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Grabowski B, Feduniw S, Orzel A, Drab M, Modzelewski J, Pruc M, Gaca Z, Szarpak L, Rabijewski M, Baran A, Scholz A. Does Exposure to Ambient Air Pollution Affect Gestational Age and Newborn Weight?-A Systematic Review. Healthcare (Basel) 2024; 12:1176. [PMID: 38921290 PMCID: PMC11203000 DOI: 10.3390/healthcare12121176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
Current evidence suggests that airborne pollutants have a detrimental effect on fetal growth through the emergence of small for gestational age (SGA) or term low birth weight (TLBW). The study's objective was to critically evaluate the available literature on the association between environmental pollution and the incidence of SGA or TLBW occurrence. A comprehensive literature search was conducted across Pubmed/MEDLINE, Web of Science, Cochrane Library, EMBASE, and Google Scholar using predefined inclusion and exclusion criteria. The methodology adhered to the PRISMA guidelines. The systematic review protocol was registered in PROSPERO with ID number: CRD42022329624. As a result, 69 selected papers described the influence of environmental pollutants on SGA and TLBW occurrence with an Odds Ratios (ORs) of 1.138 for particulate matter ≤ 10 μm (PM10), 1.338 for particulate matter ≤ 2.5 μm (PM2.5), 1.173 for ozone (O3), 1.287 for sulfur dioxide (SO2), and 1.226 for carbon monoxide (CO). All eight studies analyzed validated that exposure to volatile organic compounds (VOCs) is a risk factor for SGA or TLBW. Pregnant women in the high-risk group of SGA occurrence, i.e., those living in urban areas or close to sources of pollution, are at an increased risk of complications. Understanding the exact exposure time of pregnant women could help improve prenatal care and timely intervention for fetuses with SGA. Nevertheless, the pervasive air pollution underscored in our findings suggests a pressing need for adaptive measures in everyday life to mitigate worldwide environmental pollution.
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Affiliation(s)
- Bartlomiej Grabowski
- Department of Urology, Military Institute of Medicine, Szaserow 128, 04-349 Warsaw, Poland;
| | - Stepan Feduniw
- Department of Gynecology, University Hospital Zürich, Frauenklinikstrasse 10, 8091 Zürich, Switzerland
| | - Anna Orzel
- I Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (A.O.); (M.D.); (A.B.)
| | - Marcin Drab
- I Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (A.O.); (M.D.); (A.B.)
| | - Jan Modzelewski
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland; (J.M.); (M.R.); (A.S.)
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland; (M.P.); (Z.G.)
- Department of Public Health, International European University, 03187 Kyiv, Ukraine
- Department of Clinical Research and Development, LUXMED Group, 02-676 Warsaw, Poland;
| | - Zuzanna Gaca
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland; (M.P.); (Z.G.)
| | - Lukasz Szarpak
- Department of Clinical Research and Development, LUXMED Group, 02-676 Warsaw, Poland;
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Michal Rabijewski
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland; (J.M.); (M.R.); (A.S.)
| | - Arkadiusz Baran
- I Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (A.O.); (M.D.); (A.B.)
| | - Anna Scholz
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland; (J.M.); (M.R.); (A.S.)
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Ahn TG, Kim YJ, Lee G, You YA, Kim SM, Chae R, Hur YM, Park MH, Bae JG, Lee SJ, Kim YH, Na S. Association Between Individual Air Pollution (PM 10, PM 2.5) Exposure and Adverse Pregnancy Outcomes in Korea: A Multicenter Prospective Cohort, Air Pollution on Pregnancy Outcome (APPO) Study. J Korean Med Sci 2024; 39:e131. [PMID: 38599601 PMCID: PMC11004777 DOI: 10.3346/jkms.2024.39.e131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 03/05/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Prenatal exposure to ambient air pollution is linked to a higher risk of unfavorable pregnancy outcomes. However, the association between pregnancy complications and exposure to indoor air pollution remains unclear. The Air Pollution on Pregnancy Outcomes research is a hospital-based prospective cohort research created to look into the effects of aerodynamically exposed particulate matter (PM)10 and PM2.5 on pregnancy outcomes. METHODS This prospective multicenter observational cohort study was conducted from January 2021 to June 2023. A total of 662 women with singleton pregnancies enrolled in this study. An AirguardK® air sensor was installed inside the homes of the participants to measure the individual PM10 and PM2.5 levels in the living environment. The time-activity patterns and PM10 and PM2.5, determined as concentrations from the time-weighted average model, were applied to determine the anticipated exposure levels to air pollution of each pregnant woman. The relationship between air pollution exposure and pregnancy outcomes was assessed using logistic and linear regression analyses. RESULTS Exposure to elevated levels of PM10 throughout the first, second, and third trimesters as well as throughout pregnancy was strongly correlated with the risk of pregnancy problems according to multiple logistic regression models adjusted for variables. Except for in the third trimester of pregnancy, women exposed to high levels of PM2.5 had a high risk of pregnancy complications. During the second trimester and entire pregnancy, the risk of preterm birth (PTB) increased by 24% and 27%, respectively, for each 10 μg/m3 increase in PM10. Exposure to high PM10 levels during the second trimester increased the risk of gestational diabetes mellitus (GDM) by 30%. The risk of GDM increased by 15% for each 5 μg/m3 increase in PM2.5 during the second trimester and overall pregnancy, respectively. Exposure to high PM10 and PM2.5 during the first trimester of pregnancy increased the risk of delivering small for gestational age (SGA) infants by 96% and 26%, respectively. CONCLUSION Exposure to high concentrations of PM10 and PM2.5 is strongly correlated with the risk of adverse pregnancy outcomes. Exposure to high levels of PM10 and PM2.5 during the second trimester and entire pregnancy, respectively, significantly increased the risk of PTB and GDM. Exposure to high levels of PM10 and PM2.5 during the first trimester of pregnancy considerably increased the risk of having SGA infants. Our findings highlight the need to measure individual particulate levels during pregnancy and the importance of managing air quality in residential environment.
