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Yount CS, Scheible K, Thurston SW, Qiu X, Ge Y, Hopke PK, Lin Y, Miller RK, Murphy SK, Brunner J, Barrett E, O'Connor TG, Zhang J, Rich DQ. Short term air pollution exposure during pregnancy and associations with maternal immune markers. ENVIRONMENTAL RESEARCH 2024; 260:119639. [PMID: 39034020 DOI: 10.1016/j.envres.2024.119639] [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: 04/02/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Air pollution exposure during pregnancy has been associated with numerous adverse pregnancy, birth, and child health outcomes. One proposed mechanism underlying these associations is maternal immune activation and dysregulation. We examined associations between PM2.5 and NO2 exposure during pregnancy and immune markers within immune function groups (TH1, TH2, TH17, Innate/Early Activation, Regulatory, Homeostatic, and Proinflammatory), and examined whether those associations changed across pregnancy. METHODS In a pregnancy cohort study (n = 290) in Rochester, New York, we measured immune markers (using Luminex) in maternal plasma up to 3 times during pregnancy. We estimated ambient PM2.5 and NO2 concentrations at participants' home addresses using a spatial-temporal model. Using mixed effects models, we estimated changes in immune marker concentrations associated with interquartile range increases in PM2.5 (2.88 μg/m3) and NO2 (7.82 ppb) 0-6 days before blood collection, and assessed whether associations were different in early, mid, and late pregnancy. RESULTS Increased NO2 concentrations were associated with higher maternal immune markers, with associations observed across TH1, TH2, TH17, Regulatory, and Homeostatic groups of immune markers. Furthermore, the largest increases in immune markers associated with each 7.82 ppb increase in NO2 concentration were in late pregnancy (e.g., IL-23 = 0.26 pg/ml, 95% CI = 0.07, 0.46) compared to early pregnancy (e.g., IL-23 = 0.08 pg/ml, 95% CI = -0.11, 0.26). CONCLUSIONS Results were suggestive of NO2-related immune activation. Increases in effect sizes from early to mid to late pregnancy may be due to changes in immune function over the course of pregnancy. These findings provide a basis for immune activation as a mechanism for previously observed associations between air pollution exposure during pregnancy and reduced birthweight, fetal growth restriction, and pregnancy complications.
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Affiliation(s)
- C S Yount
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - K Scheible
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - S W Thurston
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - X Qiu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Y Ge
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA
| | - P K Hopke
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Center for Air and Aquatic Resources Engineering and Sciences, Clarkson University, Potsdam, NY, USA
| | - Y Lin
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA
| | - R K Miller
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - S K Murphy
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - J Brunner
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - E Barrett
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA; Department of Biostatistics and Epidemiology, Rutgers University School of Public Health, Piscataway, NJ, USA
| | - T G O'Connor
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA; Department of Psychology, University of Rochester, Rochester, NY, USA; Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - J Zhang
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA
| | - D Q Rich
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA; Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
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Wilkie AA, Luben TJ, Rappazzo K, Foley K, Woods CG, Serre ML, Richardson DB, Daniels JL. Long-term ambient sulfur dioxide exposure during gestation and preterm birth in North Carolina, 2003-2015. ATMOSPHERIC ENVIRONMENT (OXFORD, ENGLAND : 1994) 2024; 333:120669. [PMID: 39219580 PMCID: PMC11360850 DOI: 10.1016/j.atmosenv.2024.120669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
BACKGROUND Coal-fired power plants are major contributors of ambient sulfur dioxide (SO2) air pollution. Epidemiological literature suggests an adverse association between SO2 exposure during gestation and preterm birth (PTB; <37 weeks completed gestation). PTB is strongly associated with infant mortality and increased risk for later life morbidities. OBJECTIVE We investigated associations between SO2 and PTB in North Carolina and evaluated whether the associations were modified by race/ethnicity. METHODS We assembled a retrospective, administrative cohort of singleton births in North Carolina from 2003-2015. We used US EPA EQUATES data to assign long-term SO2 gestational exposures to eligible births for the entire pregnancy and by trimester. We used multivariable generalized linear regression to estimate risk differences (RD (95%CI)) per 1-ppb increase in SO2, adjusted for gestational parent education, Medicaid status, marital status, and season of conception. Multi-pollutant models were additionally adjusted for other criteria air co-pollutants (O3, PM2.5, NO2). RESULTS The median SO2 (24-hour average) across exposure windows was ~1.5 (IQR: 1.8) ppb. The overall baseline risk for PTB was 8,756 per 100,000 live births. When stratified by race/ethnicity, the baseline risk for PTB was 12215, 7824, and 7187 per 100,000 live births among non-Hispanic Black, non-Hispanic white, and Hispanic births, respectively. RDs per 1-ppb increase in SO2 averaged across the entire pregnancy were 317.0 (95%CI: 279.4, 354.5) and 568.2 (95%CI: 500.3, 636.1) per 100,000 live births for single- and multi-pollutant models, respectively. For the PTB multi-pollutant models, we observed similar RDs for non-Hispanic Black participants (669.6 [95%CI: 573.9, 765.2]) and non-Hispanic white participants (635.4 [95%CI: 557.2, 713.6]) with smaller RDs for Hispanic participants (336.8 [95%CI: 241.3, 432.2]). SIGNIFICANCE The results for our adjusted single- and multi-pollutant models showed adverse associations between SO2 and PTB, with some evidence of effect measure modification by race/ethnicity within subcategories of PTB.
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Affiliation(s)
- Adrien A Wilkie
- Oak Ridge Institute for Science and Education (ORISE) Postdoctoral Fellow at US EPA, Research Triangle Park, NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas J Luben
- United States Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, NC, USA
| | - Kristen Rappazzo
- United States Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, NC, USA
| | - Kristen Foley
- United States Environmental Protection Agency, Office of Research and Development, Center for Environmental Measurement and Modeling, Research Triangle Park, NC, USA
| | - Courtney G Woods
- Department of Environmental Science and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Marc L Serre
- Department of Environmental Science and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Program in Public Health, University of California at Irvine, Irvine, CA, USA
| | - Julie L Daniels
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Wang M, Wen C, Zhou C, Qi H, Wei M, Xia W, Wang Y, Zhang J. Contribution of greenness, air pollution, and residential food environment to excess gestational weight gain: A cross-sectional study in Wuhan, China. Prev Med 2024; 186:108086. [PMID: 39059478 DOI: 10.1016/j.ypmed.2024.108086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVES Our goal was to explore how greenness, air pollution, and residential food environment were linked to excessive gestational weight gain (EGWG), and to estimate their combined effects on this condition. METHOD This cross-sectional analysis included 51,507 pregnant women from the Wuhan Maternal and Child Health Management Information System between 2016 and 2019. Generalized linear mixed regression models were employed to explore the relationships between greenness, air pollution, residential food environmental exposure, and EGWG; and the combined effects were further estimated by cluster analysis and principal components analysis. RESULT We only found a significant association between convenience store density within the 250 m buffer zone (OR = 1.03 and 95% CI: 1.01,1.05) and EGWG. In terms of air pollution, sulfur dioxide(SO2), particulate matter with a diameter of 10 μm or less(PM10), and particulate matter with a diameter of 2.5 μm or less(PM2.5) were substantially correlated with a higher prevalence of EGWG and higher GWG, with (OR = 1.16 and 95% CI: 1.12,1.21; OR = 1.12 and 95% CI: 1.08,1.16; OR = 1.17 and 95% CI: 1.14,1.21, respectively) per interquartile range(IQR) increase. Cluster analysis revealed the presence of three clusters representing urban exposures. In contrast to urban environment clusters characterized by favourable conditions, those exhibiting elevated air pollution levels, high-density residential food environment and low levels of greenness were found to have increased odds of EGWG (OR = 1.10, 95% CI: 1.03, 1.19). CONCLUSION This study emphasizes that exposure to elevated air pollution, high-density residential neighbourhood food environments, and low levels of greenness is a neighbourhood obesogenic environment for pregnant women.
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Affiliation(s)
- Miyuan Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Chen Wen
- School of Architecture & Urban Planning, Huazhong University of Science and Technology, Luoyu Road, Wuhan, 430074, China; Hubei Engineering and Technology Research Center of Urbanization, Wuhan 430030, China
| | - Chenmiao Zhou
- Hanyang Maternal and Child Health Hospital, Wuhan 430030, China
| | - Haiqing Qi
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Mengna Wei
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wenqi Xia
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yimin Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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Parenteau AM, Hang S, Swartz JR, Wexler AS, Hostinar CE. Clearing the air: A systematic review of studies on air pollution and childhood brain outcomes to mobilize policy change. Dev Cogn Neurosci 2024; 69:101436. [PMID: 39244820 DOI: 10.1016/j.dcn.2024.101436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 06/14/2024] [Accepted: 08/12/2024] [Indexed: 09/10/2024] Open
Abstract
Climate change, wildfires, and environmental justice concerns have drawn increased attention to the impact of air pollution on children's health and development. Children are especially vulnerable to air pollution exposure, as their brains and bodies are still developing. The objective of this systematic review was to synthesize available empirical evidence on the associations between air pollution exposure and brain outcomes in developmental samples (ages 0-18 years old). Studies were identified by searching the PubMed and Web of Science Core Collection databases and underwent a two-phase screening process before inclusion. 40 studies were included in the review, which included measures of air pollution and brain outcomes at various points in development. Results linked air pollution to varied brain outcomes, including structural volumetric and cortical thickness differences, alterations in white matter microstructure, functional network changes, metabolic and molecular effects, as well as tumor incidence. Few studies included longitudinal changes in brain outcomes. This review also suggests methodologies for incorporating air pollution measures in developmental cognitive neuroscience studies and provides specific policy recommendations to reduce air pollution exposure and promote healthy brain development by improving access to clean air.
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Affiliation(s)
| | - Sally Hang
- Psychology Department, University of California, Davis, USA
| | - Johnna R Swartz
- Department of Human Ecology, University of California, Davis, USA
| | - Anthony S Wexler
- Air Quality Research Center, Mechanical and Aerospace Engineering, University of California, Davis, USA
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Nyma Z, Hasan SMT, Saqeeb KN, Khan MA, Ahmed T. Effects of maternal exposure to biomass cooking fuel on birth size and body proportionality in full-term infants born by vaginal delivery. Sci Rep 2024; 14:18218. [PMID: 39107379 PMCID: PMC11303780 DOI: 10.1038/s41598-024-68821-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024] Open
Abstract
It remains unclear whether and how maternal exposure to biomass fuel influences infant anthropometry or body proportionality at birth, which are linked to their survival, physical growth, and neurodevelopment. Therefore, this study seeks to explore the association between household-level exposure to biomass cooking fuels and infant size and body proportionality at birth among women in rural Bangladesh. A total of 909 women were derived from the Pregnancy Weight Gain study, which was conducted in Matlab, a rural area of Bangladesh. Infant's weight (g), length (cm), head circumference (cm), small for gestational age (SGAW), short for gestational age (SGAL), low head circumference for gestational age (SGAHC), ponderal index, and cephalization index at birth were the outcomes studied. Of the women, 721 (79.3%) were dependent on biomass fuel. Compared to infants born to mothers who used gas for cooking, those born to biomass users had lower weight (β - 94.3, CI - 155.9, - 32.6), length (β - 0.36, 95% CI - 0.68, - 0.04), head circumference (β - 0.24, CI - 0.47, - 0.02) and higher cephalization index (β 0.03, CI 0.01, 0.05) at birth. Maternal biomass exposure is more likely to lead to symmetric SGA, although there is evidence for some brain-sparing effects.
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Affiliation(s)
- Zannatun Nyma
- Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
- Shiga University of Medical Science, Setatsukinowacho, Otsu, Shiga, Japan
| | - S M Tafsir Hasan
- Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh.
| | - Kazi Nazmus Saqeeb
- Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Md Alfazal Khan
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Tahmeed Ahmed
- Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
- Office of Executive Director, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
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6
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Lee DW, Lim YH, Choi YJ, Kim S, Shin CH, Lee YA, Kim BN, Kim JI, Hong YC. Prenatal and early-life air pollutant exposure and epigenetic aging acceleration. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 283:116823. [PMID: 39096687 DOI: 10.1016/j.ecoenv.2024.116823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/11/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND This study investigated the association of prenatal and early childhood exposure to air pollution with epigenetic age acceleration (EAA) at six years of age using the Environment and Development of Children Cohort (EDC Cohort) MATERIALS & METHODS: Air pollution, including particulate matter [< 2.5 µm (PM2.5) and < 10 µm (PM10) in an aerodynamic diameter], nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), and sulfur dioxide (SO2) were estimated based on the residential address for two periods: 1) during the whole pregnancy, and 2) for one year before the follow-up in children at six years of age. The methylation levels in whole blood at six years of age were measured, and the methylation clocks, including Horvath's clock, Horvath's skin and blood clock, PedBE, and Wu's clock, were estimated. Multivariate linear regression models were constructed to analyze the association between EAA and air pollutants. RESULTS A total of 76 children in EDC cohort were enrolled in this study. During the whole pregnancy, interquartile range (IQR) increases in exposure to PM2.5 (4.56 μg/m3) and CO (0.156 ppm) were associated with 0.406 years and 0.799 years of EAA (Horvath's clock), respectively. An IQR increase in PM2.5 (4.76 μg/m3) for one year before the child was six years of age was associated with 0.509 years of EAA (Horvath's clock) and 0.289 years of EAA (Wu's clock). PM10 (4.30 μg/m3) and O3 (0.003 ppm) exposure in the period were also associated with EAA in Horvath's clock (0.280 years) and EAA in Horvath's skin and blood clock (0.163 years), respectively. CONCLUSION We found that prenatal and childhood exposure to ambient air pollutants is associated with EAA among children. The results suggest that air pollution could induce excess biological aging even in prenatal and early life.
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Affiliation(s)
- Dong-Wook Lee
- Department of Occupational and Environmental Medicine, Inha University Hospital, Inha University, Incheon, the Republic of Korea
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Yoon-Jung Choi
- National Cancer Center Graduate School of Cancer Science and Policy, Goyang, the Republic of Korea
| | - Soontae Kim
- Department of Environmental and Safety Engineering, Ajou University, Suwon, the Republic of Korea
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children's Hospital, the Republic of Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children's Hospital, the Republic of Korea
| | - Bung-Nyun Kim
- Division of Children and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, the Republic of Korea
| | - Johanna Inhyang Kim
- Department of Psychiatry, Hanyang University College of Medicine, Seoul, the Republic of Korea
| | - Yun-Chul Hong
- Department of Humans Systems Medicine, Seoul National University College of Medicine, Seoul, the Republic of Korea.
