Environmental and Respiratory Health Research, Faculty of Medicine, P.O. Box 5000, 90014, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, P.O. Box 8000, 90014, University of Oulu, Oulu, Finland
| | - A Kofi Amegah
- Public Health Research Group, Department of Biomedical Sciences, University Post Office, University of Cape Coast, Cape Coast, Ghana
| | - Niilo R I Ryti
- Center for Environmental and Respiratory Health Research, Faculty of Medicine, P.O. Box 5000, 90014, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, P.O. Box 8000, 90014, University of Oulu, Oulu, Finland
| | - Jaakko Kukkonen
- Finnish Meteorological Institute, P.O. Box 503, 00101, Helsinki, Finland
| | - Mikhail Sofiev
- Finnish Meteorological Institute, P.O. Box 503, 00101, Helsinki, Finland
| | - Maritta S Jaakkola
- Center for Environmental and Respiratory Health Research, Faculty of Medicine, P.O. Box 5000, 90014, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, P.O. Box 8000, 90014, University of Oulu, Oulu, Finland
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research, Faculty of Medicine, P.O. Box 5000, 90014, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, P.O. Box 8000, 90014, University of Oulu, Oulu, Finland.
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Huang S, Lin D, Huang Z, Yang L, Ding X, Chen Q. Acute Effects of Exposure to Ambient Air Pollutants on Preterm Birth in Xiamen City (2015-2018), China. ACS OMEGA 2020; 5:7462-7467. [PMID: 32280889 PMCID: PMC7144129 DOI: 10.1021/acsomega.0c00146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 03/17/2020] [Indexed: 05/04/2023]
Abstract
Backgrounds: Urban energy consumption is one of the important causes of air pollution. The epidemiological risk assessment guided by air pollution is of great significance to the promotion of urban environmental protection. Objectives: The work researched the acute impact of exposure to air pollution on preterm birth (PTB) in Xiamen city from 2015 to 2018. Furthermore, the economic losses were assessed as well. Methods: Association of air pollution and PTB with economic losses were assessed using the generalized additive model. Results: A total of 1991 PTB visits, who are inhabitant in Xiamen, have been investigated. An interquartile range (IQR) (10 μg/m3) increase of PM10, NO2, and SO2 in the current day corresponded to the increase of 0.64% [95% CI: -1.22, 2.54%], 0.52% [95% CI: -5.21, 6.61%], and 2.33% [95% CI: -6.41, 11.58%] in daily PTB visits. Especially, PTB visits were significantly related with PM10 and NO2 in Lag 1 and NO2 and SO2 in Lag 2. Furthermore, for multipollutants, an IQR increase in PM2.5, O3, and CO, after adjustment with SO2, was related with 5.04% [95% CI: -5.90, 17.24], 2.49% [95% CI: -6.07, 11.81], and 7.10% [95% CI: -2.79, 18.00] increase of PTB morbidity, respectively. The estimates of the number of excess PTBs attributed to typical pollutants PM10 and SO2 were ∼2400 and 1200 people, respectively, every year. The highest excess PTBs was estimated to occur as a result of PM10 and SO2 effects. Conclusions: Although Xiamen has a relatively low level of air pollution, short-term exposure to NO2, SO2, and PM10 was linked to the increase of PTB visits.
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Affiliation(s)
- Sijing Huang
- Department
of Obstetrics and Gynecology, The First Affiliated Hospital, School
of Medicine, Xiamen University, Xiamen, Fujian 361003, China
- The
Key Laboratory of Research and Diagnosis of Gynecological Diseases
of Xiamen City, The First Affiliated Hospital
of Xiamen University, Xiamen, Fujian 361003, China
| | - Dianchao Lin
- Department
of Obstetrics and Gynecology, The First Affiliated Hospital, School
of Medicine, Xiamen University, Xiamen, Fujian 361003, China
- The
Key Laboratory of Research and Diagnosis of Gynecological Diseases
of Xiamen City, The First Affiliated Hospital
of Xiamen University, Xiamen, Fujian 361003, China
| | - Zhixiong Huang
- State
Key Laboratory of Cellular Stress Biology, School of Life Sciences, Xiamen University, Xiamen, Fujian 361003, China
| | - Lin Yang
- Department
of Obstetrics and Gynecology, The First Affiliated Hospital, School
of Medicine, Xiamen University, Xiamen, Fujian 361003, China
- The
Key Laboratory of Research and Diagnosis of Gynecological Diseases
of Xiamen City, The First Affiliated Hospital
of Xiamen University, Xiamen, Fujian 361003, China
| | - Xinyu Ding
- Department
of Obstetrics and Gynecology, The First Affiliated Hospital, School
of Medicine, Xiamen University, Xiamen, Fujian 361003, China
- The
Key Laboratory of Research and Diagnosis of Gynecological Diseases
of Xiamen City, The First Affiliated Hospital
of Xiamen University, Xiamen, Fujian 361003, China
| | - Qionghua Chen
- Department
of Obstetrics and Gynecology, The First Affiliated Hospital, School
of Medicine, Xiamen University, Xiamen, Fujian 361003, China
- The
Key Laboratory of Research and Diagnosis of Gynecological Diseases
of Xiamen City, The First Affiliated Hospital
of Xiamen University, Xiamen, Fujian 361003, China
- .
Phone: +86-218-1680
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Paterson SK, Godsmark CN. Heat-health vulnerability in temperate climates: lessons and response options from Ireland. Global Health 2020; 16:29. [PMID: 32228631 PMCID: PMC7106697 DOI: 10.1186/s12992-020-00554-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/05/2020] [Indexed: 11/29/2022] Open
Abstract
Background In Ireland, rising temperatures remains the climate projection that national climate scientists associate with the highest degree of confidence. However, the health challenge of heat has been largely absent from Ireland’s public health sector. This is epitomised by the lack of a comprehensive public health-focused heat-health action plan or country-specific codes of practice for heat-health when working outdoors. Our objective is to highlight the anticipated heat-health challenges in Ireland, and other temperate regions, through analysing vulnerable groups and systems, reinforcing the need to respond. Methods A scoping literature review was conducted to determine how heat affects health of the vulnerable in temperate climatic regions, with a focus on Ireland. Additionally, national Google Trends data was coarsely analysed to determine whether heat is a growing societal concern. Results and discussion The heat-vulnerable include: older people; chronically ill; infants, pregnant women, children; outdoor workers; socio-economically disadvantaged; urban dwellers; food systems and the health sector. Google Trends data suggest an increase in heat-related health searches over time, demonstrating rising levels of concern to temperature increases, reinforcing a gap in national policy associated with communication of, and response to, the heat-health challenge. Specific, actionable recommendations for adaptation and mitigation strategies are proposed. Conclusion Heat poses a public and occupational health challenge, receiving limited attention in Ireland. Lack of a co-ordinated effort, places vulnerable populations at risk. Our recommendations, with reference to vulnerable groups and acknowledging the multi-sectoral nature of heat-health and climate change, advocate for the adoption of a “health and climate change in all policies” approach and the development of a public health-focused heat-health action plan.
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Affiliation(s)
- Shona K Paterson
- College of Business, Arts and Social Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Christie Nicole Godsmark
- School of Public Health, University College Cork, Western Gateway Building, Western Road, Cork, T12 XF62, Ireland. .,Environmental Research Institute, University College Cork, Cork, Ireland.
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Ranjbaran M, Mohammadi R, Yaseri M, Kamari M, Yazdani K. Ambient temperature and air pollution, and the risk of preterm birth in Tehran, Iran: a time series study. J Matern Fetal Neonatal Med 2020; 35:726-737. [PMID: 32160820 DOI: 10.1080/14767058.2020.1731458] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The aim of the present study was to determine the relationship between temperature and air pollution, and preterm birth in Tehran, Iran.Methods: In this time series study, the daily data of preterm births, air pollution, and maximum, minimum and mean temperature from March 2015 to March 2018 were used. To evaluate the effect of air pollution and temperature with and without adjustment of their mutual effects on preterm birth in lags (days) 0-21, the Distributed Lag Non-linear Models (DLNM) was used. The relative risk (RR) was estimated for extreme, moderate and mild heat (99th, 95th, 75th percentile) and cold (1st, 5th, 25th percentile) compared with the median, and for each 10-unit increase in PM2.5, NO2, and O3, 5-unit increase in SO2, and 1-unit increase in CO.Results: The highest RR was seen in extreme (26.9 °C) and moderate (24.8 °C) heat of minimum temperature on lag 0 (RR = 1.17; 1.05-1.31, Adjusted RR = 1.16; 1.04-1.29, RR = 1.15; 1.05-1.26, Adjusted RR = 1.14; 1.03-1.25, respectively). In regard of cold, the only significant effect was for maximum temperature on lags 7-9 (RR = 1.02; 1.00-1.04). Each 10-unit increase in PM2.5 in Lag 0 (RR = 1.008; 1.001-1.014) and lag 1 (RR = 1.004; 1.001-1.007) and in NO2 in lag 0 (RR = 1.006; 1.000-1.012) had significant effects.Conclusion: Maternal exposure to a minimum daily temperature of 26.9 and 24.8 °C compared to 13.2 °C increased the risk of preterm birth by 17 and 15% on the same day, respectively. This risk increased by 0.8 and 0.6%, on the same day for each 10-unit increase in PM2.5 and NO2, respectively.
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Affiliation(s)
- Mehdi Ranjbaran
- Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasool Mohammadi
- Department of Epidemiology & Biostatistics, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mehdi Yaseri
- Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Kamari
- Deputy of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamran Yazdani
- Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Gronlund CJ, Yang AJ, Conlon KC, Bergmans RS, Le HQ, Batterman SA, Wahl RL, Cameron L, O'Neill MS. Time series analysis of total and direct associations between high temperatures and preterm births in Detroit, Michigan. BMJ Open 2020; 10:e032476. [PMID: 32029486 PMCID: PMC7045030 DOI: 10.1136/bmjopen-2019-032476] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 12/17/2019] [Accepted: 01/09/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Preterm births (PTBs) represent significant health risks, and several studies have found associations between high outdoor temperatures and PTB. We estimated both the total and natural direct effects (independent of particulate matter, ozone and nitrogen dioxide air pollutants) of the prior 2-day mean apparent temperature (AT) on PTB. We evaluated effect modification by maternal age, race, education, smoking status and prenatal care. DESIGN AND SETTING We obtained birth records and meteorological data for the Detroit, Michigan, USA area, for the warm months (May to September), 1991 to 2001. We used a time series Poisson regression with splines of AT, wind speed, solar radiation and citywide average precipitation to estimate total effects. To accommodate multiple mediators and exposure-mediator interactions, AT inverse odds weights, predicted by meteorological and air pollutant covariates, were added in a subsequent model to estimate direct effects. RESULTS At 24.9°C relative to 18.6°C, 10.6% (95% CI: 3.8% to 17.2%) of PTBs were attributable to the total effects of AT, and 10.4% (95% CI: 2.2% to 17.5%) to direct effects. Relative excess risks of interaction indicated that the risk of PTB with increasing temperature above 18.6°C was significantly lower among black mothers and higher among mothers less than 19, older than 30, with late or no prenatal care and who smoked. CONCLUSION This additional evidence of a direct association between high temperature and PTB may motivate public health interventions to reduce extreme heat exposures among pregnant women, particularly among those who may have enhanced vulnerability.