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Affiliation(s)
- Tae Gyu Ahn
- Department of Obstetrics and Gynecology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital, Ewha Medical Research Institute College of Medicine, Seoul, Korea
| | - Gain Lee
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Soo Min Kim
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Rin Chae
- Division of Artificial Intelligence and Software/Artificial Intelligence Convergence, Ewha Womans University, Seoul, Korea
| | - Young Min Hur
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Mi Hye Park
- Department of Obstetrics and Gynecology, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Jin-Gon Bae
- Department of Obstetrics and Gynecology, School of Medicine, Keimyung University, Dongsan Medical Center, Daegu, Korea
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, Severance Hospital, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
| | - Sunghun Na
- Department of Obstetrics and Gynecology, Kangwon National University School of Medicine, Chuncheon, Korea.
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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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Ju L, Hua L, Xu H, Li C, Sun S, Zhang Q, Cao J, Ding R. Maternal atmospheric particulate matter exposure and risk of adverse pregnancy outcomes: A meta-analysis of cohort studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 317:120704. [PMID: 36436666 DOI: 10.1016/j.envpol.2022.120704] [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: 05/04/2022] [Revised: 11/04/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Ambient air particulate exposure not only capable of elevating the risks of adverse pregnancy outcomes, but also has profound implications for human health, but the results are discrepant. This meta-analysis aimed to provide higher grade evidence on the impacts of air particulate on specific pregnancy outcomes. A total of 81 eligible cohort studies were included in this meta-analysis, of which the outcomes included preterm birth (PTB), moderate PTB, very PTB, extreme PTB, term low birth weight (TLBW), term birth weight (TBW), stillbirth (SB) and small for gestational age (SGA). The results showed that every 10 μg/m3 increase of PM2.5 exposure associated with 2.7%-9.3% increase of PTB risk in entire pregnancy, 2nd and 3rd trimesters; 10.5%-19.3% increase of very PTB risk in entire pregnancy, 1st and 2nd trimesters; 8.3% and 10.1% increase of TLBW and SGA risk in entire pregnancy; 25.6% and 10.1% increase of SB in entire pregnancy and 3rd trimester; and -13.274 g and -4.916 g reduce of TBW during entire pregnancy and 2nd trimester, respectively. Every 10 μg/m3 increase of PM10 exposure associated with 12.1% and 2.6% increase of PTB risk in entire pregnancy and 3rd trimester; 48.9% and 5.0% increase of moderate PTB risk in entire pregnancy and 2nd trimester; 14.4% and 10.3% increase of very PTB risk in 1st and 3rd trimesters; 2.9% increase of extremely PTB risk in 2nd trimester; 1.5%-3.8% and 2.9%-3.7% increase of TLBW and SGA risk in entire pregnancy, 1st and 2nd trimesters; 7.0% increase of SB risk in 3rd trimesters; and -4.537 g and -5.263 g reduce of TBW in 1st and 2nd trimesters, respectively. High mean annual PM concentrations were associated with more extreme adverse pregnancy outcomes (PTBs, SGA and SB), while low mean annual PM concentrations were associated with decreased TBW and increased risk of TLBW.
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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.
| | - Lei Hua
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Hanbing Xu
- 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.
| | - 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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Zhou W, Ming X, Yang Y, Hu Y, He Z, Chen H, Li Y, Cheng J, Zhou X. Associations between maternal exposure to ambient air pollution and very low birth weight: A birth cohort study in Chongqing, China. Front Public Health 2023; 11:1123594. [PMID: 36960371 PMCID: PMC10028238 DOI: 10.3389/fpubh.2023.1123594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/15/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction There have been many researches done on the association between maternal exposure to ambient air pollution and adverse pregnancy outcomes, but few studies related to very low birth weight (VLBW). This study thus explores the association between maternal exposure to ambient air pollutants and the risk of VLBW, and estimates the sensitive exposure time window. Methods A retrospective cohort study analyzed in Chongqing, China, during 2015-2020. The Generalized Additive Model were applied to estimate exposures for each participant during each trimester and the entire pregnancy period. Results For each 10 μg/m3 increase in PM2.5 during pregnancy, the relative risk of VLBW increased on the first trimester, with RR = 1.100 (95% CI: 1.012, 1.195) in the single-pollutant model. Similarly, for each 10 μg/m3 increase in PM10, there was a 12.9% (RR = 1.129, 95% CI: 1.055, 1.209) increase for VLBW on the first trimester in the single-pollutant model, and an 11.5% (RR = 1.115, 95% CI: 1.024, 1.213) increase in the multi-pollutant model, respectively. The first and second trimester exposures of NO2 were found to have statistically significant RR values for VLBW. The RR values on the first trimester were 1.131 (95% CI: 1.037, 1.233) and 1.112 (95% CI: 1.015, 1.218) in the single-pollutant model and multi-pollutant model, respectively; The RR values on the second trimester were 1.129 (95% CI: 1.027, 1.241) and 1.146 (95% CI: 1.038, 1.265) in the single-pollutant model and multi-pollutant model, respectively. The RR of O3 exposure for VLBW on the entire trimester was 1.076 (95% CI: 1.010-1.146), and on the second trimester was 1.078 (95% CI: 1:016, 1.144) in the single-pollutant model. Conclusion This study indicates that maternal exposure to high levels of PM2.5, PM10, NO2, and O3 during pregnancy may increase the risk of very low birth weight, especially for exposure on the first and second trimester. Reducing the risk of early maternal exposure to ambient air pollution is thus necessary for pregnant women.