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Sinsamala RM, Johannessen A, Bertelsen RJ, Accordini S, Brandt J, Frohn LM, Geels C, Gislason T, Holm M, Janson C, Markevych I, Orru H, Real FG, Sigsgaard T, Skulstad SM, Svanes C, Marcon A. Pregnancy outcomes as related to in utero exposure to air pollution and greenness: The Life-GAP Project. Environ Epidemiol 2024; 8:e318. [PMID: 38919266 PMCID: PMC11196084 DOI: 10.1097/ee9.0000000000000318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
Background Lower birth weight and preterm birth may increase the risk of adverse health outcomes later in life. We examined whether maternal exposure to air pollution and greenness during pregnancy is associated with offspring birth weight and preterm birth. Methods We analyzed data on 4286 singleton births from 2358 mothers from Respiratory Health in Northern Europe, a prospective questionnaire-based cohort study (1990-2010). Mixed-effects regression models with random intercepts for mothers and centers were used to estimate the association of exposures to particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), ozone (O3), black carbon (BC), and greenness (Normalized Difference Vegetation Index in 300m-buffers [NDVI300m]) with birth outcomes, adjusting for potential confounders. Results Median (interquartile range [IQR]) exposures to PM2.5, PM10, NO2, O3, BC, and NDVI300m during pregnancy were 8.4(5.0) µg/m3, 14.4(8.3) µg/m3, 14.0(11.0) µg/m3, 54.7(10.2) µg/m3, 0.47(0.41) µg/m3, and 0.31(0.20), respectively. IQR increases in air pollution exposures during pregnancy were associated with decreased birth weight and the strongest association was seen for PM2.5 (-49g; 95% confidence interval [CI] = -83, -16). However, O3 showed an opposite association. IQR increase in NDVI300m was associated with an increase in birth weight of 25 g (95% CI = 7, 44). Preterm birth was not associated with the exposures. Conclusion Increased greenness and decreased air pollution may contribute to healthier pregnancies and improve overall health in the next generation. This emphasizes the need to adopt policies that target the reduction of air pollution emissions and exposure of the population.
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Affiliation(s)
- Robin M. Sinsamala
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Frederiks-borgvej, Roskilde, Denmark
| | - Lise M. Frohn
- Department of Environmental Science, Aarhus University, Frederiks-borgvej, Roskilde, Denmark
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Frederiks-borgvej, Roskilde, Denmark
| | - Thorarinn Gislason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Sleep, Landspitali University Hospital
| | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy & Sleep Research, Uppsala University, Uppsala Sweden
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Krakow, Poland
- Health and Quality of Life in a Green and Sustainable Environment, SRIPD-MUP, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Francisco Gómez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Torben Sigsgaard
- Department of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Svein M. Skulstad
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Cecilie Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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8
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Murphy MS, Abdulaziz KE, Lavigne É, Erwin E, Guo Y, Dingwall-Harvey AL, Stieb D, Walker MC, Wen SW, Shin HH. Association between prenatal air pollutant exposure and autism spectrum disorders in young children: A matched case-control study in Canada. ENVIRONMENTAL RESEARCH 2024; 261:119706. [PMID: 39084506 DOI: 10.1016/j.envres.2024.119706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/22/2024] [Accepted: 07/28/2024] [Indexed: 08/02/2024]
Abstract
The direction and magnitude of association between maternal exposure to ambient air pollutants across gestational windows and offspring risk of autism spectrum disorders (ASD) remains unclear. We sought to evaluate the time-varying effects of prenatal air pollutant exposure on ASD. We conducted a matched case-control study of singleton term children born in Ontario, Canada from 1-Apr-2012 to 31-Dec-2016. Provincial birth registry data were linked with applied behavioural analysis services and ambient air pollutant datasets to ascertain prenatal exposure to nitrogen dioxide (NO2), ground-level ozone (O3), fine particulate matter (PM2.5), and ASD diagnoses. Covariate balance between cases and controls was established using coarsened exact matching. Conditional logistic regression was used to assess the association between prenatal air pollutant exposure and ASD. Distributed lag non-linear models (DLNM) were used to examine the effects of single-pollutant exposure by prenatal week. Sensitivity analyses were conducted to assess the impact of exposure period on the observed findings. The final sample included 1589 ASD cases and 7563 controls. Compared to controls, cases were more likely to be born to mothers living in urban areas, delivered by Caesarean section, and assigned male sex at birth. NO2 was a consistent and significant contributor to ASD risk after accounting for co-exposure to O3, PM2.5 and covariates. The odds ratio per interquartile range increase was 2.1 (95%CI 1.8-2.3) pre-conception, 2.2 (2.0-2.5) for the 1st trimester, 2.2 (1.9-2.5) for the 2nd trimester, and 2.1 (1.9-2.4) for the 3rd trimester. In contrast, findings for O3 and PM2.5 with ASD were inconsistent. Findings from DLNM and sensitivity analyses were similar. Exposure to NO2 before and during pregnancy was significantly associated with ASD in offspring. The relationship between prenatal O3 and PM2.5 exposure and ASD remains unclear. Further investigation into the combined effects of multi-pollutant exposure on child neurodevelopment is warranted.
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Affiliation(s)
- Malia Sq Murphy
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Kasim E Abdulaziz
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry & Network (BORN) Ontario, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Éric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Erica Erwin
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry & Network (BORN) Ontario, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Yanfang Guo
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry & Network (BORN) Ontario, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Alysha Lj Dingwall-Harvey
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - David Stieb
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Mark C Walker
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry & Network (BORN) Ontario, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada; Department of Obstetrics, Gynecology & Newborn Care, Ottawa, Canada; International and Global Health Office, University of Ottawa, Ottawa, Canada
| | - Shi Wu Wen
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada; Department of Obstetrics, Gynecology & Newborn Care, Ottawa, Canada
| | - Hwashin Hyun Shin
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada; Department of Mathematics and Statistics, Queen's University, Kingston, Ontario, Canada.
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9
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Abu Ahmad W, Nirel R, Barges S, Jolles M, Levine H. Meta-analysis of fine particulate matter exposure during pregnancy and birth weight: Exploring sources of heterogeneity. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 934:173205. [PMID: 38754513 DOI: 10.1016/j.scitotenv.2024.173205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/31/2024] [Accepted: 05/11/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Several meta-analyses assessed the relationship between exposure to PM with aerodynamic diameter ≤ 2.5 μm (PM2.5) during pregnancy and birth weight (BW), but results were inconsistent and substantial unexplained heterogeneity was reported. We aimed to investigate the above association and to explore sources of heterogeneity across studies. METHODS We systematically reviewed the current worldwide evidence examining the association between PM2.5 and BW. The review protocol was registered on the PROSPERO website (CRD42020188996) and followed PRISMA guidelines. We extracted association measures for BW and low birth weight (LBW, BW < 2500 g) from each study to evaluate pooled summary measures and to explore sources of between-study heterogeneity. FINDINGS Of the 2677 articles identified, 84 met the inclusion criteria (~42 M births). Our random effects meta-analyses revealed substantial heterogeneity among included studies (I2 = 98.4 % and I2 = 77.7 %, for BW and LBW respectively). For LBW, the heterogeneity decreased (I2 = 59.7 %) after excluding four outlying studies, with a pooled odds ratio 1.07 (95 % confidence interval, CI: 1.05, 1.09) per a 10-μg/m3 increase in mean PM2.5 exposure over the entire pregnancy. Further subgroup analysis revealed geographic heterogeneity with higher association in Europe (1.34, (1.16, 1.55)) compared to Asia (1.06, (1.03, 1.10)) and US (1.07, (1.04, 1.10)). CONCLUSION The association between PM2.5 and birth weight varied depending on several factors. The sources of heterogeneity between studies included modifiers such as study region and period. Hence, it is advisable not to pool summary measures of PM2.5-BW associations and that policy would be informed by local evidence.
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Affiliation(s)
- Wiessam Abu Ahmad
- School of Public Health, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Ronit Nirel
- Department of Statistics and Data Science, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Saleh Barges
- Community Medical Services Division, Clalit Health Services, Tel-Aviv, Israel
| | - Maya Jolles
- School of Public Health, University of Haifa, Haifa, Israel
| | - Hagai Levine
- School of Public Health, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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10
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Cowan KN, Krajewski AK, Jimenez MP, Luben TJ, Messer LC, Rappazzo KM. Examining modification of the associations between air pollution and birth outcomes by neighborhood deprivation in a North Carolina birth cohort, 2011-2015. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1304749. [PMID: 39055124 PMCID: PMC11269152 DOI: 10.3389/frph.2024.1304749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 06/17/2024] [Indexed: 07/27/2024] Open
Abstract
Background Evidence from studies of air pollutants and birth outcomes suggests an association, but uncertainties around geographical variability and modifying factors still remain. As neighborhood-level social characteristics are associated with birth outcomes, we assess whether neighborhood deprivation level is an effect measure modifier on the association between air pollution and birth outcomes in a North Carolina birth cohort. Methods Using birth certificate data, all North Carolina residential singleton live births from 1 January 2011 to 31 December 2015 with gestational ages of 20-44 weeks (n = 566,799) were examined for birth defect diagnoses and preterm birth. Exposures were daily average fine particulate matter (PM2.5), daily 8-h maximum nitrogen dioxide (NO2), and daily 8-h maximum ozone (O3) modeled concentrations, and the modifier of interest was the neighborhood deprivation index (NDI). Linear binomial models were used to estimate the prevalence differences and 95% confidence intervals (CI) for the association between ambient air pollution and birth defect diagnoses. Modified Poisson regression models were used to estimate risk differences (RDs) and 95% CIs for air pollution and preterm birth. Models were stratified by the neighborhood deprivation index group (low, medium, or high) to assess potential modification by NDI. Results Approximately 3.1% of the study population had at least one birth defect and 8.18% were born preterm. For preterm birth, associations with PM2.5 and O3 did not follow a conclusive pattern and there was no evidence of modification by NDI. The associations between NO2 and preterm birth were generally negative across exposure windows except for a positive association with NO2 and preterm birth for high NDI [RD: 34.70 (95% CI 4.84-64.56)] for entire pregnancy exposure. There was no evidence of associations between pollutants examined and birth defects. Conclusions There may be differences in the association between NO2 exposure and preterm birth by NDI but we did not observe any evidence of associations for birth defects. Our results support the public health protection afforded by reductions in air pollution, even in areas of neighborhood deprivation, but future research conducted in areas with higher levels of air pollution and evaluating the potential for modification by neighborhood deprivation level would be informative.
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Affiliation(s)
- Kristen N. Cowan
- Oak Ridge Institute for Science and Education (ORISE), US EPA, Research Triangle Park, NC, United States
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Alison K. Krajewski
- Office of Research and Development, Center for Public Health & Environmental Assessment, United States Environmental Protection Agency,Research Triangle Park, NC, United States
| | - Monica P. Jimenez
- Oak Ridge Institute for Science and Education (ORISE), US EPA, Research Triangle Park, NC, United States
| | - Thomas J. Luben
- Office of Research and Development, Center for Public Health & Environmental Assessment, United States Environmental Protection Agency,Research Triangle Park, NC, United States
| | - Lynne C. Messer
- Departments of Community Health and Health Promotion and Epidemiology, OHSU-PSU School of Public Health, Portland, OR, United States
| | - Kristen M. Rappazzo
- Office of Research and Development, Center for Public Health & Environmental Assessment, United States Environmental Protection Agency,Research Triangle Park, NC, United States
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11
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Caron-Beaudoin É, Akpo H, Doyle-Waters MM, Ronald LA, Friesen M, Takaro T, Leven K, Meyer U, McGregor MJ. The human health effects of unconventional oil and gas (UOG) chemical exposures: a scoping review of the toxicological literature. REVIEWS ON ENVIRONMENTAL HEALTH 2024; 0:reveh-2024-0076. [PMID: 38985132 DOI: 10.1515/reveh-2024-0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 06/18/2024] [Indexed: 07/11/2024]
Abstract
Many chemicals associated with unconventional oil and natural gas (UOG) are known toxicants, leading to health concerns about the effects of UOG. Our objective was to conduct a scoping review of the toxicological literature to assess the effects of UOG chemical exposures in models relevant to human health. We searched databases for primary research studies published in English or French between January 2000 and June 2023 on UOG-related toxicology studies. Two reviewers independently screened abstracts and full texts to determine inclusion. Seventeen studies met our study inclusion criteria. Nine studies used solely in vitro models, while six conducted their investigation solely in animal models. Two studies incorporated both types of models. Most studies used real water samples impacted by UOG or lab-made mixtures of UOG chemicals to expose their models. Most in vitro models used human cells in monocultures, while all animal studies were conducted in rodents. All studies detected significant deleterious effects associated with exposure to UOG chemicals or samples, including endocrine disruption, carcinogenicity, behavioral changes and metabolic alterations. Given the plausibility of causal relationships between UOG chemicals and adverse health outcomes highlighted in this review, future risk assessment studies should focus on measuring exposure to UOG chemicals in human populations.
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Affiliation(s)
- Élyse Caron-Beaudoin
- Department of Health and Society, 33530 University of Toronto Scarborough , Ontario, Canada
- Department of Physical and Environmental Sciences, 33530 University of Toronto Scarborough , Ontario, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Ontario, Canada
| | - Hélène Akpo
- Department of Occupational and Environmental Health, Université de Montréal, Quebec, Canada
| | - Mary M Doyle-Waters
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, British Columbia, Canada
| | - Lisa A Ronald
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
| | - Michael Friesen
- Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
| | - Tim Takaro
- Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
| | | | - Ulrike Meyer
- Department of Family Practice, Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Margaret J McGregor
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, British Columbia, Canada
- Department of Family Practice, Faculty of Medicine, University of British Columbia, British Columbia, Canada
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12
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Hill E, Harleman M, Harris L, Sventek G, Ritz B, Campbell EJ, Willis M, Hystad P. Roadway construction as a natural experiment to examine air pollution impacts on infant health. ENVIRONMENTAL RESEARCH 2024; 252:118788. [PMID: 38555097 DOI: 10.1016/j.envres.2024.118788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/14/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
Traffic-related air pollution (TRAP) poses a significant public health risk that is associated with adverse birth outcomes. Large roadway infrastructure projects present a natural experiment to examine how resulting congestion change is associated with adverse birth outcomes for nearby populations. This study is designed to examine the influence of living close to a roadway before, during, and after a construction project using a difference-in-differences design. We integrated data on all large roadway construction projects (defined as widening of existing roads, building new roads, improving bridges, installing intelligent transportation systems, improving intersections, and installing or upgrading traffic signals) in Texas from 2007 to 2016 with Vital Statistic data for all births with residential addresses within 1 km of construction projects. Our outcomes included term low birth weight, term birth weight, preterm birth, and very preterm birth. Using a difference-in-differences design, we included births within 3 years of construction start and 2 years of construction end. In our main model, the exposed group is limited to pregnant individuals residing within 300 m of a construction project, and the control group includes those living within 300-1000 m from a project. We used regression models to estimate the influence of construction on infant health. We included 1,360 large roadway construction projects linked to 408,979 births. During construction, we found that the odds of term low birth weight increased by 19% (95% CI: 1.05, 1.36). However, we saw little evidence of an association for other birth outcomes. Contrary to our hypothesis of decreased TRAP after construction ends, we did not observe consistent improvements post-construction for pregnant individuals living within 300 m. Continued consideration of the influence of traffic congestion programs on birth outcomes is necessary to inform future policy decisions.
