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Martenies SE, Zhang M, Corrigan AE, Kvit A, Shields T, Wheaton W, Around Him D, Aschner J, Talavera-Barber MM, Barrett ES, Bastain TM, Bendixsen C, Breton CV, Bush NR, Cacho F, Camargo CA, Carroll KN, Carter BS, Cassidy-Bushrow AE, Cowell W, Croen LA, Dabelea D, Duarte CS, Dunlop AL, Everson TM, Habre R, Hartert TV, Helderman JB, Hipwell AE, Karagas MR, Lester BM, LeWinn KZ, Magzamen S, Morello-Frosch R, O’Connor TG, Padula AM, Petriello M, Sathyanarayana S, Stanford JB, Woodruff TJ, Wright RJ, Kress AM. Developing a National-Scale Exposure Index for Combined Environmental Hazards and Social Stressors and Applications to the Environmental Influences on Child Health Outcomes (ECHO) Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6339. [PMID: 37510572 PMCID: PMC10379099 DOI: 10.3390/ijerph20146339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/12/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023]
Abstract
Tools for assessing multiple exposures across several domains (e.g., physical, chemical, and social) are of growing importance in social and environmental epidemiology because of their value in uncovering disparities and their impact on health outcomes. Here we describe work done within the Environmental influences on Child Health Outcomes (ECHO)-wide Cohort Study to build a combined exposure index. Our index considered both environmental hazards and social stressors simultaneously with national coverage for a 10-year period. Our goal was to build this index and demonstrate its utility for assessing differences in exposure for pregnancies enrolled in the ECHO-wide Cohort Study. Our unitless combined exposure index, which collapses census-tract level data into a single relative measure of exposure ranging from 0-1 (where higher values indicate higher exposure to hazards), includes indicators for major air pollutants and air toxics, features of the built environment, traffic exposures, and social determinants of health (e.g., lower educational attainment) drawn from existing data sources. We observed temporal and geographic variations in index values, with exposures being highest among participants living in the West and Northeast regions. Pregnant people who identified as Black or Hispanic (of any race) were at higher risk of living in a "high" exposure census tract (defined as an index value above 0.5) relative to those who identified as White or non-Hispanic. Index values were also higher for pregnant people with lower educational attainment. Several recommendations follow from our work, including that environmental and social stressor datasets with higher spatial and temporal resolutions are needed to ensure index-based tools fully capture the total environmental context.
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Affiliation(s)
- Sheena E. Martenies
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Mingyu Zhang
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Anne E. Corrigan
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Anton Kvit
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Timothy Shields
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - William Wheaton
- Research Triangle Institute, Research Triangle Park, NC 27709, USA
| | | | - Judy Aschner
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | | | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | | | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Nicole R. Bush
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
- Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143, USA
| | - Ferdinand Cacho
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Carlos A. Camargo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Kecia N. Carroll
- Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Brian S. Carter
- Department of Pediatrics-Neonatology, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | | | - Whitney Cowell
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Lisa A. Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA;
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Cristiane S. Duarte
- New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA
| | - Anne L. Dunlop
- Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Todd M. Everson
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Tina V. Hartert
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Jennifer B. Helderman
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Barry M. Lester
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, University of California Berkeley, Berkeley, CA 94720, USA
| | - Thomas G. O’Connor
- Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 41642, USA
| | - Amy M. Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Michael Petriello
- Institute of Environmental Health Sciences and Department of Pharmacology, Wayne State University, Detroit, MI 48202, USA
| | - Sheela Sathyanarayana
- Seattle Children’s Research Institute, Seattle, WA 98105, USA
- Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
| | - Joseph B. Stanford
- Department of Pediatrics, Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Tracey J. Woodruff
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Rosalind J. Wright
- Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Amii M. Kress
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Martenies SE, Hoskovec L, Wilson A, Moore BF, Starling AP, Allshouse WB, Adgate JL, Dabelea D, Magzamen S. Using non-parametric Bayes shrinkage to assess relationships between multiple environmental and social stressors and neonatal size and body composition in the Healthy Start cohort. Environ Health 2022; 21:111. [PMID: 36401268 PMCID: PMC9675112 DOI: 10.1186/s12940-022-00934-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 10/30/2022] [Indexed: 06/09/2023]
Abstract
BACKGROUND Both environmental and social factors have been linked to birth weight and adiposity at birth, but few studies consider the effects of exposure mixtures. Our objective was to identify which components of a mixture of neighborhood-level environmental and social exposures were driving associations with birth weight and adiposity at birth in the Healthy Start cohort. METHODS Exposures were assessed at the census tract level and included air pollution, built environment characteristics, and socioeconomic status. Prenatal exposures were assigned based on address at enrollment. Birth weight was measured at delivery and adiposity was measured using air displacement plethysmography within three days. We used non-parametric Bayes shrinkage (NPB) to identify exposures that were associated with our outcomes of interest. NPB models were compared to single-predictor linear regression. We also included generalized additive models (GAM) to assess nonlinear relationships. All regression models were adjusted for individual-level covariates, including maternal age, pre-pregnancy BMI, and smoking. RESULTS Results from NPB models showed most exposures were negatively associated with birth weight, though credible intervals were wide and generally contained zero. However, the NPB model identified an interaction between ozone and temperature on birth weight, and the GAM suggested potential non-linear relationships. For associations between ozone or temperature with birth weight, we observed effect modification by maternal race/ethnicity, where effects were stronger for mothers who identified as a race or ethnicity other than non-Hispanic White. No associations with adiposity at birth were observed. CONCLUSIONS NPB identified prenatal exposures to ozone and temperature as predictors of birth weight, and mothers who identify as a race or ethnicity other than non-Hispanic White might be disproportionately impacted. However, NPB models may have limited applicability when non-linear effects are present. Future work should consider a two-stage approach where NPB is used to reduce dimensionality and alternative approaches examine non-linear effects.
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Affiliation(s)
- Sheena E Martenies
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S Goodwin Ave, M/C 052, Urbana, IL, 61801, USA.
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.
| | - Lauren Hoskovec
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Ander Wilson
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Brianna F Moore
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Anne P Starling
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD Center), University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - William B Allshouse
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, CO, USA
| | - John L Adgate
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, CO, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD Center), University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Morgan BL, Stern MC, Pérez-Stable EJ, Hooper MW, Fejerman L. Adding a One Health approach to a research framework for minority health and health disparities. eLife 2022; 11:76461. [PMID: 35796544 PMCID: PMC9262385 DOI: 10.7554/elife.76461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 06/28/2022] [Indexed: 11/24/2022] Open
Abstract
The National Institute on Minority Health and Health Disparities (NIMHD) has developed a framework to guide and orient research into health disparities and minority health. The framework depicts different domains of influence (such as biological and behavioral) and different levels of influence (such as individual and interpersonal). Here, influenced by the “One Health” approach, we propose adding two new levels of influence – interspecies and planetary – to this framework to reflect the interconnected nature of human, animal, and environmental health. Extending the framework in this way will help researchers to create new avenues of inquiry and encourage multidisciplinary collaborations. We then use the One Health approach to discuss how the COVID-19 pandemic has exacerbated health disparities, and show how the expanded framework can be applied to research into health disparities related to antimicrobial resistance and obesity.
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Affiliation(s)
- Brittany L Morgan
- Department of Public Health Sciences, University of California, Davis, Davis, United States.,Center for Animal Disease Modeling and Surveillance (CADMS), Department of Veterinary Medicine, University of California, Davis, Davis, United States
| | - Mariana C Stern
- Departments of Preventive Medicine and Urology, Keck School of Medicine of USC, Los Angeles, United States.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, United States
| | - Eliseo J Pérez-Stable
- Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, United States
| | - Monica Webb Hooper
- Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, United States
| | - Laura Fejerman
- Department of Public Health Sciences, University of California, Davis, Davis, United States.,Comprehensive Cancer Center, University of California, Davis, Davis, United States
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4
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Martenies SE, Zhang M, Corrigan AE, Kvit A, Shields T, Wheaton W, Bastain TM, Breton CV, Dabelea D, Habre R, Magzamen S, Padula AM, Him DA, Camargo CA, Cowell W, Croen LA, Deoni S, Everson TM, Hartert TV, Hipwell AE, McEvoy CT, Morello-Frosch R, O'Connor TG, Petriello M, Sathyanarayana S, Stanford JB, Woodruff TJ, Wright RJ, Kress AM. Associations between combined exposure to environmental hazards and social stressors at the neighborhood level and individual perinatal outcomes in the ECHO-wide cohort. Health Place 2022; 76:102858. [PMID: 35872389 PMCID: PMC9661655 DOI: 10.1016/j.healthplace.2022.102858] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/06/2022] [Accepted: 06/28/2022] [Indexed: 11/04/2022]
Abstract
Limited studies examine how prenatal environmental and social exposures jointly impact perinatal health. Here we investigated relationships between a neighborhood-level combined exposure (CE) index assessed during pregnancy and perinatal outcomes, including birthweight, gestational age, and preterm birth. Across all participants, higher CE index scores were associated with small decreases in birthweight and gestational age. We also observed effect modification by race; infants born to Black pregnant people had a greater risk of preterm birth for higher CE values compared to White infants. Overall, our results suggest that neighborhood social and environmental exposures have a small but measurable joint effect on neonatal indicators of health.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Dana Dabelea
- University of Colorado Anschutz Medical Campus, USA
| | | | | | | | | | | | | | - Lisa A Croen
- Kaiser Permanente Northern California Division of Research, USA
| | | | - Todd M Everson
- Rollins School of Public Health at Emory University, USA
| | | | | | | | | | | | - Michael Petriello
- Wayne State University, Institute of Environmental Health Sciences, USA
| | | | - Joseph B Stanford
- University of Utah, Departments of Family and Preventive Medicine and Pediatrics, USA
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5
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do Nascimento FP, de Almeida MF, Gouveia N. Individual and contextual socioeconomic status as effect modifier in the air pollution-birth outcome association. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 803:149790. [PMID: 34481165 DOI: 10.1016/j.scitotenv.2021.149790] [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: 01/04/2021] [Revised: 08/14/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Several studies have examined whether air pollution is associated with adverse births outcomes, but it is not clear if socioeconomic status (SES) modifies this relationship. OBJECTIVES We investigated if maternal education and area-level socioeconomic status modified the relationship between ozone, nitrogen dioxide and particulate matter with aerodynamic diameter <10 μm (PM10) on preterm births (PTB; gestational age <37 weeks) and term low birth weight (TLBW; weight < 2500 g on term deliveries). METHODS Analyses were based on almost 1 million singleton live births in São Paulo municipality between 2011 and 2016. The final sample included 979,306 births for PTB analysis and 888,133 for TLBW analysis. Exposure to PM10, NO2 and O3 were based on date of birth and estimated for the entire gestation and for each trimester. Multilevel logistic regression models were conducted to examine the effect of air pollutants on both adverse birth outcomes and whether it was modified by individual and area-level SES. RESULTS In fully adjusted models, over the entire pregnancy, a 10 μg/m3 increase in O3 and PM10 was associated with increased chance of PTB (odds ratio; OR = 1.14 CI 1.13, 1.16 and 1.08 CI = 1.02, 1.15 respectively) and PM10 with TLBW (OR = 1.08 CI 1.03, 1.14). Associations were modified by maternal educational and area-level SES for both outcomes. Mothers of lower education had an additional chance of PTB and TLBW due to PM10 exposure (OR = 1.04 CI 1.04, 1.05 and 1.10 CI 1.08, 1.14 respectively), while mothers living in low SES areas have an additional chance for TLBW (OR = 1.05 CI 1.03, 1.06). Similar modification effects were found for O3 exposure. Trimester specific associations were weaker but followed a similar pattern. CONCLUSION Socioeconomic status modifies the effect of air pollution on adverse birth outcomes. Results indicate that mothers with lower SES may be more susceptible to air pollution effects.