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Affiliation(s)
- Wenzheng Zhou
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Xin Ming
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yunping Yang
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yaqiong Hu
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Ziyi He
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Hongyan Chen
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yannan Li
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Jin Cheng
- Institute of Toxicology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
- Jin Cheng
| | - Xiaojun Zhou
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
- *Correspondence: Xiaojun Zhou
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Ahmad WA, Nirel R, Golan R, Jolles M, Kloog I, Rotem R, Negev M, Koren G, Levine H. Mother-level random effect in the association between PM 2.5 and fetal growth: A population-based pregnancy cohort. ENVIRONMENTAL RESEARCH 2022; 210:112974. [PMID: 35192805 DOI: 10.1016/j.envres.2022.112974] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 02/02/2022] [Accepted: 02/16/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND A growing body of literature reports associations between exposure to particulate matter with diameter ≤2.5 μm (PM2.5) during pregnancy and birth outcomes. However, findings are inconsistent across studies. OBJECTIVES To assess the association between PM2.5 and birth outcomes of fetal growth in a cohort with high prevalence of siblings by multilevel models accounting for geographical- and mother-level correlations. METHODS In Israel, we used Maccabi Healthcare Services data to establish a population-based cohort of 381,265 singleton births reaching 24-42 weeks' gestation and birth weight of 500-5000 g (2004-2015). Daily PM2.5 predictions from a satellite-based spatiotemporal model were linked to the date of birth and maternal residence. We generated mean PM2.5 values for the entire pregnancy and for exposure periods during pregnancy. Associations between exposure and birth outcomes were modeled by using multilevel logistic regression with random effects for maternal locality of residence, administrative census area (ACA) and mother. RESULTS In fully adjusted models with a mother-level random intercept only, a 10-μg/m3 increase in PM2.5 over the entire pregnancy was positively associated with term low birth weight (TLBW) (Odds ratio, OR = 1.25, 95% confidence interval, CI: 1.09,1.43) and small for gestational age (SGA) (OR = 1.15, 95% CI: 1.06,1.26). Locality- and ACA-level effects accounted for <0.4% of the variance while mother-level effects explained ∼50% of the variability. Associations varied by exposure period, infants' sex, birth order, and maternal pre-pregnancy BMI. CONCLUSIONS Consideration of mother-level variability in a region with high fertility rates provides new insights on the strength of associations between PM2.5 and birth outcomes.
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Affiliation(s)
| | - Ronit Nirel
- Hebrew University of Jerusalem, Jerusalem, Israel
| | - Rachel Golan
- Ben-Gurion University of the Negev, Beer Sheva, Israel
| | | | - Itai Kloog
- Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ran Rotem
- Harvard T.H. Chan School of Public Health, Boston, MA, USA; Institute of Research and Innovation, Maccabitech, Tel-Aviv, Israel
| | | | - Gideon Koren
- Institute of Research and Innovation, Maccabitech, Tel-Aviv, Israel; Tel Aviv University, Tel-Aviv, Israel
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Albahar S, Li J, Al-Zoughool M, Al-Hemoud A, Gasana J, Aldashti H, Alahmad B. Air Pollution and Respiratory Hospital Admissions in Kuwait: The Epidemiological Applicability of Predicted PM2.5 in Arid Regions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105998. [PMID: 35627536 PMCID: PMC9140349 DOI: 10.3390/ijerph19105998] [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: 04/13/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 01/27/2023]
Abstract
Dust is a major component of fine particulate matter (PM2.5) in arid regions; therefore, concentrations of this pollutant in countries such as Kuwait exceed air quality standards. There is limited understanding on the impact and burden of high PM2.5 concentrations on morbidity in these countries. In this study, we explore the association of PM2.5 and the risk of respiratory hospital admissions in Kuwait. A time-series regression model was used to investigate daily variations in respiratory admissions and PM2.5 concentrations from 2010 to 2018. Due to the lack of historical air quality sampling in Kuwait, we used estimated daily PM2.5 levels from a hybrid PM2.5 prediction model. Individual and cumulative lag effects of PM2.5 over a 5-day period were estimated using distributed lag linear models. Associations were stratified by sex, age, and nationality. There were 218,749 total respiratory admissions in Kuwait during the study period. Results indicate that for every 10 μg/m3 increase in PM2.5, a 1.61% (95% CI = 0.87, 2.35%) increase in respiratory admissions followed over a 5-day cumulative lag. Our estimates show that a 10 μg/m3 reduction in average exposure will potentially avert 391 yearly respiratory admissions (95% CI = 211,571), with 265 fewer admissions among Kuwaitis (95% CI = 139,393) and 262 fewer admissions among children under 15 years of age (95% CI = 125,351). Different strata of the Kuwaiti population are vulnerable to respiratory hospitalization with short-term exposure to PM2.5, especially those under 15 years of age. The findings are informative for public health authorities in Kuwait and other dust-prone countries.
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Affiliation(s)
- Soad Albahar
- Environmental and Occupational Health Department, College of Public Health, Kuwait University, Shadadiya 13110, Kuwait; (M.A.-Z.); (J.G.); (B.A.)
- Correspondence: (S.A.); (J.L.)
| | - Jing Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100871, China
- Correspondence: (S.A.); (J.L.)
| | - Mustafa Al-Zoughool
- Environmental and Occupational Health Department, College of Public Health, Kuwait University, Shadadiya 13110, Kuwait; (M.A.-Z.); (J.G.); (B.A.)
| | - Ali Al-Hemoud
- Environment and Life Sciences Research Center, Kuwait Institute of Scientific Research, Kuwait City 13109, Kuwait;
| | - Janvier Gasana
- Environmental and Occupational Health Department, College of Public Health, Kuwait University, Shadadiya 13110, Kuwait; (M.A.-Z.); (J.G.); (B.A.)
| | - Hassan Aldashti
- Meteorological Department, Directorate General of Civil Aviation, Kuwait City 13001, Kuwait;
| | - Barrak Alahmad
- Environmental and Occupational Health Department, College of Public Health, Kuwait University, Shadadiya 13110, Kuwait; (M.A.-Z.); (J.G.); (B.A.)