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Affiliation(s)
- Elaine Hill
- Department of Economics, School of Arts and Sciences, University of Rochester, 280 Hutchison Rd, Rochester, NY, USA; Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, 265 Crittenden Blvd Box 420644, Rochester, NY, USA.
| | - Max Harleman
- Department of Government and Sociology, College of Arts and Sciences, Georgia College and State University, 410 W Greene St, Milledgeville, GA, USA
| | - Lena Harris
- Department of Economics, School of Arts and Sciences, University of Rochester, 280 Hutchison Rd, Rochester, NY, USA
| | - Grace Sventek
- Department of Economics, School of Arts and Sciences, University of Rochester, 280 Hutchison Rd, Rochester, NY, USA; Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, 265 Crittenden Blvd Box 420644, Rochester, NY, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, USA
| | - Erin J Campbell
- Department of Epidemiology, School of Public Health, Boston University, 715 Albany St, Boston, MA, USA
| | - Mary Willis
- Department of Epidemiology, School of Public Health, Boston University, 715 Albany St, Boston, MA, USA
| | - Perry Hystad
- School of Nutrition and Public Health, College of Health, Oregon State University, 160 SW 26th St, Corvallis, OR, USA
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13
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Parasin N, Amnuaylojaroen T, Saokaew S. Prenatal PM 2.5 Exposure and Its Association with Low Birth Weight: A Systematic Review and Meta-Analysis. TOXICS 2024; 12:446. [PMID: 39058098 PMCID: PMC11280910 DOI: 10.3390/toxics12070446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/17/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024]
Abstract
Exposure to PM2.5 while pregnant is associated with negative effects on low birth weight (LBW). This study employed a systematic review and meta-analysis to investigate the impact of PM2.5 exposure during pregnancy on LBW. A search of databases such as Scopus, ScienceDirect, and PubMed identified thirteen appropriate studies. This study used a random-effects model to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs) for each trimester. The findings revealed a significant relationship between PM2.5 exposure and LBW in both the first and second trimesters (OR 1.05, 95% CI 1.00-1.09, p < 0.001). There was no significant difference between trimesters (p = 0.704). The results emphasize the persistent influence of PM2.5 on fetal development throughout all stages of pregnancy. Reducing air pollution is critical for improving pregnancy outcomes and decreasing the incidence of LBW. Further study is needed to improve exposure assessments and investigate the underlying biological pathways.
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Affiliation(s)
- Nichapa Parasin
- School of Allied Health Science, University of Phayao, Phayao 56000, Thailand;
| | - Teerachai Amnuaylojaroen
- School of Energy and Environment, University of Phayao, Phayao 56000, Thailand
- Atmospheric Pollution and Climate Change Research Units, School of Energy and Environment, University of Phayao, Phayao 56000, Thailand
| | - Surasak Saokaew
- Division of Social and Administrative Pharmacy, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao 56000, Thailand;
- Unit of Excellence on Clinical Outcomes Research and Integration (UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao 56000, Thailand
- Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao 56000, Thailand
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14
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Wu CT, Wu TS, Ku MS. The Impact of Fine Particulate Matter on Embryonic Development. Int J Mol Sci 2024; 25:6399. [PMID: 38928108 PMCID: PMC11204323 DOI: 10.3390/ijms25126399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/07/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Airborne fine particulate matter (PM2.5) in air pollution has become a significant global public health concern related to allergic diseases. Previous research indicates that PM2.5 not only affects the respiratory system but may also induce systemic inflammation in various tissues. Moreover, its impact may vary among different populations, with potential consequences during pregnancy and in newborns. However, the precise mechanisms through which PM2.5 induces inflammatory reactions remain unclear. This study aims to explore potential pathways of inflammatory responses induced by PM2.5 through animal models and zebrafish embryo experiments. In this study, zebrafish embryo experiments were conducted to analyze the effects of PM2.5 on embryo development and survival, and mouse experimental models were employed to assess the impact of PM2.5 stimulation on various aspects of mice. Wild-type zebrafish embryos were exposed to a PM2.5 environment of 25-400 μg/mL starting at 6 h after fertilization (6 hpf). At 6 days post-fertilization, the survival rates of the 25, 50, 100, and 200 µg/mL groups were 100%, 80, 40%, and 40%, respectively. Zebrafish embryos stimulated with 25 μg/mL of PM2.5 still exhibited successful development and hatching. Additionally, zebrafish subjected to doses of 25-200 μg/mL displayed abnormalities such as spinal curvature and internal swelling after hatching, indicating a significant impact of PM2.5 stimulation on embryo development. In the mouse model, mice exposed to PM2.5 exhibited apparent respiratory overreaction, infiltration of inflammatory cells into the lungs, elevated levels of inflammatory response-related cytokines, and inflammation in various organs, including the liver, lungs, and uterus. Blood tests on experimental mice revealed increased expression of inflammatory and chemotactic cytokines, and GSEA indicated the induction of various inflammatory responses and an upregulation of the TNF-α/NFκB pathway by PM2.5. Our results provide insights into the harmful effects of PM2.5 on embryos and organs. The induced inflammatory responses by PM2.5 may be mediated through the TNF-α/NFκB pathway, leading to systemic organ inflammation. However, whether PM2.5-induced inflammatory responses in various organs and abnormal embryo development are generated through different pathways requires further study to comprehensively clarify and identify potential treatment and prevention methods.
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Affiliation(s)
- Chia-Ta Wu
- School of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Chien-Kuo N. Road, Taichung 402, Taiwan;
- Department of Emergency Medicine, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Ting-Shuan Wu
- Department of Biomedical Sciences, Chung Shan Medical University, Taichung 402, Taiwan
| | - Min-Sho Ku
- School of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Chien-Kuo N. Road, Taichung 402, Taiwan;
- Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Institute of Allergy, Immunology, and Rheumatology, Chung Shan Medical University Hospital, No. 110, Sec. 1, Chien-Kuo N. Road, Taichung 402, Taiwan
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15
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Aker AM, Friesen M, Ronald LA, Doyle-Waters MM, Takaro TK, Thickson W, Levin K, Meyer U, Caron-Beaudoin E, McGregor MJ. The human health effects of unconventional oil and gas development (UOGD): A scoping review of epidemiologic studies. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:446-467. [PMID: 38457120 PMCID: PMC11133301 DOI: 10.17269/s41997-024-00860-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/23/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE Unconventional oil and gas development (UOGD, sometimes termed "fracking" or "hydraulic fracturing") is an industrial process to extract methane gas and/or oil deposits. Many chemicals used in UOGD have known adverse human health effects. Canada is a major producer of UOGD-derived gas with wells frequently located in and around rural and Indigenous communities. Our objective was to conduct a scoping review to identify the extent of research evidence assessing UOGD exposure-related health impacts, with an additional focus on Canadian studies. METHODS We included English- or French-language peer-reviewed epidemiologic studies (January 2000-December 2022) which measured exposure to UOGD chemicals directly or by proxy, and where health outcomes were plausibly caused by UOGD-related chemical exposure. Results synthesis was descriptive with results ordered by outcome and hierarchy of methodological approach. SYNTHESIS We identified 52 studies from nine jurisdictions. Only two were set in Canada. A majority (n = 27) used retrospective cohort and case-control designs. Almost half (n = 24) focused on birth outcomes, with a majority (n = 22) reporting one or more significant adverse associations of UOGD exposure with: low birthweight; small for gestational age; preterm birth; and one or more birth defects. Other studies identified adverse impacts including asthma (n = 7), respiratory (n = 13), cardiovascular (n = 6), childhood acute lymphocytic leukemia (n = 2), and all-cause mortality (n = 4). CONCLUSION There is a growing body of research, across different jurisdictions, reporting associations of UOGD with adverse health outcomes. Despite the rapid growth of UOGD, which is often located in remote, rural, and Indigenous communities, Canadian research on its effects on human health is remarkably sparse. There is a pressing need for additional evidence.
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Affiliation(s)
- Amira M Aker
- Université Laval, CHU de Quebec - Université Laval, Québec, QC, Canada
| | - Michael Friesen
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Lisa A Ronald
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Mary M Doyle-Waters
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Tim K Takaro
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Willow Thickson
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Karen Levin
- Emerald Environmental Consulting, Kent, OH, USA
| | - Ulrike Meyer
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Elyse Caron-Beaudoin
- Department of Health and Society and Department of Physical and Environmental Sciences, University of Toronto Scarborough, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Margaret J McGregor
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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16
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Hung TH, Hsu TY, Hsu J, Ou CY, Liu PH, Lo LM, Shaw SW, Wan GH. Influence of gestational hypertension and maternal air pollutant exposure on birth outcomes. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:42264-42276. [PMID: 38865044 DOI: 10.1007/s11356-024-33944-0] [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: 09/04/2023] [Accepted: 06/04/2024] [Indexed: 06/13/2024]
Abstract
The relationship between exposure to air pollutants and fetal growth outcomes has shown inconsistency, and only a limited number of studies have explored the impact of air pollution on gestational hypertension and birth outcomes. This study aimed to evaluate how maternal exposure to air pollutants and blood pressure could influence fetal birth outcomes. A total of 55 women with gestational hypertension and 131 healthy pregnant women were enrolled in this study. Data pertaining to personal characteristics, prenatal examinations, outdoor air pollutant exposure, and fetal birth outcomes were collected. The study revealed that fetal birth weight and abdominal circumference exhibited a significant reduction among women with gestational hypertension compared to healthy pregnant women, even after adjustments for body mass index, gestational age, and exposure to air pollutants had been made. Moreover, maternal exposure to outdoor air pollutants displayed a notable correlation with decreased birth length of fetuses. Consequently, the study concluded that maternal blood pressure and exposure to outdoor air pollutants during pregnancy potentially stand as pivotal factors influencing fetal birth outcomes.
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Affiliation(s)
- Tai-Ho Hung
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
- Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Te-Yao Hsu
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Jie Hsu
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yu Ou
- Department of Obstetrics, Po-Jen Hospital, Kaohsiung, Taiwan
| | - Pi-Hua Liu
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Liang-Ming Lo
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Steven W Shaw
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Gwo-Hwa Wan
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.
- Department of Respiratory Therapy, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, 333, Taiwan.
- Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan.
- Center for Environmental Sustainability and Human Health, Ming Chi University of Technology, Taishan, New Taipei, Taiwan.
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17
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Gogna P, Borghese MM, Villeneuve PJ, Kumarathasan P, Johnson M, Shutt RH, Ashley-Martin J, Bouchard MF, King WD. A cohort study of the multipollutant effects of PM 2.5, NO 2, and O 3 on C-reactive protein levels during pregnancy. Environ Epidemiol 2024; 8:e308. [PMID: 38799262 PMCID: PMC11115979 DOI: 10.1097/ee9.0000000000000308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 03/18/2024] [Indexed: 05/29/2024] Open
Abstract
Background PM2.5, NO2, and O3 contribute to the development of adverse pregnancy complications. While studies have investigated the independent effects of these exposures, literature on their combined effects is limited. Our objective was to study the multipollutant effects of PM2.5, NO2, and O3 on maternal systemic C-reactive protein (CRP) levels. Methods We used data from 1170 pregnant women enrolled in the Maternal-Infant Research on Environmental Chemicals Study (MIREC) study in Canada. Air pollution exposures were assigned to each participant based on residential location. CRP was measured in third-trimester blood samples. We fit multipollutant linear regression models and evaluated the effects of air pollutant mixtures (14-day averages) using repeated-holdout Weighted Quantile Sum (WQS) regression and by calculating the Air Quality Health Index (AQHI). Results In multipollutant models adjusting for NO2, O3, and green space, each interquartile range (IQR) increase in 14-day average PM2.5 (IQR: 6.9 µg/m3) was associated with 27.1% (95% confidence interval [CI] = 6.2, 50.7) higher CRP. In air pollution mixture models adjusting for green space, each IQR increase in AQHI was associated with 37.7% (95% CI = 13.9, 66.5) higher CRP; and an IQR increase in the WQS index was associated with 78.6% (95% CI = 29.7, 146.0) higher CRP. Conclusion PM2.5 has the strongest relationship of the individual pollutants examined with maternal blood CRP concentrations. Mixtures incorporating all three pollutants, assessed using the AQHI and WQS index, showed stronger relationships with CRP compared with individual pollutants and illustrate the importance of conducting multipollutant analyses.
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Affiliation(s)
- Priyanka Gogna
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Michael M. Borghese
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Paul J. Villeneuve
- School of Mathematics and Statistics, Carleton University, Ottawa, Ontario, Canada
| | | | - Markey Johnson
- Water and Air Quality Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Robin H. Shutt
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Jillian Ashley-Martin
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | | | - Will D. King
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
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Conway F, Portela A, Filippi V, Chou D, Kovats S. Climate change, air pollution and maternal and newborn health: An overview of reviews of health outcomes. J Glob Health 2024; 14:04128. [PMID: 38785109 PMCID: PMC11117177 DOI: 10.7189/jogh.14.04128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Background Climate change represents a fundamental threat to human health, with pregnant women and newborns being more susceptible than other populations. In this review, we aimed to describe the current landscape of available epidemiological evidence on key climate risks on maternal and newborn health (MNH). Methods We sought to identify published systematic and scoping reviews investigating the impact of different climate hazards and air pollution on MNH outcomes. With this in mind, we developed a systematic search strategy based on the concepts of 'climate/air pollution hazards, 'maternal health,' and 'newborn health,' with restrictions to reviews published between 1 January 2010 and 6 February 2023, but without geographical or language restriction. Following full text screening and data extraction, we synthesised the results using narrative synthesis. Results We found 79 reviews investigating the effects of climate hazards on MNH, mainly focussing on outdoor air pollution (n = 47, 59%), heat (n = 24, 30%), and flood/storm disasters (n = 7, 9%). Most were published after 2015 (n = 60, 76%). These reviews had consistent findings regarding the positive association of exposure to heat and to air pollution with adverse birth outcomes, particularly preterm birth. We found limited evidence for impacts of climate-related food and water security on MNH and did not identify any reviews on climate-sensitive infectious diseases and MNH. Conclusions Climate change could undermine recent improvements in maternal and newborn health. Our review provides an overview of key climate risks to MNH. It could therefore be useful to the MNH community to better understand the MNH needs for each climate hazard and to strengthen discussions on evidence and research gaps and potential actions. Despite the lack of comprehensive evidence for some climate hazards and for many maternal, perinatal, and newborn outcomes, we observed repeated findings of the impact of heat and air pollutants on birth outcomes, particularly preterm birth. It is time for policy dialogue to follow to specifically design climate policy and actions to protect the needs of MNH.