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Affiliation(s)
| | | | - Nelson Gouveia
- Department of Preventive Medicine, School of Medicine FMUSP, University of São Paulo, SP, Brazil
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Riddell CA, Goin DE, Morello-Frosch R, Apte JS, Glymour MM, Torres JM, Casey JA. Hyper-localized measures of air pollution and risk of preterm birth in Oakland and San Jose, California. Int J Epidemiol 2022; 50:1875-1885. [PMID: 34999861 PMCID: PMC8932296 DOI: 10.1093/ije/dyab097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND US preterm-birth rates are 1.6 times higher for Black mothers than for White mothers. Although traffic-related air pollution (TRAP) may increase the risk of preterm birth, evaluating its effect on preterm birth and disparities has been challenging because TRAP is often measured inaccurately. This study sought to estimate the effect of TRAP exposure, measured at the street level, on the prevalence of preterm birth by race/ethnicity. METHODS We linked birth-registry data with TRAP measured at the street level for singleton births in sampled communities during 2013-2015 in Oakland and San Jose, California. Using logistic regression and marginal standardization, we estimated the effects of exposure to black carbon, nitrogen dioxide and ultrafine particles on preterm birth after confounder adjustment and stratification by race/ethnicity. RESULTS There were 8823 singleton births, of which 760 (8.6%) were preterm. Shifting black-carbon exposure from the 10th to the 90th percentile was associated with: 6.8%age point higher risk of preterm birth (95% confidence interval = 0.1 to 13.5) among Black women; 2.1%age point higher risk (95% confidence interval = -1.1 to 5.2) among Latinas; and inconclusive null findings among Asian and White women. For Latinas, there was evidence of a positive association between the other pollutants and risk of preterm birth, although effect sizes were attenuated in models that co-adjusted for other TRAP. CONCLUSIONS Exposure to TRAP, especially black carbon, may increase the risk of preterm birth for Latina and Black women but not for Asian and White women.
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Affiliation(s)
- Corinne A Riddell
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, USA
| | - Dana E Goin
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Program on Reproductive Health and the Environment, School of Medicine, University of California, San Francisco, San Francisco, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, College of Natural Resources, Policy, & Management, University of California, Berkeley, Berkeley, USA
- Division of Community Health Sciences & Environmental Health Sciences Graduate Group, School of Public Health, University of California, Berkeley, Berkeley, USA
| | - Joshua S Apte
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, USA
- Department of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, USA
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Jacqueline M Torres
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Joan A Casey
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, NY, USA
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Yao Y, Lu T, Liu Y, Qin Q, Jiang J, Xiang H. Association of depressive symptoms with ambient PM 2.5 in middle-aged and elderly Chinese adults: A cross-sectional study from the China health and Retirement Longitudinal Study wave 4. ENVIRONMENTAL RESEARCH 2022; 203:111889. [PMID: 34418451 DOI: 10.1016/j.envres.2021.111889] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/08/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
Depressive symptoms have become a serious public health issue worldwide. Several studies showed that air pollution, especially fine particulate matter (PM2.5), may be a risk factor of mental disorders. However, existing studies reported inconsistent results and little evidence is available in developing countries, like China. To fill the gap, in this study, we explored the relationship between ambient PM2.5 exposure and depressive symptoms among middle-aged and elderly Chinese adults in the Chinese Health and Retirement Longitudinal Study (CHARLS). The social and demographic variables and depressive symptoms were obtained from the Wave4 of CHARLS in 2018. PM2.5 concentrations were obtained from the national urban air quality real-time release platform of China Environmental Monitoring Station. We applied generalized linear mixed models to determine the association between PM2.5 exposure and depressive symptoms. A total of 15,105 middle-aged and elderly adults from CHARLS Wave4 were included in the analyses. We found positive impact of ambient PM2.5 on depressive symptoms for the exposure windows of 30-day, 60-day, 120-day, 180-day, 1-year and 2-year. The most significant increase was observed for 180-day moving average. For every 10 μg/m3 increment in PM2.5 exposure, the incidence of depressive symptoms increased by 9% (OR = 1.09; 95%CI: 1.05, 1.14) after adjusting for age, sex and residence. In interaction analyses, we found PM2.5 had weaker effect on depressive symptoms among people who used to drink alcohol (OR = 1.05; 95%CI: 1.00, 1.10) and exercise (OR = 1.10; 95%CI: 1.02, 1.18). People living in western China (OR = 1.09; 95%CI: 1.03, 1.16) were more vulnerable than those living in eastern China (OR = 0.99; 95%CI: 0.94, 1.05). In conclusion, exposure to PM2.5 was significantly associated with depressive symptoms in middle-aged and elder Chinese adults, particularly for people who never drink, with lower physical activity levels, or lived in western China.
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Affiliation(s)
- Yifan Yao
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Tianjun Lu
- Department of Earth Science and Geography, California State University Dominguez Hills, 1000 E. Victoria St, Carson, CA, 90747, USA
| | - Yisi Liu
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Qiujun Qin
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Jie Jiang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
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Chu C, Zhu Y, Liu C, Chen R, Yan Y, Ren Y, Li X, Wang J, Ge W, Kan H, Gui Y. Ambient fine particulate matter air pollution and the risk of preterm birth: A multicenter birth cohort study in China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 287:117629. [PMID: 34182393 DOI: 10.1016/j.envpol.2021.117629] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 05/07/2021] [Accepted: 06/19/2021] [Indexed: 06/13/2023]
Abstract
Preterm birth (PTB), defined as live birth before the 37th week of gestation, is believed to have profound impacts on the infant's health in later life. Air pollution has been suggested to be a potential risk factor of PTB, but the evidence was inconsistent. In this multicenter birth cohort study, we aimed to examine the association between fine particulate matter (PM2.5) exposure during pregnancy and PTB in China. A total of 5976 live births were identified between Jan. 2009 and Feb. 2011 from 8 provinces in China. Residential exposures to PM2.5 were assigned based on satellite remote sensing estimates. Cox proportional hazards regressions were employed to explore the correlation for each trimester as well as the entire pregnancy. A total of 443 (7.4%) preterm births were observed. The average PM2.5 during pregnancy was 57.2 ± 8.8 μg/m3. We found exposure to PM2.5 during the whole pregnancy (hazard ratio, HR = 1.262; 95% CI: 1.087-1.465) and in the first trimester (HR = 1.114; 95% CI: 1.007-1.232) was associated with higher risk of PTB. The associations of PM2.5 were stronger for subjects with older maternal or paternal age, lower maternal pre-pregnancy BMI, and lower family income. This study adds supports to the cumulating evidence linking PM2.5 exposure and elevated PTB risk. Measures of air pollution reduction are needed during pregnancy, especially at early stage of pregnancy to prevent adverse birth outcomes.
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Affiliation(s)
- Chen Chu
- Heart Center, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China
| | - Yixiang Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Yingliu Yan
- Ultrasound Department, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Yunyun Ren
- Ultrasound Department, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Xiaotian Li
- Department of Obstetrics, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Jimei Wang
- Neonatology Department, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Wenzhen Ge
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10605, United States
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Yonghao Gui
- Heart Center, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China.
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Weuve J, Bennett EE, Ranker L, Gianattasio KZ, Pedde M, Adar SD, Yanosky JD, Power MC. Exposure to Air Pollution in Relation to Risk of Dementia and Related Outcomes: An Updated Systematic Review of the Epidemiological Literature. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:96001. [PMID: 34558969 PMCID: PMC8462495 DOI: 10.1289/ehp8716] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 05/02/2023]
Abstract
BACKGROUND Dementia is a devastating neurologic condition that is common in older adults. We previously reviewed the epidemiological evidence examining the hypothesis that long-term exposure to air pollution affects dementia risk. Since then, the evidence base has expanded rapidly. OBJECTIVES With this update, we collectively review new and previously identified epidemiological studies on air pollution and late-life cognitive health, highlighting new developments and critically discussing the merits of the evidence. METHODS Using a registered protocol (PROSPERO 2020 CRD42020152943), we updated our literature review to capture studies published through 31 December 2020, extracted data, and conducted a bias assessment. RESULTS We identified 66 papers (49 new) for inclusion in this review. Cognitive level remained the most commonly considered outcome, and particulate matter (PM) remained the most commonly considered air pollutant. Since our prior review, exposure estimation methods in this research have improved, and more papers have looked at cognitive change, neuroimaging, and incident cognitive impairment/dementia, though methodological concerns remain common. Many studies continue to rely on administrative records to ascertain dementia, have high potential for selection bias, and adjust for putative mediating factors in primary models. A subset of 35 studies met strict quality criteria. Although high-quality studies of fine particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ) and cognitive decline generally supported an adverse association, other findings related to PM 2.5 and findings related to particulate matter with aerodynamic diameter ≤ 10 μ m (PM 10 , NO 2 , and NO x ) were inconclusive, and too few papers reported findings with ozone to comment on the likely direction of association. Notably, only a few findings on dementia were included for consideration on the basis of quality criteria. DISCUSSION Strong conclusions remain elusive, although the weight of the evidence suggests an adverse association between PM 2.5 and cognitive decline. However, we note a continued need to confront methodological challenges in this line of research. https://doi.org/10.1289/EHP8716.
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Affiliation(s)
- Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Erin E. Bennett
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Lynsie Ranker
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Kan Z. Gianattasio
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Meredith Pedde
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Sara D. Adar
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Jeff D. Yanosky
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Melinda C. Power
- Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
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10
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Lee JT. Review of epidemiological studies on air pollution and health effects in children. Clin Exp Pediatr 2021; 64:3-11. [PMID: 32517422 PMCID: PMC7806407 DOI: 10.3345/cep.2019.00843] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 01/21/2020] [Accepted: 02/28/2020] [Indexed: 12/19/2022] Open
Abstract
There is a growing body of literature on the adverse health effects of ambient air pollution. Children are more adversely affected by air pollution due to their biological susceptibility and exposure patterns. This review summarized the accumulated epidemiologic evidence with emphasis on studies conducted in Korea and heterogeneity in the literature. Based on systematic reviews and meta-analyses, there is consistent evidence on the association between exposure to ambient air pollution and children's health, especially respiratory health and adverse birth outcomes, and growing evidence on neurodevelopmental outcomes. Despite these existing studies, the mechanism of the adverse health effects of air pollution and the critical window of susceptibility remain unclear. There is also a need to identify causes of heterogeneity between studies in terms of measurement of exposure/outcome, study design, and the differential characteristics of air pollutants and population.
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Affiliation(s)
- Jong-Tae Lee
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Korea
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11
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Zhang X, Fan C, Ren Z, Feng H, Zuo S, Hao J, Liao J, Zou Y, Ma L. Maternal PM 2.5 exposure triggers preterm birth: a cross-sectional study in Wuhan, China. Glob Health Res Policy 2020; 5:17. [PMID: 32377568 PMCID: PMC7193342 DOI: 10.1186/s41256-020-00144-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 03/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background Most of the studies regarding air pollution and preterm birth (PTB) in highly polluted areas have estimated the exposure level based on fixed-site monitoring. However, exposure assessment methods relying on monitors have the potential to cause exposure misclassification due to a lack of spatial variation. In this study, we utilized a land use regression (LUR) model to assess individual exposure, and explored the association between PM2.5 exposure during each time window and the risk of preterm birth in Wuhan city, China. Methods Information on 2101 singleton births, which were ≥ 20 weeks of gestation and born between November 1, 2013 and May 31, 2014; between January 1, 2015 and August 31, 2015, was obtained from the Obstetrics Department in one 3A hospital in Wuhan. Air quality index (AQI) data were accessed from the Wuhan Environmental Protection Bureau website. Individual exposure during pregnancy was assessed by LUR models and Kriging interpolation. Logistic regression analyses were conducted to determine the association between women exposure to PM2.5 and the risk of different subtypes of PTB. Results During the study period, the average individual exposure concentration of PM2.5 during the entire pregnancy was 84.54 μg/m3. A 10 μg/m3 increase of PM2.5 exposure in the first trimester (OR: 1.169; 95% CI: 1.077, 1.262), the second trimester (OR: 1.056; 95% CI: 1.015, 1.097), the third trimester (OR: 1.052; 95% CI: 1.002, 1.101), and the entire pregnancy (OR: 1.263; 95% CI: 1.158, 1.368) was significantly associated with an increased risk of PTB. For the PTB subgroup, the hazard of PM2.5 exposure during pregnancy was stronger for very preterm births (VPTB) than moderate preterm births (MPTB). The first trimester was the most susceptible exposure window. Moreover, women who had less than 9 years of education or who conceived during the cold season tended to be more susceptible to the PM2.5 exposure during pregnancy. Conclusions Maternal exposure to PM2.5 increased the risk of PTB, and this risk was stronger for VPTB than for MPTB, especially during the first trimester.