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
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Chen J, Fang J, Zhang Y, Xu Z, Byun HM, Li PH, Deng F, Guo X, Guo L, Wu S. Associations of adverse pregnancy outcomes with high ambient air pollution exposure: Results from the Project ELEFANT. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 761:143218. [PMID: 33190892 DOI: 10.1016/j.scitotenv.2020.143218] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/18/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Investigations on the potential effects of high air pollution exposure before pregnancy on adverse pregnancy outcomes are limited, and it is unknown whether air quality standards looser than that set by World Health Organization (WHO) still can provide sufficient protection pregnant women from adverse pregnancy outcomes. OBJECTIVES To evaluate the potential effects of high ambient air pollution around pregnancy on preterm birth (PTB) and low birth weight (LBW), and assess the risk of PTB and LBW associated with air pollutants with reference to different air quality standards of WHO and China. METHODS Our study leveraged 10,960 pregnant women from the Project ELEFANT. Daily average particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) and ≤10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone (O3) concentrations were collected based on Chinese Air Quality Reanalysis datasets. Hazard ratios (HR) of PTB and LBW were estimated for maternal PM2.5, PM10, NO2, SO2, CO and O3 exposures and related proportions of days with daily average air pollution concentrations exceeding air quality standards of WHO and China around pregnancy using Cox proportional hazards regression models with adjustment for potential confounders. RESULTS Ambient PM2.5, PM10, NO2, SO2 and CO exposure during the before pregnancy and pregnancy period were both significantly and positively associated with increased risk of PTB, PTB subtypes and LBW. A 10% increase in proportion of days with daily average PM2.5 exceeding 25 μg/m3 over the entire pregnancy was most apparently associated with risk of PTB (HR, 12.66; 95% CI, 8.20-19.53) and LBW (HR, 17.42; 95% CI, 6.88-44.10) among all PM2.5 proportion variables based on different air quality standards. CONCLUSION Air quality standards of WHO are necessary to be implemented to control for risks of adverse pregnancy outcomes associated with ambient air pollution in areas with high air pollution levels.
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Affiliation(s)
- Juan Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Junkai Fang
- Tianjin Institute of Medical & Pharmaceutical Sciences, Tianjin, China
| | - Ying Zhang
- Medical Genetic Laboratory, Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhouyang Xu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Hyang-Min Byun
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Peng-Hui Li
- School of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Liqiong Guo
- Institute of Disaster Medicine, Tianjin University, Tianjin, China.
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China; Key Laboratory of Molecular Cardiovascular Sciences, Peking University, Ministry of Education, China.
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Zhao Y, Wang P, Zhou Y, Xia B, Zhu Q, Ge W, Li J, Shi H, Xiao X, Zhang Y. Prenatal fine particulate matter exposure, placental DNA methylation changes, and fetal growth. ENVIRONMENT INTERNATIONAL 2021; 147:106313. [PMID: 33341587 DOI: 10.1016/j.envint.2020.106313] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/26/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
This study was designed to examine the impact of prenatal fine particulate matter (PM2.5) exposure on fetal growth and the underlying placental epigenetic mechanism in a cohort of Chinese women. Within the prospective Shanghai Mother-Child Pairs cohort (Shanghai MCPC), 329 women carrying singleton pregnancy with a due date in 2018 were recruited between 2017 and 2018. Maternal PM2.5 exposure levels were estimated using gestational exposure prediction model combining satellite-driven ambient concentrations and personal air sampling. Fetal growth characteristics were evaluated by prenatal ultrasound examinations and anthropometric measurements at birth. In a discovery phase, whole-genome DNA methylation analysis was performed using the Infinium 850 K array. In a validation phase, placental DNA methylation was measured using bisulfite pyrosequencing for five candidate genes that showed the most significant alterations and function relevance in our methylation array screen, including BID (BH3 interacting domain death agonist), FOXN3 (Forkhead box N3), FOXP1 (Forkhead box P1), IGF2 (Insulin-like growth factor 2) and HSD11B2 (Hydroxysteroid 11-beta dehydrogenase 2). Multivariate linear regression models were applied to examine the associations among PM2.5 exposure, fetal growth characteristics and DNA methylation on placental candidate genes. Sobel tests were used to evaluate the mediating role of DNA methylation in multivariable models. After excluding women who withdrew or failed to provide placenta, a total of 287 pregnant women with an average age of 30 entered the final analysis. Increased PM2.5 exposure was significantly associated with reduced biparietal diameter (BPD) (β: -0.136 mm, 95% CI: -0.228 to -0.043), head circumference (HC) (β: -0.462 mm, 95% CI: -0.782 to -0.142), femur length (FL) (β: -0.113 mm, 95% CI: -0.185 to -0.041) and abdominal circumference (AC) (β: -0.371 mm, 95% CI: -0.672 to -0.071) in the second trimester and birth length (β: -0.013 cm, 95% CI: -0.025 to -0.001). Prenatal PM2.5 exposure could lead to aberrant changes in DNA methylation profile of placenta genome, which were mainly enriched in reproductive development, energy metabolism and immune response. DNA methylation of IGF2 and BID showed significant associations with PM2.5 exposures during all exposure windows. In addition, BID methylation was negatively correlated with HC (β: -1.396 mm, 95% CI: -2.582 to -0.209) and BPD (β: -0.330 mm, 95% CI: -0.635 to -0.026) in the second trimester. Further mediation analysis indicated that BID methylation mediated about 30% of the effects of PM2.5 exposure on HC. These findings collectively suggested that prenatal PM2.5 exposure may cause adverse effects on fetal growth by modifying placental DNA methylation.
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Affiliation(s)
- Yingya Zhao
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Pengpeng Wang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yuhan Zhou
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Bin Xia
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China
| | - Qingyang Zhu
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China
| | - Wenzhen Ge
- Regeneron Pharmaceuticals Inc., New York, NY, USA
| | - Jialin Li
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Huijing Shi
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xirong Xiao
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200032, China.