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Affiliation(s)
- Carina J Gronlund
- Survey Research Center, University of Michigan Institute for Social Research, Ann Arbor, Michigan, USA
| | - Alyssa J Yang
- Urban Indian Health Institute, Seattle, Washington, USA
| | - Kathryn C Conlon
- Public Health Sciences, University of California Davis, Davis, California, USA
| | - Rachel S Bergmans
- Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Hien Q Le
- Toxicology and Risk Assessment, Chemours Co, Wilmington, Delaware, USA
| | - Stuart A Batterman
- Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Robert L Wahl
- Surveillance and Program Evaluation Section, Michigan Department of Health and Human Services, Lansing, MI, USA
| | - Lorraine Cameron
- Michigan Climate and Health Adaptation Program, Michigan Department of Health and Human Services, Lansing, Michigan, USA
| | - Marie S O'Neill
- Environmental Health Sciences and Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
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Smith RB, Beevers SD, Gulliver J, Dajnak D, Fecht D, Blangiardo M, Douglass M, Hansell AL, Anderson HR, Kelly FJ, Toledano MB. Impacts of air pollution and noise on risk of preterm birth and stillbirth in London. ENVIRONMENT INTERNATIONAL 2020; 134:105290. [PMID: 31783238 DOI: 10.1016/j.envint.2019.105290] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 10/14/2019] [Accepted: 10/25/2019] [Indexed: 05/17/2023]
Abstract
BACKGROUND Evidence for associations between ambient air pollution and preterm birth and stillbirth is inconsistent. Road traffic produces both air pollutants and noise, but few studies have examined these co-exposures together and none to date with all-cause or cause-specific stillbirths. OBJECTIVES To analyse the relationship between long-term exposure to air pollution and noise at address level during pregnancy and risk of preterm birth and stillbirth. METHODS The study population comprised 581,774 live and still births in the Greater London area, 2006-2010. Outcomes were preterm birth (<37 completed weeks gestation), all-cause stillbirth and cause-specific stillbirth. Exposures during pregnancy to particulate matter with diameter <2.5 μm (PM2.5) and <10 μm (PM10), ozone (O3), primary traffic air pollutants (nitrogen dioxide, nitrogen oxides, PM2.5 from traffic exhaust and traffic non-exhaust), and road traffic noise were estimated based on maternal address at birth. RESULTS An interquartile range increase in O3 exposure was associated with elevated risk of preterm birth (OR 1.15 95% CI: 1.11, 1.18, for both Trimester 1 and 2), all-cause stillbirth (Trimester 1 OR 1.17 95% CI: 1.07, 1.27; Trimester 2 OR 1.20 95% CI: 1.09, 1.32) and asphyxia-related stillbirth (Trimester 1 OR 1.22 95% CI: 1.01, 1.49). Odds ratios with the other air pollutant exposures examined were null or <1, except for primary traffic non-exhaust related PM2.5, which was associated with 3% increased odds of preterm birth (Trimester 1) and 7% increased odds stillbirth (Trimester 1 and 2) when adjusted for O3. Elevated risk of preterm birth was associated with increasing road traffic noise, but only after adjustment for certain air pollutant exposures. DISCUSSION Our findings suggest that exposure to higher levels of O3 and primary traffic non-exhaust related PM2.5 during pregnancy may increase risk of preterm birth and stillbirth; and a possible relationship between long-term traffic-related noise and risk of preterm birth. These findings extend and strengthen the evidence base for important public health impacts of ambient ozone, particulate matter and noise in early life.
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Affiliation(s)
- Rachel B Smith
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK; NIHR HPRU in Health Impact of Environmental Hazards, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
| | - Sean D Beevers
- MRC-PHE Centre for Environment and Health, Environmental Research Group, Faculty of Life Sciences & Medicine, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
| | - John Gulliver
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK; Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK
| | - David Dajnak
- MRC-PHE Centre for Environment and Health, Environmental Research Group, Faculty of Life Sciences & Medicine, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
| | - Daniela Fecht
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK
| | - Marta Blangiardo
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK
| | - Margaret Douglass
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK
| | - Anna L Hansell
- NIHR HPRU in Health Impact of Environmental Hazards, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK; Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK; UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK
| | - H Ross Anderson
- MRC-PHE Centre for Environment and Health, Environmental Research Group, Faculty of Life Sciences & Medicine, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK; Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Frank J Kelly
- NIHR HPRU in Health Impact of Environmental Hazards, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK; MRC-PHE Centre for Environment and Health, Environmental Research Group, Faculty of Life Sciences & Medicine, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
| | - Mireille B Toledano
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK; NIHR HPRU in Health Impact of Environmental Hazards, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK.
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18
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Cho H. Ambient temperature, birth rate, and birth outcomes: evidence from South Korea. POPULATION AND ENVIRONMENT 2019; 41:330-346. [PMID: 32214579 PMCID: PMC7089350 DOI: 10.1007/s11111-019-00333-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The effects from rising temperatures, a symptom of climate change, have become a significant concern. This study finds that one additional day with a maximum temperature of 30-32 °C (86-89.6 °F), relative to a day with a temperature of 28-30 °C (82.4-86 °F), decreases the birth rate 9 months later by 0.24%, or 92 babies per month in South Korea. This result is robust to various specifications and samples. This study also found that the impact of the temperature bin did not vary according to the mother's characteristics, including education and age. That is, high temperature has no differential effect on mothers of different backgrounds. Finally, we found no significant temperature effect on birth outcomes, but we cannot rule out that children born 9 months after summer heat are a selected (healthy) group.
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Affiliation(s)
- Hyunkuk Cho
- School of Economics and Finance, Yeungnam University, 280 Daehak-ro, Gyeongsan, 712-749 South Korea
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19
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Miao H, Li B, Li W, Yao F, Chen Y, Chen R, Lin J, Wu Y, Guo P, Zhao Q. Adverse birth outcomes in Guangdong province, China, 2014-2017: a spatiotemporal analysis of 2.9 million births. BMJ Open 2019; 9:e030629. [PMID: 31727652 PMCID: PMC6886959 DOI: 10.1136/bmjopen-2019-030629] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Adverse birth outcomes pose a great threat to the public health and bring a heavy burden of disease in China. A comprehensive examination of the temporal and spatial trends of preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA) epidemics can provide some elementary information for subsequent aetiological and epidemiological studies. This study aimed to characterise the spatiotemporal features of PTB, LBW and SGA based on a large cohort of live births in China. DESIGN Spatiotemporal descriptive analysis was performed in Guangdong province, China, from 2014 to 2017. SETTING Data involving 2 917 098 live births in Guangdong province, China from 2014 to 2017 was collected from Guangdong Birth Certificate System. Information was collected, including the date of birth, gestational age in week, birth weight, sex of the infant, age of the mother and registered residence of the mother. RESULTS The estimated rate of PTB, LBW and SGA was 4.16%, 4.14% and 12.86%, respectively. For temporal trends, the rates of PTB, LBW and SGA showed seasonal fluctuations, especially for LBW and SGA. In addition, there were regional differences in the rates of PTB, LBW and SGA between the Pearl River Delta and Non-Pearl River Delta regions. From 2014 to 2017, the high rates of PTB and LBW expanded from the Pearl River Delta region to the Non-Pearl River Delta regions. However, compared with the Pearl River Delta region, the rate of SGA was higher in the Non-Pearl River Delta regions on the whole. CONCLUSION The findings of this study contribute to the understanding of the aetiology and epidemiology of PTB, LBW and SGA in south China.
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Affiliation(s)
- Huazhang Miao
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Bing Li
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Wu Li
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Fei Yao
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Yuliang Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Ruyin Chen
- Department of Clinical Medicine, Shantou University Medical College, Shantou, China
| | - Jiumin Lin
- Department of Hepatology and Infectious Diseases, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Yuntao Wu
- Guangdong Women and Children Hospital, Guangzhou, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Qingguo Zhao
- Epidemiological Research Office of Key Laboratory of Male Reproduction and Genetics (National Health Commission of PRC), Family Planning Special Hospital of Guangdong Province, Guangzhou, China
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20
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Asta F, Michelozzi P, Cesaroni G, De Sario M, Badaloni C, Davoli M, Schifano P. The Modifying Role of Socioeconomic Position and Greenness on the Short-Term Effect of Heat and Air Pollution on Preterm Births in Rome, 2001-2013. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2497. [PMID: 31336970 PMCID: PMC6678295 DOI: 10.3390/ijerph16142497] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 01/04/2023]
Abstract
Urban green spaces have been associated with health benefits, but few studies have evaluated the role of greenness on pregnancy outcomes. We examined how the association between short-term exposure to heat and air pollution on the probability of preterm delivery is affected by the spatial variation of socioeconomic position (SEP) and greenness. We analyzed a cohort of newborns in Rome, from April to October of 2001-2013, defining preterm as births between the 22nd and the 36th week of gestation. We used a time series approach, with maximum apparent temperature (MAT), PM10, NO2, and O3 as exposure variables. As greenness indicators, we considered maternal residential proximity to green spaces and the Normalized Difference Vegetation Index (NDVI) within a 100 m buffer around each woman's residential address. We enrolled 56,576 newborns (5.1% preterm). The effect of a 1 °C increase in temperature on the daily number of preterm births was higher in women with low SEP (+2.49% (90% CI: 1.29-3.71)) and among those living within 100 m from green spaces (+3.33% (90% CI: 1.82-4.87)). No effect modification was observed for NDVI or PM10. SEP was an important effect modifier of the heat-preterm birth relationship. The role of greenness in modifying this association between heat and preterm delivery should be further investigated.
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Affiliation(s)
- Federica Asta
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy.
