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Jahanshahi B, Johnston B, McGovern ME, McVicar D, O'Reilly D, Rowland N, Vlachos S. Prenatal exposure to particulate matter and infant birth outcomes: Evidence from a population-wide database. HEALTH ECONOMICS 2024; 33:2182-2200. [PMID: 38898637 DOI: 10.1002/hec.4862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 02/15/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024]
Abstract
There are growing concerns about the impact of pollution on maternal and infant health. Despite an extensive correlational literature, observational studies which adopt methods that seek to address potential biases due to unmeasured confounders draw mixed conclusions. Using a population database of births in Northern Ireland (NI) linked to localized geographic information on pollution in mothers' postcodes (zipcodes) of residence during pregnancy, we examine whether prenatal exposure to PM2.5 is associated with a comprehensive range of birth outcomes, including placental health. Overall, we find little evidence that particulate matter is related to infant outcomes at the pollution levels experienced in NI, once we implement a mother fixed effects approach that accounts for time-invariant factors. This contrasts with strong associations in models that adjust for observed confounders but without fixed effects. While reducing ambient air pollution remains an urgent public health priority globally, our results imply that further improvements in short-run levels of prenatal PM2.5 exposure in a relatively low-pollution, higher-income country context, are unlikely to impact on birth outcomes at the population level.
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Affiliation(s)
| | - Brian Johnston
- Centre for GIS and Geomatics, Queen's University Belfast, Belfast, UK
| | | | - Duncan McVicar
- Queen's University Belfast, Belfast, UK
- IZA, Bonn, Germany
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Weeda LJZ, Bradshaw CJA, Judge MA, Saraswati CM, Le Souëf PN. How climate change degrades child health: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 920:170944. [PMID: 38360325 DOI: 10.1016/j.scitotenv.2024.170944] [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: 11/01/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Children are more vulnerable than adults to climate-related health threats, but reviews examining how climate change affects human health have been mainly descriptive and lack an assessment of the magnitude of health effects children face. This is the first systematic review and meta-analysis that identifies which climate-health relationships pose the greatest threats to children. OBJECTIVES We reviewed epidemiologic studies to analyse various child health outcomes due to climate change and identify the relationships with the largest effect size. We identify population-specific risks and provide recommendations for future research. METHODS We searched four large online databases for observational studies published up to 5 January 2023 following PRISMA (systematic review) guidelines. We evaluated each included study individually and aggregated relevant quantitative data. We used quantitative data in our meta-analysis, where we standardised effect sizes and compared them among different groupings of climate variables and health outcomes. RESULTS Of 1301 articles we identified, 163 studies were eligible for analysis. We identified many relationships between climate change and child health, the strongest of which was increasing risk (60 % on average) of preterm birth from exposure to temperature extremes. Respiratory disease, mortality, and morbidity, among others, were also influenced by climate changes. The effects of different air pollutants on health outcomes were considerably smaller compared to temperature effects, but with most (16/20 = 80 %) pollutant studies indicating at least a weak effect. Most studies occurred in high-income regions, but we found no geographical clustering according to health outcome, climate variable, or magnitude of risk. The following factors were protective of climate-related child-health threats: (i) economic stability and strength, (ii) access to quality healthcare, (iii) adequate infrastructure, and (iv) food security. Threats to these services vary by local geographical, climate, and socio-economic conditions. Children will have increased prevalence of disease due to anthropogenic climate change, and our quantification of the impact of various aspects of climate change on child health can contribute to the planning of mitigation that will improve the health of current and future generations.
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Affiliation(s)
- Lewis J Z Weeda
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia.
| | - Corey J A Bradshaw
- Global Ecology | Partuyarta Ngadluku Wardli Kuu, College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia; Australian Research Council Centre of Excellence for Australian Biodiversity and Heritage, EpicAustralia.org.au, Australia
| | - Melinda A Judge
- Telethon Kids Institute, Perth, Western Australia, Australia; Department of Mathematics and Statistics, University of Western Australia, Perth, Western Australia, Australia
| | | | - Peter N Le Souëf
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia; Telethon Kids Institute, Perth, Western Australia, Australia
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Smotherman C, Sprague B, Datta S, Braithwaite D, Qin H, Yaghjyan L. Association of air pollution with postmenopausal breast cancer risk in UK Biobank. Breast Cancer Res 2023; 25:83. [PMID: 37443054 PMCID: PMC10339564 DOI: 10.1186/s13058-023-01681-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND We investigated the association of several air pollution measures with postmenopausal breast cancer (BCa) risk. METHODS This study included 155,235 postmenopausal women (of which 6146 with BCa) from UK Biobank. Cancer diagnoses were ascertained through the linkage to the UK National Health Service Central Registers. Annual exposure averages were available from 2005, 2006, 2007, and 2010 for NO2, from 2007 and 2010 for PM10, and from 2010 for PM2.5, NOX, PM2.5-10 and PM2.5 absorbance. Information on BCa risk factors was collected at baseline. Cox proportional hazards regression was used to evaluate the associations of year-specific and cumulative average exposures with BCa risk, overall and with 2-year exposure lag, while adjusting for BCa risk factors. RESULTS PM10 in 2007 and cumulative average PM10 were positively associated with BCa risk (2007 PM10: Hazard ratio [HR] per 10 µg/m3 = 1.18, 95% CI 1.08, 1.29; cumulative average PM10: HR per 10 µg/m3 = 1.99, 95% CI 1.75, 2.27). Compared to women with low exposure, women with higher 2007 PM10 and cumulative average PM10 had greater BCa risk (4th vs. 1st quartile HR = 1.15, 95% CI 1.07, 1.24, p-trend = 0.001 and HR = 1.35, 95% CI 1.25, 1.44, p-trend < 0.0001, respectively). No significant associations were found for any other exposure measures. In the analysis with 2-year exposure lag, both 2007 PM 10 and cumulative average PM10 were positively associated with BCa risk (4th vs. 1st quartile HR = 1.19, 95% CI 1.10, 1.28 and HR = 1.29, 95% CI 1.19, 1.39, respectively). CONCLUSION Our findings suggest a positive association of 2007 PM10 and cumulative average PM10 with postmenopausal BCa risk.
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Affiliation(s)
- Carmen Smotherman
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.
| | - Brian Sprague
- Department of Surgery, University of Vermont, Burlington, VT, USA
| | - Susmita Datta
- Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Dejana Braithwaite
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Huaizhen Qin
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Lusine Yaghjyan
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA
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Liu J, Chen Y, Liu D, Ye F, Sun Q, Huang Q, Dong J, Pei T, He Y, Zhang Q. Prenatal exposure to particulate matter and term low birth weight: systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:63335-63346. [PMID: 37059952 PMCID: PMC10172254 DOI: 10.1007/s11356-023-26831-7] [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: 01/09/2023] [Accepted: 04/03/2023] [Indexed: 04/16/2023]
Abstract
To evaluate the relationships between maternal particulate matter exposure and offspring birth weight. Studies were categorized into three subgroups: term low birth weight (TLBW) among full-term births and all births (regardless of gestational age) and low birth weight (LBW) among all births, based on the search results of MEDLINE and the Web of Science from the inception of the database to April 2022. Subgroup analyses were conducted based on the economic status, region, exposure assessment, risk of bias, and adjustment. Sixty-one studies involving 34,506,975 singleton live births in 15 countries were analyzed. Overall, the risk of bias for most studies (75%) was low. In 39 of 47 term birth studies, the pooled odds ratio of TLBW among term births for per interquartile range (IQR) increases throughout the entire pregnancy was 1.02 (1.01 to 1.03) for PM2.5 and 1.03 (1.01 to 1.05) for PM10 after adjustment for covariates. No significant relevance was detected across each trimester period for PM2.5. A stronger effect was observed during the second trimester (1.03, 1.01 to 1.06) for PM10. There was no increased risk of TLBW in all births associated with IQR increases in PM2.5 and PM10. LBW was associated with PM2.5 exposure in 4 of 7 studies, but statistical heterogeneity was considerable. In the TLBW subgroup analysis, the effects of PM2.5 and PM10 were both greater in studies conducted in advanced countries, studies with low bias, and studies that adjusted for maternal age, infant sex, and parity. Stronger effects were present for PM2.5 exposure collected from monitoring stations and PM10 exposure interpolated from the inverse distance weighting model. TLBW may be associated with prenatal exposure to particulate matter, but no critical windows were identified. Stronger associations were observed in advanced countries. Future original study designs need to consider the impact of different exposure assessment modalities and all possible confounding factors.
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Affiliation(s)
- Jing Liu
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuanmei Chen
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Die Liu
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Fang Ye
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Qi Sun
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Qiang Huang
- State Key Laboratory of Resources and Environmental Information Systems, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Jing Dong
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Tao Pei
- State Key Laboratory of Resources and Environmental Information Systems, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yuan He
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
| | - Qi Zhang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China.
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Rodríguez-Arias RM, Rojo J, Fernández-González F, Pérez-Badia R. Desert dust intrusions and their incidence on airborne biological content. Review and case study in the Iberian Peninsula. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 316:120464. [PMID: 36273688 DOI: 10.1016/j.envpol.2022.120464] [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: 07/24/2022] [Revised: 09/27/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
Desert dust intrusions cause the transport of airborne particulate matter from natural sources, with important consequences for climate regulation, biodiversity, ecosystem functioning and dynamics, human health, and socio-economic activities. Some effects of desert intrusions are reinforced or aggravated by the bioaerosol content of the air during these episodes. The influence of desert intrusions on airborne bioaerosol content has been very little studied from a scientific point of view. In this study, a systematic review of scientific literature during 1970-2021 was carried out following the standard protocol Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). After this literature review, only 6% of the articles on airborne transport from desert areas published in the last 50 years are in some way associated with airborne pollen, and of these, only a small proportion focus on the study of pollen-related parameters. The Iberian Peninsula is affected by Saharan intrusions due to its proximity to the African continent and is seeing an increasing trend the number of intrusion events. There is a close relationship among the conditions favouring the occurrence of intrusion episodes, the transport of particulate matter, and the transport of bioaerosols such as pollen grains, spores, or bacteria. The lack of linearity in this relationship and the different seasonal patterns in the occurrence of intrusion events and the pollen season of most plants hinders the study of the correspondence between both phenomena. It is therefore important to analyse the proportion of pollen that comes from regional sources and the proportion that travels over long distances, and the atmospheric conditions that cause greater pollen emission during dust episodes. Current advances in aerobiological techniques make it possible to identify bioaerosols such as pollen and spores that serve as indicators of long-distance transport from remote areas belonging to other bioclimatic and biogeographical units. A greater incidence of desert intrusion episodes may pose a challenge for both traditional systems and for the calibration and correct validation of automatic aerobiological monitoring methods.