| | - Yunhui Zhang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
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Li C, Yang M, Zhu Z, Sun S, Zhang Q, Cao J, Ding R. Maternal exposure to air pollution and the risk of low birth weight: A meta-analysis of cohort studies. ENVIRONMENTAL RESEARCH 2020; 190:109970. [PMID: 32763280 DOI: 10.1016/j.envres.2020.109970] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/07/2020] [Accepted: 07/16/2020] [Indexed: 05/14/2023]
Abstract
Previous studies have evaluated the relationship between prenatal air pollution exposure and low birth weight, but the results are inconsistent. The purpose of this meta-analysis is to quantitatively analyze the relationship between maternal air pollutant exposure and low birth weight (LBW). PubMed and Web of Science databases were searched to obtain the studies on the relationship between the prenatal exposure of air pollutants and LBW that published as of June 2020. The pooled effects of air pollutant exposure and LBW were calculated using random-effect model (for studies with significant heterogeneity) or fixed-effect model (for studies without significant heterogeneity). Totally, 54 studies were included in this meta-analysis. The pooled effect of PM2.5, PM10, NO2, CO, SO2, and O3 exposure on LBW were 1.081 (95% CI: 1.043, 1.120), 1.053 (95% CI: 1.030, 1.076), 1.030 (95% CI: 1.008, 1.053), 1.007 (95% CI: 1.001, 1.014), 1.125 (95% CI: 1.017, 1.244), and 1.045 (95% CI: 1.005, 1.086), respectively. NO2 (per 10 ppb increase) and CO (per 100 ppb increase) exposure in the first trimester were positively correlated with LBW, of which the pooled effect was 1.022 (95% CI: 1.009, 1. 035) and 1.008 (95% CI: 1.004, 1.012), respectively. PM2.5 (per 10 μg/m3 increase) exposure in the third trimester significantly affected the LBW, of which the pooled effect was 1.053 (95% CI: 1.010, 1.097). In addition, PM10 (per 10 μg/m3 increase) exposure in the second trimester also significantly affected the LBW, with the pooled effect of 1.011 (95% CI: 1.005, 1.017). Prenatal exposure of the major air pollutants during the entire pregnancy could increase the risk of LBW, while the susceptible window of the pollutants varied.
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Affiliation(s)
- Changlian Li
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Mei Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Zijian Zhu
- Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Shu Sun
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Qi Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Jiyu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China; Department of Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Rui Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
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11
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Wang L, Guo P, Tong H, Wang A, Chang Y, Guo X, Gong J, Song C, Wu L, Wang T, Hopke PK, Chen X, Tang NJ, Mao H. Traffic-related metrics and adverse birth outcomes: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2020; 188:109752. [PMID: 32516633 DOI: 10.1016/j.envres.2020.109752] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 05/09/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
Given the inconsistency of epidemiologic evidence for associations between maternal exposures to traffic-related metrics and adverse birth outcomes, this manuscript aims to provide clarity on this topic. Pooled meta-estimates were calculated using random-effects analyses. Subgroup analyses were conducted by study area, study design, and Newcastle-Ottawa quality score (NOS). Funnel plots and Egger's test were conducted to evaluate the publication bias, and Fail-safe Numbers (Fail-safe N) were measured to evaluate the robustness of models. From the initial 740 studies (last search, July 11, 2019), 26 studies were included in our analysis. The pooled odds ratio for the change in small for gestational age associated with per 500 m decrease in the distance to roads was 1.016 (95% CI: 1.004, 1.029). Subgroup analyses revealed significant positive associations between term low birth weight and traffic density in higher-quality literatures with higher NOS [1.060 (95% CI: 1.002, 1.121)], cohort studies [1.020 (95% CI: 1.006, 1.033)], and studies in North America [1.018 (95% CI: 1.005, 1.131)]. The buffer of traffic density made no difference in the effect size. Traffic density seemed to be a better indicator of traffic pollution than the distance to roads.
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Affiliation(s)
- Lijun Wang
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Pengyi Guo
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Key Laboratory of Environment, Nutrition and Public Health, 300070, Tianjin, China
| | - Hui Tong
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Anxu Wang
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Ying Chang
- Tianjin Center Hospital of Obstetrics and Gynecology, Tianjin Key Laboratory of Human Development and Reproductive Regulation, China
| | - Xuemei Guo
- University Library, Tianjin Medical University, Tianjin, 300070, China
| | - Junming Gong
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Key Laboratory of Environment, Nutrition and Public Health, 300070, Tianjin, China
| | - Congbo Song
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Lin Wu
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Ting Wang
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China
| | - Philip K Hopke
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China; Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Key Laboratory of Environment, Nutrition and Public Health, 300070, Tianjin, China.
| | - Nai-Jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Key Laboratory of Environment, Nutrition and Public Health, 300070, Tianjin, China.
| | - Hongjun Mao
- Center for Urban Transport Emission Research (CUTER), And State Environmental Protection Key Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Key Laboratory of Urban Transport Emission Research, 300071, Tianjin, China.
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12
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Lin L, Li Q, Yang J, Han N, Jin C, Xu X, Liu Z, Liu J, Luo S, Raat H, Wang H. The associations of particulate matters with fetal growth in utero and birth weight: A birth cohort study in Beijing, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 709:136246. [PMID: 31927434 DOI: 10.1016/j.scitotenv.2019.136246] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/28/2019] [Accepted: 12/18/2019] [Indexed: 05/07/2023]
Abstract
BACKGROUND Previous studies examined the associations of particulate matters (PM) with fetal growth in utero or birth weight with inconsistent results, and few studies investigated that whether the associations of PM with fetal growth in utero also present at birth. We aimed to investigate the associations of PM with both fetal growth in utero and birth weight. METHODS We established a birth cohort (2014-2017) with 18,863 singleton pregnancies in Tongzhou Maternal and Child Hospital of Beijing, China. Maternal exposure to PM with aerodynamic diameters ≤2.5 μm and ≤ 10 μm (PM2.5/PM10) during pregnancy was estimated using the inverse distance weighting method. Estimated birth weight (EFW) was assessed by ultrasound measurements and birth weight was measured at birth, which were both standardized as gestational-age- and gender-adjusted Z-score. EFW undergrowth, low birth weight (LBW) and small-for-gestational-age were defined as the categorized outcomes. Generalized estimating equations and generalized linear regression were used to examine the associations of PM with quantitative and categorized outcomes, controlling for temperature, greenspace and individual covariates. RESULTS A 10 μg/m3 increase in PM2.5 and PM10 were associated with lower EFW Z-score [-0.031, 95% confident interval (CI): -0.047, -0.016 and -0.030, 95% CI: -0.043, -0.017]. A 10 μg/m3 increase in PM2.5 was associated with lower birth weight Z-score (-0.035, 95% CI: -0.061, -0.010) and higher risk of LBW (OR = 1.240, 95% CI: 1.019, 1.508). These results remained robust in co-pollutant models and sensitivity analyses. We didn't find significant results in other analyses. CONCLUSIONS The study identified an inverse association between PM and fetal growth in utero. The association between PM2.5 and fetal growth persisted from pregnancy to birth. This study supported that further actions towards controlling air pollution are strongly recommended for promoting early-life health.