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Affiliation(s)
- Xiaotong Zhang
- 1Department of Epidemiology and Health Statistics, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Cuifang Fan
- 2Department of Obstetrics, Renmin Hospital of Wuhan University, Wuhan, 430060 China
| | - Zhan Ren
- 1Department of Epidemiology and Health Statistics, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Huan Feng
- 1Department of Epidemiology and Health Statistics, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Shanshan Zuo
- 1Department of Epidemiology and Health Statistics, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Jiayuan Hao
- 1Department of Epidemiology and Health Statistics, School of Health Sciences, Wuhan University, Wuhan, 430071 China
| | - Jingling Liao
- 3Department of Public Health, Wuhan University of Science and Technology School of Medicine, Wuhan, 430081 China
| | - Yuliang Zou
- 1Department of Epidemiology and Health Statistics, School of Health Sciences, Wuhan University, Wuhan, 430071 China.,4Global Health Institute, Wuhan University, Wuhan, 430071 China
| | - Lu Ma
- 1Department of Epidemiology and Health Statistics, School of Health Sciences, Wuhan University, Wuhan, 430071 China.,4Global Health Institute, Wuhan University, Wuhan, 430071 China
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12
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Heo S, Fong KC, Bell ML. Risk of particulate matter on birth outcomes in relation to maternal socio-economic factors: a systematic review. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2019; 14. [PMID: 34108997 PMCID: PMC8186490 DOI: 10.1088/1748-9326/ab4cd0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
A growing number of studies provide evidence of an association between exposure to maternal air pollution during pregnancy and adverse birth outcomes including low birth weight and preterm birth. Prevention of these health effects of air pollution is critical to reducing the adverse infant outcomes, which can have impacts throughout the life course. However, there is no consensus on whether the association between air pollution exposure and birth outcomes varies by maternal risk factors including demographic characteristics and socio-economic status. Such information is vital to understand potential environmental health disparities. Our search found 859 unique studies, of which 45 studies met our inclusion criteria (Jan. 2000- July. 2019). We systematically reviewed the 45 identified epidemiologic studies and summarized the results on effect modifications by maternal race/ethnicity, educational attainment, income, and area-level socio-economic status. We considered adverse birth outcomes of preterm birth, low birth weight, small for gestational age (SGA), and stillbirth. Suggestive evidence of higher risk of particulate matter in infants of African-American/black mothers than infants of other women was found for preterm birth and low birth weight. We found weak evidence that particulate matter risk was higher for infants of mothers with lower educational attainment for preterm birth and low birth weight. Due to the small study numbers, we were unable to conclude whether effect modification is present for income, occupation, and area-level socio-economic status, and additional research is needed. Furthermore, adverse birth outcomes such as SGA and stillbirth need more study to understand potential environmental justice issues regarding the impact of particulate matter exposure during pregnancy on birth outcomes.
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Affiliation(s)
- Seulkee Heo
- School of Forestry and Environmental Studies, Yale University
| | - Kelvin C Fong
- School of Forestry and Environmental Studies, Yale University
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University
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13
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Rhee J, Fabian MP, Ettinger de Cuba S, Coleman S, Sandel M, Lane KJ, Yitshak Sade M, Hart JE, Schwartz J, Kloog I, Laden F, Levy JI, Zanobetti A. Effects of Maternal Homelessness, Supplemental Nutrition Programs, and Prenatal PM 2.5 on Birthweight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4154. [PMID: 31661898 PMCID: PMC6862522 DOI: 10.3390/ijerph16214154] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/15/2019] [Accepted: 10/23/2019] [Indexed: 01/15/2023]
Abstract
Few studies examined the impact of maternal socioeconomic status and of its combined effects with environmental exposures on birthweight. Our goal was to examine the impact of maternal homelessness (mothers ever homeless or who lived in shelters during pregnancy) and participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) during pregnancy in conjunction with air pollution exposure on birthweight in the Boston-based Children's HealthWatch cohort from 2007 through 2015 (n = 3366). Birthweight was obtained from electronic health records. Information on maternal homelessness and WIC participation during pregnancy were provided via a questionnaire. Prenatal fine particulate matter (PM2.5) exposures, estimated at the subject's residential address, were calculated for each trimester. We fit linear regression models adjusting for maternal and child characteristics, seasonality, and block-group-level median household income and examined the interactions between PM2.5 and each covariate. Prenatal maternal homelessness was associated with reduced birthweight (-55.7 g, 95% CI: -97.8 g, -13.7 g), while participating in WIC was marginally associated with increased birthweight (36.1 g, 95% CI: -7.3 g, 79.4 g). Only average PM2.5 during the second trimester was marginally associated with reduced birthweight (-8.5 g, 95% CI: -19.3, 2.3) for a 1 µg/m3 increase in PM2.5. The association of PM2.5 during the second trimester with reduced birthweight was stronger among non-Hispanic Black mothers and trended toward significance among immigrants and single mothers. Our study emphasizes the independent and synergistic effects of social and environmental stressors on birthweight, particularly the potentially protective effect of participating in WIC for vulnerable populations.
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Affiliation(s)
- Jongeun Rhee
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
| | - M Patricia Fabian
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02115, USA.
| | | | - Sharon Coleman
- Biostatistics and Epidemiology Data Analytics Center, School of Public Health, Boston University, Boston, MA 02118, USA.
| | - Megan Sandel
- Department of Pediatrics, School of Medicine, Boston University, Boston, MA 02118, USA.
- Department of Pediatrics, Boston Medical Center, Boston, MA 02118, USA.
| | - Kevin James Lane
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02115, USA.
| | - Maayan Yitshak Sade
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
| | - Jaime E Hart
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
| | - Joel Schwartz
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel.
| | - Francine Laden
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
| | - Jonathan I Levy
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02115, USA.
| | - Antonella Zanobetti
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
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14
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Li Q, Wang YY, Guo Y, Zhou H, Wang X, Wang Q, Shen H, Zhang Y, Yan D, Zhang Y, Zhang H, Li S, Chen G, Lin L, Zhao J, He Y, Yang Y, Xu J, Wang Y, Peng Z, Wang HJ, Ma X. Effect of airborne particulate matter of 2.5 μm or less on preterm birth: A national birth cohort study in China. ENVIRONMENT INTERNATIONAL 2018; 121:1128-1136. [PMID: 30352698 DOI: 10.1016/j.envint.2018.10.025] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 10/11/2018] [Accepted: 10/14/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Most evidences regarding ambient PM2.5 or PM10 (particulate matter of median aerodynamic diameter ≤2.5 μm or ≤10 μm) and preterm birth (PTB) come from western countries which has relatively low PM pollution exposure, and the results are still inconsistent. This study aims to examine whether exposure to high concentrations of PM2.5 or PM10 was associated with PTB (<37 weeks) and near term birth (37-38 weeks). METHOD We established a birth cohort with 1,280,524 singleton pregnancies who delivered from Dec 1st, 2013 to Nov 30th, 2014 and matched their home address to PM2.5 and PM10 concentrations which were predicted with machine learning methods based satellite remote sensing, meteorological and land use information. Cox proportional hazard regression models were used to analyze the associations between PTB and exposure of PM2.5 or PM10, after controlling for individual level covariates. RESULTS Exposure to PM2.5 or PM10 during pregnancy increases the risk of PTB and near term birth [e.g., Hazard ratios: 1.09 (95% CI: 1.09, 1.10), 1.08 (95% CI: 1.07, 1.08), 1.01 (95% CI: 1.01, 1.02), and 1.09 (95% CI: 1.08, 1.10) for each 10 μg/m3 increase in PM2.5 for the 1st, 2nd, 3rd trimester and over the entire pregnancy, respectively]. The effects appeared to be stronger among women who come from rural areas, worked as farmers, were overweight before conception, whose mate was smoking during pregnancy, and conceived in autumn. CONCLUSION This study provides clear evidence that exposure to PM2.5 or PM10 during pregnancy increases the risk of PTB and near term birth. Public policies regarding improvement of air quality would produce great health benefit by reducing the burden of preterm birth.
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Affiliation(s)
- Qin Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China; National Center for Human Genetic Resources, Beijing, China
| | - Yuan-Yuan Wang
- National Center for Human Genetic Resources, Beijing, China; National Research Institute for Family Planning, Beijing, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Hong Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China; National Research Institute for Family Planning, Beijing, China
| | - Xiaobin Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA; Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, USA
| | - Qiaomei Wang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Ya Zhang
- National Research Institute for Family Planning, Beijing, China
| | - Hongguang Zhang
- National Research Institute for Family Planning, Beijing, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Gongbo Chen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lizi Lin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China; National Center for Human Genetic Resources, Beijing, China
| | - Jun Zhao
- National Research Institute for Family Planning, Beijing, China
| | - Yuan He
- National Research Institute for Family Planning, Beijing, China
| | - Ying Yang
- National Research Institute for Family Planning, Beijing, China
| | - Jihong Xu
- National Research Institute for Family Planning, Beijing, China
| | - Yan Wang
- National Research Institute for Family Planning, Beijing, China
| | - Zuoqi Peng
- National Research Institute for Family Planning, Beijing, China
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China; National Center for Human Genetic Resources, Beijing, China.
| | - Xu Ma
- National Center for Human Genetic Resources, Beijing, China; National Research Institute for Family Planning, Beijing, China.
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15
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Using a Clustering Approach to Investigate Socio-Environmental Inequality in Preterm Birth-A Study Conducted at Fine Spatial Scale in Paris (France). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091895. [PMID: 30200368 PMCID: PMC6163167 DOI: 10.3390/ijerph15091895] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/23/2018] [Accepted: 08/29/2018] [Indexed: 12/13/2022]
Abstract
Background & Objectives: Today, to support public policies aiming to tackle environmental and health inequality, identification and monitoring of the spatial pattern of adverse birth outcomes are crucial. Spatial identification of the more vulnerable population to air pollution may orient health interventions. In this context, the objective of this study is to investigate the geographical distribution of the risk of preterm birth (PTB, gestational age ≤36 weeks) at the census block level in in city of Paris, France. We also aimed to assess the implication of neighborhood characteristics including air pollution and socio-economic deprivation. Material & Methods: Newborn health data are available from the first birth certificate registered by the Maternal and Child Care department of Paris. All PTB from January 2008 to December 2011 were geocoded at the mother residential census block. Each census block was assigned a socioeconomic deprivation level and annual average ambient concentrations of NO2. A spatial clustering approach was used to investigate the spatial distribution of PTB. Results: Our results highlight that PTB is non-randomly spatially distributed, with a cluster of high risk in the northeastern area of Paris (RR = 1.15; p = 0.06). After adjustment for socio-economic deprivation and NO2 concentrations, this cluster becomes not statistically significant or shifts suggesting that these characteristics explain the spatial distribution of PTB; further, their combination shows an interaction in comparison with SES or NO2 levels alone. Conclusions: Our results may inform the decision makers about the areas where public health efforts should be strengthened to tackle the risk of PTB and to choose the most appropriate and specific community-oriented health interventions.