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Affiliation(s)
- R M Rodríguez-Arias
- University of Castilla-La Mancha, Institute of Environmental Sciences (Botany), Toledo, Spain
| | - J Rojo
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
| | - F Fernández-González
- University of Castilla-La Mancha, Institute of Environmental Sciences (Botany), Toledo, Spain
| | - R Pérez-Badia
- University of Castilla-La Mancha, Institute of Environmental Sciences (Botany), Toledo, Spain.
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Xiao P, Wang L, Yao Y, Chang Y, Hou J. Exposure to Ambient Air Pollutant PM 10 in the Second Trimester of Pregnancy Is Associated with Preterm Birth: A Birth-Based Health Information Cohort Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1008538. [PMID: 35782076 PMCID: PMC9242815 DOI: 10.1155/2022/1008538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/18/2022]
Abstract
Objectives We evaluated the effects of exposure to high concentrations of particulate matter (PM)10 on preterm birth (PTB) and identified a critical concentration of PM10 that could lead to PTB via a birth-based health information cohort study. Methods We conducted a birth-based cohort study consisting of nonanomalous singleton births at 22-42 weeks. PTB was defined as babies born alive before 37 weeks of pregnancy. Pregnancy period exposure averages were estimated for PM10 based on the China National Environmental Monitoring Centre (CNEMC). Pregnant women who lived within 50 km of the monitor station were recruited into this study. Logistic regression analyses were performed to determine the association between PTB and exposure to PM10 at different pregnancy periods with adjustment for confounding factors. Results The relative frequency of PTB was 8.7% in the study cohort of 5,291 singleton live births. A total of 1137 women had a high level of PM10 exposure (≥60 μg/m3) in the second trimester of pregnancy. The average concentrations of PM10 in the first, second, and third trimesters of pregnancy and throughout pregnancy were 53.8 μg/m3, 54.2 μg/m3, 55.6 μg/m3, and 54.3 μg/m3, respectively. The generalized additive model (GAM) analysis showed that there was a nonlinear correlation between PM10 and PTB in the second trimester of pregnancy (P < 0.001). The adjusted odds ratio between PTB and low concentration PM10 exposure (PM10 < 60 μg/m3) in the second trimester of pregnancy was 1.01 (95% CI 0.95-1.05). However, high PM10 exposure (PM10 ≥ 60 μg/m3) in the second trimester of pregnancy had an increased PTB risk even after adjustment for coexisting risk factors with an adjusted odds ratio of 1.78 (95% CI 1.69-1.87), and the incidence of PTB increased with an increase in PM10 exposure. Conclusions Our research discovered that exposure to high levels of PM10 increases the risk of PTB and the second trimester is the most vulnerable gestational period to ambient air pollution exposure. PM10 concentrations more than 60 μg/m3 are detrimental to pregnant women in their second trimester. This study has implications for health informatics-oriented healthcare decision support systems.
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Affiliation(s)
- Pengying Xiao
- Clinical Research Center of Kunming Maternal and Child Health Hospital, Kunming 650031, China
| | - Lijun Wang
- Clinical Research Center of Kunming Maternal and Child Health Hospital, Kunming 650031, China
| | - Yingjie Yao
- Clinical Research Center of Kunming Maternal and Child Health Hospital, Kunming 650031, China
| | - Yu Chang
- Clinical Research Center of Kunming Maternal and Child Health Hospital, Kunming 650031, China
| | - Jianghou Hou
- Clinical Research Center of Kunming Maternal and Child Health Hospital, Kunming 650031, China
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Villeneuve PJ, Lam S, Tjepkema M, Pinault L, Crouse DL, Osornio-Vargas AR, Hystad P, Jerrett M, Lavigne E, Stieb DM. Residential proximity to greenness and adverse birth outcomes in urban areas: Findings from a national Canadian population-based study. ENVIRONMENTAL RESEARCH 2022; 204:112344. [PMID: 34742713 DOI: 10.1016/j.envres.2021.112344] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/07/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Over the last decade, several studies have reported that residential proximity to vegetation, or 'greenness', is associated with improved birth outcomes, including for term birth weight (TBW), preterm birth (PTB), and small for gestational age (SGA). However, there remain several uncertainties about these possible benefits including the role of air pollution, and the extent to they are influenced socioeconomic status. METHODS We addressed these gaps using a national population-based study of 2.2 million singleton live births in Canadian metropolitan areas between 1999 and 2008. Exposures to greenness, fine particulate matter (PM2.5), and nitrogen dioxide (NO2) were assigned to infants using the postal code of their mother's residence at the time of birth. The Normalized Difference Vegetation Index (NDVI) was used to characterize greenness, while estimates of ambient PM2.5 and NO2 were estimated using remote sensing, and a national land-use regression surface, respectively. Multivariable regression analysis was performed to describe associations between residential greenness and the birth outcomes. Stratified analyses explored whether these associations were modified by neighbourhood measures of socioeconomic status. RESULTS Mothers who lived in greener areas had a lower risk of low TBW, PTB, and SGA babies. These associations persisted after adjustment for ambient NO2 and PM2.5. Specifically, in fully adjusted models, an interquartile range (IQR = 0.16) increase in the NDVI within a residential buffer of 250 m yielded odds ratios of 0.93 (95% confidence interval (CI): 0.92, 0.94), 0.94 (95% CI: 0.92, 0.95), and 0.94 (95% CI: 0.93, 0.95) for the outcomes of PTB, low TBW, and SGA, respectively. Similarly, an IQR increase in greenness was associated with a 16.3 g (95% CI: 15.3, 17.4) increase in TBW. We found inverse associations between greenness and the occurrence of adverse birth outcomes regardless of the socioeconomic status of the neighbourhood. INTERPRETATION Our findings support the hypothesis that residential greenness contributes to healthier pregnancies, that these associations are independent from exposure to air pollution. , and that proximity to greenness benefits all mothers regardless of socioeconomic status.
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Affiliation(s)
- Paul J Villeneuve
- CHAIM Research Center, Carleton University, Herzberg Building, Room 5413, Ottawa, ON, K1S 5B6, Canada; Department of Neuroscience, Carleton University, Ottawa, ON, Canada.
| | - Sandy Lam
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | | | - Lauren Pinault
- Health Analysis Division, Statistics Canada, Ottawa, ON, Canada
| | | | - Alvaro R Osornio-Vargas
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Perry Hystad
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Eric Lavigne
- Air Health Science Division, Health Canada, Ottawa, Canada
| | - David M Stieb
- School of Epidemiology and Public Health, University of Ottawa, Canada; Environmental Health Science and Research Bureau, Health Canada, Vancouver, Canada
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Ju L, Li C, Yang M, Sun S, Zhang Q, Cao J, Ding R. Maternal air pollution exposure increases the risk of preterm birth: Evidence from the meta-analysis of cohort studies. ENVIRONMENTAL RESEARCH 2021; 202:111654. [PMID: 34252430 DOI: 10.1016/j.envres.2021.111654] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/19/2021] [Accepted: 07/03/2021] [Indexed: 06/13/2023]
Abstract
Preterm birth (PTB), a major public health impact, has been shown to be associated with prenatal air pollution exposure, but the results are still inconsistent. This meta-analysis was performed to quantitatively evaluate the correlation between maternal air pollutant exposure and PTB, and provide evidence of higher grade to help improving the pregnancy outcomes. Databases including Web of Science and PubMed were searched to retrieve eligible studies published up to October 2020. The quality of the articles was assessed by the Newcastle-Ottawa Quality Score (NOS), after which the pooled estimate of the effect was calculated. The robustness of the joint estimates was confirmed by sensitivity analysis of excluded studies one by one, and the sources of heterogeneity were discussed by stratification analysis. Egger's and Begg's tests were performed to examine publication bias. Sixty studies that met the eligible criteria were finally included in this study. The findings showed combined relative risks of 1.032-1.070 for PTB, 0.859-1.081 for moderate PTB, 1.119-1.194 for very PTB and 1.128-1.259 for extremely PTB when mothers were exposed to PM2.5, PM10, NO2, O3, SO2, CO and NOx during pregnancy, while the sensitive windows varied for different air pollutants. Notably, PM2.5 exposure in only the 2nd trimester, NO2 exposure in only the 3rd trimester, and O3 exposure in all three trimesters were positively associated with PTB, while NO2 exposure in the 1st trimester was negatively associated with PTB. In addition, exposure of PM2.5 and PM10 in the 2nd trimester was positively associated with moderate PTB, and in the 1st and 2nd trimesters were positively associated with very PTB. These findings demonstrated that PM2.5, PM10, O3, NO2 were associated with PTB (including moderate PTB, very PTB, and/or extremely PTB), while NOx was not, and the relationship between CO and SO2 and PTB was not stable.