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Affiliation(s)
- Francesca Conway
- World Health Organization, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Anayda Portela
- World Health Organization, Department of Maternal, Newborn, Child and Adolescent Health and Ageing, Geneva, Switzerland
| | - Veronique Filippi
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, United Kingdom
| | - Doris Chou
- UNDP/UNFPA/UNICEF/WHO/The World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Department of Sexual and Reproductive Health, Geneva, Switzerland
| | - Sari Kovats
- London School of Hygiene and Tropical Medicine, NIHR Health Protection Research Unit in Environmental Change and Health, London, United Kingdom
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Mahfouz Y, Tydeman F, Robertson M. Investigating the air quality surrounding new schools in England: polluted playgrounds and school buildings are a source of avoidable harm. Arch Dis Child 2024; 109:483-487. [PMID: 38503436 DOI: 10.1136/archdischild-2023-325947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/30/2023] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To assess levels of pollutants at the sites of new schools and whether pupils are likely to be protected from associated risks. SETTING Air pollution causes damage to children's health by increasing respiratory tract infection rates, asthma exacerbations, allergies and childhood cancers. Further effects include poorer neurocognitive outcomes and multisystemic illness in adulthood. DESIGN We obtained a list of all 187 proposed new schools in England from 2017 to 2025 and found locations for 147 of them. We assessed air quality against WHO air quality targets and the air quality percentile of the location relative to pollution levels across the UK. We review relevant legislation and guidance. RESULTS Our analysis found 86% of new schools (126/147) exceeded all three WHO targets, and every location exceeded at least one. Nationally, 76% (112/147) of sites were in the 60th or greater pollution percentile. Within London, the median pollution percentile was the 90th, with a minimum of 76th and maximum of 99th (IQR=83 rd to 94th). CONCLUSION The guidance for school proposals does not include any requirement to assess air quality at the identified site. Building regulations also fail to consider how widespread poor air quality is, and significantly underestimates the levels of major air pollutants surrounding schools. Therefore it is unlikely that adequate action to reduce pupil and staff exposure is undertaken.We argue that air quality assessment should be mandatory at the proposal and planning stage of any new school building and that national guidance and legislation urgently needs to be updated.
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Feng Y, Liu X, Zhang X, Zhao X, Chang H, Ouyang F, Yu Z, Gao Z, Zhang H. Global air pollution exposure and congenital anomalies: an updated systematic review and meta-analysis of epidemiological studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:2333-2352. [PMID: 37610216 DOI: 10.1080/09603123.2023.2246383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023]
Abstract
A systematic review and meta-analysis was conducted to evaluate recent epidemiological evidence on the association of air pollution with congenital anomalies (CAs). Of 11,014 records, 49 were finally included in this meta-analysis. Per 10 μg/m3 increase in air pollutant, PM10 exposure during the 1st month of pregnancy and at the first trimester (T1) was associated with increased overall CAs. Further, exposure to PM10 was associated with congenital heart disease (OR = 1.055, 95% CI: 1.035, 1.074) and patent ductus arteriosus (OR = 1.094, 95% CI: 1.020, 1.168) at T1, with chromosomal anomalies during the entire pregnancy and with nervous system anomalies when exposure occurred 3 months prior to pregnancy, during the 1st, 2nd months of pregnancy and at T1. Besides, a significant association with overall CAs was observed for a combined exposure of PM10 and SO2 during the 1st month of gestation (OR: 1.101, 95% CI: 1.023, 1.180). A combined exposure of PM10 and CO was also associated with tetralogy of Fallot during 3-8 weeks of gestation (OR: 1.016, 95% CI: 1.005, 1.027). No significant associations were observed between PM2.5, NO2, and O3 exposure and CAs.
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Affiliation(s)
- Yang Feng
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xinxin Liu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaoan Zhang
- Clinical Nutrition Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Zhao
- Clinical Nutrition Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Chang
- Clinical Nutrition Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fan Ouyang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zengli Yu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhan Gao
- Clinical Nutrition Department, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huanhuan Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, China
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21
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Ahn TG, Kim YJ, Lee G, You YA, Kim SM, Chae R, Hur YM, Park MH, Bae JG, Lee SJ, Kim YH, Na S. Association Between Individual Air Pollution (PM 10, PM 2.5) Exposure and Adverse Pregnancy Outcomes in Korea: A Multicenter Prospective Cohort, Air Pollution on Pregnancy Outcome (APPO) Study. J Korean Med Sci 2024; 39:e131. [PMID: 38599601 PMCID: PMC11004777 DOI: 10.3346/jkms.2024.39.e131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 03/05/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Prenatal exposure to ambient air pollution is linked to a higher risk of unfavorable pregnancy outcomes. However, the association between pregnancy complications and exposure to indoor air pollution remains unclear. The Air Pollution on Pregnancy Outcomes research is a hospital-based prospective cohort research created to look into the effects of aerodynamically exposed particulate matter (PM)10 and PM2.5 on pregnancy outcomes. METHODS This prospective multicenter observational cohort study was conducted from January 2021 to June 2023. A total of 662 women with singleton pregnancies enrolled in this study. An AirguardK® air sensor was installed inside the homes of the participants to measure the individual PM10 and PM2.5 levels in the living environment. The time-activity patterns and PM10 and PM2.5, determined as concentrations from the time-weighted average model, were applied to determine the anticipated exposure levels to air pollution of each pregnant woman. The relationship between air pollution exposure and pregnancy outcomes was assessed using logistic and linear regression analyses. RESULTS Exposure to elevated levels of PM10 throughout the first, second, and third trimesters as well as throughout pregnancy was strongly correlated with the risk of pregnancy problems according to multiple logistic regression models adjusted for variables. Except for in the third trimester of pregnancy, women exposed to high levels of PM2.5 had a high risk of pregnancy complications. During the second trimester and entire pregnancy, the risk of preterm birth (PTB) increased by 24% and 27%, respectively, for each 10 μg/m3 increase in PM10. Exposure to high PM10 levels during the second trimester increased the risk of gestational diabetes mellitus (GDM) by 30%. The risk of GDM increased by 15% for each 5 μg/m3 increase in PM2.5 during the second trimester and overall pregnancy, respectively. Exposure to high PM10 and PM2.5 during the first trimester of pregnancy increased the risk of delivering small for gestational age (SGA) infants by 96% and 26%, respectively. CONCLUSION Exposure to high concentrations of PM10 and PM2.5 is strongly correlated with the risk of adverse pregnancy outcomes. Exposure to high levels of PM10 and PM2.5 during the second trimester and entire pregnancy, respectively, significantly increased the risk of PTB and GDM. Exposure to high levels of PM10 and PM2.5 during the first trimester of pregnancy considerably increased the risk of having SGA infants. Our findings highlight the need to measure individual particulate levels during pregnancy and the importance of managing air quality in residential environment.
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Affiliation(s)
- Tae Gyu Ahn
- Department of Obstetrics and Gynecology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital, Ewha Medical Research Institute College of Medicine, Seoul, Korea
| | - Gain Lee
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Soo Min Kim
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Rin Chae
- Division of Artificial Intelligence and Software/Artificial Intelligence Convergence, Ewha Womans University, Seoul, Korea
| | - Young Min Hur
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Mi Hye Park
- Department of Obstetrics and Gynecology, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Jin-Gon Bae
- Department of Obstetrics and Gynecology, School of Medicine, Keimyung University, Dongsan Medical Center, Daegu, Korea
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, Severance Hospital, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
| | - Sunghun Na
- Department of Obstetrics and Gynecology, Kangwon National University School of Medicine, Chuncheon, Korea.
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22
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Leutsch F, Solovieva A. Incidence of histologic chorioamnionitis in a rural community hospital. Ir J Med Sci 2024; 193:791-796. [PMID: 37639160 DOI: 10.1007/s11845-023-03505-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/20/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Histological chorioamnionitis (HCA) is a pathological condition defined as an acute inflammation of the amniochorionic membranes which has been linked to a wide range of adverse neonatal events. AIM The purpose of this study is to identify the incidence of HCA in the rural population and evaluate whether there are significant differences in these incidences within the different clinical parameters of delivery method, gravidity, gestational age, previous cesarean section, reason for cesarean section and body mass index (BMI). METHODS A retrospective chart review was conducted on 462 consecutive deliveries that occurred in a rural hospital during a four-year period. Data collected was analyzed using independent sample T-tests, chi-squared tests, and descriptive statistics, with a p-value of < 0.05. RESULTS Overall incidence of HCA was 15.9% (73/459), with a term incidence of 16.2% (68/421) and preterm incidence of 13.2% (5/38). The incidence of HCA was significantly higher in vaginal deliveries (18.8%; n = 54/288) than C-section deliveries (11.1%; n = 19/171) (p = 0.03). Incidence of clinical chorioamnionitis was 0.43% (2/462), with 2.74% (2/73) of HCA manifesting clinically. CONCLUSIONS Evaluation of the incidence of HCA and associated clinical parameters in this study showed a marked decrease in the incidence of HCA when compared to other studies. Strategies to reduce the incidence of HCA include reducing the length of labor via active labor management. We hypothesize that these findings are due to the consistent use of active labor management and our rural study population, but further investigation is required to confirm this.
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Li B, Sun W. How does air pollution affect household consumption? Evidence from China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:25769-25786. [PMID: 38488919 DOI: 10.1007/s11356-024-32872-3] [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: 09/04/2023] [Accepted: 03/08/2024] [Indexed: 03/17/2024]
Abstract
Increasing air pollution not only affects the population's health but also changes its consumption structures and patterns. Using China Family Panel Studies, this study investigates the relationship between air pollution and household consumption. The findings reveal that household consumption is considerably affected by air pollution: One standard deviation rise of PM2.5 concentration will decrease the household consumption by 8.7%. Moreover, this effect is irreversible in the short term. What is more, air pollution has significantly changed consumption structure and patterns. Heterogeneous analysis indicates that the influence of air pollution on consumption generates the so-called Matthew Effect, wherein medium and low-income and rural households are exposed to a greater negative effect. Mechanism tests indicate that air pollution may reduce household consumption through three channels: increase negative emotions, decrease outdoor activities, and depress future expectations. The conclusions drawn in this paper enrich our understanding of the economic impact caused by air pollution and bring important significance to the government in promoting the coordination and sustainable development of the environment and economy.
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Affiliation(s)
- Boning Li
- Beijing Wuzi University, Beijing, 101149, China
| | - Weizeng Sun
- School of Economics, Central University of Finance and Economics, Beijing, 100081, China.
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24
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Lee SA, Corbett GA, McAuliffe FM. Obstetric care for environmental migrants. Ir J Med Sci 2024; 193:797-812. [PMID: 37715828 PMCID: PMC10961262 DOI: 10.1007/s11845-023-03481-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/26/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Migration due to environmental factors is an international crisis affecting many nations globally. Pregnant people are a vulnerable subgroup of migrants. AIM This article explores the potential effects of environmental migration on pregnancy and aims to draw attention to this rising concern. METHODS Based on the study aim, a semi-structured literature review was performed. The following databases were searched: MEDLine (PubMed) and Google Scholar. The search was originally conducted on 31st January 2021 and repeated on 22nd September 2022. RESULTS Pregnant migrants are at increased risk of mental health disorders, congenital anomalies, preterm birth, and maternal mortality. Pregnancies exposed to natural disasters are at risk of low birth weight, preterm birth, hypertensive disorders, gestational diabetes, and mental health morbidity. Along with the health risks, there are additional complex social factors affecting healthcare engagement in this population. CONCLUSION Maternity healthcare providers are likely to provide care for environmental migrants over the coming years. Environmental disasters and migration as individual factors have complex effects on perinatal health, and environmental migrants may be at risk of specific perinatal complications. Obstetricians and maternity healthcare workers should be aware of these challenges and appreciate the individualised and specialised care that these patients require.
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Affiliation(s)
- Sadhbh A Lee
- National Maternity Hospital, Holles St., Dublin 2, Ireland
| | | | - Fionnuala M McAuliffe
- National Maternity Hospital, Holles St., Dublin 2, Ireland.
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.
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25
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Park S, Shim M, Lee G, You YA, Kim SM, Hur YM, Ko H, Park MH, Na SH, Kim YH, Cho GJ, Bae JG, Lee SJ, Lee SH, Lee DK, Kim YJ. Urinary metabolite biomarkers of pregnancy complications associated with maternal exposure to particulate matter. Reprod Toxicol 2024; 124:108550. [PMID: 38280687 DOI: 10.1016/j.reprotox.2024.108550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/02/2024] [Accepted: 01/23/2024] [Indexed: 01/29/2024]
Abstract
Particulate matter 2.5 (PM2.5) is associated with reproductive health and adverse pregnancy outcomes. However, studies evaluating biological markers of PM2.5 are lacking, and identifying biomarkers for estimating prenatal exposure to prevent pregnancy complications is essential. Therefore, we aimed to explore urine metabolites that are easy to measure as biomarkers of exposure. In this matched case-control study based on the PM2.5 exposure, 30 high PM2.5 group (>15 μg/m3) and 30 low PM2.5 group (<15 μg/m3) were selected from air pollution on pregnancy outcome (APPO) cohort study. We used a time-weighted average model to estimate individual PM exposure, which used indoor PM2.5 and outdoor PM2.5 concentrations by atmospheric measurement network based on residential addresses. Clinical characteristics and urine samples were collected from participants during the second trimester of pregnancy. Urine metabolites were quantitatively measured using gas chromatography-mass spectrometry following multistep chemical derivatization. Statistical analyses were conducted using SPSS version 21 and MetaboAnalyst 5.0. Small for gestational age and gestational diabetes (GDM) were significantly increased in the high PM2.5 group, respectively (P = 0.042, and 0.022). Fifteen metabolites showed significant differences between the two groups (P < 0.05). Subsequent pathway enrichment revealed that four pathways, including pentose and glucuronate interconversion with three pentose sugars (ribose, arabinose, and xylose; P < 0.05). The concentration of ribose increased preterm births (PTB) and GDM (P = 0.044 and 0.049, respectively), and the arabinose concentration showed a tendency to increase in PTB (P = 0.044). Therefore, we identified urinary pentose metabolites as biomarkers of PM2.5 and confirmed the possibility of their relationship with pregnancy complications.