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16
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Casey JA, Karasek D, Ogburn EL, Goin DE, Dang K, Braveman PA, Morello-Frosch R. Retirements of Coal and Oil Power Plants in California: Association With Reduced Preterm Birth Among Populations Nearby. Am J Epidemiol 2018; 187:1586-1594. [PMID: 29796613 PMCID: PMC6070091 DOI: 10.1093/aje/kwy110] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/20/2018] [Accepted: 03/22/2018] [Indexed: 12/21/2022] Open
Abstract
Coal and oil power plant retirements reduce air pollution nearby, but few studies have leveraged these natural experiments for public health research. We used California Department of Public Health birth records and US Energy Information Administration data from 2001-2011 to evaluate the relationship between the retirements of 8 coal and oil power plants and nearby preterm (gestational age of <37 weeks) birth. We conducted a difference-in-differences analysis using adjusted linear mixed models that included 57,005 births-6.3% of which were preterm-to compare the probability of preterm birth before and after power plant retirement among mothers residing within 0-5 km and 5-10 km of the 8 power plants. We found that power plant retirements were associated with a decrease in the proportion of preterm birth within 5 km (-0.019, 95% CI: -0.031, -0.008) and 5-10 km (-0.015, 95% CI: -0.024, -0.007), controlling for secular trends with mothers living 10-20 km away. For the 0-5-km area, this corresponds to a reduction in preterm birth from 7.0% to 5.1%. Subgroup analyses indicated a potentially larger association among non-Hispanic black and Asian mothers than among non-Hispanic white and Hispanic mothers and no differences in educational attainment. Future coal and oil power plant retirements may reduce preterm birth among nearby populations.
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Affiliation(s)
- Joan A Casey
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Deborah Karasek
- Preterm Birth Initiative, University of California, San Francisco, San Francisco, California
| | - Elizabeth L Ogburn
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Dana E Goin
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Kristina Dang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Paula A Braveman
- Center on Social Disparities in Health, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California
| | - Rachel Morello-Frosch
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, Berkeley, California
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17
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Wang YY, Li Q, Guo Y, Zhou H, Wang X, Wang Q, Shen H, Zhang Y, Yan D, Zhang Y, Zhang H, Li S, Chen G, Zhao J, He Y, Yang Y, Xu J, Wang Y, Peng Z, Wang HJ, Ma X. Association of Long-term Exposure to Airborne Particulate Matter of 1 μm or Less With Preterm Birth in China. JAMA Pediatr 2018; 172:e174872. [PMID: 29297052 PMCID: PMC5885853 DOI: 10.1001/jamapediatrics.2017.4872] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Airborne particulate matter pollution has been associated with preterm birth (PTB) in some studies. However, most of these studies assessed only populations living near monitoring stations, and the association of airborne particulate matter having a median diameter of 1 μm or less (PM1) with PTB has not been studied. OBJECTIVE To evaluate whether PM1 concentrations are associated with the risk of PTB. DESIGN, SETTING, AND PARTICIPANTS This national cohort study used National Free Preconception Health Examination Project data collected in 324 of 344 prefecture-level cities from 30 provinces of mainland China. In total, 1 300 342 healthy singleton pregnancies were included from women who were in labor from December 1, 2013, through November 30, 2014. Data analysis was conducted between December 1, 2016, and April 1, 2017. EXPOSURES Predicted weekly PM1 concentration data collected using satellite remote sensing, meteorologic, and land use information matched with the home addresses of pregnant women. MAIN OUTCOMES AND MEASURES Preterm birth (<37 gestational weeks). Gestational age was assessed using the time since the first day of the last menstrual period. Cox proportional hazards regression analysis was used to examine the associations between trimester-specific PM1 concentrations and PTB after controlling for temperature, seasonality, spatial variation, and individual covariates. RESULTS Of the 1 300 342 singleton live births at the gestational age of 20 to 45 weeks included in this study, 104 585 (8.0%) were preterm. In fully adjusted models, a PM1 concentration increase of 10 μg/m3 over the entire pregnancy was significantly associated with increased risk of PTB (hazard ratio [HR], 1.09; 95% CI, 1.09-1.10), very PTB as defined as gestational age from 28 through 31 weeks (HR, 1.20; 95% CI, 1.18-1.23), and extremely PTB as defined as 20 through 27 weeks' gestation (HR, 1.29; 95% CI, 1.25-1.34). Pregnant women who were older (30-50 years) at conception (HR, 1.13; 95% CI, 1.11-1.14), were overweight before pregnancy (HR, 1.13; 95% CI, 1.11-1.15), had a rural household registration (HR, 1.09; 95% CI, 1.09-1.10), worked as farmers (HR, 1.10; 95% CI, 1.09-1.11), and conceived in autumn (HR, 1.48; 95% CI, 1.46-1.50) appeared to be more sensitive to PM1 exposure than their counterparts. CONCLUSIONS AND RELEVANCE Results from this national cohort study examining more than 1.3 million births indicated that exposure to PM1 air pollution was associated with an increased risk of PTB in China. These findings will provide evidence to inform future research studies, public health interventions, and environmental policies.
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Affiliation(s)
- Yuan-yuan Wang
- Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, China,National Research Institute for Family Planning, Beijing, China
| | - Qin Li
- Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, China,Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Yuming Guo
- Institute for Environment and Climate Research, Jinan University, Guangzhou, China,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Hong Zhou
- Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, China,Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Xiaobin Wang
- Center on the Early Life Origins of Disease, Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland,Department of Pediatrics, School of Medicine, The Johns Hopkins University, Baltimore, Maryland
| | - Qiaomei Wang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the People’s Republic of China, Beijing
| | - Haiping Shen
- Department of Maternal and Child Health, National Health and Family Planning Commission of the People’s Republic of China, Beijing
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the People’s Republic of China, Beijing
| | - Donghai Yan
- Department of Maternal and Child Health, National Health and Family Planning Commission of the People’s Republic of China, Beijing
| | - Ya Zhang
- National Research Institute for Family Planning, Beijing, China
| | - Hongguang Zhang
- National Research Institute for Family Planning, Beijing, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Gongbo Chen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jun Zhao
- National Research Institute for Family Planning, Beijing, China
| | - Yuan He
- National Research Institute for Family Planning, Beijing, China
| | - Ying Yang
- National Research Institute for Family Planning, Beijing, China
| | - Jihong Xu
- National Research Institute for Family Planning, Beijing, China
| | - Yan Wang
- National Research Institute for Family Planning, Beijing, China
| | - Zuoqi Peng
- National Research Institute for Family Planning, Beijing, China
| | - Hai-Jun Wang
- Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, China,Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Xu Ma
- Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, China,National Research Institute for Family Planning, Beijing, China
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Vesterinen HM, Morello-Frosch R, Sen S, Zeise L, Woodruff TJ. Cumulative effects of prenatal-exposure to exogenous chemicals and psychosocial stress on fetal growth: Systematic-review of the human and animal evidence. PLoS One 2017; 12:e0176331. [PMID: 28700705 PMCID: PMC5507491 DOI: 10.1371/journal.pone.0176331] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/14/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Adverse effects of prenatal stress or environmental chemical exposures on fetal growth are well described, yet their combined effect remains unclear. OBJECTIVES To conduct a systematic review on the combined impact and interaction of prenatal exposure to stress and chemicals on developmental outcomes. METHODS We used the first three steps of the Navigation Guide systematic review. We wrote a protocol, performed a robust literature search to identify relevant animal and human studies and extracted data on developmental outcomes. For the most common outcome (fetal growth), we evaluated risk of bias, calculated effect sizes for main effects of individual and combined exposures, and performed a random effects meta-analysis of those studies reporting on odds of low birthweight (LBW) by smoking and socioeconomic status (SES). RESULTS We identified 17 human- and 22 animal-studies of combined chemical and stress exposures and fetal growth. Human studies tended to have a lower risk of bias across nine domains. Generally, we found stronger effects for chemicals than stress, and these exposures were associated with reduced fetal growth in the low-stress group and the association was often greater in high stress groups, with limited evidence of effect modification. We found smoking associated with significantly increased odds of LBW, with a greater effect for high stress (low SES; OR 4.75 (2.46-9.16)) compared to low stress (high SES; OR 1.95 (95% CI 1.53-2.48)). Animal studies generally had a high risk of bias with no significant combined effect or effect modification. CONCLUSIONS We found that despite concern for the combined effects of environmental chemicals and stress, this is still an under-studied topic, though limited available human studies indicate chemical exposures exert stronger effects than stress, and this effect is generally larger in the presence of stress.
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Affiliation(s)
- Hanna M. Vesterinen
- Program on Reproductive Health and the Environment, University of California, San Francisco, United States of America
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, United States of America
| | - Saunak Sen
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, United States of America
| | - Lauren Zeise
- California Environmental Protection Agency Office of Environmental Health Hazard Assessment, Oakland, United States of America
| | - Tracey J. Woodruff
- Program on Reproductive Health and the Environment, University of California, San Francisco, United States of America
- * E-mail:
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Malley CS, Kuylenstierna JCI, Vallack HW, Henze DK, Blencowe H, Ashmore MR. Preterm birth associated with maternal fine particulate matter exposure: A global, regional and national assessment. ENVIRONMENT INTERNATIONAL 2017; 101:173-182. [PMID: 28196630 DOI: 10.1016/j.envint.2017.01.023] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 05/22/2023]
Abstract
Reduction of preterm births (<37 completed weeks of gestation) would substantially reduce neonatal and infant mortality, and deleterious health effects in survivors. Maternal fine particulate matter (PM2.5) exposure has been identified as a possible risk factor contributing to preterm birth. The aim of this study was to produce the first estimates of ambient PM2.5-associated preterm births for 183 individual countries and globally. To do this, national, population-weighted, annual average ambient PM2.5 concentration, preterm birth rate and number of livebirths were combined to calculate the number of PM2.5-associated preterm births in 2010 for 183 countries. Uncertainty was quantified using Monte-Carlo simulations, and analyses were undertaken to investigate the sensitivity of PM2.5-associated preterm birth estimates to assumptions about the shape of the concentration-response function at low and high PM2.5 exposures, inclusion of provider-initiated preterm births, and exposure to indoor air pollution. Globally, in 2010, the number of PM2.5-associated preterm births was estimated as 2.7 million (1.8-3.5 million, 18% (12-24%) of total preterm births globally) with a low concentration cut-off (LCC) set at 10μgm-3, and 3.4 million (2.4-4.2 million, 23% (16-28%)) with a LCC of 4.3μgm-3. South and East Asia, North Africa/Middle East and West sub-Saharan Africa had the largest contribution to the global total, and the largest percentage of preterm births associated with PM2.5. Sensitivity analyses showed that PM2.5-associated preterm birth estimates were 24% lower when provider-initiated preterm births were excluded, 38-51% lower when risk was confined to the PM2.5 exposure range in the studies used to derive the effect estimate, and 56% lower when mothers who live in households that cook with solid fuels (and whose personal PM2.5 exposure is likely dominated by indoor air pollution) were excluded. The concentration-response function applied here derives from a meta-analysis of studies, most of which were conducted in the US and Europe, and its application to the areas of the world where we estimate the greatest effects on preterm births remains uncertain. Nevertheless, the substantial percentage of preterm births estimated to be associated with anthropogenic PM2.5 (18% (13%-24%) of total preterm births globally) indicates that reduction of maternal PM2.5 exposure through emission reduction strategies should be considered alongside mitigation of other risk factors associated with preterm births.