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Affiliation(s)
- Lizi Lin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, People's Republic of China; Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Qin Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, People's Republic of China; Reproductive Medical Centre, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Jie Yang
- Maternal and Child Health Care Hospital of Tongzhou District, Beijing 101101, People's Republic of China
| | - Na Han
- Maternal and Child Health Care Hospital of Tongzhou District, Beijing 101101, People's Republic of China
| | - Chuyao Jin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, People's Republic of China
| | - Xiangrong Xu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, People's Republic of China
| | - Zheng Liu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, People's Republic of China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Healths, Peking University, Beijing 100191, People's Republic of China
| | - Shusheng Luo
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, People's Republic of China
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Haijun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, People's Republic of China.
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Zhang H, Dong H, Ren M, Liang Q, Shen X, Wang Q, Yu L, Lin H, Luo Q, Chen W, Knibbs LD, Jalaludin B, Wang Q, Huang C. Ambient air pollution exposure and gestational diabetes mellitus in Guangzhou, China: A prospective cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 699:134390. [PMID: 31525546 DOI: 10.1016/j.scitotenv.2019.134390] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/08/2019] [Accepted: 09/09/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Evidence concerning the effect of ambient air pollution exposure on gestational diabetes mellitus (GDM) is limited. No published studies have examined maternal weekly air pollution exposure and GDM, and the possible effect modification by folic acid supplementation has not been assessed. OBJECTIVES To evaluate the association between air pollution exposure and GDM at trimester and weekly levels, and to explore the potential effect modification by folic acid supplementation. METHODS A total of 5421 pregnant women were recruited during 2011-2014 in Guangzhou, China. Daily PM2.5, PM10, SO2 and NO2 levels were collected from 10 monitoring stations. Individual's exposure during pregnancy was estimated using inverse-distance weighting approach. Binary logistic regression was used to examine the trimester-specific association between air pollution exposure and GDM. Distributed lag models (DLMs) were applied to estimate maternal weekly air pollution exposure and GDM. Stratified analyses by folic acid supplementation and interaction test were performed. RESULTS The GDM incidence was 11.69%. An interquartile range (IQR) increase in first trimester SO2 was associated with increased GDM risk in the single pollutant model, the adjusted odds ratio (aOR) and 95% confidence interval (CI) was 1.22 (1.02-1.47). In DLMs, an IQR increase in SO2 during 4th to 10th gestational weeks was associated with increased GDM risk, with the strongest effect in the 7th gestational week. When stratified by maternal folic acid supplementation, first trimester exposure to SO2 was associated with increased GDM risk among women taking folic acid supplements (aOR = 1.25, 95% CI: 1.03-1.53) and P value for interaction was 0.13. No significant effects were observed for PM2.5, PM10 and NO2. CONCLUSION First trimester exposure to SO2 was associated with increased GDM risk, especially during the 4th to 10th gestational weeks. The effect might be stronger among women taking folic acid supplements.
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Affiliation(s)
- Huanhuan Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Shanghai Typhoon Institute, China Meteorological Administration, Shanghai 200030, China; Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai 200030, China
| | - Haotian Dong
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Meng Ren
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qianhong Liang
- Department of Ultrasound, Panyu Maternal and Child Care Service Center of Guangzhou
| | - Xiaoting Shen
- Center for Reproductive Medicine, The first Affiliated Hospital of Sun Yat-sen University, China
| | - Qiang Wang
- Department of Emergency, Guangzhou Women and Children's Medical Center, Guangzhou
| | - Le Yu
- Department of Pediatrics in Traditional Chinese Medicine, Guangzhou Women and Children's Medical Center
| | - Hualiang Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qiwei Luo
- Department of Obstetrics, Panyu Maternal and Child Care Service Center of Guangzhou, China
| | - Weiyi Chen
- Department of Obstetrics, Panyu Maternal and Child Care Service Center of Guangzhou, China
| | - Luke D Knibbs
- School of Public Health, The University of Queensland, Herston, Australia
| | - Bin Jalaludin
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Shanghai Typhoon Institute, China Meteorological Administration, Shanghai 200030, China; Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai 200030, China
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Al-Hemoud A, Gasana J, Al-Dabbous A, Alajeel A, Al-Shatti A, Behbehani W, Malak M. Exposure levels of air pollution (PM 2.5) and associated health risk in Kuwait. ENVIRONMENTAL RESEARCH 2019; 179:108730. [PMID: 31550597 DOI: 10.1016/j.envres.2019.108730] [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: 06/26/2019] [Revised: 08/28/2019] [Accepted: 09/05/2019] [Indexed: 06/10/2023]
Abstract
It is well established that respiratory and cardiovascular mortality and morbidity rates are associated with poor air quality as measured by high concentrations of fine particulate matter such as PM2.5 parameters. Since such information is lacking for the State of Kuwait, this study examined the exposure levels of PM2.5 and the associated health risk as evaluated by five mortality measures embodied in ischemic heart disease, stroke, lung cancer, chronic obstructive pulmonary disease and acute lower respiratory infection as well as two morbidity outcomes related to both cardiovascular and respiratory diseases. The measurement models utilized in this investigation followed the WHO guidelines. Over a span of a four-year period (2014-2017), the annual PM2.5 concentration levels ranged from 38.0 μg/m3 to 75.2 μg/m3. In general, exposure levels tended to fluctuate throughout the day with the higher levels recorded during rush hours (early morning and early evening), weekends (particularly Saturdays), and summer (i.e., August and September). The highest number of excess cases and attributable proportions of premature mortalities were related to ischemic heart disease and stroke at 352 (95% CI 275-426) and 70.8% (95% CI 39.7-85.2), respectively. In general, respiratory diseases showed a higher number of excess cases and attributable proportions than cardiovascular diseases. Relative to other findings on the global stage, the results emanating from Kuwait are emerging on the higher side. The study outcomes suggest that control strategies are in dire need to bend the pollution levels in Kuwait.