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Affiliation(s)
- Sunwha Park
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Minki Shim
- College of Pharmacy, Chung-Ang University, Seoul, Korea
| | - Gain Lee
- Graduate program in system health science and engineering, Ewha Womans University, Seoul, Korea
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Soo Min Kim
- Graduate program in system health science and engineering, Ewha Womans University, Seoul, Korea
| | - Young Min Hur
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Hyejin Ko
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Mi Hye Park
- Department of Obstetrics and Gynecology, Ewha Womans University Seoul Hospital, Korea
| | - Sung Hun Na
- Department of Obstetrics and Gynecology, Kangwon National University, School of Medicine, Korea
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea
| | - Jin-Gon Bae
- Department of Obstetrics and Gynecology, Keimyung University, School of Medicine, Dongsan Medical Center, Korea
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Korea
| | | | - Dong-Kyu Lee
- College of Pharmacy, Chung-Ang University, Seoul, Korea.
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea; Graduate program in system health science and engineering, Ewha Womans University, Seoul, Korea.
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26
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Hegelund ER, Mehta AJ, Andersen ZJ, Lim YH, Loft S, Brunekreef B, Hoek G, de Hoogh K, Mortensen LH. Air pollution and human health: a phenome-wide association study. BMJ Open 2024; 14:e081351. [PMID: 38423777 PMCID: PMC10910582 DOI: 10.1136/bmjopen-2023-081351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVES To explore the associations of long-term exposure to air pollution with onset of all human health conditions. DESIGN Prospective phenome-wide association study. SETTING Denmark. PARTICIPANTS All Danish residents aged ≥30 years on 1 January 2000 were included (N=3 323 612). After exclusion of individuals with missing geocoded residential addresses, 3 111 988 participants were available for the statistical analyses. MAIN OUTCOME MEASURE First registered diagnosis of every health condition according to the International Classification of Diseases, 10th revision, from 2000 to 2017. RESULTS Long-term exposure to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were both positively associated with the onset of more than 700 health conditions (ie, >80% of the registered health conditions) after correction for multiple testing, while the remaining associations were inverse or insignificant. As regards the most common health conditions, PM2.5 and NO2 were strongest positively associated with chronic obstructive pulmonary disease (PM2.5: HR 1.06 (95% CI 1.05 to 1.07) per 1 IQR increase in exposure level; NO2: 1.14 (95% CI 1.12 to 1.15)), type 2 diabetes (PM2.5: 1.06 (95% CI 1.05 to 1.06); NO2: 1.12 (95% CI 1.10 to 1.13)) and ischaemic heart disease (PM2.5: 1.05 (95% CI 1.04 to 1.05); NO2: 1.11 (95% CI 1.09 to 1.12)). Furthermore, PM2.5 and NO2 were both positively associated with so far unexplored, but highly prevalent outcomes relevant to public health, including senile cataract, hearing loss and urinary tract infection. CONCLUSIONS The findings of this study suggest that air pollution has a more extensive impact on human health than previously known. However, as this study is the first of its kind to investigate the associations of long-term exposure to air pollution with onset of all human health conditions, further research is needed to replicate the study findings.
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Affiliation(s)
| | | | | | | | | | | | - Gerard Hoek
- Utrecht University, Utrecht, the Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
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Yang N, Quick HS, Melly SJ, Mullin AM, Zhao Y, Edwards J, Clougherty JE, Schinasi LH, Burris HH. Spatial Patterning of Spontaneous and Medically Indicated Preterm Birth in Philadelphia. Am J Epidemiol 2024; 193:469-478. [PMID: 37939071 DOI: 10.1093/aje/kwad207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 07/18/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023] Open
Abstract
Preterm birth (PTB) remains a key public health issue that disproportionately affects Black individuals. Since spontaneous PTB (sPTB) and medically indicated PTB (mPTB) may have different causes and interventions, we quantified racial disparities for sPTB and mPTB, and we characterized the geographic patterning of these phenotypes, overall and according to race/ethnicity. We examined a pregnancy cohort of 83,952 singleton births at 2 Philadelphia hospitals from 2008-2020, and classified each PTB as sPTB or mPTB. We used binomial regression to quantify the magnitude of racial disparities between non-Hispanic Black and non-Hispanic White individuals, then generated small area estimates by applying a Bayesian model that accounts for small numbers and smooths estimates of PTB risk by borrowing information from neighboring areas. Racial disparities in both sPTB and mPTB were significant (relative risk of sPTB = 1.83, 95% confidence interval: 1.70, 1.98; relative risk of mPTB = 2.20, 95% confidence interval: 2.00, 2.42). The disparity was 20% greater in mPTB than sPTB. There was substantial geographic variation in PTB, sPTB, and mPTB risks and racial disparity. Our findings underscore the importance of distinguishing PTB phenotypes within the context of public health and preventive medicine. Future work should consider social and environmental exposures that may explain geographic differences in PTB risk and disparities.
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28
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Willis MD, Harris L, Campbell EJ, Chaskes M, Sawyer E, Harleman M, Ritz B, Hill EL, Hystad P. A population-based cohort study of electronic tolling, traffic congestion, and adverse birth outcomes. ENVIRONMENT INTERNATIONAL 2024; 183:108355. [PMID: 38056094 DOI: 10.1016/j.envint.2023.108355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/06/2023] [Accepted: 11/25/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Although traffic-related air pollution is largely regulated at the federal level, congestion reduction projects may reduce local traffic and air pollution to levels that create positive co-benefits for population health. In recent years, many urban areas have implemented electronic tolling systems to improve traffic conditions. OBJECTIVE Quantify associations between implementing electronic tolling and local changes in traffic and infant health. METHODS Using a population-based birth cohort (Texas, 1999-2016), we calculated residential proximity to the nearest tolled road segment within 5 km (n = 625,279) and examined changes in local traffic before and after toll implementation. Using a difference-in-differences design, we compared four markers of adverse birth outcomes (term birth weight, term low birth weight, preterm birth, very preterm birth) among infants from pregnant people residing < 0.5 km from a road segment before and after the tolls were implemented and compared them to a contemporaneous population of pregnant people residing at 2-5 km. RESULTS We observed minimal changes in local traffic after the implementation of tolling. Among births within 500 m of a tolled road, we found little evidence of an association between the implementation of tolling and adverse birth outcomes (term birth weight [β: -4.5, 95 % CI: -11.7, 2.6], term low birth weight [OR: 1.00, 95 % CI: 0.89, 1.13], preterm birth [OR: 0.99, 95 % CI: 0.92, 1.05], very preterm birth [OR: 1.00, 95 % CI: 0.84, 1.18]), compared to the contemporaneous control group of births at 2-5 km. In sub-analyses, we found some evidence of a reduced association between toll booth removal and preterm birth (OR: 0.84, 95 % CI: 0.70, 1.01) but not for other outcomes or tolling types. DISCUSSION In this large population-based retrospective cohort study of births in Texas, we found little evidence that the implementation of tolling was consistently associated with improvements in local infant health outcomes.
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Affiliation(s)
- Mary D Willis
- Department of Epidemiology, School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118, United States.
| | - Lena Harris
- Department of Economics, School of Arts and Sciences, University of Rochester, 238 Harkness Hall, P.O. Box 270156, Rochester, NY 14627, United States
| | - Erin J Campbell
- Department of Epidemiology, School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118, United States
| | - Mira Chaskes
- Department of Economics, School of Arts and Sciences, University of Rochester, 238 Harkness Hall, P.O. Box 270156, Rochester, NY 14627, United States
| | - Ethan Sawyer
- Department of Economics, School of Arts and Sciences, University of Rochester, 238 Harkness Hall, P.O. Box 270156, Rochester, NY 14627, United States
| | - Max Harleman
- Department of Government and Sociology, College of Arts and Sciences, Georgia College and State University, 410 W. Greene Streer, Campus Box 18, Milledgeville, GA 31061, United States
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Box 951772 Suite 71-254 CHS, Los Angeles, CA 90095, United States; School of Nutrition and Public Health, College of Health, Oregon State University, 101 Milam Hall, Corvallis, OR 97331, United States
| | - Elaine L Hill
- Department of Economics, School of Arts and Sciences, University of Rochester, 238 Harkness Hall, P.O. Box 270156, Rochester, NY 14627, United States; Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, 265 Crittenden Blvd, Rochester, NY 14642, United States
| | - Perry Hystad
- School of Nutrition and Public Health, College of Health, Oregon State University, 101 Milam Hall, Corvallis, OR 97331, United States
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Hazlehurst MF, Sathyanarayana S. Invited Perspective: Prenatal PM2.5 Exposure Associated with Adverse Birth Outcomes Requiring Medical Interventions. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:11303. [PMID: 38271059 PMCID: PMC10810298 DOI: 10.1289/ehp14290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024]
Affiliation(s)
- Marnie F. Hazlehurst
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Sheela Sathyanarayana
- Seattle Children’s Research Institute, Seattle, Washington, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
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Johnson M, Mazur L, Fisher M, Fraser WD, Sun L, Hystad P, Gandhi CK. Prenatal Exposure to Air Pollution and Respiratory Distress in Term Newborns: Results from the MIREC Prospective Pregnancy Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:17007. [PMID: 38271058 PMCID: PMC10810300 DOI: 10.1289/ehp12880] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 11/03/2023] [Accepted: 12/11/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Respiratory distress is the leading cause of neonatal morbidity and mortality worldwide, and prenatal exposure to air pollution is associated with adverse long-term respiratory outcomes; however, the impact of prenatal air pollution exposure on neonatal respiratory distress has not been well studied. OBJECTIVES We examined associations between prenatal exposures to fine particular matter (PM 2.5 ) and nitrogen dioxide (NO 2 ) with respiratory distress and related neonatal outcomes. METHODS We used data from the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a prospective pregnancy cohort (n = 2,001 ) recruited in the first trimester from 10 Canadian cities. Prenatal exposures to PM 2.5 (n = 1,321 ) and NO 2 (n = 1,064 ) were estimated using land-use regression and satellite-derived models coupled with ground-level monitoring and linked to participants based on residential location at birth. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between air pollution and physician-diagnosed respiratory distress in term neonates in hierarchical logistic regression models adjusting for detailed maternal and infant covariates. RESULTS Approximately 7 % of newborns experienced respiratory distress. Neonates received clinical interventions including oxygen therapy (6%), assisted ventilation (2%), and systemic antibiotics (3%). Two percent received multiple interventions and 4% were admitted to the neonatal intensive care unit (NICU). Median PM 2.5 and NO 2 concentrations during pregnancy were 8.81 μ g / m 3 and 18.02 ppb , respectively. Prenatal exposures to air pollution were not associated with physician-diagnosed respiratory distress, oxygen therapy, or NICU admissions. However, PM 2.5 exposures were strongly associated with assisted ventilation (OR per 1 - μ g / m 3 increase in PM 2.5 = 1.17 ; 95% CI: 1.02, 1.35), multiple clinical interventions (OR per 1 - μ g / m 3 increase in PM 2.5 = 1.16 ; 95% CI: 1.07, 1.26), and systemic antibiotics, (OR per 1 - μ g / m 3 increase in PM 2.5 = 1.12 ; 95% CI: 1.04, 1.21). These associations were consistent across exposure periods-that is, during prepregnancy, individual trimesters, and total pregnancy-and robust to model specification. NO 2 exposure was associated with administration of systemic antibiotics (OR per 1-ppb increase in NO 2 = 1.03 ; 95% CI: 1.00, 1.06). DISCUSSION Prenatal exposures to PM 2.5 increased the risk of severe respiratory distress among term newborns. These findings support the development and prioritization of public health and prenatal care strategies to increase awareness and minimize prenatal exposures to air pollution. https://doi.org/10.1289/EHP12880.
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Affiliation(s)
- Markey Johnson
- Water and Air Quality Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Lauren Mazur
- Department of Pediatrics, Penn State College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Mandy Fisher
- Environmental Health Sciences and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - William D. Fraser
- Department of Obstetrics and Gynecology, Centre de Recherche du CHUS, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Liu Sun
- Water and Air Quality Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Perry Hystad
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Chintan K. Gandhi
- Department of Pediatrics, Penn State College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
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Bole A, Bernstein A, White MJ. The Built Environment and Pediatric Health. Pediatrics 2024; 153:e2023064773. [PMID: 38105697 DOI: 10.1542/peds.2023-064773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 12/19/2023] Open
Abstract
Buildings, parks, and roads are all elements of the "built environment," which can be described as the human-made structures that comprise the neighborhoods and communities where people live, work, learn, and recreate (https://www.epa.gov/smm/basic-information-about-built-environment). The design of communities where children and adolescents live, learn, and play has a profound impact on their health. Moreover, the policies and practices that determine community design and the built environment are a root cause of disparities in the social determinants of health that contribute to health inequity. An understanding of the links between the built environment and pediatric health will help to inform pediatricians' and other pediatric health professionals' care for patients and advocacy on their behalf. This technical report describes the range of pediatric physical and mental health conditions influenced by the built environment, as well as historical and persistent effects of the built environment on health disparities. The accompanying policy statement outlines community design solutions that can improve pediatric health and health equity, including opportunities for pediatricians and the health care sector to incorporate this knowledge in patient care, as well as to play a role in advancing a health-promoting built environment for all children and families.
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Affiliation(s)
- Aparna Bole
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Aaron Bernstein
- Department of General Pediatrics, Boston Children's Hospital, and Center for Climate, Health and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Michelle J White
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
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Bravo MA, Zephyr D, Fiffer MR, Miranda ML. Weekly prenatal PM 2.5 and NO 2 exposures in preterm, early term, and full term infants: Decrements in birth weight and critical windows of susceptibility. ENVIRONMENTAL RESEARCH 2024; 240:117509. [PMID: 37890819 PMCID: PMC10842146 DOI: 10.1016/j.envres.2023.117509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/13/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Previous studies have observed associations between birth weight and prenatal air pollution exposure, but there is not consensus on timing of critical windows of susceptibility. OBJECTIVE We estimated the difference in birth weight among preterm, early term and full term births associated with weekly exposure to PM2.5 and NO2 throughout gestation. METHODS We included all singleton live births in the Lower Peninsula of Michigan (United States) between 2007 and 2012 occurring at or after 32 weeks gestational age (n = 497,897). Weekly ambient PM2.5 and NO2 concentrations were estimated at maternal residences using 1-km gridded data from ensemble-based models. We utilized a distributed lag nonlinear model to estimate the difference in birth weight associated with weekly exposures from the last menstrual period (week 0) through 31 weeks gestation for preterm births; through 36 weeks gestation for early term births; and through 38 weeks gestation for full term births. RESULTS In single-pollutant models, a 5 μg/m3 increase in PM2.5 exposure was associated with a reduction in birth weight among preterm births (-37.1 g [95% confidence interval [CI]: 60.8 g, -13.5 g]); early term births (-13.5 g [95% CI: 26.2 g, -0.67 g]); and full term births (-8.23 g [95% CI: 15.8 g, -0.68 g])]. In single-pollutant models, a 10 ppb increase in NO2 exposure was associated with a -11.7 g (95% CI: 14.46 g, -8.92 g) decrement in birth weight among full term births only. In models co-adjusted for PM2.5 and NO2, PM2.5 exposure was associated with reduced birth weight among preterm births (-36.9 g [95% CI: 61.9 g, -11.8 g]) and NO2 exposure was associated with reduced birth weight among full term births (-11.8 g [95% CI: 14.7 g, -8.94 g]). The largest decrements in birth weight were associated with PM2.5 exposure between approximately 10 and 26 weeks of pregnancy; for NO2 exposure, the largest decrements in birth weight in full term births were associated with exposure between weeks 6-18. CONCLUSION We observed the largest and most persistent adverse associations between PM2.5 exposure and birth weight in preterm infants, and between NO2 exposure and birth weight in full term infants. Exposure during the first half of pregnancy had a greater impact on birthweight.