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Affiliation(s)
- Liangliang Ju
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Changlian Li
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Mei Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Shu Sun
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Qi Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Jiyu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China; Department of Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Rui Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
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Marczynski M, Lieleg O. Forgotten but not gone: Particulate matter as contaminations of mucosal systems. BIOPHYSICS REVIEWS 2021; 2:031302. [PMID: 38505633 PMCID: PMC10903497 DOI: 10.1063/5.0054075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/14/2021] [Indexed: 03/21/2024]
Abstract
A decade ago, environmental issues, such as air pollution and the contamination of the oceans with microplastic, were prominently communicated in the media. However, these days, political topics, as well as the ongoing COVID-19 pandemic, have clearly taken over. In spite of this shift in focus regarding media representation, researchers have made progress in evaluating the possible health risks associated with particulate contaminations present in water and air. In this review article, we summarize recent efforts that establish a clear link between the increasing occurrence of certain pathological conditions and the exposure of humans (or animals) to airborne or waterborne particulate matter. First, we give an overview of the physiological functions mucus has to fulfill in humans and animals, and we discuss different sources of particulate matter. We then highlight parameters that govern particle toxicity and summarize our current knowledge of how an exposure to particulate matter can be related to dysfunctions of mucosal systems. Last, we outline how biophysical tools and methods can help researchers to obtain a better understanding of how particulate matter may affect human health. As we discuss here, recent research has made it quite clear that the structure and functions of those mucosal systems are sensitive toward particulate contaminations. Yet, our mechanistic understanding of how (and which) nano- and microparticles can compromise human health via interacting with mucosal barriers is far from complete.
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Favarato G, Clemens T, Cunningham S, Dibben C, Macfarlane A, Milojevic A, Taylor J, Wijlaars LPMM, Wood R, Hardelid P. Air Pollution, housing and respirfatory tract Infections in Children: NatIonal birth Cohort study (PICNIC): study protocol. BMJ Open 2021; 11:e048038. [PMID: 33941636 PMCID: PMC8098990 DOI: 10.1136/bmjopen-2020-048038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Respiratory tract infections (RTIs) are the most common reason for hospital admission among children <5 years in the UK. The relative contribution of ambient air pollution exposure and adverse housing conditions to RTI admissions in young children is unclear and has not been assessed in a UK context. METHODS AND ANALYSIS The aim of the PICNIC study (Air Pollution, housing and respiratory tract Infections in Children: NatIonal birth Cohort Study) is to quantify the extent to which in-utero, infant and childhood exposures to ambient air pollution and adverse housing conditions are associated with risk of RTI admissions in children <5 years old. We will use national administrative data birth cohorts, including data from all children born in England in 2005-2014 and in Scotland in 1997-2020, created via linkage between civil registration, maternity and hospital admission data sets. We will further enhance these cohorts via linkage to census data on housing conditions and socioeconomic position and small area-level data on ambient air pollution and building characteristics. We will use time-to-event analyses to examine the association between air pollution, housing characteristics and the risk of RTI admissions in children, calculate population attributable fractions for ambient air pollution and housing characteristics, and use causal mediation analyses to explore the mechanisms through which housing and air pollution influence the risk of infant RTI admission. ETHICS, EXPECTED IMPACT AND DISSEMINATION To date, we have obtained approval from six ethics and information governance committees in England and two in Scotland. Our results will inform parents, national and local governments, the National Health Service and voluntary sector organisations of the relative contribution of adverse housing conditions and air pollution to RTI admissions in young children. We will publish our results in open-access journals and present our results to the public via parent groups and social media and on the PICNIC website. Code and metadata will be published on GitHub.
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Affiliation(s)
- Graziella Favarato
- Population, Policy and Practice Research and Teaching Department, University College London Institute of Child Health, London, UK
| | - Tom Clemens
- School of Geosciences, The University of Edinburgh, Edinburgh, UK
| | - Steven Cunningham
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
| | - Chris Dibben
- School of Geosciences, The University of Edinburgh, Edinburgh, UK
| | | | - Ai Milojevic
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Jonathon Taylor
- Faculty of Built Environment, Tampere University, Tampere, Finland
| | | | - Rachael Wood
- Clinical and Public Health Intelligence Team, Public Health Scotland, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Pia Hardelid
- Population, Policy and Practice Research and Teaching Department, University College London Institute of Child Health, London, UK
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Macchi C, Iodice S, Persico N, Ferrari L, Cantone L, Greco MF, Ischia B, Dozio E, Corsini A, Sirtori CR, Ruscica M, Bollati V. Maternal exposure to air pollutants, PCSK9 levels, fetal growth and gestational age - An Italian cohort. ENVIRONMENT INTERNATIONAL 2021; 149:106163. [PMID: 33556817 DOI: 10.1016/j.envint.2020.106163] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 08/24/2020] [Accepted: 09/23/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Exposure to airborne pollutants during pregnancy appears to be associated with uterine growth restriction and adverse neonatal outcome. Proprotein convertase subtilisin/kexin type (PCSK9), the key modulator of low-density lipoprotein (LDL) metabolism, increases following particulate matter (PM10) exposure. Because maternal cholesterol is required for fetal growth, PCSK9 levels could be used to evaluate the potential impact of airborne pollutants on fetal growth. DESIGN A cohort of 134 healthy women during early pregnancy (11-12 weeks of gestational age) was studied. RESULTS A significant association between circulating PCSK9 levels and three tested air pollutants (PM10, PM2.5, nitric oxide (NO2)) was found. Of importance, gestational age at birth was reduced by approximately 1 week for each 100 ng/mL rise in circulating PCSK9 levels, an effect that became more significant at the highest quartile of PM2.5 (with a 1.8 week advance in delivery date for every 100 ng/mL rise in circulating PCSK9; p for interaction = 0.026). This finding was supported by an elevation of the odds ratio for urgent cesarean delivery for each 100 ng/mL rise in PCSK9 (2.99, 95% CI, 1.22-6.57), similar trends being obtained for PM10 and NO2. CONCLUSIONS The association between exposure to air pollutants during pregnancy and elevation in PCSK9 advances our understanding of the unforeseen influences of environmental exposure in terms of pregnancy associated disorders.
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Affiliation(s)
- C Macchi
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Italy
| | - S Iodice
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - N Persico
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; Department of Obstetrics and Gynecology 'L. Mangiagalli', Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - L Ferrari
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - L Cantone
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - M F Greco
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Italy
| | - B Ischia
- Department of Obstetrics and Gynecology 'L. Mangiagalli', Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - E Dozio
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - A Corsini
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Italy; IRCCS MultiMedica, Sesto S. Giovanni, Milan, Italy
| | - C R Sirtori
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Italy
| | - M Ruscica
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Italy.
| | - V Bollati
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
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12
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Santri IN, Jiang CB, Chen YH, Wu CD, Zou ML, Chien LC, Lo YC, Chao HJ. Associations of birth outcomes with air pollution and land use characteristics in the Greater Taipei Area. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 750:141579. [PMID: 32853937 DOI: 10.1016/j.scitotenv.2020.141579] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/20/2020] [Accepted: 08/07/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Understanding the effects of environmental factors on birth outcomes is crucial for public health because newborns' birth size affects their likelihood of childhood survival, risk of perinatal morbidity, and subsequent health and growth. Therefore, we investigated the associations of birth outcomes with prenatal air pollutant exposure and residential land use characteristics in the Greater Taipei Area. METHODS Participants were selected from the Longitudinal Examination across Prenatal and Postpartum Health in Taiwan study, which is an ongoing prospective study launched in July 2011. Parental sociodemographic data and medical histories were collected using standardized questionnaires. Mean air pollutant levels during each trimester were estimated using the spatial interpolation technique (Ordinary Kriging). Land use types surrounding participants' homes were evaluated within a designated radius of their residential addresses. We used multiple regressions to examine relationships between birth outcomes (i.e., birth weight, height, and head circumference) and environmental factors after adjustment for parental characteristics. RESULTS A total of 436 pregnant women-infant pairs were included. Birth weight was negatively associated with commercial land and greenhouse areas near the residence. Living near greenhouse areas negatively affected birth height, but higher greenness level within 100 m of the residence had a positive effect. Birth head circumference was only associated with sociodemographic factors in the multivariate model. CONCLUSION Land use types near the homes of pregnant women, but not exposure to air pollutants, were significantly associated with birth weight and height in the Greater Taipei Area. Increased greenness level was positively associated with birth height, and living near commercial or greenhouse areas had adverse effects on birth outcomes. Living in a healthy neighborhood is critical for the birth outcomes of infants and presumably their health in early childhood.
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Affiliation(s)
| | - Chuen-Bin Jiang
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Ming-Lun Zou
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Ling-Chu Chien
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chun Lo
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan; Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Hsing Jasmine Chao
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan.
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13
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Adverse Birth Outcomes Related to NO 2 and PM Exposure: European Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218116. [PMID: 33153181 PMCID: PMC7662294 DOI: 10.3390/ijerph17218116] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 12/27/2022]
Abstract
There is a growing number of international studies on the association between ambient air pollution and adverse pregnancy outcomes, and this systematic review and meta-analysis has been conducted focusing on European countries, to assess the crucial public health issue of this suspected association on this geographical area. A systematic literature search (based on Preferred Reporting Items for Systematic reviews and Meta-Analyses, PRISMA, guidelines) has been performed on all European epidemiological studies published up until 1 April 2020, on the association between maternal exposure during pregnancy to nitrogen dioxide (NO2) or particular matter (PM) and the risk of adverse birth outcomes, including: low birth weight (LBW) and preterm birth (PTB). Fourteen articles were included in the systematic review and nine of them were included in the meta-analysis. Our meta-analysis was conducted for 2 combinations of NO2 exposure related to birth weight and PTB. Our systematic review revealed that risk of LBW increases with the increase of air pollution exposure (including PM10, PM2.5 and NO2) during the whole pregnancy. Our meta-analysis found that birth weight decreases with NO2 increase (pooled beta = −13.63, 95% confidence interval (CI) (−28.03, 0.77)) and the risk of PTB increase for 10 µg/m3 increase in NO2 (pooled odds ratio (OR) = 1.07, 95% CI (0.90, 1.28)). However, the results were not statistically significant. Our finding support the main international results, suggesting that increased air pollution exposure during pregnancy might contribute to adverse birth outcomes, especially LBW. This body of evidence has limitations that impede the formulation of firm conclusions. Further studies, well-focused on European countries, are called to resolve the limitations which could affect the strength of association such as: the exposure assessment, the critical windows of exposure during pregnancy, and the definition of adverse birth outcomes. This analysis of limitations of the current body of research could be used as a baseline for further studies and may serve as basis for reflection for research agenda improvements.