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy
| | - Manuela De Sario
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy
| | - Chiara Badaloni
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy
| | - Patrizia Schifano
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy
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Sun S, Weinberger KR, Spangler KR, Eliot MN, Braun JM, Wellenius GA. Ambient temperature and preterm birth: A retrospective study of 32 million US singleton births. ENVIRONMENT INTERNATIONAL 2019; 126:7-13. [PMID: 30776752 PMCID: PMC6441631 DOI: 10.1016/j.envint.2019.02.023] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 01/13/2019] [Accepted: 02/06/2019] [Indexed: 05/17/2023]
Abstract
BACKGROUND Days of extreme temperature may be associated with transiently higher risk of preterm birth, but prior studies have been limited and results have been heterogeneous. OBJECTIVES To evaluate the association between days of extreme heat and cold and risk of preterm birth among ~32 million live singleton births between 1989 and 2002 across 403 counties in the contiguous United States (US). METHODS We used a distributed lag nonlinear model to estimate the association between population-weighted daily mean temperature and risk of preterm birth in each county and then pooled results across geographic regions and climate zones. We defined extreme heat and cold as the 95th and 5th percentile of the county-specific temperatures, respectively. RESULTS Preterm birth accounted for 9.3% of deliveries. There was a monotonic association between ambient temperature and risk of preterm birth. Days of extreme heat and cold were associated with a relative risk of preterm birth of 1.025 (95% CI: 1.015, 1.036) and 0.985 (95% CI: 0.976, 0.993) over the subsequent four days, respectively, relative to the county-specific median temperature. If causal, the fraction of preterm births attributable to extreme heat was 0.17% (empirical 95% CI: 0.14%, 0.19%), corresponding to 154 (empirical 95% CI: 127, 173) preterm births per million births. Extreme heat was more strongly associated with preterm birth in regions with colder and drier climates, and among younger women. Days of extreme cold temperature were associated with lower rather than higher risk of preterm birth. CONCLUSIONS Days of extreme heat, but not extreme cold, are associated with higher risk of preterm birth in the contiguous US. If causal, these results may have important implications for the management of pregnant women during forecasted periods of extreme heat.
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Affiliation(s)
- Shengzhi Sun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA.
| | - Kate R Weinberger
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA
| | - Keith R Spangler
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA; Department of Earth, Environmental and Planetary Sciences, Brown University, Providence, RI 02912, USA
| | - Melissa N Eliot
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA
| | - Joseph M Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA
| | - Gregory A Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA
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Mohammadi D, Naghshineh E, Sarsangi A, Zare Sakhvidi MJ. Environmental extreme temperature and daily preterm birth in Sabzevar, Iran: a time-series analysis. Environ Health Prev Med 2019; 24:5. [PMID: 30611198 PMCID: PMC6320631 DOI: 10.1186/s12199-018-0760-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 12/21/2018] [Indexed: 11/16/2022] Open
Abstract
Objectives Most of the studies on the effect of heat stress on preterm birth (PTB) are conducted in temperate climates. Evidence on this effect in hot and arid countries with low and middle income is limited. This paper describes the short-term effect of exposure to the hot and cold environment on a daily number of PTB in Iran. Methods The daily number of PTB was obtained from all hospitals of the city. Meteorological and air pollution data from 2011 to 2017 were obtained from a metrological station in the city. A semi-parametric generalized additive model following a quasi-Poisson distribution with the distributed lag non-linear model was selected as a modeling framework for time-series analysis to simultaneously model the short-term and lagged effect of heat stress on PTB in the Sabzevar city. Results The minimum and maximum daily temperature were − 11.2 and 45.4 °C respectively. The highest risk estimate at extreme cold temperature was found for apparent temperature (relative risk (RR) 1.83; 95% CI 1.61: 2.09). This pattern was seen for both models. For extreme hot temperatures, the model with mean temperature showed the highest risk increase for both the main model and air pollution adjusted model (RR 1.36; 95% CI 1.25: 1.49). The lowest risk estimate in extremely cold conditions was found in the model with mean temperature. However, for extremely hot temperature conditions, the lowest risk estimate was found for both maximum and apparent temperature. Conclusion Obstetricians working in semi-arid areas should be aware of the influence of environmental extreme temperature on the incidence of PTB. Electronic supplementary material The online version of this article (10.1186/s12199-018-0760-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Danial Mohammadi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elham Naghshineh
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Sarsangi
- Department of Remote Sensing and GIS, Faculty of Geography, University of Tehran, Tehran, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. .,Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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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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Xiong L, Xu Z, Tan J, Wang H, Liu Z, Wang A, Xie D, Kong F. Acute effects of air pollutants on adverse birth outcomes in Changsha, China: A population data with time-series analysis from 2015 to 2017. Medicine (Baltimore) 2019; 98:e14127. [PMID: 30653143 PMCID: PMC6370066 DOI: 10.1097/md.0000000000014127] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Evidence for the acute effects of air pollutants on adverse birth outcomes is not yet conclusive. Furthermore, there are no investigations relating to the association between air pollutants and macrosomia. The aim of this study was to determine the relationship between air pollutants and low birth weight, preterm birth, and macrosomia in Changsha. Time-series analysis, using a generalized additive model was applied. Data about the adverse birth outcomes was collected from 78 midwifery institutions. Air pollution data including SO2, NO2, particulate matter <10 μm in diameter (PM10), particulate matter <2.5 μm in diameter (PM2.5), O3, CO, and climate data were respectively collected from the Changsha Environmental Protection Agency and the Changsha Meteorological Bureau from January 2015 to December 2017. During the study period, there were 344,880 live births to be studied. In a single pollutant model, for every increase of 10 μg/m in PM10 and PM2.5, low birth weight increased by 0.12% (95% confidence interval [CI]: 0.01-0.23%) at a lag 06 and 0.44% (95% CI: 0.35-0.53%) at a lag 3, respectively. Preterm birth increased most by 1.60% (95% CI: 1.41-1.80%) at a lag 2 for every increase of 10 μg/m in SO2. The highest increases in macrosomia associated with a 10 μg/m increase in air pollutant were 3.53% (95% CI: 3.41-3.64%) for NO2 at lag 0, 3.33% (95% CI: 3.05-3.60%) for SO2 at lag03. Multi-pollutant models showed that only PM10 increased the low birth weight and preterm birth risk effect by 3.91% (95% CI: 3.67-4.12%) and 0.25% (95% CI: 0.14-0.37%). NO2 increased macrosomia risk by 4.14% (95% CI: 3.97-4.31%) with a 10 μg/m increase. There was no association observed between the air pollutants O3 and CO and adverse birth outcomes. Pregnant women should also take steps to limit their exposure to high levels of air pollutants during the final weeks of pregnancy.
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Affiliation(s)
- Lili Xiong
- Hunan Province Maternal and Children Care Hospital
| | | | - Jie Tan
- Hunan Province Environmental Monitoring Centre, Changsha, China
| | - Hua Wang
- Hunan Province Maternal and Children Care Hospital
| | - Zhiyu Liu
- Hunan Province Maternal and Children Care Hospital
| | - Aihua Wang
- Hunan Province Maternal and Children Care Hospital
| | - Donghua Xie
- Hunan Province Maternal and Children Care Hospital
| | - Fanjuan Kong
- Hunan Province Maternal and Children Care Hospital
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Zhong Q, Lu C, Zhang W, Zheng X, Deng Q. Preterm birth and ambient temperature: Strong association during night-time and warm seasons. J Therm Biol 2018; 78:381-390. [DOI: 10.1016/j.jtherbio.2018.11.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 11/03/2018] [Accepted: 11/05/2018] [Indexed: 11/29/2022]
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Liang Z, Wang P, Zhao Q, Wang BQ, Ma Y, Lin H, Xiao J, Zhou JY. Effect of the 2008 cold spell on preterm births in two subtropical cities of Guangdong Province, Southern China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 642:307-313. [PMID: 29902628 DOI: 10.1016/j.scitotenv.2018.06.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/05/2018] [Accepted: 06/02/2018] [Indexed: 05/27/2023]
Abstract
BACKGROUND A few studies have reported that low temperatures were associated with an increased risk of preterm birth. However, the effect of extreme weather events, such as cold spell, on preterm birth has not been studied in China. OBJECTIVE This study was conducted to evaluate the impact of the 2008 cold spell on preterm birth in two subtropical cities of Guangdong Province. METHODS Data of daily preterm birth, air pollution and meteorological variables from 2006 to 2010 were collected in Dongguan and Shenzhen. A Poisson regression with a distributed lag nonlinear model was used to investigate the association between the 2008 cold spell and daily rate of preterm birth for each city. RESULTS During the 2008 cold spell, total vaginal preterm births were increased by 22.44% and 21.25% in Dongguan and Shenzhen, respectively. The effect of the cold spell on preterm births lasted for more than 1 week, the lag0-6 days cumulative relative risk (RR) is 1.32 (95% CI: 1.10-1.58) and 1.40 (95% CI: 1.18-1.68) in Dongguan and Shenzhen, respectively. The effects were found to be more pronounced for the pregnant women with 34-36 gestation weeks, maternal age < 35 years group. CONCLUSION This study demonstrates that cold spell could increase the risk of preterm births in Dongguan and Shenzhen, and the effect lasts for more than 1 week. Specific measures should be considered to protect the pregnant women, especially the vulnerable subgroups.
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Affiliation(s)
- Zhijiang Liang
- State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China; Department of Public Health, Guangdong Women and Children Hospital, Guangzhou 511442, China
| | - Peng Wang
- State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Qingguo Zhao
- Department of Epidemiology, Family Planning Research Institute of Guangdong Province, Guangzhou 510600, China
| | - Bei-Qi Wang
- State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yuanzhu Ma
- Department of Public Health, Guangdong Women and Children Hospital, Guangzhou 511442, China
| | - Hualiang Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jianpeng Xiao
- Department of Occupational Health and Occupational Medicine, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Ji-Yuan Zhou
- State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China.