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Affiliation(s)
- Mercedes A Bravo
- Global Health Institute, School of Medicine, Duke University, Durham, NC, USA; Children's Environmental Health Initiative, University of Illinois Chicago, Chicago, IL, USA.
| | - Dominique Zephyr
- Children's Environmental Health Initiative, University of Illinois Chicago, Chicago, IL, USA
| | - Melissa R Fiffer
- Children's Environmental Health Initiative, University of Illinois Chicago, Chicago, IL, USA
| | - Marie Lynn Miranda
- Children's Environmental Health Initiative, University of Illinois Chicago, Chicago, IL, USA; Department of Pediatrics, University of Illinois Chicago, Chicago, IL, USA
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Friedman C, Dabelea D, Glueck DH, Allshouse WB, Adgate JL, Keller KP, Martenies SE, Magzamen S, Starling AP. Early-life exposure to residential black carbon and childhood cardiometabolic health. ENVIRONMENTAL RESEARCH 2023; 239:117285. [PMID: 37832765 PMCID: PMC10842121 DOI: 10.1016/j.envres.2023.117285] [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: 03/24/2023] [Revised: 09/08/2023] [Accepted: 09/30/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Early life exposure to air pollution, such as particulate matter ≤2.5 μm (PM2.5), may be associated with obesity and adverse cardiometabolic health outcomes in childhood. However, the toxicity of PM2.5 varies according to its chemical composition. Black carbon (BC) is a constituent of PM2.5, but few studies have examined its impact on childhood cardiometabolic health. Therefore, we examined relationships between prenatal and early childhood exposure to BC and markers of adiposity and cardiometabolic health in early childhood. METHODS This study included 578 mother-child pairs enrolled in the Healthy Start study (2009-2014) living in the Denver-metro area. Using a spatiotemporal prediction model, we assessed average residential black carbon levels during pregnancy and in the year prior to the early childhood follow-up visit at approximately 5 years old. We estimated associations between prenatal and early childhood BC and indicators of adiposity and cardiometabolic biomarkers in early childhood (mean 4.8 years; range, 4.0, 8.3), using linear regression. RESULTS We found higher early childhood BC was associated with higher percent fat mass, fat mass index, insulin, and homeostatic model assessment for insulin resistance (HOMA-IR), and lower leptin and waist circumference at approximately 5 years old, after adjusting for covariates. For example, per interquartile range (IQR) increase in early childhood BC (IQR, 0.49 μg/m3) there was 3.32% higher fat mass (95% CI; 2.05, 4.49). Generally, we did not find consistent evidence of associations between prenatal BC and cardiometabolic health outcomes in early childhood, except for an inverse association between prenatal BC and adiponectin, an adipocyte-secreted hormone typically inversely associated with adiposity. CONCLUSIONS Higher early childhood, but not in utero, ambient concentrations of black carbon, a component of air pollution, were associated with greater adiposity and altered insulin homeostasis at approximately 5 years old. Future studies should examine whether these changes persist later in life.
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Affiliation(s)
- Chloe Friedman
- 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.
| | - 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
| | - Deborah H Glueck
- 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
| | - William B Allshouse
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John L Adgate
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kayleigh P Keller
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Sheena E Martenies
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Department of Epidemiology, Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA
| | - Anne P Starling
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Hao H, Yoo SR, Strickland MJ, Darrow LA, D'Souza RR, Warren JL, Moss S, Wang H, Zhang H, Chang HH. Effects of air pollution on adverse birth outcomes and pregnancy complications in the U.S. state of Kansas (2000-2015). Sci Rep 2023; 13:21476. [PMID: 38052850 PMCID: PMC10697947 DOI: 10.1038/s41598-023-48329-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/24/2023] [Indexed: 12/07/2023] Open
Abstract
Neonatal mortality and morbidity are often caused by preterm birth and lower birth weight. Gestational diabetes mellitus (GDM) and gestational hypertension (GH) are the most prevalent maternal medical complications during pregnancy. However, evidence on effects of air pollution on adverse birth outcomes and pregnancy complications is mixed. Singleton live births conceived between January 1st, 2000, and December 31st, 2015, and reached at least 27 weeks of pregnancy in Kansas were included in the study. Trimester-specific and total pregnancy exposures to nitrogen dioxide (NO2), particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5), and ozone (O3) were estimated using spatiotemporal ensemble models and assigned to maternal residential census tracts. Logistic regression, discrete-time survival, and linear models were applied to assess the associations. After adjustment for demographics and socio-economic status (SES) factors, we found increases in the second and third trimesters and total pregnancy O3 exposures were significantly linked to preterm birth. Exposure to the second and third trimesters O3 was significantly associated with lower birth weight, and exposure to NO2 during the first trimester was linked to an increased risk of GDM. O3 exposures in the first trimester were connected to an elevated risk of GH. We didn't observe consistent associations between adverse pregnancy and birth outcomes with PM2.5 exposure. Our findings indicate there is a positive link between increased O3 exposure during pregnancy and a higher risk of preterm birth, GH, and decreased birth weight. Our work supports limiting population exposure to air pollution, which may lower the likelihood of adverse birth and pregnancy outcomes.
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Affiliation(s)
- Hua Hao
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd., NE, Atlanta, GA, 30322, USA.
| | - Sodahm R Yoo
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Matthew J Strickland
- Depatment of Health Analytics and Biostatistics, Epidemiology and Environmental Health, School of Public Health, University of Nevada, Reno, NV, 89557, USA
| | - Lyndsey A Darrow
- Depatment of Health Analytics and Biostatistics, Epidemiology and Environmental Health, School of Public Health, University of Nevada, Reno, NV, 89557, USA
| | - Rohan R D'Souza
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Joshua L Warren
- Department of Biostatistics, School of Medicine, Yale University, New Haven, CT, 06510, USA
| | - Shannon Moss
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Huaqing Wang
- Department of Landscape Architecture and Environment Planning, College of Agriculture and Applied Sciences, Utah State University, Logan, UT, 84322, USA
| | - Haisu Zhang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd., NE, Atlanta, GA, 30322, USA
| | - Howard H Chang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd., NE, Atlanta, GA, 30322, USA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
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Krajewski AK, Luben TJ, Warren JL, Rappazzo KM. Associations between weekly gestational exposure of fine particulate matter, ozone, and nitrogen dioxide and preterm birth in a North Carolina Birth Cohort, 2003-2015. Environ Epidemiol 2023; 7:e278. [PMID: 38912391 PMCID: PMC11189686 DOI: 10.1097/ee9.0000000000000278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/04/2023] [Indexed: 06/25/2024] Open
Abstract
Background Preterm birth (PTB; <37 weeks completed gestation) is associated with exposure to air pollution, though variability in association magnitude and direction across exposure windows exists. We evaluated associations between weekly gestational exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) with PTB in a North Carolina Birth Cohort from 2003 to 2015 (N = 1,367,517). Methods Daily average PM2.5 and daily 8-hour maximum NO2 concentration estimates were obtained from a hybrid ensemble model with a spatial resolution of 1 km2. Daily 8-hour maximum census tract-level concentration estimates for O3 were obtained from the EPA's Fused Air Quality Surface Using Downscaling model. Air pollutant concentrations were linked by census tract to residential address at delivery and averaged across each week of pregnancy. Modified Poisson regression models with robust errors were used to estimate risk differences (RD [95% confidence intervals (CI)]) for an interquartile range increase in pollutants per 10,000 births, adjusted for potential confounders. Results Associations were similar in magnitude across weeks. We observed positive associations for PM2.5 and O3 exposures, but generally null associations with NO2. RDs ranged from 15 (95% CI = 11, 18) to 32 (27, 37) per 10,000 births for PM2.5; from -7 (-14, -1) to 0 (-5, 4) for NO2; and from 4 (1, 7) to 13 (10, 16) for O3. Conclusion Our results show that increased PM2.5 exposure is associated with an increased risk of PTB across gestational weeks, and these associations persist in multipollutant models with NO2 and/or O3.
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Affiliation(s)
- Alison K. Krajewski
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina
| | - Thomas J. Luben
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina
| | - Joshua L. Warren
- Department of Biostatistics, School of Public Health, Yale University, New Haven, Connecticut
| | - Kristen M. Rappazzo
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina
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Li ZH, Mao YC, Li Y, Zhang S, Hu HY, Liu ZY, Liu XJ, Zhao JW, Huang K, Chen ML, Gao GP, Hu CY, Zhang XJ. Joint effects of prenatal exposure to air pollution and pregnancy-related anxiety on birth weight: A prospective birth cohort study in Ma'anshan, China. ENVIRONMENTAL RESEARCH 2023; 238:117161. [PMID: 37717800 DOI: 10.1016/j.envres.2023.117161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/03/2023] [Accepted: 09/15/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND A growing number of studies have shown that prenatal exposure to chemical and non-chemical stressors has effects on fetal growth. The co-exposure of both better reflects real-life exposure patterns. However, no studies have included air pollutants and pregnancy-related anxiety (PrA) as mixtures in the analysis. METHOD Using the birth cohort study method, 576 mother-child pairs were included in the Ma'anshan Maternal and Child Health Hospital. Evaluate the exposure levels of six air pollutants during pregnancy using inverse distance weighting (IDW) based on the pregnant woman's residential address and air pollution data from monitoring stations. Prenatal anxiety levels were assessed using the PrA Questionnaire. Generalized linear regression (GLR), quantile g-computation (QgC) and bayesian kernel machine regression (BKMR) were used to assess the independent or combined effects of air pollutants and PrA on birth weight for gestational age z-score (BWz). RESULT The results of GLR indicate that the correlation between the six air pollutants and PrA with BWz varies depending on the different stages of pregnancy and pollutants. The QgC shows that during trimester 1, when air pollutants and PrA are considered as a whole exposure, an increase of one quartile is significantly negatively correlated with BWz. The BKMR similarly indicates that during trimester 1, the combined exposure of air pollutants and PrA is moderately correlated with a decrease in BWz. CONCLUSION Using the method of analyzing mixed exposures, we found that during pregnancy, the combined exposure of air pollutants and PrA, particularly during trimester 1, is associated with BWz decrease. This supports the view that prenatal exposure to chemical and non-chemical stressors has an impact on fetal growth.
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Affiliation(s)
- Zhen-Hua Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yi-Cheng Mao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yang Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Sun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Hui-Yu Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Zhe-Ye Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xue-Jie Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Jia-Wen Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Kai Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Mao-Lin Chen
- Department of Gynecology and Obstetrics, Ma'anshan Maternal and Child Health Hospital, Ma'anshan, 243000, China
| | - Guo-Peng Gao
- Department of Child Health Care, Ma'anshan Maternal and Child Health Hospital, Ma'anshan, 243000, China
| | - Cheng-Yang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei, 230032, China.
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Heo S, Afanasyeva Y, Trasande L, Bell ML, Ghassabian A. Residential mobility in pregnancy and potential exposure misclassification of air pollution, temperature, and greenness. Environ Epidemiol 2023; 7:e273. [PMID: 38912392 PMCID: PMC11189681 DOI: 10.1097/ee9.0000000000000273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 09/06/2023] [Indexed: 06/25/2024] Open
Abstract
Introduction Epidemiological studies commonly use residential addresses at birth to estimate exposures throughout pregnancy, ignoring residential mobility. Lack of consideration for residential mobility during pregnancy might lead to exposure misclassification that should be addressed in environmental epidemiology. Methods We investigated potential exposure misclassification from estimating exposure during pregnancy by residence at delivery utilizing a prospective cohort of pregnant women in New York, United States (n = 1899; 2016-2019). We calculated exposure during pregnancy corresponding to each address for fine particles (PM2.5), temperature, and greenness (Enhanced Vegetation Index [EVI]). Results Twenty-two percent of participants moved at least once during pregnancy; 82.3% of movers changed residences during the second or third trimesters. Participants with better health, lower parity, and higher socioeconomic status were more likely to move. Exposures based on address at delivery rather than residential history overestimated exposure for PM2.5 (exposure error: range -5.7 to 4.6 µg/m3, average -0.6 µg/m3) and EVI (range -0.305 to 0.307, average -0.013), but not temperature. Overestimations were significantly larger for mothers with higher socioeconomic status. Our findings indicate that the error for prenatal exposure can occur when residential mobility is not considered and is disproportional by maternal characteristics. Conclusions Epidemiological studies should consider residential mobility in exposure assessments based on geolocation when possible, and results based on mother's residence at birth should be interpreted with understanding of potential differential exposure misclassification.
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Affiliation(s)
- Seulkee Heo
- School of the Environment, Yale University, New Haven, Connecticut
| | - Yelena Afanasyeva
- Department of Population Health at NYU Grossman School of Medicine, New York University, New York, New York
- Department of Pediatrics at NYU Grossman School of Medicine, New York University, New York, New York
| | - Leonardo Trasande
- Department of Population Health at NYU Grossman School of Medicine, New York University, New York, New York
- Department of Pediatrics at NYU Grossman School of Medicine, New York University, New York, New York
| | - Michelle L. Bell
- School of the Environment, Yale University, New Haven, Connecticut
| | - Akhgar Ghassabian
- Department of Population Health at NYU Grossman School of Medicine, New York University, New York, New York
- Department of Pediatrics at NYU Grossman School of Medicine, New York University, New York, New York
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Noghanibehambari H, Bagheri H, Salari M, Tavassoli N, Javid R, Toranji M. Breathing in the future: prenatal exposure to air pollution and infants' health outcomes in the USA. Public Health 2023; 225:198-205. [PMID: 37939461 PMCID: PMC10842113 DOI: 10.1016/j.puhe.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/04/2023] [Accepted: 10/05/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES This study aimed to investigate the impact of air pollution on birth outcomes in the USA over several decades. STUDY DESIGN Approximately 70 million birth records were assessed for the years 1980-2020. This study focussed on seven measures of birth outcomes, including birth weight, low birth weight, very low birth weight, full-term birth weight, foetal growth, gestational age and very premature birth. METHODS An instrumental variable identification strategy was used that exploited within county-month and within month-year of birth variations in exposure to precipitation-induced changes in air pollution. RESULTS Air pollution was found to have negative and large effects on a wide range of birth outcomes. The study findings suggest that a one-standard-deviation increase in ozone was associated with a 6.4% and 12.8% increase (from the mean) in the proportion of low birth weight and very preterm birth infants, respectively. Further analyses suggest that these effects were heterogeneous across trimesters of pregnancy and reveal larger impacts during the second and third trimesters. CONCLUSIONS The results suggest that the ordinary least square estimates of previous studies considerably underestimate the true effects of pollution on birth outcomes. Policies that aim to improve the health capital of future generations should allocate more resources and initiatives to improving environmental air quality.