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14
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Lu C, Zhang W, Zheng X, Sun J, Chen L, Deng Q. Combined effects of ambient air pollution and home environmental factors on low birth weight. CHEMOSPHERE 2020; 240:124836. [PMID: 31561165 DOI: 10.1016/j.chemosphere.2019.124836] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/29/2019] [Accepted: 09/10/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Low birth weight (LBW) remains a major public health problem worldwide, yet its crucial environmental risk factors are still unclear. OBJECTIVE To examine the association between LBW (term and preterm LBW) and prenatal exposure to ambient air pollution and home environmental factors as well as their combination, in order to identify critical time window for exposure and key outdoor and indoor factors in LBW development. METHODS A cohort study of 3509 preschool children was performed in Changsha, China during the period 2011-2012. A questionnaire was conducted to survey each child's birth outcome and each mother's exposure to home environmental factors including parental smoking, new furniture, redecoration, mold/damp stains, window pane condensation, and household pets during pregnancy. Maternal exposure to inhalable particulate matter (PM10), industrial air pollutant (SO2), and traffic air pollutant (NO2) was estimated during different time windows of gestation, including conception month, three trimesters, birth month, and whole gestation. Associations of term and preterm LBW with ambient air pollutants and home environmental factors were assessed by multiple logistic regression models in terms of odds ratio (OR) with 95% confidence interval (CI). RESULTS Term LBW (TLBW) was significantly associated with exposure to ambient PM10 during pregnancy, with OR (95% CI) = 1.47 (1.00-2.14) for per IQR increase after adjustment for the covariates and home environmental factors. Specifically, we identified the significant association in early phase of pregnancy including conception month (1.90, 1.09-3.30) and the first trimester (1.72, 1.10-2.69). We further found that TLBW was significantly related with parental smoking at home, OR (95% CI) = 2.17 (1.09-4.33). However, no association was observed for preterm LBW (PLBW). The TLBW risk of ambient air pollution and home environmental factors was independent each other and hence the combined exposure to ambient PM10 and indoor parental smoking caused the highest risk. Sensitivity analysis suggested that foetus with younger mothers were significantly more susceptible to risk of indoor parental smoking, while those with smaller house and cockroaches were more sensitive to risk of outdoor PM10 exposure. CONCLUSION Prenatal exposure to combined outdoor and indoor air pollution, particularly in critical window(s) during early pregnancy, significantly increases the risk of term LBW.
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, China; Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University, Changsha, China.
| | - Weishe Zhang
- Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University, Changsha, China; Department of Obstetrics, XiangYa Hospital, Central South University, Changsha, China
| | - Xiangrong Zheng
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China
| | - Jingchi Sun
- Department of Obstetrics, XiangYa Hospital, Central South University, Changsha, China
| | - Lv Chen
- XiangYa School of Public Health, Central South University, Changsha, China
| | - Qihong Deng
- XiangYa School of Public Health, Central South University, Changsha, China; Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University, Changsha, China; School of Architecture and Art, Central South University, Changsha, China.
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15
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Moreira I, Linares C, Follos F, Sánchez-Martínez G, Vellón JM, Díaz J. Short-term effects of Saharan dust intrusions and biomass combustion on birth outcomes in Spain. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 701:134755. [PMID: 31704398 DOI: 10.1016/j.scitotenv.2019.134755] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 09/24/2019] [Accepted: 09/29/2019] [Indexed: 05/24/2023]
Abstract
The objective of this study is to analyze the short-term effects of atmospheric pollutant concentrations (PM10, NO2 and O3) and heat and cold waves on the number of pre-term births and cases of low birth weight related to Saharan dust advection and biomass combustion. The dependent variables used in this analysis were the total number of births, births with low weight (>2.500 g) and pre-term births (<37 weeks), that occurred at the province level. Data provided by the NSI included: days with Saharan dust intrusion or biomass advection classified in terms of information provided by MITECO for each of the nine regions in Spain. A representative city was selected for reach region in which the registered average daily concentrations of PM10, NO2 and O3 (μg/m3) were used. These were also provided by MITECO. The daily maximum and daily minimum temperature (°C) used was those registered by the meteorological observatory station located in each province capital, provided by AEMET. Using Poisson log linear regression models, the associated relative risks (RR) were measured as well as the population attributable risk (PAR) corresponding to the variables that resulted statistically significant at p < 0.05 for days with and without intrusion of natural particulate matter. The results obtained show that the days with Saharan dust intrusion or advections due to biomass combustion- beyond the impact of PM10, primary pollutants such as NO2 (in Saharan intrusions), heat waves and O3 - are associated with the number of births, low birth weight and pre-term birth. The RR and percent PAR of the pollutants and the heat waves are greater than those obtained for PM10. The results of this study indicate that days with natural particulate matter due to biomass combustion or advection of Saharan dust put pregnant women at risk.
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Affiliation(s)
- I Moreira
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain
| | - C Linares
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain
| | - F Follos
- Tdot Soluciones Sostenibles, S.L. Ferrol, A Coruña, Spain
| | | | - J M Vellón
- Tdot Soluciones Sostenibles, S.L. Ferrol, A Coruña, Spain
| | - J Díaz
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain.
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Skrivankova V, Zwahlen M, Adams M, Low N, Kuehni C, Egger M. Spatial epidemiology of gestational age and birth weight in Switzerland: census-based linkage study. BMJ Open 2019; 9:e027834. [PMID: 31666260 PMCID: PMC6830696 DOI: 10.1136/bmjopen-2018-027834] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Gestational age and birth weight are strong predictors of infant morbidity and mortality. Understanding spatial variation can inform policies to reduce health inequalities. We examined small-area variation in gestational age and birth weight in Switzerland. METHODS All singleton live births recorded in the Swiss Live Birth Register 2011 to 2014 were eligible. We deterministically linked the Live Birth Register with census and survey data to create data sets including neonatal and pregnancy-related variables, parental characteristics and geographical variables. We produced maps of 705 areas and fitted linear mixed-effect models to assess to what extent spatial variation was explained by these variables. RESULTS We analysed all 315 177 eligible live births. Area-level averages of gestational age varied between 272 and 279 days, and between 3138 and 3467 g for birth weight. The fully adjusted models explained 31% and 87% of spatial variation of gestational age and birth weight, respectively. Language region accounted for most of the explained variation (23% in gestational age and 62% in birth weight), with shorter gestational age (-0.6 days and -0.9 days) and lower birth weight (-1.1% and -1.8%) in French-speaking and Italian-speaking areas, respectively, compared with German-speaking areas. Other variables explaining variation were, for gestational age, the level of urbanisation (10%) and parental nationality (3%). For birth weight, they were gestational age (27%), parental nationality (27%), civil status (10%) and altitude (10%). In a random sample of 81 968 live births with data on parental education, levels of education were only weakly associated with gestational age (-0.9 days for compulsory vs tertiary maternal education) or birth weight (-0.7% for compulsory vs tertiary maternal education). CONCLUSIONS In Switzerland, small area variation in birth weight is largely explained, and variation in gestational age partially explained, by geocultural, sociodemographic and pregnancy factors.
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Affiliation(s)
- Veronika Skrivankova
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Mark Adams
- Department of Neonatology, University of Zurich, Zurich, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Claudia Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Matthias Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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Seabrook JA, Smith A, Clark AF, Gilliland JA. Geospatial analyses of adverse birth outcomes in Southwestern Ontario: Examining the impact of environmental factors. ENVIRONMENTAL RESEARCH 2019; 172:18-26. [PMID: 30769185 DOI: 10.1016/j.envres.2018.12.068] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 12/01/2018] [Accepted: 12/30/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND A growing body of research has examined the association between exposure to environmental factors during pregnancy and adverse birth outcomes; however, many studies do not control for potential covariates and findings vary considerably. OBJECTIVE To test the relative influence of environmental factors including exposure to air pollution, major roads, highways, industry, parks, greenspaces, and food retailers on low birth weight (LBW) and preterm birth (PTB) in Southwestern Ontario (SWO), Canada, while accounting for medical (e.g., previous preterm birth, gestational diabetes), behavioral (e.g., alcohol, smoking), demographic (e.g., maternal age, body mass index), and neighborhood-level socioeconomic (e.g., household income, education) factors. METHODS This retrospective cohort study consisted of a large sample of pregnant women from SWO who gave birth to singleton newborns between February 2009 and February 2014 at London Health Sciences Centre. Data on maternal postal codes were entered into a Geographic Information System to map the distribution of maternal residences and determine selected characteristics of their neighborhood environments (i.e., socioeconomic, built, natural). These variables were developed based on postal codes where the mothers lived prior to giving birth. Logistic regression was used to assess the relative effects of the physical environment, socioeconomic status, clinical history, and behavioral risk factors on mothers having a LBW or PTB infant. RESULTS Out of 25,263 live births, 5.7% were LBW and 7.5% were PTB. Exposure to sulfur dioxide was a top predictor of both LBW and PTB. For every one-unit increase in sulfur dioxide, the odds of a LBW and PTB were 3.4 (95% CI: 2.2, 5.2) and 2.0 (95% CI: 1.4, 3.0) times higher, after controlling for other variables in the model, respectively (p < 0.001). Previous PTB was also highly associated with both birth outcomes. CONCLUSIONS Health care providers should be informed about the hazards of air pollution to developing fetuses so that recommendations can be made to their pregnant patients about limiting exposure when air quality is poor.