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Kloog I, Novack L, Erez O, Just AC, Raz R. Associations between ambient air temperature, low birth weight and small for gestational age in term neonates in southern Israel. Environ Health 2018; 17:76. [PMID: 30413171 PMCID: PMC6234799 DOI: 10.1186/s12940-018-0420-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/25/2018] [Indexed: 05/15/2023]
Abstract
BACKGROUND The increase in ambient temperatures (Ta) and emissions of greenhouse gases over the last century has focused attention on the effects of ambient temperatures on health outcomes. We aimed to investigate the association between Ta and the clinical measures of term low birth weight (tLBW) and small for gestational age (SGA) in singleton term infants using a decade of regional hospital data in southern Israel. METHODS We linked all births in Soroka University Medical Center in the southern district of Israel insured by Clalit Health Services with pregnancy Ta estimated by our novel hybrid spatio-temporally resolved prediction model. Logistic regression generalized additive models and general linear models were used, with either tLBW or SGA as the dependent variable, modeling entire pregnancy and trimester-specific Ta adjusting for seasonality, time trend, particulate matter, maternal age, gravidity, parity, ethnicity, sex, poverty index and population density. RESULTS The study population included 56,141 singleton term newborns, with 1716 (3.1%) cases of tLBW and 8634 (15.4%) cases of SGA. The average and the median Ta across the entire pregnancy were 19.9 (SD: 1.77, range: 14.6-24.9) degrees centigrade. The lowest Ta quartile (Ta = < 18.5) was associated with higher risk of tLBW (odds ratio = 1.33, 95%CI 1.11-1.58) while the highest Ta quartile (Ta > =21.3) was not significantly associated with tLBW (odds ratio = 1.17, 95%CI 0.99-1.38), in comparison to the two intermediate quartiles. When analyzing SGA as the dependent variable, the lowest Ta quartile was associated with significantly higher risk of SGA (odds ratio = 1.18, 95%CI 1.09-1.29) while the highest quartile was associated with significantly lower risk of SGA (odds ratio = 0.91, 95%CI 0.84-0.99) in comparison to the two intermediate quartiles. CONCLUSIONS Our findings suggest that lower pregnancy Ta may increase the risk of tLBW and SGA, and higher pregnancy Ta may decrease the risk of SGA in singleton term infants in southern Israel.
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Affiliation(s)
- Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, P.O.B, 653 Beer Sheva, Israel
| | - Lena Novack
- Department of Public Health, Ben-Gurion University of the Negev, P.O.B, 653 Beer Sheva, Israel
| | - Offer Erez
- Department of Gynecology and Obstetrics, Soroka medical center, Beer Sheva, Israel
| | - Allan C. Just
- Department of Preventive Medicine, Icahn School of Medicine at Mt Sinai, New York, NY USA
| | - Raanan Raz
- Braun School of Public Health and Community Medicine, Faculty of medicine, the Hebrew University of Jerusalem, Jerusalem, Israel
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Aik J, Heywood AE, Newall AT, Ng LC, Kirk MD, Turner R. Climate variability and salmonellosis in Singapore - A time series analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 639:1261-1267. [PMID: 29929293 DOI: 10.1016/j.scitotenv.2018.05.254] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/03/2018] [Accepted: 05/21/2018] [Indexed: 05/16/2023]
Abstract
Climate change is expected to bring about global warming and an increase in the frequency of extreme weather events. This may consequently influence the transmission of food-borne diseases. The short term associations between climatic conditions and Salmonella infections are well documented in temperate climates but not in the tropics. We conducted an ecological time series analysis to estimate the short term associations between non-outbreak, non-travel associated reports of Salmonella infections and observed climatic conditions from 2005 to 2015 for Singapore. We used a negative binomial time series regression model to analyse the associations on a weekly scale, controlling for season, long term trend, delayed weather effects, autocorrelation and the period where Salmonella was made legally notifiable. There were a total of 11,324 Salmonella infections reported during our study period. A 1 °C increase in mean ambient air temperature was associated with a 4.3% increase (Incidence Rate Ratio [IRR]: 1.043, 95% confidence interval [CI] = 1.003, 1.084) in reported Salmonella infections in the same week and a 6.3% increase (IRR: 1.063, 95% CI = 1.022, 1.105) three weeks later. A 1% increase in the mean relative humidity was associated with a 1.3% decrease (IRR: 0.987, 95% CI = 0.981, 0.994) in cases six weeks later, while a 10 mm increase in weekly cumulative rainfall was associated with a 0.8% increase (IRR: 1.008, 95% CI = 1.002, 1.015) in cases 2 weeks later but a 0.9% decrease (IRR: 0.991, 95% CI = 0.984, 0.998) in cases 5 weeks later. No thresholds for these weather effects were detected. This study confirms the short-term influence of climatic conditions on Salmonella infections in Singapore and the potential impact of climate change on Salmonellosis in the tropics.
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Affiliation(s)
- Joel Aik
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Level 3, Samuels Building, Botany Road, Kensington, New South Wales 2052, Australia; National Environment Agency, 40 Scotts Road, #13-00, 228231, Singapore.
| | - Anita E Heywood
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Level 3, Samuels Building, Botany Road, Kensington, New South Wales 2052, Australia
| | - Anthony T Newall
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Level 3, Samuels Building, Botany Road, Kensington, New South Wales 2052, Australia
| | - Lee-Ching Ng
- National Environment Agency, 40 Scotts Road, #13-00, 228231, Singapore
| | - Martyn D Kirk
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 0200, Australia
| | - Robin Turner
- Biostatistics Unit, Dunedin School of Medicine, University of Otago, Ground Floor, Adams Building, 18 Frederick Street, Dunedin 9016, New Zealand
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Zheng X, Zhang W, Lu C, Norbäck D, Deng Q. An epidemiological assessment of the effect of ambient temperature on the incidence of preterm births: Identifying windows of susceptibility during pregnancy. J Therm Biol 2018; 74:201-207. [PMID: 29801628 DOI: 10.1016/j.jtherbio.2018.04.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 03/31/2018] [Accepted: 04/03/2018] [Indexed: 01/07/2023]
Abstract
It is well known that exposure to thermal stress during pregnancy can lead to an increased incidence of premature births. However, there is little known regarding window(s) of susceptibility during the course of a pregnancy. We attempted to identify possible windows of susceptibility in a cohort study of 3604 children in Changsha with a hot-summer and cold winter climatic characteristics. We examined the association between PTB and ambient temperature during different timing windows of pregnancy: conception month, three trimesters, birth month and entire pregnancy. We found a U-shaped relation between the prevalence of PTB and mean ambient temperature during pregnancy. Both high and low temperatures were associated with PTB risk, adjusted OR (95% CI) respectively 2.57 (1.98-3.33) and 2.39 (1.93-2.95) for 0.5 °C increase in high temperature range (>18.2°C) and 0.5°C decrease in low temperature range (< 18.2°C). Specifically, PTB was significantly associated with ambient temperature and extreme heat/cold days during conception month and the third trimester. Sensitivity analysis indicated that female fetus were more susceptible to the risk of ambient temperature. Our study indicates that the risk of preterm birth due to high or low temperature may exist early during the conception month.
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Affiliation(s)
- Xiangrong Zheng
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China
| | - Weishe Zhang
- Department of Obstetrics, XiangYa Hospital, Central South University, Changsha, China
| | - Chan Lu
- School of Energy Science and Engineering, Central South University, Changsha, China
| | - Dan Norbäck
- School of Energy Science and Engineering, Central South University, Changsha, China; Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Qihong Deng
- School of Energy Science and Engineering, Central South University, Changsha, China; XiangYa School of Public Health, Central South University, Changsha, China; Center for Environment and Water Resources, Central South University, Changsha, China.
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Arbuthnott KG, Hajat S. The health effects of hotter summers and heat waves in the population of the United Kingdom: a review of the evidence. Environ Health 2017; 16:119. [PMID: 29219088 PMCID: PMC5773858 DOI: 10.1186/s12940-017-0322-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
It is widely acknowledged that the climate is warming globally and within the UK. In this paper, studies which assess the direct impact of current increased temperatures and heat-waves on health and those which project future health impacts of heat under different climate change scenarios in the UK are reviewed.This review finds that all UK studies demonstrate an increase in heat-related mortality occurring at temperatures above threshold values, with respiratory deaths being more sensitive to heat than deaths from cardiovascular disease (although the burden from cardiovascular deaths is greater in absolute terms). The relationship between heat and other health outcomes such as hospital admissions, myocardial infarctions and birth outcomes is less consistent. We highlight the main populations who are vulnerable to heat. Within the UK, these are older populations, those with certain co-morbidities and those living in Greater London, the South East and Eastern regions.In all assessments of heat-related impacts using different climate change scenarios, deaths are expected to increase due to hotter temperatures, with some studies demonstrating that an increase in the elderly population will also amplify burdens. However, key gaps in knowledge are found in relation to how urbanisation and population adaptation to heat will affect health impacts, and in relation to current and future strategies for effective, sustainable and equitable adaptation to heat. These and other key gaps in knowledge, both in terms of research needs and knowledge required to make sound public- health policy, are discussed.
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Affiliation(s)
- Katherine G Arbuthnott
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
- Chemicals and Environmental Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon, OX11 0RQ, UK.
| | - Shakoor Hajat
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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Curtis S, Fair A, Wistow J, Val DV, Oven K. Impact of extreme weather events and climate change for health and social care systems. Environ Health 2017; 16:128. [PMID: 29219105 PMCID: PMC5773887 DOI: 10.1186/s12940-017-0324-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
This review, commissioned by the Research Councils UK Living With Environmental Change (LWEC) programme, concerns research on the impacts on health and social care systems in the United Kingdom of extreme weather events, under conditions of climate change. Extreme weather events considered include heatwaves, coldwaves and flooding. Using a structured review method, we consider evidence regarding the currently observed and anticipated future impacts of extreme weather on health and social care systems and the potential of preparedness and adaptation measures that may enhance resilience. We highlight a number of general conclusions which are likely to be of international relevance, although the review focussed on the situation in the UK. Extreme weather events impact the operation of health services through the effects on built, social and institutional infrastructures which support health and health care, and also because of changes in service demand as extreme weather impacts on human health. Strategic planning for extreme weather and impacts on the care system should be sensitive to within country variations. Adaptation will require changes to built infrastructure systems (including transport and utilities as well as individual care facilities) and also to institutional and social infrastructure supporting the health care system. Care sector organisations, communities and individuals need to adapt their practices to improve resilience of health and health care to extreme weather. Preparedness and emergency response strategies call for action extending beyond the emergency response services, to include health and social care providers more generally.