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Affiliation(s)
- Ali Al-Hemoud
- Environment and Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, 13109, Safat, Kuwait.
| | - Janvier Gasana
- Faculty of Public Health, Kuwait University, P.O. Box 24923, 13110, Safat, Kuwait
| | - Abdullah Al-Dabbous
- Environment and Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, 13109, Safat, Kuwait
| | | | | | - Weam Behbehani
- Techno-Economics Division, Kuwait Institute for Scientific Research, P.O. Box 24885, 13109, Safat, Kuwait
| | - Mariam Malak
- Environment and Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, 13109, Safat, Kuwait
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Hao J, Zhang F, Chen D, Liu Y, Liao L, Shen C, Liu T, Liao J, Ma L. Association between ambient air pollution exposure and infants small for gestational age in Huangshi, China: a cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:32029-32039. [PMID: 31493084 PMCID: PMC6875112 DOI: 10.1007/s11356-019-06268-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 08/16/2019] [Indexed: 05/05/2023]
Abstract
Small for gestational age (SGA) is defined as intrauterine growth retardation or small sample, referring to the 10th percentile of birth weight lower or two standard deviations less than the average weight at the same gestational age. SGA infants bring great economic and psychological burdens to families and society. The association between exposure to air pollution and SGA in underdeveloped cities with poor air quality remains unclear. Thus, this study is conducted to estimate the effects of maternal exposure to air pollutants on SGA numbers. Birth information was collected from the Huangshi Maternity and Children's Health Hospital from January 1st to December 31st in 2017. Data of pregnancy exposure were accessed using stationary monitors. These data included particulate matter less than or equal to 10 μm in aerodynamic diameter (PM10), particulate matter less than or equal to 2.5 μm in aerodynamic diameter (PM2.5), nitrogen dioxide (NO2), and sulfur dioxide (SO2). Multivariate logistic regression models were performed to estimate the association between ambient air pollution and the risk of SGA during different exposure windows. It was found that a 1 μg/m3 increase in air pollution concentrations during the entire pregnancy was associated with a higher risk of SGA, with an adjusted odds ratio (OR) and 95% confidence interval (CI) of 1.055 (1.035-1.076), 1.084 (1.053-1.116), 1.000 (0.953-1.049), and 1.051 (0.968-1.141) for PM10, PM2.5, NO2, and SO2, respectively. Thus, it is suggested that exposure to air pollution is associated with an increased risk of SGA. The effects of PM10 and PM2.5 were more stable than NO2 and SO2.
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Affiliation(s)
- Jiayuan Hao
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Faxue Zhang
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Dieyi Chen
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Yanyun Liu
- Huangshi Maternity and Children's Health Hospital of Edong Healthcare Group, Huangshi, Hubei Province, China
| | - Lina Liao
- Huangshi Maternity and Children's Health Hospital of Edong Healthcare Group, Huangshi, Hubei Province, China
| | - Cui Shen
- Huangshi Maternity and Children's Health Hospital of Edong Healthcare Group, Huangshi, Hubei Province, China
| | - Tianyu Liu
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Jingling Liao
- Department of Public Health, Wuhan University of Science and Technology School of Medicine, Wuhan, China
| | - Lu Ma
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan, 430071, China.
- Global Health Institute, Wuhan University, Wuhan, 430071, China.
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Choe SA, Jang J, Kim MJ, Jun YB, Kim SY. Association between ambient particulate matter concentration and fetal growth restriction stratified by maternal employment. BMC Pregnancy Childbirth 2019; 19:246. [PMID: 31307418 PMCID: PMC6632189 DOI: 10.1186/s12884-019-2401-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 07/04/2019] [Indexed: 12/11/2022] Open
Abstract
Background Fetal growth has been known to be associated with particulate matter (PM) air pollution during gestation. Given that regular working may deviate outdoor air pollution exposure, the association between air pollution and fetal growth restriction can be different across maternal working status. This study was to assess possible effect modification by maternal employment in the association between exposure to PM during pregnancy and fetal growth restriction. Methods Using hourly PM less than or equal to 10 and 2.5 μm in diameter (PM10 and PM2.5) regulatory monitoring data for 2001–2012 and 2008–2012, respectively, and birth certificate data for 2002–2012, we computed maternal exposures with district-level averages of PM10 and PM2.5 during one year before birth, entire pregnancy, and the 1st, 2nd and 3rd trimesters. The outcomes of fetal growth restriction were assessed by small for gestational age (SGA, weighted <10th percentile in the same gestational age) as well as low birth weight (LBW, < 2.5 kg) at term. We performed logistic regression to examine the association between PM and each of fetal growth restriction outcomes adjusting for individual risk factors. For effect modification by maternal employment, we estimated adjusted odds ratio (OR) of SGA or LBW for interquartile (IQR) increases in PM10 or PM2.5 stratified by employed and non-employed mothers. We also computed relative excess risk due to interaction (RERI) to investigate additive interaction. Results Among 824,011 singleton term births, 34.0% (279,856) were employed and 66.0% (544,155) were non-employed mothers. Proportions of LBW were 1.5% in employed and 1.6% in non-employed (P < 0.001). SGA occurred in 12.7% of employed and 12.8% of non- employed (P = 0.124) mothers. For non-employed mothers, we observed increased odds of SGA per IQR increase in PM10 for one year before birth (OR = 1.02, 95% confidence intervals (CI): 1.00–1.04, P = 0.028). ORs of SGA for full pregnancy period and the 3rd trimester were also positive but did not reach statistical significance. We did not observe positive association for PM2.5. RERI was not significant both for PM10 and PM2.5. Conclusions We did not observe evidence of effect modification by maternal employment in the association between ambient PM and fetal growth restriction. Future studies using more refined exposure measures should confirm this finding. Electronic supplementary material The online version of this article (10.1186/s12884-019-2401-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Seung-Ah Choe
- Department of Obstetrics and Gynaecology, CHA University School of Medicine, Gyeonggi-do, 11160, Korea.,Department of Epidemiology, Graduate School of Public Health, Brown University, Providence, RI, 02903, USA
| | - Jiyeong Jang
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, 60607, USA
| | - Min Jung Kim
- Department of Statistics, Seoul National University, Seoul, 08826, South Korea
| | - Yoon-Bae Jun
- Department of Statistics, Seoul National University, Seoul, 08826, South Korea
| | - Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Gyeonggi-do, 10408, Korea.