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Affiliation(s)
- Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College, 1285 Western Road, London, Ontario, Canada, N6G 1H2; Department of Paediatrics, Western University, 800 Commissioners Road East, London, Ontario, Canada, N6A 5W9; Department of Epidemiology and Biostatistics, Western University, 1151 Richmond Street, London, Ontario, Canada, N6A 5C1; Children's Health Research Institute, 800 Commissioners Road East, London, Ontario, Canada, N6C 2V5; Lawson Health Research Institute, 750 Base Line Road East, London, Ontario, Canada, N6C 2R5; Human Environments Analysis Laboratory, Western University, 1151 Richmond Street, London, Ontario, Canada, N6A 3K7
| | - Alexandra Smith
- School of Food and Nutritional Sciences, Brescia University College, 1285 Western Road, London, Ontario, Canada, N6G 1H2
| | - Andrew F Clark
- Children's Health Research Institute, 800 Commissioners Road East, London, Ontario, Canada, N6C 2V5; Human Environments Analysis Laboratory, Western University, 1151 Richmond Street, London, Ontario, Canada, N6A 3K7; Department of Geography, Western University, 1151 Richmond Street, London, Ontario, Canada, N6A 5C2
| | - Jason A Gilliland
- Department of Paediatrics, Western University, 800 Commissioners Road East, London, Ontario, Canada, N6A 5W9; Department of Epidemiology and Biostatistics, Western University, 1151 Richmond Street, London, Ontario, Canada, N6A 5C1; Children's Health Research Institute, 800 Commissioners Road East, London, Ontario, Canada, N6C 2V5; Lawson Health Research Institute, 750 Base Line Road East, London, Ontario, Canada, N6C 2R5; Human Environments Analysis Laboratory, Western University, 1151 Richmond Street, London, Ontario, Canada, N6A 3K7; Department of Geography, Western University, 1151 Richmond Street, London, Ontario, Canada, N6A 5C2; School of Health Studies, Western University, 1151 Richmond Street, London, Ontario, Canada, N6A 3K7.
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18
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Arroyo V, Linares C, Díaz J. Premature births in Spain: Measuring the impact of air pollution using time series analyses. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 660:105-114. [PMID: 30639707 DOI: 10.1016/j.scitotenv.2018.12.470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/27/2018] [Accepted: 12/30/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Premature birth (<37 weeks of gestation) is the principal indicator of neonatal death during the first month of life and the second cause of death of children under age five. There are 15 million premature births (PTB) worldwide. Air pollution in cities, primarily the result of urban traffic, greatly impacts PTBs, though there are few studies carried out on this topic at the country level. The objective of this study is to quantify the relative risks (RR) and the population attributable risk (PAR) of concentrations of contaminants on PTBs in Spain, and to analyze the most susceptible trimesters. METHODS For each province average weekly PTBs were calculated (ICD-10: P07.2-P07.3) during the period 2001-2009 as well as weekly average concentrations of PM10, NO2 and O3. Estimations were made of RR and PAR using generalized linear models with link Poisson, controlling for the trend, seasonality, the autoregressive nature of the series and the influence of temperature in periods of heat and/or cold waves. A meta-analysis was carried out to estimate RR and PAR at the global level based on the RR obtained for each of the provinces. RESULTS For all of Spain, the global RR of PTB due to the impact of PM10 was 1.071 (1.049, 1.093) and 1.150 (1.084, 1.220) for NO2, with no detected association for O3. Therefore, with decreases of 10 μg/m3 in the concentrations of PM10 and NO2, around 12.5% and 4.5% of PTBs could have been avoided respectively. CONCLUSIONS Around 1.35% of PTBs that occurred in Spain during the study period can be attributed to air pollution. The adoption of structural measures to reduce these air pollutants should result in a decrease in the number of PTBs in Spain.
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Affiliation(s)
- Virginia Arroyo
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain; Autonomous University of Madrid, Spain
| | - Cristina Linares
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Julio Díaz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
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Lee D, Robertson C, Ramsay C, Gillespie C, Napier G. Estimating the health impact of air pollution in Scotland, and the resulting benefits of reducing concentrations in city centres. Spat Spatiotemporal Epidemiol 2019; 29:85-96. [PMID: 31128634 DOI: 10.1016/j.sste.2019.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 02/19/2019] [Accepted: 02/23/2019] [Indexed: 11/18/2022]
Abstract
Air pollution continues to be a key health issue in Scotland, despite recent improvements in concentrations. The Scottish Government published the Cleaner Air For Scotland strategy in 2015, and will introduce Low Emission Zones (LEZs) in the four major cities (Aberdeen, Dundee, Edinburgh and Glasgow) by 2020. However, there is no epidemiological evidence quantifying the current health impact of air pollution in Scotland, which this paper addresses. Additionally, we estimate the health benefits of reducing concentrations in city centres where most LEZs are located. We focus on cardio-respiratory disease and total non-accidental mortality outcomes, linking them to concentrations of both particulate (PM10 and PM2.5) and gaseous (NO2 and NOx) pollutants. Our two main findings are that: (i) all pollutants exhibit significant associations with respiratory disease but not cardiovascular disease; and (ii) reducing concentrations in city centres with low resident populations only provides a small health benefit.
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Affiliation(s)
- Duncan Lee
- School of Mathematics and Statistics, University of Glasgow, Glasgow G12 8SQ, Scotland, United Kingdom.
| | - Chris Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Scotland, United Kingdom
| | - Colin Ramsay
- Health Protection Scotland, Scotland, United Kingdom
| | - Colin Gillespie
- Scottish Environment Protection Agency Scotland, Scotland, United Kingdom
| | - Gary Napier
- School of Mathematics and Statistics, University of Glasgow, Glasgow G12 8SQ, Scotland, United Kingdom
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20
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Arroyo V, Díaz J, Salvador P, Linares C. Impact of air pollution on low birth weight in Spain: An approach to a National Level Study. ENVIRONMENTAL RESEARCH 2019; 171:69-79. [PMID: 30660920 DOI: 10.1016/j.envres.2019.01.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/11/2019] [Accepted: 01/12/2019] [Indexed: 05/23/2023]
Abstract
BACKGROUND According to the WHO, low birth weight (<2500 gr) is a primary maternal health indicator as the cause of multiple morbi-mortality in the short and long-term. It is known that air pollution from road traffic (PM10, NO2) and O3 have an important impact on low birth weight (LBW), but there are few studies of this topic in Spain. The objective of this study is to determine the possible exposure windows in the gestational period in which there is greater susceptibility to urban air pollution and to quantify the relative risks (RR) and population attributable risks (PAR) of low birth weight associated with pollutant concentrations in Spain. METHODS We calculated the weekly average births with low birth weight (ICD-10: P07.0-P07.1) for each Spanish province for the period 2001-2009, using the average weekly concentrations of PM10, NO2 and O3, measured in the capital cities of the provinces. The estimation of RR and PAR were carried out using generalized linear models with link Poisson, controlling for the trend, seasonality and auto-regressive character of the series and for the influence of temperature during periods of heat waves and/or cold. Finally, a meta-analysis was used to estimate the global RR and PAR based on the RR obtained for each of the provinces. RESULTS The RR for the whole of Spain is 1.104 (CI95%: 1.072, 1.138) for the association between LBW and PM10, and 1.091 (CI95%: 1.059, 1.124) for the association between NO2 and LBW. Our results suggest that 5% of low birth weight births in the case of PM10 and 8% in the case of NO2 could have been avoided with a reduction of 10 μg/m3 in the concentrations of these pollutants. CONCLUSIONS The impact of the results obtained- with 6105 cases attributable to PM10 and up to 9385 cases attributable to NO2 in a period of 9 study years- suggest the need to design structural and awareness public health measures to reduce air pollution in Spain.
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Affiliation(s)
- Virginia Arroyo
- National School of Public Health, Carlos III Institute of Health. Madrid, Spain; Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
| | - Julio Díaz
- National School of Public Health, Carlos III Institute of Health. Madrid, Spain.
| | - P Salvador
- Environmental Department of research, Centre for energy, Environment and Technology (Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas/CIEMAT), Madrid, Spain
| | - Cristina Linares
- National School of Public Health, Carlos III Institute of Health. Madrid, Spain
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Richardson EA, Shortt NK, Mitchell R, Pearce J. A sibling study of whether maternal exposure to different types of natural space is related to birthweight. Int J Epidemiol 2019; 47:146-155. [PMID: 29253203 PMCID: PMC5837571 DOI: 10.1093/ije/dyx258] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 11/25/2017] [Indexed: 11/13/2022] Open
Abstract
Background Birthweight is an important determinant of health across the life course. Maternal exposure to natural space has been linked to higher birthweight, but stronger evidence of a causal link is needed. We use a quasi-experimental sibling study design to investigate if change in the mother’s exposure to natural space between births was related to birthweight, in urban Scotland. Methods Amount (% area) of total natural space, total accessible (public) natural space, parks, woodlands and open water within 100 m of the mother’s postcode was calculated for eligible births (n = 40 194; 1991–2010) in the Scottish Longitudinal Study (a semi-random 5.3% sample of the Scottish population). Associations between natural space and birthweight were estimated, using ordinary least squares and fixed effects models. Results Birthweight was associated with the total amount of natural space around the mother’s home (+8.2 g for interquartile range increase), but was unrelated to specific types of natural space. This whole-sample relationship disappeared in the sibling analysis, indicating residual confounding. The sibling models showed effects for total natural space with births to women who already had children (+20.1 g), and to those with an intermediate level of education (+14.1 g). Conclusions The importance of total natural space for birthweight suggests that benefits can be experienced near to as well as within natural space. Ensuring expectant mothers have good access to high quality neighbourhood natural space has the potential to improve the infant’s start in life, and consequently their health trajectory over the life course.