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Affiliation(s)
- Sarah Curtis
- Department of Geography, Durham University, Durham, DH1 3LE UK
| | - Alistair Fair
- Edinburgh School of Architecture & Landscape Architecture, University of Edinburgh, Edinburgh, UK
| | - Jonathan Wistow
- School of Applied Social Science, Durham University, Durham, UK
| | - Dimitri V. Val
- School of Energy, Geoscience, Infrastructure and Society, Hariot-Watt University, Edinburgh, UK
| | - Katie Oven
- Department of Geography, Durham University, Durham, DH1 3LE UK
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Michikawa T, Morokuma S, Nitta H, Kato K, Yamazaki S. Comparison between air pollution concentrations measured at the nearest monitoring station to the delivery hospital and those measured at stations nearest the residential postal code regions of pregnant women in Fukuoka. Environ Health Prev Med 2017; 22:55. [PMID: 29165140 PMCID: PMC5664789 DOI: 10.1186/s12199-017-0663-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 06/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Numerous earlier studies examining the association of air pollution with maternal and foetal health estimated maternal exposure to air pollutants based on the women's residential addresses. However, residential addresses, which are personally identifiable information, are not always obtainable. Since a majority of pregnant women reside near their delivery hospitals, the concentrations of air pollutants at the respective delivery hospitals may be surrogate markers of pollutant exposure at home. We compared air pollutant concentrations measured at the nearest monitoring station to Kyushu University Hospital with those measured at the closest monitoring stations to the respective residential postal code regions of pregnant women in Fukuoka. METHODS Aggregated postal code data for the home addresses of pregnant women who delivered at Kyushu University Hospital in 2014 was obtained from Kyushu University Hospital. For each of the study's 695 women who resided in Fukuoka Prefecture, we assigned pollutant concentrations measured at the nearest monitoring station to Kyushu University Hospital and pollutant concentrations measured at the nearest monitoring station to their respective residential postal code regions. RESULTS Among the 695 women, 584 (84.0%) resided in the proximity of the nearest monitoring station to hospital or one of the four other stations (as the nearest stations to their respective residential postal code region) in Fukuoka city. Pearson's correlation for daily mean concentrations among the monitoring stations in Fukuoka city was strong for fine particulate matter (PM2.5), suspended particulate matter (SPM), and photochemical oxidants (Ox) (coefficients ≥0.9), but moderate for coarse particulate matter (the result of subtracting the PM2.5 from the SPM concentrations), nitrogen dioxide, and sulphur dioxide. Hospital-based and residence-based concentrations of PM2.5, SPM, and Ox were comparable. CONCLUSIONS For PM2.5, SPM, and Ox, exposure estimation based on the delivery hospital is likely to approximate that based on the home of pregnant women.
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Affiliation(s)
- Takehiro Michikawa
- Environmental Epidemiology Section, Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, 305-8506, Japan.
| | - Seiichi Morokuma
- Department of Obstetrics and Gynaecology, Kyushu University Hospital, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hiroshi Nitta
- Environmental Epidemiology Section, Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, 305-8506, Japan
| | - Kiyoko Kato
- Department of Obstetrics and Gynaecology, Kyushu University Hospital, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shin Yamazaki
- Environmental Epidemiology Section, Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, 305-8506, Japan
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Zhang Y, Yu C, Wang L. Temperature exposure during pregnancy and birth outcomes: An updated systematic review of epidemiological evidence. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 225:700-712. [PMID: 28284544 DOI: 10.1016/j.envpol.2017.02.066] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/24/2017] [Accepted: 02/28/2017] [Indexed: 05/02/2023]
Abstract
Seasonal patterns of birth outcomes have been observed worldwide, and there was increasing evidence that ambient temperature played as a trigger of adverse birth outcomes, such as preterm birth (PTB), low birth weight (LBW), and stillbirth. To systematically review updated epidemiological evidence about the relationship between temperature exposure during pregnancy and PTB, LBW, and stillbirth, we searched for related studies published in English from electronic databases and references of identified papers. We only included original articles that directly reported the effects of prenatal temperature exposure on birth outcomes. The characteristics and main findings of included studies were examined. A total of 36 epidemiological studies were finally included in this review. Most of these studies focused on PTB and LBW, while less attention has been paid to stillbirth that was relatively rare in the occurrence. Several designs including ecological (e.g., descriptive and time-series) and retrospective cohort studies (e.g., case-crossover and time-to-event) were applied to assess temperature effects on birth outcomes. Temperature metrics and exposure windows varied greatly in these investigations. Exposure to high temperature was generally found to be associated with PTB, LBW, and stillbirth, while several studies also reported the adverse impact of low temperature on birth outcomes of PTB and LBW. Despite no conclusive causality demonstrated, the current evidence for adverse effect on birth outcomes was stronger for heat than for cold. In summary, the evidence linking birth outcomes with ambient temperature was still very limited. Consequently, more related studies are needed worldwide and should be conducted in diversified climate zones, so as to further ascertain the association between temperature and birth outcomes. Future studies should focus on more sophisticated study designs, more accurate estimation of temperature exposure during pregnancy, and more efficient methods to find out the exposure windows, as well as cold-related effects on birth outcomes.
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Affiliation(s)
- Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan 430071, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan 430071, China; Global Health Institute, Wuhan University, 8 Donghunan Road, Wuchang District, Wuhan 430072, China.
| | - Lu Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan 430071, China
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Giovannini N, Schwartz L, Cipriani S, Parazzini F, Baini I, Signorelli V, Cetin I. Particulate matter (PM10) exposure, birth and fetal-placental weight and umbilical arterial pH: results from a prospective study. J Matern Fetal Neonatal Med 2017; 31:651-655. [PMID: 28277922 DOI: 10.1080/14767058.2017.1293032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This prospective study aims to analyze the relation between particulate matter (PM10) exposure during pregnancy and birth weight (BW), placental weight (PW) and umbilical artery PH (UAPH). STUDY DESIGN Population included 3614 women born in Italy, living in Lombardia Region, consecutively admitted to the Clinica Mangiagalli for an elective cesarean section from January 2004 through December 2006. Outdoor air quality data were provided by the Department of the Regional Environmental Protection Agency and obtained by a network of fixed monitoring stations representatively distributed in eight geographical areas. RESULTS AND CONCLUSION Birth weight was negatively associated with exposure to PM10 concentration during the first trimester of pregnancy (mean change -22.2 g, 95%CI -8.7 to -35.7, p = 0.0013). Placental weight and umbilical artery PH were not associated with exposure to PM10 concentration. Fetal weight was negatively associated with exposure to PM10 concentration during the first trimester of pregnancy.
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Affiliation(s)
- Niccolò Giovannini
- a Dipartimento Materno infantile IRCCS Fondazione Policlinico Mangiagalli Regina Elena , Università degli Studi di Milano , Milano , Italy
| | - Lianne Schwartz
- b School of Nursing and Midwifery, Griffith University , Brisbane , Australia
| | - Sonia Cipriani
- a Dipartimento Materno infantile IRCCS Fondazione Policlinico Mangiagalli Regina Elena , Università degli Studi di Milano , Milano , Italy
| | - Fabio Parazzini
- a Dipartimento Materno infantile IRCCS Fondazione Policlinico Mangiagalli Regina Elena , Università degli Studi di Milano , Milano , Italy.,c Dipartimento Scienze Cliniche e di Comunità , Università di Milano , Milano , Italy
| | - Ilaria Baini
- a Dipartimento Materno infantile IRCCS Fondazione Policlinico Mangiagalli Regina Elena , Università degli Studi di Milano , Milano , Italy
| | - Valentina Signorelli
- d Dipartimento Materno Infantile , Istituti Clinici di Perfezionamento , Milano , Italy
| | - Irene Cetin
- e Dipartimento di Scienze Biologiche e Cliniche , University of Milan, Sacco Hospital , Milan , Italy
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Mathew S, Mathur D, Chang AB, McDonald E, Singh GR, Nur D, Gerritsen R. Examining the Effects of Ambient Temperature on Pre-Term Birth in Central Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E147. [PMID: 28165406 PMCID: PMC5334701 DOI: 10.3390/ijerph14020147] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 01/23/2017] [Accepted: 01/30/2017] [Indexed: 12/04/2022]
Abstract
Preterm birth (born before 37 completed weeks of gestation) is one of the leading causes of death among children under 5 years of age. Several recent studies have examined the association between extreme temperature and preterm births, but there have been almost no such studies in arid Australia. In this paper, we explore the potential association between exposures to extreme temperatures during the last 3 weeks of pregnancy in a Central Australian town. An immediate effect of temperature exposure is observed with an increased relative risk of 1%-2% when the maximum temperature exceeded the 90th percentile of the summer season maximum temperature data. Delayed effects are also observed closer to 3 weeks before delivery when the relative risks tend to increase exponentially. Immediate risks to preterm birth are also observed for cold temperature exposures (0 to -6 °C), with an increased relative risk of up to 10%. In the future, Central Australia will face more hot days and less cold days due to climate change and hence the risks posed by extreme heat is of particular relevance to the community and health practitioners.
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Affiliation(s)
- Supriya Mathew
- Northern Institute, Charles Darwin University, Ellengowan Dr., Casuarina, NT 0810, Australia.
| | - Deepika Mathur
- Northern Institute, Charles Darwin University, Ellengowan Dr., Casuarina, NT 0810, Australia.
| | - Anne B Chang
- Menzies School of Health Research, Rocklands Drive, Casuarina, NT 0810, Australia.
| | - Elizabeth McDonald
- Menzies School of Health Research, Rocklands Drive, Casuarina, NT 0810, Australia.
| | - Gurmeet R Singh
- Menzies School of Health Research, Rocklands Drive, Casuarina, NT 0810, Australia.
| | - Darfiana Nur
- School of Computer Science, Engineering and Mathematics, Flinders University, Adelaide, SA 5001, Australia.
| | - Rolf Gerritsen
- Northern Institute, Charles Darwin University, Ellengowan Dr., Casuarina, NT 0810, Australia.
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Avalos LA, Chen H, Li DK, Basu R. The impact of high apparent temperature on spontaneous preterm delivery: a case-crossover study. Environ Health 2017; 16:5. [PMID: 28143601 PMCID: PMC5286689 DOI: 10.1186/s12940-017-0209-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 01/03/2017] [Indexed: 05/09/2023]
Abstract
BACKGROUND Despite the prediction that temperatures are expected to increase in the future, little is known about the health effects of increasing temperatures on pregnant women. The objective of this study was to investigate the impact of apparent temperature on spontaneous preterm delivery (PTD). METHODS A case-crossover study of 14,466 singleton spontaneous preterm deliveries occurring between January 1, 1995 and December 31, 2009 among Kaiser Permanente Northern California (KPNC) members was conducted. Preterm deliveries were identified through KPNC's Electronic Health Records (EHR) data. Data on gestational age at delivery, infant sex, and maternal address were also extracted from KPNC's EHR and linked to meteorologic and air pollution monitoring data based on residential zip code. RESULTS An 11.6% (95% CI: 4.1, 19.7) increase in spontaneous PTD was associated with a 10 °F (5.6 °C) increase in weekly average (lag06) apparent temperature, during the warm season. During the cold season, increases in apparent temperature did not significantly impact the overall effect of spontaneous PTD (6.2%, (95% CI: -3.0, 16.2) per 10 °F (5.6 °C) increase in weekly average (lag06) apparent temperature). Significant differences in the relationship between apparent temperature and spontaneous PTD emerged for region, gestational age and infant sex, during the cold season. No significant differences emerged for air pollutants. CONCLUSIONS Our findings provide evidence for an increase in the odds of spontaneous PTD associated with increases in apparent temperature, especially during the warm season.