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Affiliation(s)
- H Noghanibehambari
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI 53706, USA.
| | - H Bagheri
- Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - M Salari
- Department of Accounting, Finance, and Economics, California State University Dominguez Hills, Carson, CA 90747, USA.
| | - N Tavassoli
- Department of Economics, University of Wisconsin Milwaukee, Milwaukee, WI 53211, USA.
| | - R Javid
- School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
| | - M Toranji
- Department of Economics, University of Tehran, Tehran, Iran.
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Singh T, Jalaludin B, Hajat S, Morgan GG, Meissner K, Kaldor J, Green D, Jegasothy E. Acute air pollution and temperature exposure as independent and joint triggers of spontaneous preterm birth in New South Wales, Australia: a time-to-event analysis. Front Public Health 2023; 11:1220797. [PMID: 38098836 PMCID: PMC10720724 DOI: 10.3389/fpubh.2023.1220797] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/23/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Exposure to high ambient temperatures and air pollution has been shown to increase the risk of spontaneous preterm birth (sPTB). Less clear are the effects of cold and the joint effects of air pollution and temperature. Methods Using a Cox proportional hazard regression model, we assessed the risk of independent and combined short-term exposure to ambient daily mean temperature and PM2.5 associated with sPTB in the last week before delivery on overall sPTB (weeks 23-36) and three subtypes: extremely sPTB, very sPTB, and moderate-to-late sPTB for a birth cohort of 1,318,570 births from Australia (Jan 2001-Dec 2019), while controlling for chronic exposure (i.e., throughout pregnancy except the last week before delivery) to PM2.5 and temperature. The temperature was modeled as a natural cubic spline, PM2.5 as a linear term, and the interaction effect was estimated using a multiplicative term. For short-term exposure to temperature hazard ratios reported are relative to the median temperature (18.1°C). Results Hazard ratios at low temperature [5th percentile(11.5°C)] were 0.95 (95% CI: 0.90, 1.00), 1.08 (95% CI: 0.84, 1.4), 0.87 (95% CI: 0.71, 1.06), and 1.00 (95% CI: 0.94, 1.06) and greater for high temperature [95th percentile (24.5°C)]: 1.22 (95% CI: 1.16, 1.28), 1.27 (95% CI: 1.03, 1.57), and 1.26 (95% CI: 1.05, 1.5) and 1.05 (1.00, 1.11), respectively, for overall, extremely, very, and moderate-to-late sPTBs. While chronic exposure to PM2.5 had adverse effects on sPTB, short-term exposure to PM2.5 appeared to have a negative association with all types of sPTB, with hazard ratios ranging from 0.86 (95th CI: 0.80, 0.94) to 0.98 (95th CI: 0.97, 1.00) per 5 μg/m3 increase in PM2.5. Discussion The risk of sPTB was found to increase following acute exposure to hot and cold ambient temperatures. Earlier sPTB subtypes seemed to be the most vulnerable. This study adds to the evidence that short-term exposure to ambient cold and heat and longer term gestational exposure to ambient PM2.5 are associated with an elevated risk of sPTB.
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Affiliation(s)
- Tanya Singh
- Climate Change Research Centre, University of New South Wales, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence for Climate Extremes, University of New South Wales, Sydney, NSW, Australia
| | - Bin Jalaludin
- School of Population Health, University of New South Wales, Kensington, NSW, Australia
- Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia
| | - Shakoor Hajat
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Geoffrey G. Morgan
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Lismore, NSW, Australia
- Healthy Environments and Lives (HEAL) National Research Network, Australian National University, Canberra, ACT, Australia
- Centre for Air Pollution, Energy and Health Research (CAR), Glebe, NSW, Australia
| | - Katrin Meissner
- Climate Change Research Centre, University of New South Wales, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence for Climate Extremes, University of New South Wales, Sydney, NSW, Australia
| | - John Kaldor
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Donna Green
- Climate Change Research Centre, University of New South Wales, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence for Climate Extremes, University of New South Wales, Sydney, NSW, Australia
| | - Edward Jegasothy
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Lismore, NSW, Australia
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Khan W, Zaki N, Ahmad A, Masud MM, Govender R, Rojas-Perilla N, Ali L, Ghenimi N, Ahmed LA. Node embedding-based graph autoencoder outlier detection for adverse pregnancy outcomes. Sci Rep 2023; 13:19817. [PMID: 37963898 PMCID: PMC10645849 DOI: 10.1038/s41598-023-46726-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 11/04/2023] [Indexed: 11/16/2023] Open
Abstract
Adverse pregnancy outcomes, such as low birth weight (LBW) and preterm birth (PTB), can have serious consequences for both the mother and infant. Early prediction of such outcomes is important for their prevention. Previous studies using traditional machine learning (ML) models for predicting PTB and LBW have encountered two important limitations: extreme class imbalance in medical datasets and the inability to account for complex relational structures between entities. To address these limitations, we propose a node embedding-based graph outlier detection algorithm to predict adverse pregnancy outcomes. We developed a knowledge graph using a well-curated representative dataset of the Emirati population and two node embedding algorithms. The graph autoencoder (GAE) was trained by applying a combination of original risk factors and node embedding features. Samples that were difficult to reconstruct at the output of GAE were identified as outliers considered representing PTB and LBW samples. Our experiments using LBW, PTB, and very PTB datasets demonstrated that incorporating node embedding considerably improved performance, achieving a 12% higher AUC-ROC compared to traditional GAE. Our study demonstrates the effectiveness of node embedding and graph outlier detection in improving the prediction performance of adverse pregnancy outcomes in well-curated population datasets.
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Affiliation(s)
- Wasif Khan
- Department of Computer Science and Software Engineering, College of Information Technology, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Nazar Zaki
- Department of Computer Science and Software Engineering, College of Information Technology, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates.
- ASPIRE Precision Medicine Research Institute Abu Dhabi (ASPIREPMRIAD), Al Ain, United Arab Emirates.
| | - Amir Ahmad
- Department of Information Systems and Security, College of Information Technology, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Mohammad M Masud
- Department of Information Systems and Security, College of Information Technology, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Romana Govender
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Natalia Rojas-Perilla
- Department of Analytics in the Digital Era, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Luqman Ali
- Department of Computer Science and Software Engineering, College of Information Technology, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Nadirah Ghenimi
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Luai A Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
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Ling X. The effect of ambient air pollution on birth outcomes in Norway. BMC Public Health 2023; 23:2248. [PMID: 37964290 PMCID: PMC10647155 DOI: 10.1186/s12889-023-16957-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 10/11/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Ambient air pollution can be harmful to the fetus even in countries with relatively low levels of pollution. Most of the established literature estimates the association between air pollution and health rather than causality. In this paper, I examine the causal effects of ambient air pollution on birth outcomes in Norway. METHODS With the large sample size and geographic division of sub-postal codes in Norway, I can control for a rich set of spatio-temporal fixed effects to overcome most of the endogeneity problems caused by the choice of residential area and date of delivery. After controlling for a rich set of spatio-temporal fixed effects, my paper uses the variance in ambient air pollutant concentrations over narrow time intervals and in a small geographic area of Norway to determine how prenatal air pollution exposure affects birth outcomes. My data contain extensive information about parents as well as meteorological conditions that can be used to control for potential confounding factors. RESULTS I find that prenatal exposure to ambient nitric oxide in the last trimester causes significant birth weight and birth length loss under the same sub-postcode fixed effects and calendar month fixed effects, whereas other ambient air pollutants such as nitrogen dioxide and sulfur dioxide appear to be at safe levels for the fetus in Norway. In addition, the marginal adverse effect of ambient nitric oxide is larger for newborns with disadvantaged parents. Both average concentrations of nitric oxide and occasional high concentration events can adversely affect birth outcomes. CONCLUSIONS Prenatal exposure to NO pollution has an adverse effect on birth outcomes. This suggests that government and researchers should pay more attention to examining NO pollution and that health care providers need to advise pregnant women about the risks of air pollution during pregnancy.
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Affiliation(s)
- Xiaoguang Ling
- Department of Economics, University of Oslo, Oslo, Norway.
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42
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Harleman M, Harris L, Willis MD, Ritz B, Hystad P, Hill EL. Changes in traffic congestion and air pollution due to major roadway infrastructure improvements in Texas. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 898:165463. [PMID: 37459983 DOI: 10.1016/j.scitotenv.2023.165463] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/25/2023] [Accepted: 07/09/2023] [Indexed: 07/25/2023]
Abstract
Traffic-related air pollution (TRAP) is an established health hazard, and roadway construction has the potential to affect TRAP by relieving congestion. The relationship between roadway construction and congestion is of policy importance, but few studies examine it using large samples of construction projects and detailed traffic and air pollution data. We create a dataset of construction projects in Texas and link them to data on air pollution and three variables operationalizing congestion: average annual daily traffic (AADT), AADT per lane, and delay in hours. We use difference-in-difference methods to estimate the effect of widening and intersection improvements on congestion and air pollution. On average over the period during construction, we find that widening increases delay by 42% (95% CI: 30, 56%), but intersection projects do not affect delay. On average and over the first three years post-construction, we find that widening reduces delay by 33% (95% CI: -41, -24%) and reduces NO2 levels within 500 m by 13% (95% CI: -22, -2%), and intersection projects reduce delay by 52% (95% CI: -65, -35%) and reduce NO2 levels within 500 m by 12% (95% CI: -18, -5%). These short-term impacts are relevant for understanding the impact of roadway construction on human health.
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Affiliation(s)
- Max Harleman
- Department of Government and Sociology, College of Arts and Sciences, Georgia College and State University, Milledgeville, GA 31061, United States of America.
| | - Lena Harris
- Department of Economics, University of Rochester, 280 Hutchison Road, Box 270156, Rochester, NY 14627, United States of America.
| | - Mary D Willis
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States of America.
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States of America.
| | - Perry Hystad
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States of America.
| | - Elaine L Hill
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America.
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Mork D, Kioumourtzoglou MA, Weisskopf M, Coull BA, Wilson A. Heterogeneous Distributed Lag Models to Estimate Personalized Effects of Maternal Exposures to Air Pollution. J Am Stat Assoc 2023; 119:14-26. [PMID: 38835505 PMCID: PMC11147136 DOI: 10.1080/01621459.2023.2258595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/07/2023] [Indexed: 06/06/2024]
Abstract
Children's health studies support an association between maternal environmental exposures and children's birth outcomes. A common goal is to identify critical windows of susceptibility-periods during gestation with increased association between maternal exposures and a future outcome. The timing of the critical windows and magnitude of the associations are likely heterogeneous across different levels of individual, family, and neighborhood characteristics. Using an administrative Colorado birth cohort we estimate the individualized relationship between weekly exposures to fine particulate matter (PM 2.5) during gestation and birth weight. To achieve this goal, we propose a statistical learning method combining distributed lag models and Bayesian additive regression trees to estimate critical windows at the individual level and identify characteristics that induce heterogeneity from a high-dimensional set of potential modifying factors. We find evidence of heterogeneity in the PM 2.5 -birth weight relationship, with some mother-child dyads showing a 3 times larger decrease in birth weight for an IQR increase in exposure (5.9 to 8.5 PM 2.5 μg/m3) compared to the population average. Specifically, we find increased vulnerabilitity for non-Hispanic mothers who are either younger, have higher body mass index or lower educational attainment. Our case study is the first precision health study of critical windows.
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Affiliation(s)
- Daniel Mork
- Department of Biostatistics, Harvard T.H. Chan School of Public Health
| | | | - Marc Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health
| | - Ander Wilson
- Department of Statistics, Colorado State University
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Hu B, Xu L, Yang X, Qu S, Wu L, Sun Y, Yan J, Zhang Y, Yu Z, Wang Y, Jia R. Association between ambient air pollution exposure in pregnant women with antiphospholipid syndrome in Nanjing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:116266-116278. [PMID: 37910359 PMCID: PMC10682106 DOI: 10.1007/s11356-023-29937-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/13/2023] [Indexed: 11/03/2023]
Abstract
Antenatal exposure to air pollutants is thought to be associated with a variety of maternal blood markers as well as adverse birth outcomes. However, the dysgenic influence of air pollutants on the antiphospholipid syndrome (APS) in mothers and their pregnancy outcomes remains unclear. In the current study, 371 mother-infant pairs (189 healthy: 182 APS) from Nanjing Maternal and Child Health Hospital as well as air pollutants concentration from their living environment were used to investigate correlations between air pollution with maternal blood indicators and fetal birth weight in the groups of APS and healthy mothers. Generalized linear model was used to evaluate the contributions of air pollutant exposure during pregnancy to the blood indicators variation. The relationships between birth weight with specific air pollutant and blood index were analyzed using ridge regression. Results showed that APS fetal birth weight was significantly impacted by air pollutant exposure during pregnancy, in particular, the birth weight decreased significantly along with increasing fine particulate matter 2.5 (PM2.5) and fine particulate matter 10 (PM10) exposure concentrations throughout pregnancy. In contrast, birth weight increased significantly with sulfur dioxide (SO2) exposure. In addition, APS-related blood indicators comprised of platelet distribution width (PDW), total bilirubin (TBIL), mean platelet volume (MPV), platelet-larger cell ratio (P_LCR), homocysteine (HCY), alkaline phosphatase (ALP), direct bilirubin (DBIL), basophilic granulocyte (BAS), platelet thrombocytocrit (PCT), preprandial glucose levels (OGTT0), monocytes (MON), and monocytes ratio (MON_ratio) were also strongly related with prenatal exposure to PM2.5 and PM10, in which PDW levels showed most strongly negative impaction on fetal birth weight. Together, we showed that prenatal exposure to air pollutant (PM2.5 and PM10) may exacerbate the poor birth outcomes of low birth weight by impacting APS maternal blood indicators especially for PDW.
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Affiliation(s)
- Bimei Hu
- Lianyungang Branch of Traditional Chinese Medicine, Jiangsu Union Technical Institute, Lianyungang, 222000, Jiangsu, China
| | - Linjie Xu
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Xu Yang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, 210000, Jiangsu, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Shiwen Qu
- Lianyungang Branch of Traditional Chinese Medicine, Jiangsu Union Technical Institute, Lianyungang, 222000, Jiangsu, China
| | - Lan Wu
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Yumei Sun
- Information Center, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Jun Yan
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Yexiao Zhang
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Zhaoer Yu
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Yixiao Wang
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Ruizhe Jia
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China.