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Affiliation(s)
- Elizabeth A Richardson
- National Health Service Health Scotland, Edinburgh, UK.,Centre for Research on Environment, Society and Health (CRESH), University of Edinburgh, Edinburgh, UK and
| | - Niamh K Shortt
- Centre for Research on Environment, Society and Health (CRESH), University of Edinburgh, Edinburgh, UK and
| | - Richard Mitchell
- Centre for Research on Environment, Society and Health (CRESH), University of Glasgow, Glasgow, UK
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health (CRESH), University of Edinburgh, Edinburgh, UK and
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Murray SR, Juodakis J, Bacelis J, Sand A, Norman JE, Sengpiel V, Jacobsson B. Geographical differences in preterm delivery rates in Sweden: A population-based cohort study. Acta Obstet Gynecol Scand 2019; 98:106-116. [PMID: 30169899 PMCID: PMC6492021 DOI: 10.1111/aogs.13455] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 08/20/2018] [Accepted: 08/22/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Preterm delivery is a major global public health challenge. The objective of this study was to determine how preterm delivery rates differ in a country with a very high human development index and to explore rural vs urban environmental and socioeconomic factors that may be responsible for this variation. MATERIAL AND METHODS A population-based study was performed using data from the Swedish Medical Birth Register from 1998 to 2013. Sweden was chosen as a model because of its validated, routinely collected data and availability of individual social data. The total population comprised 1 335 802 singleton births. A multiple linear regression was used to adjust gestational age for known risk factors (maternal smoking, ethnicity, maternal education, maternal age, height, fetal sex, maternal diabetes, maternal hypertension, and parity). A second and a third model were subsequently fitted allowing separate intercepts for each municipality (as fixed or random effects). Adjusted gestational ages were converted to preterm delivery rates and mapped onto maternal residential municipalities. Additionally, the effects of six rural vs urban environmental and socioeconomic factors on gestational age were tested using a simple weighted linear regression. RESULTS The study population preterm delivery rate was 4.12%. Marked differences from the overall preterm delivery rate were observed (rate estimates ranged from 1.73% to 6.31%). The statistical significance of this heterogeneity across municipalities was confirmed by a chi-squared test (P < 0.001). Around 20% of the gestational age variance explained by the full model (after adjustment for known variables described above) could be attributed to municipality-level effects. In addition, gestational age was found to be longer in areas with a higher fraction of built-upon land and other urban features. CONCLUSIONS After adjusting for known risk factors, large geographical differences in rates of preterm delivery remain. Additional analyses to look at the effect of environmental and socioeconomic factors on gestational age found an increased gestational age in urban areas. Future research strategies could focus on investigating the urbanity effect to try to explain preterm delivery variation across countries with a very high human development index.
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Affiliation(s)
- Sarah R. Murray
- MRC Centre for Reproductive Health, Queen’s Medical Research Institute, University of EdinburghEdinburghUK
| | - Julius Juodakis
- Department of Obstetrics and Gynecology, Institute of Clinical SciencesSahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Jonas Bacelis
- Department of Obstetrics and Gynecology, Institute of Clinical SciencesSahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Anna Sand
- Karolinska University HospitalStockholmSweden
| | - Jane E. Norman
- MRC Centre for Reproductive Health, Queen’s Medical Research Institute, University of EdinburghEdinburghUK
| | - Verena Sengpiel
- Department of Obstetrics and Gynecology, Institute of Clinical SciencesSahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Institute of Clinical SciencesSahlgrenska Academy, University of GothenburgGothenburgSweden
- Department of Genetics and Bioinformatics, Area of Health Data and DigitalizationNorwegian Institute of Public HealthOsloNorway
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Lee D. A locally adaptive process-convolution model for estimating the health impact of air pollution. Ann Appl Stat 2018. [DOI: 10.1214/18-aoas1167] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Klepac P, Locatelli I, Korošec S, Künzli N, Kukec A. Ambient air pollution and pregnancy outcomes: A comprehensive review and identification of environmental public health challenges. ENVIRONMENTAL RESEARCH 2018; 167:144-159. [PMID: 30014896 DOI: 10.1016/j.envres.2018.07.008] [Citation(s) in RCA: 211] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 05/19/2023]
Abstract
There is a growing number of studies on the association between ambient air pollution and adverse pregnancy outcomes, but their results have been inconsistent. Consequently, a comprehensive review of this research area is needed. There was a wide variability in studied pregnancy outcomes, observed gestational windows of exposure, observed ambient air pollutants, applied exposure assessment methods and statistical analysis methods Gestational duration, preterm birth, (low) birth weight, and small for gestational age/intrauterine growth restriction were most commonly investigated pregnancy outcomes. Gestational windows of exposure typically included were whole pregnancy period, 1st, 2nd, 3rd trimester, first and last gestational months. Preterm birth was the outcome most extensively studied across various gestational windows, especially at the beginning and at the end of pregnancy. Particulate matter, nitrogen dioxide, ozone, and carbon monoxide were the most commonly used markers of ambient air pollution. Continuous monitoring data were frequently combined with spatially more precisely modelled estimates of exposure. Exposure to particulate matter and ozone over the entire pregnancy was significantly associated with higher risk for preterm birth: the pooled effect estimates were 1.09 (1.03-1.16) per 10 μg/m3 increase in particulate matter with an aerodynamic diameter of 10 µm or less (PM10),1.24 (1.08-1.41) per 10 μg/m3 increase in particulate matter with an aerodynamic diameter of 2.5 µm or less (PM2.5), and 1.03 (1.01-1.04) per 10 ppb increase in ozone. For pregnancy outcomes other than PTB, ranges of observed effect estimates were reported due to smaller number of studies included in each gestational window of exposure. Further research is needed to link the routine pregnancy outcome data with spatially and temporally resolved ambient air pollution data, while adjusting for commonly defined confounders. Methods for assessing exposure to mixtures of pollutants, indoor air pollution exposure, and various other environmental exposures, need to be developed.
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Affiliation(s)
- Petra Klepac
- National institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia.
| | - Igor Locatelli
- University of Ljubljana, Faculty of Pharmacy, Aškerčeva 7, 1000 Ljubljana, Slovenia.
| | - Sara Korošec
- Department of Obstetrics and Gynecology, Reproductive Unit, University Medical Centre Ljubljana, Zaloška 3, 1525 Ljubljana, Slovenia.
| | - Nino Künzli
- Swiss Tropical and Public Health Institute (SwissTPH), Socinstrasse 57, 4002 Basel, Switzerland; University of Basel, Petersplatz 1, 4001 Basel, Switzerland.
| | - Andreja Kukec
- National institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia; University of Ljubljana, Faculty of Medicine, Vrazov trg 2, 1000 Ljubljana, Slovenia.
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Soyiri IN, Sheikh A, Reis S, Kavanagh K, Vieno M, Clemens T, Carnell EJ, Pan J, King A, Beck RC, Ward HJT, Dibben C, Robertson C, Simpson CR. Improving predictive asthma algorithms with modelled environment data for Scotland: an observational cohort study protocol. BMJ Open 2018; 8:e023289. [PMID: 29780034 PMCID: PMC5961591 DOI: 10.1136/bmjopen-2018-023289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Asthma has a considerable, but potentially, avoidable burden on many populations globally. Scotland has some of the poorest health outcomes from asthma. Although ambient pollution, weather changes and sociodemographic factors have been associated with asthma attacks, it remains unclear whether modelled environment data and geospatial information can improve population-based asthma predictive algorithms. We aim to create the afferent loop of a national learning health system for asthma in Scotland. We will investigate the associations between ambient pollution, meteorological, geospatial and sociodemographic factors and asthma attacks. METHODS AND ANALYSIS We will develop and implement a secured data governance and linkage framework to incorporate primary care health data, modelled environment data, geospatial population and sociodemographic data. Data from 75 recruited primary care practices (n=500 000 patients) in Scotland will be used. Modelled environment data on key air pollutants at a horizontal resolution of 5 km×5 km at hourly time steps will be generated using the EMEP4UK atmospheric chemistry transport modelling system for the datazones of the primary care practices' populations. Scottish population census and education databases will be incorporated into the linkage framework for analysis. We will then undertake a longitudinal retrospective observational analysis. Asthma outcomes include asthma hospitalisations and oral steroid prescriptions. Using a nested case-control study design, associations between all covariates will be measured using conditional logistic regression to account for the matched design and to identify suitable predictors and potential candidate algorithms for an asthma learning health system in Scotland.Findings from this study will contribute to the development of predictive algorithms for asthma outcomes and be used to form the basis for our learning health system prototype. ETHICS AND DISSEMINATION The study received National Health Service Research Ethics Committee approval (16/SS/0130) and also obtained permissions via the Public Benefit and Privacy Panel for Health and Social Care in Scotland to access, collate and use the following data sets: population and housing census for Scotland; Scottish education data via the Scottish Exchange of Data and primary care data from general practice Data Custodians. Analytic code will be made available in the open source GitHub website. The results of this study will be published in international peer reviewed journals.