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Affiliation(s)
- Lyndsay A. Avalos
- Kaiser Permanente Northern California, Division of Research, 2000 Broadway, Oakland, California 94612 USA
| | - Hong Chen
- Kaiser Permanente Northern California, Division of Research, 2000 Broadway, Oakland, California 94612 USA
| | - De-Kun Li
- Kaiser Permanente Northern California, Division of Research, 2000 Broadway, Oakland, California 94612 USA
| | - Rupa Basu
- California Office of Environmental Health Hazard Assessment, Air and Climate Epidemiology Section, 1515 Clay Street, 16th Floor, Oakland, California 94612 USA
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Walfisch A, Kabakov E, Friger M, Sheiner E. Trends, seasonality and effect of ambient temperature on preterm delivery. J Matern Fetal Neonatal Med 2016; 30:2483-2487. [PMID: 27806682 DOI: 10.1080/14767058.2016.1253063] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To identify trends in preterm delivery (PTD) as well as seasonality, temporal variation and the effect of heat stress on its incidence. MATERIALS AND METHODS In this retrospective population-based study, we included all deliveries taking place at the Soroka University Medical Center between the years 1988-2012. A time series database was built including meteorological factors and the number of spontaneous versus induced PTDs for each day. Data were analyzed using time-series analyses. RESULTS During the study period, 263 709 deliveries occurred, 7.9% of which were preterm. Spontaneous PTD rate steadily decreased, while induced PTD rate increased. A significant annual and seasonal variation was noted in PTD incidence. A significant higher incidence of spontaneous PTD was demonstrated during the summer period with an incidence rate ratio (IRR) of 4.1 (95%CI: 3.1-5.5; p < 0.001). This trend was not significant for induced PTD. A significant linear association was noted between the heat-stress index and the rates of spontaneous (IRR = 1.07, 95%CI: 1.05-1.10; p < 0.001) but not induced PTDs. CONCLUSIONS Spontaneous PTD is more common during the summer and its rate is declining steadily over the past decades. Increased outdoor temperature has a significant effect on the incidence of spontaneous, but not induced, PTD.
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Affiliation(s)
- Asnat Walfisch
- a Department of Obstetrics and Gynecology , Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer-Sheva , Israel and
| | - Eli Kabakov
- b Faculty of Health Sciences , Department of Epidemiology and Health Services, Evaluation, Ben Gurion University of the Negev , Beer-Sheva , Israel
| | - Michael Friger
- b Faculty of Health Sciences , Department of Epidemiology and Health Services, Evaluation, Ben Gurion University of the Negev , Beer-Sheva , Israel
| | - Eyal Sheiner
- a Department of Obstetrics and Gynecology , Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer-Sheva , Israel and
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Liang Z, Lin Y, Ma Y, Zhang L, Zhang X, Li L, Zhang S, Cheng Y, Zhou X, Lin H, Miao H, Zhao Q. The association between ambient temperature and preterm birth in Shenzhen, China: a distributed lag non-linear time series analysis. Environ Health 2016; 15:84. [PMID: 27503307 PMCID: PMC4977688 DOI: 10.1186/s12940-016-0166-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 07/24/2016] [Indexed: 05/18/2023]
Abstract
BACKGROUND A few studies have examined the association between ambient temperature and preterm birth (PTB), and the results have been inconsistent. This study explored the association between ambient temperature and PTB in Shenzhen, China. METHODS Data of daily singleton PTB, air pollution and meteorological variables from 2005 to 2011 were collected in Shenzhen. A distributed lag non-linear model (DLNM) was used to investigate the association of the low and high temperatures (1st, 5th, 95th, and 99th percentiles) with PTB. RESULTS The median temperature was 24.5 °C and the 1st, 5th, 95th, and 99th percentiles of daily mean temperatures were 9, 12.5, 29.9 and 30.7 °C, respectively. The prevalence of singleton PTB was 5.61 % in Shenzhen. The association between temperature and PTB was not linear. There was an immediate positive association of low temperature (1st and 5th percentiles) and a negative association of high temperature (95th and 99th percentiles) with PTB. The effect of low temperature 9 °C (1st) on PTB on the current day was stronger than that of 12.5 °C (5th), with a relative risk (RR) of 1.54 (95 % CI: 1.36-1.75) and 1.49 (95 % CI: 1.35-1.63), respectively. The cumulative RR (up to 30 days) of 9 and 12.5 °C was 1.72 (95 % CI: 1.28-2.33) and 1.96 (95 % CI: 1.60-2.39), respectively. The cumulative effects (up to 30 days) of high temperature (95th and 99th percentiles) on PTB were 0.69 (95 % CI: 0.60-0.80) and 0.62 (95 % CI: 0.52-0.74), respectively. The cumulative effect (up to 30 days) of low temperatures on vaginal delivery PTB was lower than that of the cesarean section PTB with an RR of 1.58 (95 % CI: 1.12-2.22) and 1.93 (95 % CI: 1.21-3.08), respectively. CONCLUSIONS This study suggests that low temperature might be a risk factor, while high temperature might be a protective factor of PTB in Shenzhen.
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Affiliation(s)
- Zhijiang Liang
- Department of Public Health, Guangdong Women And Children Hospital, 521, 523 Xing Nan Street, Panyu District, 511442 Guangzhou, Guangdong China
| | - Yan Lin
- Department of Children Health Care, Shenzhen Women and Children Hospital, Shenzhen, Guangdong China
| | - Yuanzhu Ma
- Department of Public Health, Guangdong Women And Children Hospital, 521, 523 Xing Nan Street, Panyu District, 511442 Guangzhou, Guangdong China
| | - Lei Zhang
- Department of Information Network, Meteorological Bureau of Shenzhen Municipality, Shenzhen, Guangdong China
| | - Xue Zhang
- Department of Public Health, Fu Tian Maternal and Children Health Hospital, Shenzhen, Guangdong China
| | - Li Li
- Department of Public Health, Luo Hu Maternal and Children Health Hospital, Shenzhen, Guangdong China
| | - Shaoqiang Zhang
- Department of Public Health, Long Gang Maternal and Children Health Hospital, Shenzhen, Guangdong China
| | - Yuli Cheng
- Department of Public Health, Bao An Maternal and Children Health Hospital, Shenzhen, Guangdong China
| | - Xiaomei Zhou
- Fu Tian Hospital of TCM, Shenzhen, Guangdong China
| | - Hualiang Lin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong China
| | - Huazhang Miao
- Department of Public Health, Guangdong Women And Children Hospital, 521, 523 Xing Nan Street, Panyu District, 511442 Guangzhou, Guangdong China
| | - Qingguo Zhao
- Department of Public Health, Guangdong Women And Children Hospital, 521, 523 Xing Nan Street, Panyu District, 511442 Guangzhou, Guangdong China
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Fell DB, Buckeridge DL, Platt RW, Kaufman JS, Basso O, Wilson K. Circulating Influenza Virus and Adverse Pregnancy Outcomes: A Time-Series Study. Am J Epidemiol 2016; 184:163-75. [PMID: 27449415 DOI: 10.1093/aje/kww044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 02/19/2016] [Indexed: 11/14/2022] Open
Abstract
Individual-level epidemiologic studies of pregnancy outcomes after maternal influenza are limited in number and quality and have produced inconsistent results. We used a time-series design to investigate whether fluctuation in influenza virus circulation was associated with short-term variation in population-level rates of preterm birth, stillbirth, and perinatal death in Ontario between 2003 and 2012. Using Poisson regression, we assessed the association between weekly levels of circulating influenza virus and counts of outcomes offset by the number of at-risk gestations during 3 gestational exposure windows. The rate of preterm birth was not associated with circulating influenza level in the week preceding birth (adjusted rate ratio = 1.01, 95% confidence interval: 1.00, 1.02) or in any other exposure window. These findings were robust to alternate specifications of the model and adjustment for potential confounding. Stillbirth and perinatal death rates were similarly not associated with gestational exposure to influenza circulation during late pregnancy. We could not assess mortality outcomes relative to early gestational exposure because of missing dates of conception for many stillbirths. In this time-series study, population-level influenza circulation was not associated with short-term variation in rates of preterm birth, stillbirth, or perinatal death.
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Benmarhnia T, Auger N, Stanislas V, Lo E, Kaufman JS. The Relationship Between Apparent Temperature and Daily Number of Live Births in Montreal. Matern Child Health J 2016; 19:2548-51. [PMID: 26156826 DOI: 10.1007/s10995-015-1794-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Temperature is a hypothesized determinant of early delivery, but seasonal and long term trends, delayed effects of temperature, and the influence of extreme cold temperatures have not yet been addressed. We aim to study the influence of apparent temperature on daily number of births, considering lag structures, seasonality and long term trends. METHODS We used daily number of births in conjunction with apparent outdoor temperatures between 1981 and 2010 in Montreal. We used Poisson regression combined with a distributed lag nonlinear model to consider non-linear relationships between temperature and daily number of births across specific lag periods. RESULTS We found that apparent temperature was associated with the daily number of births in Montreal, with a 1-day delay. We found an increase in births on hot days, and decrease on cold days, both offset by a harvesting effect after 4 and 5 days. CONCLUSIONS FOR PRACTICE This study suggests that the number of births is affected by extreme temperatures. Obstetric and perinatal service providers should be prepared for spikes in the number of births caused by extreme temperatures.