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Affiliation(s)
- Christopher S Malley
- Stockholm Environment Institute, Environment Department, University of York, York, United Kingdom.
| | - Johan C I Kuylenstierna
- Stockholm Environment Institute, Environment Department, University of York, York, United Kingdom
| | - Harry W Vallack
- Stockholm Environment Institute, Environment Department, University of York, York, United Kingdom
| | - Daven K Henze
- Department of Mechanical Engineering, University of Colorado, Boulder, CO, United States
| | - Hannah Blencowe
- Maternal, Adolescent, Reproductive, and Child Health Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mike R Ashmore
- Stockholm Environment Institute, Environment Department, University of York, York, United Kingdom
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Association between Exposure to Endocrine Disruptors in Drinking Water and Preterm Birth, Taking Neighborhood Deprivation into Account: A Historic Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080796. [PMID: 27517943 PMCID: PMC4997482 DOI: 10.3390/ijerph13080796] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/01/2016] [Accepted: 08/03/2016] [Indexed: 12/24/2022]
Abstract
Background: The relationship between preterm birth (PTB) and endocrine disruptor exposure in drinking-water has only occasionally been studied. The objective of this work was to investigate the relation between exposure to atrazine metabolites, or atrazine/nitrate mixtures, in drinking-water during pregnancy and prevalence of PTB neonates, while taking neighborhood deprivation into account. Method: A historic cohort study in Deux-Sèvres, France, between 2005 and 2010 with a multiple imputation model for data of exposure to atrazine metabolites and a logistic regression were carried out. Results: We included 13,654 mother/neonate pairs living in 279 different census districts. The prevalence of PTB was 4%. Average atrazine metabolite concentration was 0.019 ± 0.009 (0.014–0.080) µg/L and 39% of mothers lived in less deprived areas. The individual data were associated with risk of PTB. The risk of PTB when exposed to highest concentration of atrazine metabolite adjusted for confounders, was ORa 1.625 95% CI [0.975; 2.710]. Taking, or not, neighborhood deprivation into account did not change the result. Exposure to atrazine/nitrate mixtures remained non-significant. Conclusions: Even if we took neighborhood deprivation into account, we could not show a significant relationship between exposure to atrazine metabolites, or mixtures, in drinking-water during the second trimester of pregnancy and PTB.
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Stieb DM, Chen L, Hystad P, Beckerman BS, Jerrett M, Tjepkema M, Crouse DL, Omariba DW, Peters PA, van Donkelaar A, Martin RV, Burnett RT, Liu S, Smith-Doiron M, Dugandzic RM. A national study of the association between traffic-related air pollution and adverse pregnancy outcomes in Canada, 1999-2008. ENVIRONMENTAL RESEARCH 2016; 148:513-526. [PMID: 27155984 DOI: 10.1016/j.envres.2016.04.025] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/24/2016] [Accepted: 04/20/2016] [Indexed: 05/06/2023]
Abstract
Numerous studies have examined the association of air pollution with preterm birth and birth weight outcomes. Traffic-related air pollution has also increasingly been identified as an important contributor to adverse health effects of air pollution. We employed a national nitrogen dioxide (NO2) exposure model to examine the association between NO2 and pregnancy outcomes in Canada between 1999 and 2008. National models for NO2 (and particulate matter of median aerodynamic diameter <2.5µm (PM2.5) as a covariate) were developed using ground-based monitoring data, estimates from remote-sensing, land use variables and, for NO2, deterministic gradients relative to road traffic sources. Generalized estimating equations were used to examine associations with preterm birth, term low birth weight (LBW), small for gestational age (SGA) and term birth weight, adjusting for covariates including infant sex, gestational age, maternal age and marital status, parity, urban/rural place of residence, maternal place of birth, season, year of birth and neighbourhood socioeconomic status and per cent visible minority. Associations were reduced considerably after adjustment for individual covariates and neighbourhood per cent visible minority, but remained significant for SGA (odds ratio 1.04, 95%CI 1.02-1.06 per 20ppb NO2) and term birth weight (16.2g reduction, 95% CI 13.6-18.8g per 20ppb NO2). Associations with NO2 were of greater magnitude in a sensitivity analysis using monthly monitoring data, and among births to mothers born in Canada, and in neighbourhoods with higher incomes and a lower proportion of visible minorities. In two pollutant models, associations with NO2 were less sensitive to adjustment for PM2.5 than vice versa, and there was consistent evidence of a dose-response relationship for NO2 but not PM2.5. In this study of approximately 2.5 million Canadian births between 1999 and 2008, we found significant associations of NO2 with SGA and term birth weight which remained significant after adjustment for PM2.5, suggesting that traffic may be a particularly important source with respect to the role of air pollution as a risk factor for adverse pregnancy outcomes.
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Affiliation(s)
- David M Stieb
- Population Studies Division, Health Canada, 420-757 West Hastings St. - Federal Tower, Vancouver, British Columbia, Canada V6C 1A1.
| | - Li Chen
- Population Studies Division, Health Canada, AL 1907A, Tunney's Pasture, Ottawa, Ontario, Canada K1A 0K9.
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Milam Hall 20C, Corvallis, OR 97331, USA.
| | - Bernardo S Beckerman
- Geographic Information Health and Exposure Science Laboratory (GIS HEAL), School of Public Health, University of California, Berkeley, Berkeley, CA 94720-7360, USA.
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Charles E. Young Drive South, 56-070B CHS, Los Angeles, CA 90095, USA.
| | - Michael Tjepkema
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, Canada K1A OT6.
| | - Daniel L Crouse
- Department of Sociology, University of New Brunswick, Tilley Hall, Room 20, 9 Macaulay Lane, P.O. Box 4400, Fredericton, New Brunswick, Canada E3B 5A3.
| | - D Walter Omariba
- Special Surveys Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, Canada K1A OT6.
| | - Paul A Peters
- Department of Sociology, University of New Brunswick, Tilley Hall, Room 20, 9 Macaulay Lane, P.O. Box 4400, Fredericton, New Brunswick, Canada E3B 5A3.
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, 6310 Coburg Road PO Box 15000, Halifax, NS, Canada B3H 4R2.
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, 6310 Coburg Road PO Box 15000, Halifax, NS, Canada B3H 4R2; Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA.
| | - Richard T Burnett
- Population Studies Division, Health Canada, AL 1907A, Tunney's Pasture, Ottawa, Ontario, Canada K1A 0K9.
| | - Shiliang Liu
- Maternal, Child and Youth Health, Surveillance and Epidemiology Division, Public Health Agency of Canada, 4th floor, 785 Carling Ave. AL 6804A, Ottawa, Ontario, Canada K1A 0K9.
| | - Marc Smith-Doiron
- Population Studies Division, Health Canada, AL 1907A, Tunney's Pasture, Ottawa, Ontario, Canada K1A 0K9.
| | - Rose M Dugandzic
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada.
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Stieb DM, Chen L, Beckerman BS, Jerrett M, Crouse DL, Omariba DWR, Peters PA, van Donkelaar A, Martin RV, Burnett RT, Gilbert NL, Tjepkema M, Liu S, Dugandzic RM. Associations of Pregnancy Outcomes and PM2.5 in a National Canadian Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:243-9. [PMID: 26090691 PMCID: PMC4749076 DOI: 10.1289/ehp.1408995] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 06/17/2015] [Indexed: 05/03/2023]
Abstract
BACKGROUND Numerous studies have examined associations between air pollution and pregnancy outcomes, but most have been restricted to urban populations living near monitors. OBJECTIVES We examined the association between pregnancy outcomes and fine particulate matter in a large national study including urban and rural areas. METHODS Analyses were based on approximately 3 million singleton live births in Canada between 1999 and 2008. Exposures to PM2.5 (particles of median aerodynamic diameter ≤ 2.5 μm) were assigned by mapping the mother's postal code to a monthly surface based on a national land use regression model that incorporated observations from fixed-site monitoring stations and satellite-derived estimates of PM2.5. Generalized estimating equations were used to examine the association between PM2.5 and preterm birth (gestational age < 37 weeks), term low birth weight (< 2,500 g), small for gestational age (SGA; < 10th percentile of birth weight for gestational age), and term birth weight, adjusting for individual covariates and neighborhood socioeconomic status (SES). RESULTS In fully adjusted models, a 10-μg/m(3) increase in PM2.5 over the entire pregnancy was associated with SGA (odds ratio = 1.04; 95% CI 1.01, 1.07) and reduced term birth weight (-20.5 g; 95% CI -24.7, -16.4). Associations varied across subgroups based on maternal place of birth and period (1999-2003 vs. 2004-2008). CONCLUSIONS This study, based on approximately 3 million births across Canada and employing PM2.5 estimates from a national spatiotemporal model, provides further evidence linking PM2.5 and pregnancy outcomes.
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Affiliation(s)
- David M. Stieb
- Population Studies Division, Health Canada, Vancouver, British Columbia, Canada
- Address correspondence to D.M. Stieb, Population Studies Division, Health Canada, 445-757 West Hastings St.–Federal Tower, Vancouver, British Columbia, Canada, V6C 1A1. Telephone: (604) 666-3701. E-mail:
| | - Li Chen
- Population Studies Division, Health Canada, Ottawa, Ontario, Canada
| | - Bernardo S. Beckerman
- Geographic Information Health and Exposure Science Laboratory (GIS HEAL), School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Daniel L. Crouse
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | | | - Paul A. Peters
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Randall V. Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
- Harvard-Smithsonian Center for Astrophysics, Cambridge, Massachusetts, USA
| | | | - Nicolas L. Gilbert
- Vaccine and Immunization Program Surveillance Division, Public Health Agency of Canada, Ottawa, Canada
| | - Michael Tjepkema
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada
| | - Shiliang Liu
- Maternal, Child and Youth Health, Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
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Tenailleau QM, Mauny F, Joly D, François S, Bernard N. Air pollution in moderately polluted urban areas: How does the definition of "neighborhood" impact exposure assessment? ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2015; 206:437-448. [PMID: 26275728 DOI: 10.1016/j.envpol.2015.07.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 07/16/2015] [Indexed: 06/04/2023]
Abstract
Environmental health studies commonly quantify subjects' pollution exposure in their neighborhood. How this neighborhood is defined can vary, however, leading to different approaches to quantification whose impacts on exposure levels remain unclear. We explore the relationship between neighborhood definition and exposure assessment. NO2, benzene, PM10 and PM2.5 exposure estimates were computed in the vicinity of 10,825 buildings using twelve exposure assessment techniques reflecting different definitions of "neighborhood". At the city scale, its definition does not significantly influence exposure estimates. It does impact levels at the building scale, however: at least a quarter of the buildings' exposure estimates for a 400 m buffer differ from the estimated 50 m buffer value (±1.0 μg/m(3) for NO2, PM10 and PM2.5; and ±0.05 μg/m(3) for benzene). This variation is significantly related to the definition of neighborhood. It is vitally important for investigators to understand the impact of chosen assessment techniques on exposure estimates.