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Affiliation(s)
- Ireneous N Soyiri
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, Centre for Medical Informatics, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, Centre for Medical Informatics, The University of Edinburgh, Edinburgh, UK
| | - Stefan Reis
- Atmospheric Chemistry and Effects, NERC Centre for Ecology & Hydrology, Penicuik, UK
- Knowledge Spa, University of Exeter Medical School, Truro, UK
| | - Kimberly Kavanagh
- Department of Mathematics and Statistics, The University of Strathclyde, Glasgow, UK
| | - Massimo Vieno
- Atmospheric Chemistry and Effects, NERC Centre for Ecology & Hydrology, Penicuik, UK
| | - Tom Clemens
- School of Geosciences, Institute of Geography, The University of Edinburgh, Edinburgh, UK
| | - Edward J Carnell
- Atmospheric Chemistry and Effects, NERC Centre for Ecology & Hydrology, Penicuik, UK
| | - Jiafeng Pan
- Department of Mathematics and Statistics, The University of Strathclyde, Glasgow, UK
| | - Abby King
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, Centre for Medical Informatics, The University of Edinburgh, Edinburgh, UK
| | - Rachel C Beck
- Atmospheric Chemistry and Effects, NERC Centre for Ecology & Hydrology, Penicuik, UK
| | - Hester J T Ward
- Information Services Division and Health Protection Scotland, NHS National Services Scotland, Edinburgh, UK
| | - Chris Dibben
- School of Geosciences, Institute of Geography, The University of Edinburgh, Edinburgh, UK
| | - Chris Robertson
- Department of Mathematics and Statistics, The University of Strathclyde, Glasgow, UK
| | - Colin R Simpson
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, Centre for Medical Informatics, The University of Edinburgh, Edinburgh, UK
- Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
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Clemens T, Dibben C. Living in stressful neighbourhoods during pregnancy: an observational study of crime rates and birth outcomes. Eur J Public Health 2017; 27:197-202. [PMID: 27578830 PMCID: PMC5444251 DOI: 10.1093/eurpub/ckw131] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Patterns of adverse birth outcomes vary spatially and there is evidence that this may relate to features of the physical environment such as air pollution. However, other social characteristics of the environment such as levels of crime are relatively understudied. This study examines the association between crime rates and birth weight and prematurity. Methods: Maternity inpatient data recorded at birth, including residential postcode, was linked to a representative 5% sample of Scottish Census data and small area crime rates from Scottish Police forces. Coefficients associated with crime were reported from crude and confounder adjusted models predicting low birth weight (< 2500 g), mean birthweight, small for gestational age and prematurity for all singleton live births. Results: Total crime rates were associated with strong and significant reductions in mean birth weight and increases in the risks of both a small for gestational age baby and premature birth. These effects, with the exception of prematurity, were robust to adjustment for individual characteristics including smoking, ethnicity and other socio-economic variables as well as area based confounders including air pollution. Mean birth weight was robust to additional adjustment for neighbourhood income deprivation. Conclusion: The level of crime in a mother’s area of residence, which may be a proxy for the degree of threat felt and therefore stress experienced, appears to be an important determinant of the risk of adverse birth outcomes.
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Ji Y, Song F, Xu B, Zhu Y, Lu C, Xia Y. Association between exposure to particulate matter during pregnancy and birthweight: a systematic review and a meta-analysis of birth cohort studies. J Biomed Res 2017; 33:56. [PMID: 29089474 PMCID: PMC6352882 DOI: 10.7555/jbr.31.20170038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 05/23/2017] [Indexed: 11/07/2022] Open
Abstract
Studies of the associations between maternal exposure to particulate matter (PM) and risk of adverse effects on fetal growth are inconsistent and inconclusive. This question can be well answered by carefully designed birth cohort studies; however, so far the evidence from such studies has not come to the same conclusion. We sought to evaluate the association between maternal exposures to PM and low birthweight (LBW) enrolling 14 studies from 11 centers, and to explore the influence of trimester and exposure assessment methods on between-center heterogeneity in this association. Data were derived from PubMed, Embase, Google Scholar, CNKI, and WanFang database, references from relevant articles, and results from published studies until March 2017. Using a random-effects meta-analysis, we combined the coefficient and odds ratios (OR) of individual studies conducted among 14 birth cohort studies. Random-effect meta-analysis results suggested that a 17% and 6% increase in risk of LBW was relevant to a 10 mg/m3 rise in PM2.5 and PM10 exposure concentrations at the 3rd trimester (pooled odds ratios (OR), 1.17 and 1.06; 95% confidence interval (CI), 0.94-1.46 and 0.97-1.15, respectively), but the null value was included in our 95% CI. Our results showed that exposure to PM2.5 and PM10 during pregnancy has a positive relevance to LBW based on birth cohort studies. However, neither reached formal statistical significance. Negative impacts on outcomes of birth is implied by maternal exposure to PM. Further mechanistic researches are needed to explain the connection between PM pollution and LBW.
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Affiliation(s)
- Yinwen Ji
- . State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- . Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- . Department of Research and Education, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China
| | - Fei Song
- . Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Bo Xu
- . State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- . Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Yining Zhu
- . Department of Thoracic Surgery, The First School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Chuncheng Lu
- . State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- . Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Yankai Xia
- . State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- . Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
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Clemens T, Turner S, Dibben C. Maternal exposure to ambient air pollution and fetal growth in North-East Scotland: A population-based study using routine ultrasound scans. ENVIRONMENT INTERNATIONAL 2017; 107:216-226. [PMID: 28753483 PMCID: PMC5571229 DOI: 10.1016/j.envint.2017.07.018] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 05/04/2023]
Abstract
BACKGROUND Maternal ambient air pollution exposure is associated with reduced birthweight. Few studies have examined the effect on growth in utero and none have examined the effect of exposure to particulates less than 2.5µm (PM2.5) and possible effect modification by smoking status. OBJECTIVES Examine the effect of maternal exposure to ambient concentrations of PM10, PM2.5 and nitrogen dioxide (NO2) for in utero fetal growth, size at birth and effect modification by smoking status. METHODS Administratively acquired second and third trimester fetal measurements (bi-parietal diameter, femur length and abdominal circumference), birth outcomes (weight, crown heel length and occipito-frontal circumference) and maternal details were obtained from routine fetal ultrasound scans and maternity records (period 1994-2009). These were modelled against residential annual pollution concentrations (calendar year mean) adjusting for covariates and stratifying by smoking status. RESULTS In the whole sample (n=13,775 pregnancies), exposure to PM10, PM2.5 and NO2 was associated with reductions in measurements at birth and biparietal diameter from late second trimester onwards. Among mothers who did not smoke at all during pregnancy (n=11,075), associations between biparietal diameter and pollution exposure remained significant but were insignificant among those who did smoke (n=2700). Femur length and abdominal circumference were not significantly associated with pollution exposure. CONCLUSIONS Fetal growth is strongly associated with particulates exposure from later in second trimester onwards but the effect appears to be subsumed by smoking. Typical ambient exposures in this study were relatively low compared to other studies and given these results, it may be necessary to consider reducing recommended "safe" ambient air exposures.
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Affiliation(s)
- Tom Clemens
- School of Geosciences, University of Edinburgh, Edinburgh, Scotland, UK.
| | - Steve Turner
- Child Health, University of Aberdeen, Aberdeen, Scotland, UK
| | - Chris Dibben
- School of Geosciences, University of Edinburgh, Edinburgh, Scotland, UK
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Li X, Huang S, Jiao A, Yang X, Yun J, Wang Y, Xue X, Chu Y, Liu F, Liu Y, Ren M, Chen X, Li N, Lu Y, Mao Z, Tian L, Xiang H. Association between ambient fine particulate matter and preterm birth or term low birth weight: An updated systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 227:596-605. [PMID: 28457735 DOI: 10.1016/j.envpol.2017.03.055] [Citation(s) in RCA: 270] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/18/2017] [Accepted: 03/24/2017] [Indexed: 05/19/2023]
Abstract
An increasing number of studies have been conducted to determine a possible linkage between maternal exposure to ambient fine particulate matter and effects on the developing human fetus that can lead to adverse birth outcomes, but, the present results are not consistent. A total of 23 studies published before July 2016 were collected and analyzed and the mean value of reported exposure to fine particulate matter (PM2.5) ranged from 1.82 to 22.11 We found a significantly increased risk of preterm birth with interquartile range increase in PM2.5 exposure throughout pregnancy (odds ratio (OR) = 1.03; 95% conditional independence (CI): 1.01-1.05). The pooled OR for the association between PM2.5 exposure, per interquartile range increment, and term low birth weight throughout pregnancy was 1.03 (95% CI: 1.02-1.03). The pooled ORs for the association between PM2.5 exposure per 10 increment, and term low birth weight and preterm birth were 1.05 (95% CI: 0.98-1.12) and 1.02 (95% CI: 0.93-1.12), respectively throughout pregnancy. There is a significant heterogeneity in most meta-analyses, except for pooled OR per interquartile range increase for term low birth weight throughout pregnancy. We here show that maternal exposure to fine particulate air pollution increases the risk of preterm birth and term low birth weight. However, the effect of exposure time needs to be further explored. In the future, prospective cohort studies and personal exposure measurements needs to be more widely utilized to better characterize the relationship between ambient fine particulate exposure and adverse birth outcomes.
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Affiliation(s)
- Xiangyu Li
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Shuqiong Huang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, Hubei Province, China.
| | - Anqi Jiao
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Xuhao Yang
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Junfeng Yun
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Yuxin Wang
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Xiaowei Xue
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Yuanyuan Chu
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Feifei Liu
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Yisi Liu
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Meng Ren
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Xi Chen
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Na Li
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Yuanan Lu
- Environmental Health Laboratory, Department of Public Health Sciences, University of Hawaii at Manoa, 1960 East-West Rd, Biomed Bldg, D105, Honolulu, HI, 96822, USA.
| | - Zongfu Mao
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Liqiao Tian
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, 430079, China.
| | - Hao Xiang
- Department of Epidemiology and Biostatistics, School of Health Science, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
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Megaw L, Clemens T, Dibben C, Weller R, Stock S. Pregnancy outcome and ultraviolet radiation; A systematic review. ENVIRONMENTAL RESEARCH 2017; 155:335-343. [PMID: 28264782 DOI: 10.1016/j.envres.2017.02.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 02/11/2017] [Accepted: 02/21/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Season and vitamin D are indirect and direct correlates of ultraviolet (UV) radiation and are associated with pregnancy outcomes. Further to producing vitamin D, UV has positive effects on cardiovascular and immune health that may support a role for UV directly benefitting pregnancy. OBJECTIVES To investigate the effects of UV exposure on pregnancy; specifically fetal growth, preterm birth and hypertensive complications. METHODS We conducted a systematic review of Medline, EMBASE, DoPHER, Global Health, ProQuest Public Health, AustHealth Informit, SCOPUS and Google Scholar to identify 537 citations, 8 of which are included in this review. This review was registered on PROSPERO and a. narrative synthesis is presented following PRISMA guidance. RESULTS All studies were observational and assessed at high risk of bias. Higher first trimester UV was associated with and improved fetal growth and increased hypertension in pregnancy. Interpretation is limited by study design and quality. Meta-analysis was precluded by the variety of outcomes and methods. DISCUSSION The low number of studies and risk of bias limit the validity of any conclusions. Environmental health methodological issues are discussed with consideration given to design and analytical improvements to further address this reproductive environmental health question. CONCLUSIONS The evidence for UV having benefits for pregnancy hypertension and fetal growth is limited by the methodological approaches utilized. Future epidemiological efforts should focus on improving the methods of modeling and linking widely available environmental data to reproductive health outcomes.