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Affiliation(s)
- Tarik Benmarhnia
- Institute for Health and Social Policy, McGill University, Meredith, Charles, House, 1130 Pine Avenue West, Montreal, QC, H3A 1A3, Canada.
| | - Nathalie Auger
- Institut National de Santé Publique du Québec, Montreal, QC, Canada
| | | | - Ernest Lo
- Institut National de Santé Publique du Québec, Montreal, QC, Canada
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
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He JR, Liu Y, Xia XY, Ma WJ, Lin HL, Kan HD, Lu JH, Feng Q, Mo WJ, Wang P, Xia HM, Qiu X, Muglia LJ. Ambient Temperature and the Risk of Preterm Birth in Guangzhou, China (2001-2011). ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:1100-6. [PMID: 26672059 PMCID: PMC4937853 DOI: 10.1289/ehp.1509778] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 11/30/2015] [Indexed: 05/02/2023]
Abstract
BACKGROUND Although effects of weather changes on human health have been widely reported, there is limited information regarding effects on pregnant women in developing countries. OBJECTIVE We investigated the association between maternal exposure to ambient temperature and the risk of preterm birth (< 37 weeks of gestation) in Guangzhou, China. METHODS We used a Cox proportional hazards model to estimate associations between preterm birth and average temperature during each week of gestation, with weekly temperature modeled as a time-varying exposure during four time windows: 1 week (the last week of the pregnancy), 4 weeks (the last 4 weeks of the pregnancy), late pregnancy (gestational week 20 onward), and the entire pregnancy. Information on singleton vaginal birth between 2001 and 2011 was collected. Daily meteorological data during the same period were obtained from the Guangzhou Meteorological Bureau. RESULTS A total of 838,146 singleton vaginal births were included, among which 47,209 (5.6%) were preterm births. High mean temperatures during the 4 weeks, late pregnancy, and the entire pregnancy time windows were associated with an increased risk of preterm birth. Compared with the median temperature (24.4°C), weekly exposures during the last 4 weeks of the pregnancy to extreme cold (7.6°C, the 1st percentile) and extreme heat (31.9°C, the 99th percentile) were associated with 17.9% (95% CI: 10.2, 26.2%) and 10.0% (95% CI: 2.9, 17.6%) increased risks of preterm birth, respectively. The association between extreme heat and preterm birth was stronger for preterm births during weeks 20-31 and 32-34 than those during weeks 35-36. CONCLUSIONS These findings might have important implications in preventing preterm birth in Guangzhou as well as other areas with similar weather conditions. CITATION He JR, Liu Y, Xia XY, Ma WJ, Lin HL, Kan HD, Lu JH, Feng Q, Mo WJ, Wang P, Xia HM, Qiu X, Muglia LJ. 2016. Ambient temperature and the risk of preterm birth in Guangzhou, China (2001-2011). Environ Health Perspect 124:1100-1106; http://dx.doi.org/10.1289/ehp.1509778.
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Affiliation(s)
- Jian-Rong He
- Division of Birth Cohort Study, and
- Department of Health Care, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yu Liu
- Division of Birth Cohort Study, and
- Department of Health Care, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiao-Yan Xia
- Division of Birth Cohort Study, and
- Department of Health Care, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- Guangzhou Women and Children’s Health Information Center, Guangzhou, China
- Address correspondence to X. Qiu, Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Jinsui Rd., Guangzhou 510623, China. Telephone: 86 2038367162. E-mail: , or H.-M. Xia, Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Jinsui Rd., Guangzhou 510623, China. Telephone: 86 2038076020. E-mail:
| | - Wen-Jun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Hua-Liang Lin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Hai-Dong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, China
| | - Jin-Hua Lu
- Division of Birth Cohort Study, and
- Department of Health Care, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Qiong Feng
- Department of Health Care, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Wei-Jian Mo
- Department of Health Care, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Ping Wang
- Department of Health Care, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Hui-Min Xia
- Division of Birth Cohort Study, and
- Address correspondence to X. Qiu, Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Jinsui Rd., Guangzhou 510623, China. Telephone: 86 2038367162. E-mail: , or H.-M. Xia, Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Jinsui Rd., Guangzhou 510623, China. Telephone: 86 2038076020. E-mail:
| | - Xiu Qiu
- Division of Birth Cohort Study, and
- Department of Health Care, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- Address correspondence to X. Qiu, Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Jinsui Rd., Guangzhou 510623, China. Telephone: 86 2038367162. E-mail: , or H.-M. Xia, Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Jinsui Rd., Guangzhou 510623, China. Telephone: 86 2038076020. E-mail:
| | - Louis J. Muglia
- Center for Prevention of Preterm Birth, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
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Cox B, Vicedo-Cabrera AM, Gasparrini A, Roels HA, Martens E, Vangronsveld J, Forsberg B, Nawrot TS. Ambient temperature as a trigger of preterm delivery in a temperate climate. J Epidemiol Community Health 2016; 70:1191-1199. [DOI: 10.1136/jech-2015-206384] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 04/05/2016] [Accepted: 05/03/2016] [Indexed: 11/03/2022]
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Schifano P, Asta F, Dadvand P, Davoli M, Basagana X, Michelozzi P. Heat and air pollution exposure as triggers of delivery: A survival analysis of population-based pregnancy cohorts in Rome and Barcelona. ENVIRONMENT INTERNATIONAL 2016; 88:153-159. [PMID: 26760712 DOI: 10.1016/j.envint.2015.12.013] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 12/10/2015] [Accepted: 12/11/2015] [Indexed: 05/11/2023]
Abstract
INTRODUCTION Environmental exposures have been linked to length of gestation but the question as to during which weeks of gestation pregnancies are most susceptible still remains little explored. We estimated the effect of maximum apparent temperature and air pollution levels on risk of birth by week of gestation. METHODS We analyzed two cohorts of singleton live births in Rome (2001-2010) and Barcelona (2007-2012). Maximum apparent temperature (MAT), PM10, O3 and NO2 were analyzed in the warm period (1st April-31st October). Gestational week-specific hazard ratios of giving birth associated to a 1-unit increase in exposure were estimated fitting Cox regression models adjusted for seasonality, and demographic and clinical characteristics of the mother. RESULTS We observed 78,633 births (5.5% preterm) in Rome and 27,255 (4.5% preterm) in Barcelona. The highest hazard ratios for 1°C increase in MAT were in the 22nd-26th weeks of gestation, 1.071, (95% CI 1.052-1.091) in Rome and 1.071 (95% CI 1.036-1.106) in Barcelona, and decreased to 1.032 (95% CI 1.026-1.038) and 1.033 (95% CI 1.020-1.045) at the 36th week of gestation, respectively. Similar associations and trends were observed for PM10 and NO2 after adjusting for MAT. O3 showed similar trends but weaker associations. CONCLUSIONS We found, consistently in Rome and Barcelona, an increased risk of delivery for a unit increase in MAT, PM10, NO2 and O3, especially in the second half of the second trimester, thus effectively increasing the risk of preterm and particularly early preterm birth. Results may help to increase awareness of these risks among public-health regulators and clinicians, leading to better preventive strategies.
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Affiliation(s)
- Patrizia Schifano
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
| | - Federica Asta
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Payam Dadvand
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Xavier Basagana
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
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Kim J, Shin J, Lim YH, Honda Y, Hashizume M, Guo YL, Kan H, Yi S, Kim H. Comprehensive approach to understand the association between diurnal temperature range and mortality in East Asia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 539:313-321. [PMID: 26363726 DOI: 10.1016/j.scitotenv.2015.08.134] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 08/06/2015] [Accepted: 08/27/2015] [Indexed: 04/13/2023]
Abstract
An adverse association between diurnal temperature range (DTR) and mortality has been suggested, but with variable relationships in different cities. Comprehensive approaches to understanding the health effects of DTR using multinational data are required. We investigated the association between DTR and cause-specific mortality in an age-specific population and assessed the dependency of the health effects of DTR on geographic and climatic factors. Poisson generalized linear regression analyses with allowances for over-dispersion were applied to daily DTR and cause-specific mortality data from 30 cities in China, Japan, Korea, and Taiwan between 1979 and 2010, adjusted for various climatic and environmental factors. City-specific effects of DTR were estimated and summarized for the overall effects using geographic and climatic determinants in a meta-analysis. For all-cause, circulatory, and respiratory mortality, the greatest city-specific effects per 1°C DTR were found in Tianjin, China (1.80%; 95% confidence interval [CI]: 0.48, 3.14); Tangshan, China (2.25%; 95% CI: 0.65, 3.87); and Incheon, Korea (2.84%; 95% CI: 0.04, 5.73), respectively, and overall effects across 30 cities were 0.58% (95% CI: 0.44, 0.72), 0.81% (95% CI: 0.60, 1.03), and 0.90% (95% CI: 0.63, 1.18), respectively. Using quartile cutoff values for climatic (DTR, and mean temperature) and geographic (latitude, and longitude) characteristics, we divided the 30 cities into 4 different groups and conducted a meta-analysis within the groups using either a random or fixed effects model. Adverse effects of DTR were more pronounced for those aged ≥65years and varied according to geographic, longitudinal (0.07%; 95% CI: 0.05, 0.10), and climatic characteristics and the scale of DTR (0.33%; 95% CI: 0.12, 0.55) for overall all-cause mortality. The DTR is a risk factor affecting human health, depending on geographic location and the temperature variation, with particular vulnerability in aged populations.
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Affiliation(s)
- Jayeun Kim
- School of Public Health, Seoul National University, Seoul, South Korea
| | - Jihye Shin
- School of Public Health, Seoul National University, Seoul, South Korea
| | - Youn-Hee Lim
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, South Korea; Environmental Health Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | | | - Yue Leon Guo
- Institute of Occupational Medicine and Industrial Hygiene and Department of Environmental and Occupational Medicine, National Taiwan University, Taipei City, Taiwan
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Seungmuk Yi
- School of Public Health, Seoul National University, Seoul, South Korea
| | - Ho Kim
- School of Public Health, Seoul National University, Seoul, South Korea; Institute of Health and Environment, Seoul National University, Seoul, South Korea.