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Affiliation(s)
- Quentin M Tenailleau
- Laboratoire Chrono-environnement, UMR6249, Centre National de la Recherche Scientifique, Université de Bourgogne/Franche-Comté, France.
| | - Frédéric Mauny
- Laboratoire Chrono-environnement, UMR6249, Centre National de la Recherche Scientifique, Université de Bourgogne/Franche-Comté, France; Centre Hospitalier Régional Universitaire de Besançon, France
| | - Daniel Joly
- Laboratoire ThéMA, UMR6049, Centre National de la Recherche Scientifique, Université de Bourgogne/Franche-Comté, France
| | | | - Nadine Bernard
- Laboratoire Chrono-environnement, UMR6249, Centre National de la Recherche Scientifique, Université de Bourgogne/Franche-Comté, France; Laboratoire ThéMA, UMR6049, Centre National de la Recherche Scientifique, Université de Bourgogne/Franche-Comté, France
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Padula AM, Mortimer KM, Tager IB, Hammond SK, Lurmann FW, Yang W, Stevenson DK, Shaw GM. Traffic-related air pollution and risk of preterm birth in the San Joaquin Valley of California. Ann Epidemiol 2015; 24:888-95e4. [PMID: 25453347 DOI: 10.1016/j.annepidem.2014.10.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 09/22/2014] [Accepted: 10/10/2014] [Indexed: 01/27/2023]
Abstract
PURPOSE To evaluate associations between traffic-related air pollution during pregnancy and preterm birth in births in four counties in California during years 2000 to 2006. METHODS We used logistic regression to examine the association between the highest quartile of ambient air pollutants (carbon monoxide, nitrogen dioxide, particulate matter <10 and 2.5 μm) and traffic density during pregnancy and each of five levels of prematurity based on gestational age at birth (20-23, 24-27, 28-31, 32-33, and 34-36 weeks) versus term (37-42 weeks). We examined trimester averages and the last month and the last 6 weeks of pregnancy. Models were adjusted for birthweight, maternal age, race/ethnicity, education, prenatal care, and birth costs payment. Neighborhood socioeconomic status (SES) was evaluated as a potential effect modifier. RESULTS There were increased odds ratios (ORs) for early preterm birth for those exposed to the highest quartile of each pollutant during the second trimester and the end of pregnancy (adjusted OR, 1.4-2.8). Associations were stronger among mothers living in low SES neighborhoods (adjusted OR, 2.1-4.3). We observed exposure-response associations for multiple pollutant exposures and early preterm birth. Inverse associations during the first trimester were observed. CONCLUSIONS The results confirm associations between traffic-related air pollution and prematurity, particularly among very early preterm births and low SES neighborhoods.
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Paydar-Darian N, Pursley DM, Haviland MJ, Mao W, Golen T, Burris HH. Improvement in Perinatal HIV Status Documentation in a Massachusetts Birth Hospital, 2009-2013. Pediatrics 2015; 136:e234-41. [PMID: 26055851 DOI: 10.1542/peds.2014-3849] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Despite recommendations for universal HIV testing during routine prenatal care, maternal HIV status is not always available at the time of delivery, which may lead to missed opportunities for antiretroviral prophylaxis. We completed a quality improvement project focused on increasing the availability of maternal HIV status documentation at our perinatal facility. Our primary aim was to improve documentation rates from 50% to 100% between 2009 and 2013. Our secondary aim was to identify predictors of documentation. METHODS After an initial needs assessment, we performed a multidisciplinary quality improvement effort to address lack of HIV documentation in perinatal charts. The interventions included a switch to a verbal-only consent process, a rapid HIV testing protocol, and a simplified newborn admission document. To assess the impact of our intervention, we audited 100 charts per month and formally analyzed a second random sample of 200 charts in the postimplementation phase. RESULTS Rates of HIV status documentation improved between 2009 and 2013, from 55.5% to 96.5%. Multivariable models revealed that before our interventions, mothers receiving care at freestanding offices (versus community-based outreach clinics) and those privately insured (versus publicly) were less likely to have HIV status documented. In 2013, neither ambulatory site nor insurance type predicted documentation. CONCLUSIONS We demonstrated improvement in maternal HIV status documentation on admission to labor and delivery after implementation of a 3-pronged intervention. Next steps include investigating persistent barriers to achieving universal screening and documentation.
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Affiliation(s)
- Niloufar Paydar-Darian
- Department of Medicine, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; and
| | - DeWayne M Pursley
- Harvard Medical School, Boston, Massachusetts; and Departments of Neonatology and
| | - Miriam J Haviland
- Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | | | - Toni Golen
- Harvard Medical School, Boston, Massachusetts; and Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Heather H Burris
- Harvard Medical School, Boston, Massachusetts; and Departments of Neonatology and
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Snelgrove JW, Murphy KE. Preterm birth and social inequality: assessing the effects of material and psychosocial disadvantage in a UK birth cohort. Acta Obstet Gynecol Scand 2015; 94:766-775. [PMID: 25846179 DOI: 10.1111/aogs.12648] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 03/30/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the association between social inequalities and preterm birth, testing both psychosocial and material determinants. DESIGN Retrospective cohort study with linked hospital data. SETTING AND POPULATION 17 285 women in England, Scotland, Northern Ireland and Wales giving birth to singletons included in wave 1 of the UK Millennium Cohort Study. METHODS Social inequalities were measured with material (household income, housing tenure) and psychosocial (education, occupational class, employment, social support) indicators. Analysis using multivariable logistic regression assessed odds of preterm birth, adjusting for demographics, health and health-related behaviors, pregnancy and delivery conditions, and pregnancy complications. MAIN OUTCOME MEASURE Preterm birth between 24 and 36 weeks, 6 days' gestation. RESULTS Initial bivariable analysis suggested associations between preterm birth and household income, housing tenure, and education. These effects were largely explained by adjustment for other social determinants in multivariable models. Following full adjustment, effects of unemployment [OR = 1.52, 95% confidence interval (CI) 1.21-1.90, p < 0.001] and one indicator of poor social support (OR = 1.17, 95% CI 1.01-1.35, p = 0.04) remained significant. CONCLUSION Unemployment and lack of social support are associated with higher risk of preterm birth, supporting the hypothesis that poor psychosocial circumstances elevate a woman's risk of this adverse perinatal outcome. Further research is needed to examine the causal pathways through which social inequalities affect preterm birth.
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Affiliation(s)
- John W Snelgrove
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kellie E Murphy
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mt. Sinai Hospital, Toronto, Ontario, Canada
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Padula AM, Noth EM, Hammond SK, Lurmann FW, Yang W, Tager IB, Shaw GM. Exposure to airborne polycyclic aromatic hydrocarbons during pregnancy and risk of preterm birth. ENVIRONMENTAL RESEARCH 2014; 135:221-6. [PMID: 25282280 PMCID: PMC4262545 DOI: 10.1016/j.envres.2014.09.014] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 09/19/2014] [Accepted: 09/20/2014] [Indexed: 05/22/2023]
Abstract
BACKGROUND Preterm birth is an important marker of health and has a prevalence of 12-13% in the U.S. Polycyclic aromatic hydrocarbons (PAHs) are a group of organic contaminants that form during the incomplete combustion of hydrocarbons, such as coal, diesel and gasoline. Studies suggest that exposure to PAHs during pregnancy is related to adverse birth outcomes. The aim of this study is to evaluate the association between exposure to PAHs during the pregnancy and preterm birth. METHODS The study population included births from years 2001 to 2006 of women whose maternal residence was within 20km of the primary monitoring site in Fresno, California. Data in the Fresno area were used to form a spatio-temporal model to assign daily exposure to PAHs with 4, 5, or 6 rings at the maternal residence throughout pregnancy of all of the births in the study area. Gestational age at birth and relevant covariates were extracted from the birth certificate. RESULTS We found an association between PAHs during the last 6 weeks of pregnancy and birth at 20-27 weeks (OR=2.74; 95% CI: 2.24-3.34) comparing the highest quartile to the lower three. The association was consistent when each quartile was compared to the lowest (OR2nd=1.49, 95% CI: 1.08-2.06; OR3rd=2.63, 95% CI:1.93-3.59; OR4th=3.94, 95% CI:3.03-5.12). Inverse associations were also observed for exposure to PAHs during the entire pregnancy and the first trimester and birth at 28-31 weeks and 20-27 weeks. CONCLUSION An association between PAH exposure during the 6 weeks before delivery and early preterm birth was observed. However, the inverse association with early preterm birth offers an unclear, and potentially complex, inference of these associations.
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Affiliation(s)
- Amy M Padula
- Stanford University, School of Medicine, Department of Pediatrics, Stanford, CA, USA
| | - Elizabeth M Noth
- University of California, Berkeley, School of Public Health, Division of Environmental Health Sciences, Berkeley, CA, USA
| | - S Katharine Hammond
- University of California, Berkeley, School of Public Health, Division of Environmental Health Sciences, Berkeley, CA, USA
| | | | - Wei Yang
- Stanford University, School of Medicine, Department of Pediatrics, Stanford, CA, USA
| | - Ira B Tager
- University of California, Berkeley, School of Public Health, Division of Environmental Health Sciences, Berkeley, CA, USA
| | - Gary M Shaw
- Stanford University, School of Medicine, Department of Pediatrics, Stanford, CA, USA
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Limousi F, Albouy-Llaty M, Carles C, Dupuis A, Rabouan S, Migeot V. Does area deprivation modify the association between exposure to a nitrate and low-dose atrazine metabolite mixture in drinking water and small for gestational age? A historic cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2014; 21:4964-4973. [PMID: 23771441 DOI: 10.1007/s11356-013-1893-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 05/30/2013] [Indexed: 06/02/2023]
Abstract
Birth weight may be influenced by environmental and socio-economic factors that could interact. The main objective of our research was to investigate whether area deprivation may modify the association between drinking water exposure to a mixture of atrazine metabolites and nitrates during the second trimester of pregnancy and prevalence of small for gestational age (SGA) neonates. We conducted a historic cohort study in Deux-Sèvres, France between 2005 and 2010, using birth records, population census and regularly performed drinking water withdrawals at community water systems. Exposure to an atrazine metabolite/nitrate mixture in drinking water was divided into six classes according to the presence or absence of atrazine metabolites and to the terciles of nitrate concentrations in each trimester of pregnancy. We used a logistic regression to model the association between SGA and mixture exposure at the second trimester while taking into account the area deprivation measured by the Townsend index as an effect modifier and controlling for the usual confounders. We included 10,784 woman-neonate couples. The risk of SGA when exposed to second tercile of nitrate without atrazine metabolites was significantly greater in women living in less deprived areas (OR = 2.99; 95 % CI (1.14, 7.89)), whereas it was not significant in moderately and more deprived areas. One of the arguments used to explain this result is the presence of competing risk factors in poorer districts.
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Affiliation(s)
- F Limousi
- IC2MP, UMR7285-CNRS, Medicine and Pharmacy Faculty, University of Poitiers, 6 rue de la Miletrie, 86034, Poitiers, Cedex, France,
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Kihal-Talantikite W, Padilla CM, Lalloue B, Rougier C, Defrance J, Zmirou-Navier D, Deguen S. An exploratory spatial analysis to assess the relationship between deprivation, noise and infant mortality: an ecological study. Environ Health 2013; 12:109. [PMID: 24341620 PMCID: PMC3882103 DOI: 10.1186/1476-069x-12-109] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 10/28/2013] [Indexed: 05/12/2023]
Abstract
BACKGROUND Few studies have explored how noise might contribute to social health inequalities, and even fewer have considered infant mortality or its risk factors as the health event of interest.In this paper, we investigate the impact of neighbourhood characteristics - both socio-economic status and ambient noise levels - on the spatial distribution of infant mortality in the Lyon metropolitan area, in France. METHODS All infant deaths (n = 715) occurring between 2000 and 2009 were geocoded at census block level. Each census block was assigned multi-component socio-economic characteristics and Lden levels, which measure exposure to noise. Using a spatial-scan statistic, we examined whether there were significant clusters of high risk of infant mortality according to neighbourhood characteristics. RESULTS Our results highlight the fact that infant mortality is non-randomly distributed spatially, with clusters of high risk in the south-east of the Lyon metropolitan area (RR = 1.44; p = 0.09). After adjustments for socio-economic characteristics and noise levels, this cluster disappears or shifts according to in line with different scenarios, suggesting that noise and socio-economic characteristics can partially explain the spatial distribution of infant mortality. CONCLUSION Our findings show that noise does have an impact on the spatial distribution of mortality after adjustments for socio-economic characteristics. A link between noise and infant mortality seems plausible in view of the three hypothetical, non-exclusive, pathways we propose in our conceptual framework: (i) a psychological pathway, (ii) a physiological disruption process and (iii) an unhealthy behaviours pathway. The lack of studies makes it is difficult to compare our findings with others. They require further research for confirmation and interpretation.