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Gordon M, Casey JA, McBrien H, Gemmill A, Hernández D, Catalano R, Chakrabarti S, Bruckner T. Disparities in preterm birth following the July 1995 Chicago heat wave. Ann Epidemiol 2023; 87:S1047-2797(23)00166-7. [PMID: 37678645 PMCID: PMC10842513 DOI: 10.1016/j.annepidem.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE To evaluate if changes in preterm birth (PTB, <37 weeks of gestation) incidence differed between non-Hispanic (NH) Black and NH white births following the July 1995 Chicago heat wave-among the most severe U.S. heat waves since 1950. METHODS We used an ecologic study design. We obtained birth data from January 1990-December 1996 from the National Vital Statistics File to calculate the mean monthly PTB incidence in Chicago's Cook County, Illinois. Births between July 1995 and February 1996 were potentially exposed to the heat wave in utero. We generated time series models for NH Black and NH white births, which incorporated synthetic controls of Cook County based on unexposed counties. We ran a secondary analysis considering socioeconomic status (SES). RESULTS From 1990-1996, the mean monthly PTB incidence among NH Black births was 18.6% compared to 7.8% among NH white births. The mean monthly PTB incidence among NH Black births from August 1995-January 1996 was 16.7% higher than expected (three additional PTBs per 100 live births per month [95% confidence interval (CI): 1, 5]). A similar increase occurred among low-SES NH Black births. No increase appeared among NH white births. CONCLUSIONS Severe heat waves may increase racial disparities in PTB incidence.
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Affiliation(s)
- Milo Gordon
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Joan A Casey
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY; Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA
| | - Heather McBrien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Alison Gemmill
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Diana Hernández
- Sociomedical Sciences Department, Columbia University Mailman School of Public Health, New York, NY
| | - Ralph Catalano
- School of Public Health, University of California, Berkeley
| | | | - Tim Bruckner
- Program in Public Health, University of California, Irvine.
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Bartha I, De La Fuente M, Martinez‐Sanchez N, De La Calle M, Martin Boado E, Bartha JL. The influence of air pollution on gestational age at delivery and birthweight in patients with or without respiratory allergy: A nested case-control study. Acta Obstet Gynecol Scand 2023; 102:1593-1601. [PMID: 37602745 PMCID: PMC10577623 DOI: 10.1111/aogs.14655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 06/15/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023]
Abstract
INTRODUCTION Air pollution is a current major health issue. The burden of airborne pollutants and aeroallergen levels varies throughout the year, as well as their interaction and consequences. Prenatal exposure during pregnancy has been associated with adverse perinatal outcomes. The aim of this study was to evaluate the impact of air pollutants on perinatal outcomes in patients with or without respiratory allergy. MATERIAL AND METHODS Nested case-control retrospective study on 3006 pregnant women. Correlations between concentrations of common pollutants in each trimester of pregnancy and on average during the whole pregnancy and both gestational age at delivery and birthweight were studied. Pearson's correlation coefficient and binary logistic regression were used. RESULTS In general, pollutants correlated more strongly with birthweight than with gestational age at delivery. Nine-month NO2 , SO2 , CO, and benzene, and second-trimester CO negatively correlated with birthweight, whereas only first-trimester NO2 showed a very mild correlation with gestational age at delivery. Negative correlations between pollutants and birthweight were much stronger in the respiratory allergy group (n = 43; 1.4%) than in the non-allergic group. After adjustments, the most significant predictive pollutant of birthweight was SO2 in both groups. The best predictive model was much stronger in the allergic group for third-trimester SO2 (R2 = 0.12, p = 0.02) than in the non-allergic group for total SO2 (R2 = 0.002, p = 0.02). For each unit that SO2 increased, birthweight reduced by 3.22% vs. 1.28% in each group, respectively. CONCLUSIONS Air pollutant concentrations, especially SO2 , negatively influenced birthweight. The impact of this association was much stronger and more relevant in the group of women with respiratory allergies.
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Affiliation(s)
- Irene Bartha
- Faculty of MedicineUniversidad Autónoma de MadridMadridSpain
- Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College London and Guy's and St Thomas' NHS Foundation TrustLondonUK
| | - Miguel De La Fuente
- Department of Neonatology, Faculty of Life Sciences and MedicineKing's College London and Guy's and St Thomas' NHS Foundation TrustLondonUK
| | | | - María De La Calle
- Department of Obstetrics and GynecologyUniversity Hospital La PazMadridSpain
| | - Elena Martin Boado
- Department of Obstetrics and GynecologyUniversity Hospital La PazMadridSpain
| | - José Luis Bartha
- Faculty of MedicineUniversidad Autónoma de MadridMadridSpain
- Department of Obstetrics and GynecologyUniversity Hospital La PazMadridSpain
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Park S, Kwon E, Lee G, You YA, Kim SM, Hur YM, Jung S, Jee Y, Park MH, Na SH, Kim YH, Cho GJ, Bae JG, Lee SJ, Lee SH, Kim YJ. Effect of Particulate Matter 2.5 on Fetal Growth in Male and Preterm Infants through Oxidative Stress. Antioxidants (Basel) 2023; 12:1916. [PMID: 38001768 PMCID: PMC10669397 DOI: 10.3390/antiox12111916] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Particulate matter 2.5 (PM2.5) levels are associated with adverse pregnancy outcomes. In this retrospective cohort study, we examined whether the concentration of indoor PM2.5 affected pregnancy outcomes. Additionally, we evaluated biomarkers of pregnancy-related complications caused by fine dust. We collected clinical information and data based on residential addresses from the Air Korea database to assess PM2.5 exposure levels. As a multicenter prospective cohort study, we measured the indoor PM2.5 concentration and inflammatory and oxidative stress markers. The PM2.5 concentration of the low-birth-weight (LBW) delivery group was 27.21 μg/m3, which was significantly higher than that of the normal-birth-weight (NBW) group (26.23 μg/m3) (p = 0.02). When the newborns were divided by sex, the PM2.5 concentration of the LBW group was 27.89 μg/m3 in male infants, which was significantly higher than that of the NBW group (26.26 μg/m3) (p = 0.01). In the prospective study, 8-hydroxy-2-deoxyguanosine significantly increased in the high-concentration group (113.55 ng/mL, compared with 92.20 ng/mL in the low-concentration group); in the high-concentration group, the rates of preterm birth (PTB) and small size for gestational age significantly increased (p < 0.01, p = 0.01). This study showed an association between PM2.5, oxidative stress, and fetal growth, with the PTB group being more vulnerable.
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Affiliation(s)
- Sunwha Park
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
| | - Eunjin Kwon
- Division of Allergy and Respiratory Disease Research, Department of Chronic Disease Convergence Research, Korea National Institute of Health, Cheongju-si 28159, Republic of Korea;
| | - Gain Lee
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07985, Republic of Korea; (G.L.); (S.M.K.)
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
| | - Soo Min Kim
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07985, Republic of Korea; (G.L.); (S.M.K.)
| | - Young Min Hur
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
| | - Sooyoung Jung
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
| | - Yongho Jee
- Advanced Biomedical Research Institute, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea;
| | - Mi Hye Park
- Department of Obstetrics and Gynecology, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea;
| | - Sung Hun Na
- Department of Obstetrics and Gynecology, School of Medicine, Kangwon National University, Chuncheon-si 24289, Republic of Korea;
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea;
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul 02841, Republic of Korea;
| | - Jin-Gon Bae
- Department of Obstetrics and Gynecology, School of Medicine, Keimyung University, Dongsan Medical Center, Daegu 42601, Republic of Korea;
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, College of Medicine, Ulsan University, Ulsan 44610, Republic of Korea;
| | - Sun Hwa Lee
- Seegene Medical Foundation, Seoul 04805, Republic of Korea;
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07985, Republic of Korea; (G.L.); (S.M.K.)
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Liao J, Zhang Y, Yang Z, Qiu C, Chen W, Zhang JJ, Berhane K, Bai Z, Han B, Xu J, Jiang YH, Gilliland F, Yan W, Huang G, Chen Z. Identifying critical windows of air pollution exposure during preconception and gestational period on birthweight: a prospective cohort study. Environ Health 2023; 22:71. [PMID: 37858139 PMCID: PMC10585741 DOI: 10.1186/s12940-023-01022-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 09/26/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Few studies have assessed air pollution exposure association with birthweight during both preconception and gestational periods. METHODS Leveraging a preconception cohort consisting of 14220 pregnant women and newborn children in Shanghai, China during 2016-2018, we aim to assess associations of NO2 and PM2.5 exposure, derived from high-resolution spatial-temporal models, during preconception and gestational periods with outcomes including term birthweight, birthweight Z-score, small-for-gestational age (SGA) and large-for-gestational age (LGA). Linear and logistic regressions were used to estimate 3-month preconception and trimester-averaged air pollution exposure associations; and distributed lag models (DLM) were used to identify critical exposure windows at the weekly resolution from preconception to delivery. Two-pollutant models and children's sex-specific associations were explored. RESULTS After controlling for covariates, one standard deviation (SD) (11.5 μg/m3, equivalent to 6.1 ppb) increase in NO2 exposure during the second and the third trimester was associated with 13% (95% confidence interval: 2 - 26%) and 14% (95% CI: 1 - 29%) increase in SGA, respectively; and one SD (9.6 μg/m3) increase in PM2.5 exposure during the third trimester was associated with 15% (95% CI: 1 - 31%) increase in SGA. No association have been found for outcomes of birthweight, birthweight Z-score and LGA. DLM found that gestational weeks 22-32 were a critical window, when NO2 exposure had strongest associations with SGA. The associations of air pollution exposure tended to be stronger in female newborns than in male newborns. However, no significant associations of air pollution exposure during preconception period on birthweight outcomes were found. CONCLUSION Consistent with previous studies, we found that air pollution exposure during mid-to-late pregnancy was associated with adverse birthweight outcomes.
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Affiliation(s)
- Jiawen Liao
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Yi Zhang
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center & Shanghai Key Laboratory of Birth Defects, Shanghai, China
| | - Zhenchun Yang
- Duke Global Health Institute, Durham, NC, United States of America
| | - Chenyu Qiu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Wu Chen
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Junfeng Jim Zhang
- Duke Global Health Institute, Durham, NC, United States of America
- Division of Environmental Science and Policy, Nicholas School of the Environment, Duke University, Durham, NC, United States of America
| | - Kiros Berhane
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Zhipeng Bai
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Bin Han
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Jia Xu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Yong-Hui Jiang
- Department of Genetics, Neuroscience, and Pediatrics, Yale University School of Medicine, New Haven, CT, United States of America
| | - Frank Gilliland
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Weili Yan
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center & Shanghai Key Laboratory of Birth Defects, Shanghai, China
| | - Guoying Huang
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center & Shanghai Key Laboratory of Birth Defects, Shanghai, China.
| | - Zhanghua Chen
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America.
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49
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Song S, Gao Z, Zhang X, Zhao X, Chang H, Zhang J, Yu Z, Huang C, Zhang H. Ambient fine particulate matter and pregnancy outcomes: An umbrella review. ENVIRONMENTAL RESEARCH 2023; 235:116652. [PMID: 37451569 DOI: 10.1016/j.envres.2023.116652] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
The available evidence on the effects of ambient fine particulate matter (PM2.5) and pregnancy outcomes (birth outcomes and pregnancy complications) has increased substantially. The purpose of this umbrella review is to refine the evidence of the association between birth outcome (birth defects) and PM2.5; and summarize the credibility of existing research on the association between pregnancy complications and PM2.5. We searched PubMed, Web of Science, Embase, and Cochrane databases for relevant systematic reviews and meta-analyses up to March 16, 2022 in accordance with PRISMA guidelines. Two independent investigators conducted data extraction. AMSTAR 2 and GRADE assessment criteria were used to evaluate the methodological and evidence quality. We performed subgroup analyses by trimesters of pregnancy. The review protocol for this study has been registered in PROSPERO (CRD42022325550). This umbrella review identified a total of 41 systematic reviews, including 28 articles evaluating the influence of PM2.5 on birth outcomes and 13 on pregnancy complications. Positive associations between perinatal PM2.5 exposure and adverse birth outcomes were found, including low birth weight, preterm birth, stillbirth, small for gestational age, and birth defects. Pregnant women exposed to PM2.5 had a significantly higher risk of developing hypertensive disorder of pregnancy, gestational diabetes mellitus, gestational hypertension, and preeclampsia. The findings of subgroup analysis demonstrated that the effects of ambient PM2.5 exposure on pregnancy outcomes varied by trimesters. The findings of this extensive umbrella review provide convincing proof that exposure to ambient PM2.5 raises the risks of unfavorable birth outcomes and pregnancy complications. Some associations show considerable disparity between trimesters. These findings have implications for strengthen perinatal health care on air pollution and improving intergenerational equity.
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Affiliation(s)
- Shuaixing Song
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China; College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhan Gao
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoan Zhang
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Zhao
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Chang
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junxi Zhang
- NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention, Zhengzhou, China
| | - Zengli Yu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Huanhuan Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, China; NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention, Zhengzhou, China.
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50
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Nelin TD, Scott KA, Just AC, Burris HH. Place-Based Strategies Addressing Neighborhood Environments to Improve Perinatal and Preterm Infant Outcomes. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1646. [PMID: 37892309 PMCID: PMC10605196 DOI: 10.3390/children10101646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/21/2023] [Accepted: 09/30/2023] [Indexed: 10/29/2023]
Abstract
Preterm birth (defined as birth <37 weeks of gestation) is a significant health concern globally, with lasting implications for individuals, families, and society. In the United States, high preterm birth rates among Black and low-income populations likely result from differences in environmental exposures. Structural racism and economic disadvantage have led to unequal distribution of polluting industrial sites and roadways across society as well as differential access to health-promoting resources which contribute to preterm birth risk. Once born, preterm infants remain at risk for numerous environmentally responsive adverse health outcomes that affect growth and development throughout childhood and adulthood. In this commentary, we describe associations of neighborhood environments with pregnancy and preterm infant health outcomes and propose strategies to address harmful exposures that affect families across the lifespan.
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Affiliation(s)
- Timothy D. Nelin
- Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA; (K.A.S.); (H.H.B.)
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center of Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Leonard Davis Institute of Health Economics, Philadelphia, PA 19104, USA
| | - Kristan A. Scott
- Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA; (K.A.S.); (H.H.B.)
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Allan C. Just
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, USA;
| | - Heather H. Burris
- Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA; (K.A.S.); (H.H.B.)
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center of Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Leonard Davis Institute of Health Economics, Philadelphia, PA 19104, USA
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