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Grabich SC, Robinson WR, Engel SM, Konrad CE, Richardson DB, Horney JA. County-level hurricane exposure and birth rates: application of difference-in-differences analysis for confounding control. Emerg Themes Epidemiol 2015; 12:19. [PMID: 26702293 PMCID: PMC4688997 DOI: 10.1186/s12982-015-0042-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 12/04/2015] [Indexed: 11/10/2022] Open
Abstract
Background Epidemiological analyses of aggregated data are often used to evaluate theoretical health effects of natural disasters. Such analyses are susceptible
to confounding by unmeasured differences between the exposed and unexposed populations. To demonstrate the difference-in-difference method our population included all recorded Florida live births that reached 20 weeks gestation and conceived after the first hurricane of 2004 or in 2003 (when no hurricanes made landfall). Hurricane exposure was categorized using ≥74 mile per hour hurricane wind speed as well as a 60 km spatial buffer based on weather data from the National Oceanic and Atmospheric Administration. The effect of exposure was quantified as live birth rate differences and 95 % confidence intervals [RD (95 % CI)]. To illustrate sensitivity of the results, the difference-in-differences estimates were compared to general linear models adjusted for census-level covariates. This analysis demonstrates difference-in-differences as a method to control for time-invariant confounders investigating hurricane exposure on live birth rates. Results Difference-in-differences analysis yielded consistently null associations across exposure metrics and hurricanes for the post hurricane rate difference between exposed and unexposed areas (e.g., Hurricane Ivan for 60 km spatial buffer [−0.02 births/1000 individuals (−0.51, 0.47)]. In contrast, general linear models suggested a positive association between hurricane exposure and birth rate [Hurricane Ivan for 60 km spatial buffer (2.80 births/1000 individuals (1.94, 3.67)] but not all models. Conclusions Ecological studies of associations between environmental exposures and health are susceptible to confounding due to unmeasured population attributes. Here we demonstrate an accessible method of control for time-invariant confounders for future research. Electronic supplementary material The online version of this article (doi:10.1186/s12982-015-0042-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shannon C Grabich
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599 USA
| | - Whitney R Robinson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599 USA
| | - Stephanie M Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599 USA
| | - Charles E Konrad
- Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599 USA
| | - Jennifer A Horney
- Department of Epidemiology and Biostatistics, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX USA
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Kloog I, Melly SJ, Coull BA, Nordio F, Schwartz JD. Using Satellite-Based Spatiotemporal Resolved Air Temperature Exposure to Study the Association between Ambient Air Temperature and Birth Outcomes in Massachusetts. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:1053-8. [PMID: 25850104 PMCID: PMC4590741 DOI: 10.1289/ehp.1308075] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 04/02/2015] [Indexed: 05/02/2023]
Abstract
BACKGROUND Studies looking at air temperature (Ta) and birth outcomes are rare. OBJECTIVES We investigated the association between birth outcomes and daily Ta during various prenatal exposure periods in Massachusetts (USA) using both traditional Ta stations and modeled addresses. METHODS We evaluated birth outcomes and average daily Ta during various prenatal exposure periods in Massachusetts (USA) using both traditional Ta stations and modeled address Ta. We used linear and logistic mixed models and accelerated failure time models to estimate associations between Ta and the following outcomes among live births > 22 weeks: term birth weight (≥ 37 weeks), low birth weight (LBW; < 2,500 g at term), gestational age, and preterm delivery (PT; < 37 weeks). Models were adjusted for individual-level socioeconomic status, traffic density, particulate matter ≤ 2.5 μm (PM2.5), random intercept for census tract, and mother's health. RESULTS Predicted Ta during multiple time windows before birth was negatively associated with birth weight: Average birth weight was 16.7 g lower (95% CI: -29.7, -3.7) in association with an interquartile range increase (8.4 °C) in Ta during the last trimester. Ta over the entire pregnancy was positively associated with PT [odds ratio (OR) = 1.02; 95% CI: 1.00, 1.05] and LBW (OR = 1.04; 95% CI: 0.96, 1.13). CONCLUSIONS Ta during pregnancy was associated with lower birth weight and shorter gestational age in our study population.
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Affiliation(s)
- Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel
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47
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Su JG, Apte JS, Lipsitt J, Garcia-Gonzales DA, Beckerman BS, de Nazelle A, Texcalac-Sangrador JL, Jerrett M. Populations potentially exposed to traffic-related air pollution in seven world cities. ENVIRONMENT INTERNATIONAL 2015; 78:82-89. [PMID: 25770919 DOI: 10.1016/j.envint.2014.12.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 12/11/2014] [Accepted: 12/20/2014] [Indexed: 06/04/2023]
Abstract
Traffic-related air pollution (TRAP) likely exerts a large burden of disease globally, and in many places, traffic is increasing dramatically. The impact, however, of urban form on the portion of population potentially exposed to TRAP remains poorly understood. In this study, we estimate portions of population potentially exposed to TRAP across seven global cities of various urban forms. Data on population distributions and road networks were collected from the best available sources in each city and from remote sensing analysis. Using spatial mapping techniques, we first overlaid road buffers onto population data to estimate the portions of population potentially exposed for four plausible impact zones. Based on a most likely scenario with impacts from highways up to 300meters and major roadways up to 50meters, we identified that the portions of population potentially exposed for the seven cities ranged from 23 to 96%. High-income North American cities had the lowest potential exposure portions, while those in Europe had the highest. Second, we adjusted exposure zone concentration levels based on a literature suggested multiplier for each city using corresponding background concentrations. Though Beijing and Mexico City did not have the highest portion of population exposure, those in their exposure zones had the highest levels of exposure. For all seven cities, the portion of population potentially exposed was positively correlated with roadway density and, to a lesser extent, with population density. These analyses suggest that urban form may influence the portion of population exposed to TRAP and vehicle emissions and other factors may influence the exposure levels. Greater understanding of urban form and other factors influencing potential exposure to TRAP may help inform interventions that protect public health.
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Affiliation(s)
- Jason G Su
- Environmental Health Sciences, School of Public Health, University of California at Berkeley, Berkeley 94720-7360, USA.
| | - Joshua S Apte
- Energy and Resources Group, University of California at Berkeley, Berkeley 94720-3050, USA
| | - Jonah Lipsitt
- Environmental Health Sciences, School of Public Health, University of California at Berkeley, Berkeley 94720-7360, USA
| | - Diane A Garcia-Gonzales
- Environmental Health Sciences, School of Public Health, University of California at Berkeley, Berkeley 94720-7360, USA
| | - Bernardo S Beckerman
- Environmental Health Sciences, School of Public Health, University of California at Berkeley, Berkeley 94720-7360, USA
| | | | | | - Michael Jerrett
- Environmental Health Sciences, School of Public Health, University of California at Berkeley, Berkeley 94720-7360, USA; Environmental Health Sciences Department, Fielding School of Public Health, University of California, Los Angeles, 90095-1772, USA
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Su JG, Jerrett M, Meng YY, Pickett M, Ritz B. Integrating smart-phone based momentary location tracking with fixed site air quality monitoring for personal exposure assessment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 506-507:518-526. [PMID: 25437768 DOI: 10.1016/j.scitotenv.2014.11.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 10/21/2014] [Accepted: 11/04/2014] [Indexed: 06/04/2023]
Abstract
Epidemiological studies investigating relationships between environmental exposures from air pollution and health typically use residential addresses as a single point for exposure, while environmental exposures in transit, at work, school or other locations are largely ignored. Personal exposure monitors measure individuals' exposures over time; however, current personal monitors are intrusive and cannot be operated at a large scale over an extended period of time (e.g., for a continuous three months) and can be very costly. In addition, spatial locations typically cannot be identified when only personal monitors are used. In this paper, we piloted a study that applied momentary location tracking services supplied by smart phones to identify an individual's location in space-time for three consecutive months (April 28 to July 28, 2013) using available Wi-Fi networks. Individual exposures in space-time to the traffic-related pollutants Nitrogen Oxides (NOX) were estimated by superimposing an annual mean NOX concentration surface modeled using the Land Use Regression (LUR) modeling technique. Individual's exposures were assigned to stationary (including home, work and other stationary locations) and in-transit (including commute and other travel) locations. For the individual, whose home/work addresses were known and the commute route was fixed, it was found that 95.3% of the time, the individual could be accurately identified in space-time. The ambient concentration estimated at the home location was 21.01 ppb. When indoor/outdoor infiltration, indoor sources of air pollution and time spent outdoors were taken into consideration, the individual's cumulative exposures were 28.59 ppb and 96.49 ppb, assuming a respective indoor/outdoor ratio of 1.33 and 5.00. Integrating momentary location tracking services with fixed-site field monitoring, plus indoor-outdoor air exchange calibration, makes exposure assessment of a very large population over an extended time period feasible.
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Affiliation(s)
- Jason G Su
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley 94720-7360, United States.
| | - Michael Jerrett
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley 94720-7360, United States
| | - Ying-Ying Meng
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley 94720-7360, United States
| | - Melissa Pickett
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley 94720-7360, United States
| | - Beate Ritz
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley 94720-7360, United States
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Edwards S, Maxson P, Sandberg N, Miranda ML. Air Pollution and Pregnancy Outcomes. MOLECULAR AND INTEGRATIVE TOXICOLOGY 2015. [DOI: 10.1007/978-1-4471-6669-6_3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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50
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Pattinson W, Longley I, Kingham S. Proximity to busy highways and local resident perceptions of air quality. Health Place 2014; 31:154-62. [PMID: 25541086 DOI: 10.1016/j.healthplace.2014.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 12/03/2014] [Accepted: 12/07/2014] [Indexed: 11/26/2022]
Abstract
This study investigated variations in perceptions of air quality as a function of residential proximity to busy highways, across two suburbs of South Auckland, New Zealand. While plenty is known about the spatial gradients of highway emissions, very little is known about variation of lay understanding at the fine spatial scale and whether there are gradients in severity of concerns. One-hundred and four near-highway residents agreed to participate in a semi-structured interview on their knowledge and attitudes towards highway traffic emissions. Proximity to the highway edge varied within 5-380 m at the predominantly downwind side of the highway and 13-483 m at the upwind side. Likert-type ordered response questions were analysed using multivariate regression. Inverse linear relationships were identified for distance from highway and measures of concern for health impacts, as well as for noise (p<0.05). Positive linear relationships were identified for distance from highway and ratings of both outdoor and indoor air quality (p<0.05). Measures of level of income had no conclusive statistically significant effect on perceptions. Additional discussion was made surrounding participant's open-ended responses, within the context of limited international research. Findings indicate that there may be quantifiable psychological benefits of separating residents just a short distance (40 m+) from highways and that living within such close proximity can be detrimental to wellbeing by restricting local outdoor activity. This work lends additional rationale for a residential separation buffer of ~100 m alongside major highways in the interests of protecting human health.
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Affiliation(s)
- Woodrow Pattinson
- Department of Geography, University of Canterbury, Private Bag 4800, Christchurch 8020, New Zealand.
| | - Ian Longley
- National Institute of Water & Atmospheric Research, Auckland 1010, New Zealand.
| | - Simon Kingham
- Department of Geography, University of Canterbury, Private Bag 4800, Christchurch 8020, New Zealand.
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