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Affiliation(s)
| | - Cindy M Padilla
- EHESP School of Public Health, Rennes, France
- INSERM U1085-IRSET, Research Institute of Environmental and Occupational Health, Rennes, France
| | - Benoit Lalloue
- EHESP School of Public Health, Rennes, France
- INSERM U1085-IRSET, Research Institute of Environmental and Occupational Health, Rennes, France
- Lorraine University, Nancy, France
| | - Christophe Rougier
- CSTB Scientific and Technical Center for Building, Saint-Martin-d’Hères, France
| | - Jérôme Defrance
- CSTB Scientific and Technical Center for Building, Saint-Martin-d’Hères, France
| | - Denis Zmirou-Navier
- EHESP School of Public Health, Rennes, France
- INSERM U1085-IRSET, Research Institute of Environmental and Occupational Health, Rennes, France
- Lorraine University, Nancy, France
| | - Séverine Deguen
- EHESP School of Public Health, Rennes, France
- INSERM U1085-IRSET, Research Institute of Environmental and Occupational Health, Rennes, France
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Padilla CM, Deguen S, Lalloue B, Blanchard O, Beaugard C, Troude F, Navier DZ, Vieira VM. Cluster analysis of social and environment inequalities of infant mortality. A spatial study in small areas revealed by local disease mapping in France. THE SCIENCE OF THE TOTAL ENVIRONMENT 2013; 454-455:433-41. [PMID: 23563257 PMCID: PMC4097309 DOI: 10.1016/j.scitotenv.2013.03.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 01/07/2013] [Accepted: 03/08/2013] [Indexed: 05/13/2023]
Abstract
Mapping spatial distributions of disease occurrence can serve as a useful tool for identifying exposures of public health concern. Infant mortality is an important indicator of the health status of a population. Recent literature suggests that neighborhood deprivation status can modify the effect of air pollution on preterm delivery, a known risk factor for infant mortality. We investigated the effect of neighborhood social deprivation on the association between exposure to ambient air NO2 and infant mortality in the Lille and Lyon metropolitan areas, north and center of France, respectively, between 2002 and 2009. We conducted an ecological study using a neighborhood deprivation index estimated at the French census block from the 2006 census data. Infant mortality data were collected from local councils and geocoded using the address of residence. We generated maps using generalized additive models, smoothing on longitude and latitude while adjusting for covariates. We used permutation tests to examine the overall importance of location in the model and identify areas of increased and decreased risk. The average death rate was 4.2‰ and 4.6‰ live births for the Lille and Lyon metropolitan areas during the period. We found evidence of statistically significant precise clusters of elevated infant mortality for Lille and an east-west gradient of infant mortality risk for Lyon. Exposure to NO2 did not explain the spatial relationship. The Lille MA, socioeconomic deprivation index explained the spatial variation observed. These techniques provide evidence of clusters of significantly elevated infant mortality risk in relation with the neighborhood socioeconomic status. This method could be used for public policy management to determine priority areas for interventions. Moreover, taking into account the relationship between social and environmental exposure may help identify areas with cumulative inequalities.
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Affiliation(s)
- Cindy M. Padilla
- EHESP School of Public Health –Sorbonne Paris Cité – Rennes, France
- INSERM U1085-IRSET – Research Institute of Environmental and Occupational Health, Rennes, France
- French Environment and Energy Management Agency, Angers, France
| | - Severine Deguen
- EHESP School of Public Health –Sorbonne Paris Cité – Rennes, France
- INSERM U1085-IRSET – Research Institute of Environmental and Occupational Health, Rennes, France
| | - Benoit Lalloue
- EHESP School of Public Health –Sorbonne Paris Cité – Rennes, France
- INSERM U1085-IRSET – Research Institute of Environmental and Occupational Health, Rennes, France
- Lorraine University Medical School–Institut Elie Cartan UMR 7502, Nancy University, CNRS, INRIA, Vandoeuvre-les-Nancy, France
| | - Olivier Blanchard
- EHESP School of Public Health –Sorbonne Paris Cité – Rennes, France
- INSERM U1085-IRSET – Research Institute of Environmental and Occupational Health, Rennes, France
| | - Charles Beaugard
- Official Air Quality Monitoring Associations (AASQA), Atmo Nord Pas-de-Calais, Air Rhône-Alpes, France
| | - Florence Troude
- Official Air Quality Monitoring Associations (AASQA), Atmo Nord Pas-de-Calais, Air Rhône-Alpes, France
| | - Denis Zmirou Navier
- EHESP School of Public Health –Sorbonne Paris Cité – Rennes, France
- INSERM U1085-IRSET – Research Institute of Environmental and Occupational Health, Rennes, France
- Lorraine University Medical School–Institut Elie Cartan UMR 7502, Nancy University, CNRS, INRIA, Vandoeuvre-les-Nancy, France
| | - Verónica M. Vieira
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA
- Program in Public Health, Chao Family Cancer Center, University of Irvine, CA 92697, USA
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Yorifuji T, Naruse H, Kashima S, Takao S, Murakoshi T, Doi H, Kawachi I. Residential proximity to major roads and adverse birth outcomes: a hospital-based study. Environ Health 2013; 12:34. [PMID: 23597260 PMCID: PMC3639132 DOI: 10.1186/1476-069x-12-34] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 04/08/2013] [Indexed: 05/29/2023]
Abstract
BACKGROUND Exposure to air pollution has been demonstrated to increase the risk of preterm birth and low birth weight (LBW). Although evidence has accumulated on characteristics associated with increased risk of air pollution-related health effects, most studies have been conducted in the adult population and evidence on reproductive outcomes is limited. We examined whether socio-economic position (SEP) and parental characteristics (parental behavior and co-morbidity) modified the relationship between air pollution and adverse birth outcomes. METHODS Data were extracted from a perinatal hospital database based in Shizuoka, Japan. We restricted the analysis to mothers who delivered live-born single births from January 1997 to December 2010 (n = 16,615). Each birth was assigned proximity to major roads. Multivariate adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated for the outcomes of preterm birth and term LBW. We stratified subjects by individual/area-level SEP and parental characteristics. We then measured interactions on the additive scale between the respective factors and exposure. RESULTS Lower SEP at both individual and area levels was associated with the increased occurrence of adverse birth outcomes. Living within 200 m from a major road increased the risk of preterm birth by 1.5 times (95% CI: 1.3-1.9) and LBW by 1.2 times (95% CI: 0.9-1.6). Mothers with lower individual SEP defined by household occupation experienced higher ORs for term LBW (OR = 3.1, 95% CI: 1.2-8.2) compared with those with higher individual SEP. In contrast, mothers who lived in the highest area-level SEP region (i.e., affluent areas) showed slightly higher point estimates compared with those who lived in middle or poor areas. In addition, maternal diabetic and hypertensive status modified the association between proximity and preterm birth, while maternal smoking status modified the association between proximity and term LBW. CONCLUSIONS The present study demonstrated that air pollution is an independent risk factor for adverse birth outcomes. Mothers with lower individual SEP and mothers living in higher SEP region may be susceptible to the adverse effect of air pollution. Maternal diabetic, hypertensive, and smoking status may also increase susceptibility to this air pollution-related health effect.
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Affiliation(s)
- Takashi Yorifuji
- Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, 1-1-1 Tsushima-naka, Kita-ku, Okayama 700-8530, Japan
| | - Hiroo Naruse
- Department of Obstetrics, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka 430-8558, Japan
| | - Saori Kashima
- Department of Public Health and Health Policy, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Soshi Takao
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Takeshi Murakoshi
- Department of Obstetrics, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka 430-8558, Japan
| | - Hiroyuki Doi
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Ichiro Kawachi
- Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
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Saravia J, Lee GI, Lomnicki S, Dellinger B, Cormier SA. Particulate matter containing environmentally persistent free radicals and adverse infant respiratory health effects: a review. J Biochem Mol Toxicol 2012; 27:56-68. [PMID: 23281110 DOI: 10.1002/jbt.21465] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Revised: 10/25/2012] [Accepted: 11/03/2012] [Indexed: 12/19/2022]
Abstract
The health impacts of airborne particulate matter (PM) are of global concern, and the direct implications to the development/exacerbation of lung disease are immediately obvious. Most studies to date have sought to understand mechanisms associated with PM exposure in adults/adult animal models; however, infants are also at significant risk for exposure. Infants are affected differently than adults due to drastic immaturities, both physiologically and immunologically, and it is becoming apparent that they represent a critically understudied population. Highlighting our work funded by the ONES award, in this review we argue the understated importance of utilizing infant models to truly understand the etiology of PM-induced predisposition to severe, persistent lung disease. We also touch upon various mechanisms of PM-mediated respiratory damage, with a focus on the emerging importance of environmentally persistent free radicals (EPFRs) ubiquitously present in combustion-derived PM. In conclusion, we briefly comment on strengths/challenges facing current PM research, while giving perspective on how we may address these challenges in the future.
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Affiliation(s)
- Jordy Saravia
- Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
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Padula AM, Mortimer K, Hubbard A, Lurmann F, Jerrett M, Tager IB. Exposure to traffic-related air pollution during pregnancy and term low birth weight: estimation of causal associations in a semiparametric model. Am J Epidemiol 2012; 176:815-24. [PMID: 23045474 DOI: 10.1093/aje/kws148] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Traffic-related air pollution is recognized as an important contributor to health problems. Epidemiologic analyses suggest that prenatal exposure to traffic-related air pollutants may be associated with adverse birth outcomes; however, there is insufficient evidence to conclude that the relation is causal. The Study of Air Pollution, Genetics and Early Life Events comprises all births to women living in 4 counties in California's San Joaquin Valley during the years 2000-2006. The probability of low birth weight among full-term infants in the population was estimated using machine learning and targeted maximum likelihood estimation for each quartile of traffic exposure during pregnancy. If everyone lived near high-volume freeways (approximated as the fourth quartile of traffic density), the estimated probability of term low birth weight would be 2.27% (95% confidence interval: 2.16, 2.38) as compared with 2.02% (95% confidence interval: 1.90, 2.12) if everyone lived near smaller local roads (first quartile of traffic density). Assessment of potentially causal associations, in the absence of arbitrary model assumptions applied to the data, should result in relatively unbiased estimates. The current results support findings from previous studies that prenatal exposure to traffic-related air pollution may adversely affect birth weight among full-term infants.
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Affiliation(s)
- Amy M Padula
- Department of Epidemiology, School of Public Health, University of California, Berkeley, USA.
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Son JY, Lee JT, Kim H, Yi O, Bell ML. Susceptibility to air pollution effects on mortality in Seoul, Korea: a case-crossover analysis of individual-level effect modifiers. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2012; 22:227-34. [PMID: 22395258 PMCID: PMC3543153 DOI: 10.1038/jes.2012.6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Accepted: 09/23/2011] [Indexed: 05/21/2023]
Abstract
Air pollution's mortality effects may differ by subpopulation; however, few studies have investigated this issue in Asia. We investigated susceptibility to air pollutants on total, cardiovascular, and respiratory mortality in Seoul, Korea for the period 2000-2007. We applied time-stratified case-crossover analysis, which allows direct modeling of interaction terms, to estimate susceptibility based on sex, age, education, marital status, and occupation. An interquartile range increase in pollution was associated with odds ratios of 0.94 (95% confidence interval, 0.25-1.62), 2.27 (1.03-3.53), 1.94 (0.80-3.09), and 2.21 (1.00-3.43) for total mortality and 1.95 (0.64-3.27), 4.82 (2.18-7.54), 3.64 (1.46-5.87), and 4.32 (1.77-6.92) for cardiovascular mortality for PM(10), nitrogen dioxide (NO(2)), sulfur dioxide (SO(2)), and carbon monoxide (CO), respectively. Ozone effect estimates were positive, but not statistically significant. Results indicate that some populations are more susceptible than others. For total or cardiovascular mortality, associations were higher for males, those 65-74 years, and those with no education or manual occupation for some pollutants. For example, the odds ratio for SO(2) and cardiovascular mortality was 1.19 (1.03-1.37) times higher for those with manual occupations than professional occupations. Our findings provide evidence that some populations are more susceptible to the effects of air pollution than others, which has implications for public policy and risk assessment for susceptible subpopulations.