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Affiliation(s)
- Lauren Megaw
- School of Women's and Infants Health, University of Western Australia, 35 Crawley Ave, Crawley, Perth, Western Australia, Australia; Edinburgh Tommy's Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, United Kingdom.
| | - Tom Clemens
- School of Geosciences, University of Edinburgh, Drummond St, Edinburgh, Midlothian, United Kingdom.
| | - Chris Dibben
- School of Geosciences, University of Edinburgh, Drummond St, Edinburgh, Midlothian, United Kingdom.
| | - Richard Weller
- MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, United Kingdom.
| | - Sarah Stock
- School of Women's and Infants Health, University of Western Australia, 35 Crawley Ave, Crawley, Perth, Western Australia, Australia; Edinburgh Tommy's Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, United Kingdom.
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Malley CS, Kuylenstierna JCI, Vallack HW, Henze DK, Blencowe H, Ashmore MR. Preterm birth associated with maternal fine particulate matter exposure: A global, regional and national assessment. ENVIRONMENT INTERNATIONAL 2017; 101:173-182. [PMID: 28196630 DOI: 10.1016/j.envint.2017.01.023] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 05/22/2023]
Abstract
Reduction of preterm births (<37 completed weeks of gestation) would substantially reduce neonatal and infant mortality, and deleterious health effects in survivors. Maternal fine particulate matter (PM2.5) exposure has been identified as a possible risk factor contributing to preterm birth. The aim of this study was to produce the first estimates of ambient PM2.5-associated preterm births for 183 individual countries and globally. To do this, national, population-weighted, annual average ambient PM2.5 concentration, preterm birth rate and number of livebirths were combined to calculate the number of PM2.5-associated preterm births in 2010 for 183 countries. Uncertainty was quantified using Monte-Carlo simulations, and analyses were undertaken to investigate the sensitivity of PM2.5-associated preterm birth estimates to assumptions about the shape of the concentration-response function at low and high PM2.5 exposures, inclusion of provider-initiated preterm births, and exposure to indoor air pollution. Globally, in 2010, the number of PM2.5-associated preterm births was estimated as 2.7 million (1.8-3.5 million, 18% (12-24%) of total preterm births globally) with a low concentration cut-off (LCC) set at 10μgm-3, and 3.4 million (2.4-4.2 million, 23% (16-28%)) with a LCC of 4.3μgm-3. South and East Asia, North Africa/Middle East and West sub-Saharan Africa had the largest contribution to the global total, and the largest percentage of preterm births associated with PM2.5. Sensitivity analyses showed that PM2.5-associated preterm birth estimates were 24% lower when provider-initiated preterm births were excluded, 38-51% lower when risk was confined to the PM2.5 exposure range in the studies used to derive the effect estimate, and 56% lower when mothers who live in households that cook with solid fuels (and whose personal PM2.5 exposure is likely dominated by indoor air pollution) were excluded. The concentration-response function applied here derives from a meta-analysis of studies, most of which were conducted in the US and Europe, and its application to the areas of the world where we estimate the greatest effects on preterm births remains uncertain. Nevertheless, the substantial percentage of preterm births estimated to be associated with anthropogenic PM2.5 (18% (13%-24%) of total preterm births globally) indicates that reduction of maternal PM2.5 exposure through emission reduction strategies should be considered alongside mitigation of other risk factors associated with preterm births.
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Affiliation(s)
- Christopher S Malley
- Stockholm Environment Institute, Environment Department, University of York, York, United Kingdom.
| | - Johan C I Kuylenstierna
- Stockholm Environment Institute, Environment Department, University of York, York, United Kingdom
| | - Harry W Vallack
- Stockholm Environment Institute, Environment Department, University of York, York, United Kingdom
| | - Daven K Henze
- Department of Mechanical Engineering, University of Colorado, Boulder, CO, United States
| | - Hannah Blencowe
- Maternal, Adolescent, Reproductive, and Child Health Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mike R Ashmore
- Stockholm Environment Institute, Environment Department, University of York, York, United Kingdom
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Ferguson KK, Chin HB. Environmental chemicals and preterm birth: Biological mechanisms and the state of the science. CURR EPIDEMIOL REP 2017; 4:56-71. [PMID: 28944158 PMCID: PMC5608103 DOI: 10.1007/s40471-017-0099-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE OF REVIEW Preterm birth is a significant worldwide health problem of uncertain origins. The extant body of literature examining environmental contaminant exposures in relation to preterm birth is extensive but results remain ambiguous for most organic pollutants, metals and metalloids, and air pollutants. In the present review we examine recent epidemiologic studies investigating these associations, and identify recent advances and the state of the science. Additionally, we highlight biological mechanisms of action in the pathway between chemical exposures and preterm birth, including inflammation, oxidative stress, and endocrine disruption, that deserve more attention in this context. RECENT FINDINGS Important advances have been made in the study of the environment and preterm birth, particularly in regard to exposure assessment methods, exploration of effect modification by co-morbidities and exposures, and in identification of windows of vulnerability during gestation. There is strong evidence for an association between maternal exposure to some persistent pesticides, lead, and fine particulate matter, but data on other contaminants is sparse and only suggestive trends can be noted with the current data. SUMMARY Beyond replicating current findings, further work must be done to improve understanding of mechanisms underlying the associations observed between environmental chemical exposures and preterm birth. By examining windows of vulnerability, disaggregating preterm birth by phenotypes, and measuring biomarkers of mechanistic pathways in these epidemiologic studies we can improve our ability to detect associations with exposure, provide additional evidence for causality in an observational setting, and identify opportunities for intervention.
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Affiliation(s)
- Kelly K. Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Helen B. Chin
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
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Tan Y, Yang R, Zhao J, Cao Z, Chen Y, Zhang B. The Associations Between Air Pollution and Adverse Pregnancy Outcomes in China. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1017:181-214. [PMID: 29177963 DOI: 10.1007/978-981-10-5657-4_8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Research on the potential impact of air pollution on the human's health has increased rapidly in recent years. Several studies have suggested that exposure to air pollutants during period of pregnancy which is a crucial time point of mother-fetus development may have long-term and serious impact on adverse pregnancy outcomes. There is lack of review to evaluate the existed epidemiologic evidence on the associations between air pollutants and adverse pregnancy outcomes in China, so we conducted a review to explore the current epidemiological evidence on the effects of air pollutants to pregnancy outcomes and possible mechanisms during the pregnancy process. We used keywords to systematically search all the English and Chinese literatures on studies that were conducted in China. Exposure to air pollutants during pregnancy had shown there were harmful effects for different birth outcomes: preterm birth, low birth weight, stillbirth, birth defects, infertility, and macrosomia fetus. Results on the effects of air pollutants on adverse pregnancy outcomes are small and inconsistent because they vary in their design and methodology. The existed available evidence is compatible with either a small negative effect of air pollutants on pregnancy outcomes or with no effect; therefore, further studies are needed to confirm and quantify the possible associations and potential biologic mechanisms between air pollutants and pregnancy outcomes.
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Affiliation(s)
- Yafei Tan
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Rong Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Jinzhu Zhao
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Zhongqiang Cao
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Yawen Chen
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Bin Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China.
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Zheng T, Zhang J, Sommer K, Bassig BA, Zhang X, Braun J, Xu S, Boyle P, Zhang B, Shi K, Buka S, Liu S, Li Y, Qian Z, Dai M, Romano M, Zou A, Kelsey K. Effects of Environmental Exposures on Fetal and Childhood Growth Trajectories. Ann Glob Health 2016; 82:41-99. [PMID: 27325067 PMCID: PMC5967632 DOI: 10.1016/j.aogh.2016.01.008] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Delayed fetal growth and adverse birth outcomes are some of the greatest public health threats to this generation of children worldwide because these conditions are major determinants of mortality, morbidity, and disability in infancy and childhood and are also associated with diseases in adult life. A number of studies have investigated the impacts of a range of environmental conditions during pregnancy (including air pollution, endocrine disruptors, persistent organic pollutants, heavy metals) on fetal and child development. The results, while provocative, have been largely inconsistent. This review summarizes up to date epidemiologic studies linking major environmental pollutants to fetal and child development and suggested future directions for further investigation.
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Affiliation(s)
- Tongzhang Zheng
- Department of Epidemiology, Brown School of Public Health, Providence, RI.
| | - Jie Zhang
- Department of Epidemiology, Brown School of Public Health, Providence, RI
| | | | - Bryan A Bassig
- National Cancer Institute, Division of Cancer Epidemiology & Genetics, Occupational and Environmental Epidemiology Branch, Bethesda, MD
| | - Xichi Zhang
- George Washington University, Washington, DC
| | - Jospeh Braun
- Department of Epidemiology, Brown School of Public Health, Providence, RI
| | - Shuangqing Xu
- Tongji School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Peter Boyle
- International Prevention Research Institute, Lyon, France
| | - Bin Zhang
- Wuhan Medical & Health Center for Women and Children, Wuhan, Hubei, P.R. China
| | - Kunchong Shi
- Department of Epidemiology, Brown School of Public Health, Providence, RI
| | - Stephen Buka
- Department of Epidemiology, Brown School of Public Health, Providence, RI
| | - Siming Liu
- Department of Epidemiology, Brown School of Public Health, Providence, RI
| | - Yuanyuan Li
- Department of Epidemiology, Brown School of Public Health, Providence, RI; Tongji School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Zengmin Qian
- College for Public Health & Social Justice, Saint Louis University, St. Louis, MO
| | - Min Dai
- China National Cancer Center, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Megan Romano
- Department of Epidemiology, Brown School of Public Health, Providence, RI
| | - Aifen Zou
- Wuhan Medical & Health Center for Women and Children, Wuhan, Hubei, P.R. China
| | - Karl Kelsey
- Department of Epidemiology, Brown School of Public Health, Providence, RI
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