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Li Z, Yuan X, Fu J, Zhang L, Hong L, Hu L, Liu L. Association of ambient air pollutants and birth weight in Ningbo, 2015-2017. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 249:629-637. [PMID: 30933760 DOI: 10.1016/j.envpol.2019.03.076] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/28/2019] [Accepted: 03/18/2019] [Indexed: 06/09/2023]
Abstract
Previous studies have suggested a change of birth weight linked with elevated ambient air pollutant concentrations during the pregnancy. However, investigations of the influence of higher pollutant levels on birth weight change are limited. The goal of this study is to evaluate whether the air pollution of Ningbo is associated with birth weight, and which trimester could be a window period for maternal exposure to air pollution. A total of 170,008 live births were selected in the Ningbo city of Zhejiang, China, from 2015 to 2017. We estimated the association between the decreased birth weight and the increased air pollutant concentrations in the three trimesters and full gestation. The effects of interaction among pollutants were identified using a co-pollutant adjustment model. An interquartile range increases in PM2.5 (10.55 μg/m3), SO2(4.6 μg/m3), CO (125.59 μg/m3), and O3 (14.54 μg/m3) concentrations during the entire gestation were associated with 3.65 g (95% confidence interval: -6.02 g, -1.29 g), 5.02 g (-6.89 g, -3.14 g), 2.64 g (-4.65 g, -0.63 g) and 2.9 g (-4.8 g, 1 g) decreases, respectively, in birth weight. With each interquartile range increment in NO2 concentration was associated with an 8.05 g (6.24 g, 9.85 g) increase in birth weight. In the first trimester, only the PM2.5 exposure seemed to be associated with the greatest decline in birth weight. After adjustment for co-pollutant, both PM2.5 and SO2 were still associated with birth weight, except for CO for O3 adjustment, O3 for SO2 adjustment, and O3 for NO2 adjustment. Maternal exposure to air pollution may be associated with a decrease of birth weight, but the contribution of various pollutants is necessary to verify by future research.
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Affiliation(s)
- Zhen Li
- Department of Preventative Medicine, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China
| | - Xiaoqi Yuan
- Pediatric Surgery Ward, Ningbo Women and Children Hospital, Ningbo, Zhejiang Province 315012, People's Republic of China
| | - Jianfei Fu
- Department of Medical Records and Statistics, Ningbo First Hospital, Ningbo, Zhejiang Province 315010, People's Republic of China
| | - Lingyun Zhang
- Department of Preventative Medicine, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China
| | - Lixia Hong
- Department of Preventative Medicine, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China
| | - Lingjie Hu
- Department of Preventative Medicine, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China
| | - Liya Liu
- Department of Preventative Medicine, Medicine School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang Province 315211, People's Republic of China.
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Ji PY, Li ZY, Wang H, Dong JT, Li XJ, Yi HL. Arsenic and sulfur dioxide co-exposure induce renal injury via activation of the NF-κB and caspase signaling pathway. CHEMOSPHERE 2019; 224:280-288. [PMID: 30825854 DOI: 10.1016/j.chemosphere.2019.02.111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/02/2019] [Accepted: 02/17/2019] [Indexed: 06/09/2023]
Abstract
Although emerging evidence suggests positive association of arsenic (As) or sulfur dioxide (SO2) exposure with human diseases, reports concerning the effects of co-exposure of As and SO2 are lacking. Moreover, there is insufficient information in the literature about As and SO2 co-exposure to renal injury. In this study, we focus on the environmental problems of excessive As and SO2 that co-exist in many coal consumption areas. We used both C57BL/6 mice and 293T cells to detect toxicities of As and SO2 exposure alone or in combination. Our results showed that co-exposure significantly increased the hazard compared with exposure to As or SO2 alone. Mouse kidney tissue slices showed that co-exposure caused more severe diffuse sclerosing glomerulonephritis than As and SO2 exposure alone. Meanwhile experiments showed that apoptosis was aggravated by co-exposure of As and SO2 in 293T cells. Because As and SO2 cause cell toxicity through increasing oxidative stress, next we detected ROS and other oxidative stress parameters, and the results showed oxidative stress was increased by co-exposure compared with the other three groups. The expression levels of downstream genes in the NF-κB and caspase pathways were higher in the co-exposure group than in the groups of As or SO2 exposure alone in mice and 293T cells. Based on the above results, co-exposure could induce higher toxicity in vitro and in vivo compared with single exposure to As or SO2, indicating that people living in places that contaminated by As and SO2 may have higher chance to get renal injury.
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Affiliation(s)
- Peng-Yu Ji
- School of Life Science, Shanxi University, Taiyuan, China; College of Environmental and Resource, Shanxi University, Taiyuan, China
| | - Zhuo-Yu Li
- School of Life Science, Shanxi University, Taiyuan, China
| | - Hong Wang
- School of Life Science, Shanxi University, Taiyuan, China; Monell Chemical Senses Center, Philadelphia, PA, USA
| | - Jin-Tang Dong
- School of Life Science, Shanxi University, Taiyuan, China; Emory University Winship Cancer Insititute, Atlanta, GA, USA
| | - Xiu-Juan Li
- School of Life Science, Shanxi University, Taiyuan, China; College of Environmental and Resource, Shanxi University, Taiyuan, China
| | - Hui-Lan Yi
- School of Life Science, Shanxi University, Taiyuan, China.
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