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Affiliation(s)
- Ji-Young Son
- School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA
| | - Jong-Tae Lee
- Department of Environmental Health, College of Health Science, Korea University, Seoul, Korea
| | - Ho Kim
- Department of Epidemiology and Biostatistics, School of Public Health, Seoul National University, Seoul, Korea
| | - Okhee Yi
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Korea
| | - Michelle L. Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA
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Schwartz J, Bellinger D, Glass T. Exploring potential sources of differential vulnerability and susceptibility in risk from environmental hazards to expand the scope of risk assessment. Am J Public Health 2011; 101 Suppl 1:S94-101. [PMID: 22021315 DOI: 10.2105/ajph.2011.300272] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Genetic factors, other exposures, individual disease states and allostatic load, psychosocial stress, and socioeconomic position all have the potential to modify the response to environmental exposures. Moreover, many of these modifiers covary with the exposure, leading to much higher risks in some subgroups. These are not theoretical concerns; rather, all these patterns have already been demonstrated in studies of the effects of lead and air pollution. However, recent regulatory impact assessments for these exposures have generally not incorporated these findings. Therefore, differential risk and vulnerability is a critically important but neglected area within risk assessment, and should be incorporated in the future.
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Affiliation(s)
- Joel Schwartz
- Department of Environmental Health and Epidemiology, Harvard School of Public Health, and Harvard Center for Risk Analysis, Harvard University, Boston, MA 02215, USA.
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Wilhelm M, Ghosh JK, Su J, Cockburn M, Jerrett M, Ritz B. Traffic-related air toxics and preterm birth: a population-based case-control study in Los Angeles County, California. Environ Health 2011; 10:89. [PMID: 21981989 PMCID: PMC3204282 DOI: 10.1186/1476-069x-10-89] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 10/07/2011] [Indexed: 05/18/2023]
Abstract
BACKGROUND Numerous studies have associated air pollutant exposures with adverse birth outcomes, but there is still relatively little information to attribute effects to specific emission sources or air toxics. We used three exposure data sources to examine risks of preterm birth in Los Angeles women when exposed to high levels of traffic-related air pollutants--including specific toxics--during pregnancy. METHODS We identified births during 6/1/04-3/31/06 to women residing within five miles of a Southern California Air Quality Management District (SCAQMD) Multiple Air Toxics Exposure Study (MATES III) monitoring station. We identified preterm cases and, using a risk set approach, matched cases to controls based on gestational age at birth. Pregnancy period exposure averages were estimated for a number of air toxics including polycyclic aromatic hydrocarbons (PAHs), source-specific PM2.5 (fine particulates with aerodynamic diameter less than 2.5 μm) based on a Chemical Mass Balance model, criteria air pollutants based on government monitoring data, and land use regression (LUR) estimates of nitric oxide (NO), nitrogen dioxide (NO2) and nitrogen oxides (NOx). Associations between these metrics and odds of preterm birth were estimated using conditional logistic regression. RESULTS Odds of preterm birth increased 6-21% per inter-quartile range increase in entire pregnancy exposures to organic carbon (OC), elemental carbon (EC), benzene, and diesel, biomass burning and ammonium nitrate PM2.5, and 30% per inter-quartile increase in PAHs; these pollutants were positively correlated and clustered together in a factor analysis. Associations with LUR exposure metrics were weaker (3-4% per inter-quartile range increase). CONCLUSIONS These latest analyses provide additional evidence of traffic-related air pollution's impact on preterm birth for women living in Southern California and indicate PAHs as a pollutant of concern that should be a focus of future studies. Other PAH sources besides traffic were also associated with higher odds of preterm birth, as was ammonium nitrate PM2.5, the latter suggesting potential importance of secondary pollutants. Future studies should focus on accurate modeling of both local and regional spatial and temporal distributions, and incorporation of source information.
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Affiliation(s)
- Michelle Wilhelm
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, USA
| | - Jo Kay Ghosh
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, USA
| | - Jason Su
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, USA
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, USA
| | - Michael Jerrett
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, USA
| | - Beate Ritz
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, USA
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Salihu HM, August EM, Mbah AK, Alio AP, de Cuba R, Jaward FM, Berry EL. Effectiveness of a Federal Healthy Start Program in Reducing the Impact of Particulate Air Pollutants on Feto-Infant Morbidity Outcomes. Matern Child Health J 2011; 16:1602-11. [DOI: 10.1007/s10995-011-0854-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Parker JD, Rich DQ, Glinianaia SV, Leem JH, Wartenberg D, Bell ML, Bonzini M, Brauer M, Darrow L, Gehring U, Gouveia N, Grillo P, Ha E, van den Hooven EH, Jalaludin B, Jesdale BM, Lepeule J, Morello-Frosch R, Morgan GG, Slama R, Pierik FH, Pesatori AC, Sathyanarayana S, Seo J, Strickland M, Tamburic L, Woodruff TJ. The International Collaboration on Air Pollution and Pregnancy Outcomes: initial results. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:1023-8. [PMID: 21306972 PMCID: PMC3222970 DOI: 10.1289/ehp.1002725] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 02/09/2011] [Indexed: 05/05/2023]
Abstract
BACKGROUND The findings of prior studies of air pollution effects on adverse birth outcomes are difficult to synthesize because of differences in study design. OBJECTIVES The International Collaboration on Air Pollution and Pregnancy Outcomes was formed to understand how differences in research methods contribute to variations in findings. We initiated a feasibility study to a) assess the ability of geographically diverse research groups to analyze their data sets using a common protocol and b) perform location-specific analyses of air pollution effects on birth weight using a standardized statistical approach. METHODS Fourteen research groups from nine countries participated. We developed a protocol to estimate odds ratios (ORs) for the association between particulate matter ≤ 10 μm in aerodynamic diameter (PM₁₀) and low birth weight (LBW) among term births, adjusted first for socioeconomic status (SES) and second for additional location-specific variables. RESULTS Among locations with data for the PM₁₀ analysis, ORs estimating the relative risk of term LBW associated with a 10-μg/m³ increase in average PM₁₀ concentration during pregnancy, adjusted for SES, ranged from 0.63 [95% confidence interval (CI), 0.30-1.35] for the Netherlands to 1.15 (95% CI, 0.61-2.18) for Vancouver, with six research groups reporting statistically significant adverse associations. We found evidence of statistically significant heterogeneity in estimated effects among locations. CONCLUSIONS Variability in PM₁₀-LBW relationships among study locations remained despite use of a common statistical approach. A more detailed meta-analysis and use of more complex protocols for future analysis may uncover reasons for heterogeneity across locations. However, our findings confirm the potential for a diverse group of researchers to analyze their data in a standardized way to improve understanding of air pollution effects on birth outcomes.
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Affiliation(s)
- Jennifer D Parker
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland 20782, USA.
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Son JY, Bell ML, Lee JT. Survival analysis of long-term exposure to different sizes of airborne particulate matter and risk of infant mortality using a birth cohort in Seoul, Korea. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:725-30. [PMID: 21169127 PMCID: PMC3094428 DOI: 10.1289/ehp.1002364] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 12/17/2010] [Indexed: 05/05/2023]
Abstract
BACKGROUND Several studies suggest that airborne particulate matter (PM) is associated with infant mortality; however, most focused on short-term exposure to larger particles. OBJECTIVES We evaluated associations between long-term exposure to different sizes of particles [total suspended particles (TSP), PM ≤ 10 μm in aerodynamic diameter (PM₁₀), ≤ 10-2.5 μm (PM(10-2.5)), and ≤ 2.5 μm (PM(2.5))] and infant mortality in a cohort in Seoul, Korea, 2004-2007. METHODS The study includes 359,459 births with 225 deaths. We applied extended Cox proportional hazards modeling with time-dependent covariates to three mortality categories: all causes, respiratory, and sudden infant death syndrome (SIDS). We calculated exposures from birth to death (or end of eligibility for outcome at 1 year of age) and pregnancy (gestation and each trimester) and treated exposures as time-dependent variables for subjects' exposure for each pollutant. We adjusted by sex, gestational length, season of birth, maternal age and educational level, and heat index. Each cause of death and exposure time frame was analyzed separately. RESULTS We found a relationship between gestational exposures to PM and infant mortality from all causes or respiratory causes for normal-birth-weight infants. For total mortality (all causes), risks were 1.44 (95% confidence interval, 1.06-1.97), 1.65 (1.18-2.31), 1.53 (1.22-1.90), and 1.19 (0.83-1.70) per interquartile range increase in TSP, PM₁₀, PM(2.5), and PM(10-2.5), respectively; for respiratory mortality, risks were 3.78 (1.18-12.13), 6.20 (1.50-25.66), 3.15 (1.26-7.85), and 2.86 (0.76-10.85). For SIDS, risks were 0.92 (0.33-2.58), 1.15 (0.38-3.48), 1.42 (0.71-2.87), and 0.57 (0.16-1.96), respectively. CONCLUSIONS Our findings provide supportive evidence of an association of long-term exposure to PM air pollution with infant mortality.
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Affiliation(s)
- Ji-Young Son
- School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA
| | - Michelle L. Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA
| | - Jong-Tae Lee
- Department of Environmental Health, College of Health Science, Korea University, Seoul, Korea
- Address correspondence to J.-T. Lee, Department of Environmental Health, College of Health Science, Korea University, San 1 Jeongreung-dong, Seongbuk-gu, Seoul, Korea 136-703. Telephone: 822-940-2867. Fax: 822-2298-0248. E-mail:
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Abstract
PURPOSE OF REVIEW Despite advances in medical care, preterm birth and its associated racial/ethnic disparities remain major public health issues. Environmental exposures may contribute to racial disparities in preterm birth. RECENT FINDINGS Recent work in Iran demonstrated lead levels less than 10 μg/dl to be associated with preterm birth and premature rupture of membranes. Data on air pollution are mixed. A study in California found exposure to nitric oxide species to be associated with preterm birth. However, results from large birth cohorts in the Netherlands found no association. Interestingly, a study in South Korea recently demonstrated that socioeconomic status modifies the association between air pollution and preterm birth. A recent promising study randomized minority pregnant women in Washington, District of Columbia, to cognitive behavioral therapy vs. usual care to decrease exposure to environmental tobacco smoke (ETS). The investigators reported reductions in ETS exposure and the risk of very preterm birth. SUMMARY Clues about potential mechanisms underlying disparities in preterm birth can be gained from exploring differences in environmental exposures. Investigators should include environmental variables when studying birth outcomes. Such efforts should result in targeted interventions to decrease the incidence of preterm birth and its disparities.
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Affiliation(s)
- Heather H Burris
- Department of Neonatology, Division of Newborn Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, and Division of Emergency Medicine, Children's Hospital Boston, Boston, Massachusetts 02215, USA.
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Caserta D, Mantovani A, Marci R, Fazi A, Ciardo F, La Rocca C, Maranghi F, Moscarini M. Environment and women's reproductive health. Hum Reprod Update 2011; 17:418-33. [DOI: 10.1093/humupd/dmq061] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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