Air pollution and infant health: Lessons from New Jersey

Mortality caused by tropical cyclones in the United States

Natural disasters trigger complex chains of events within human societies1. Immediate deaths and damage are directly observed after a disaster and are widely studied, but delayed downstream outcomes, indirectly caused by the disaster, are difficult to trace back to the initial event1,2. Tropical cyclones (TCs)-that is, hurricanes and tropical storms-are widespread globally and have lasting economic impacts3-5, but their full health impact remains unknown. Here we conduct a large-scale evaluation of long-term effects of TCs on human mortality in the contiguous United States (CONUS) for all TCs between 1930 and 2015. We observe a robust increase in excess mortality that persists for 15 years after each geophysical event. We estimate that the average TC generates 7,000-11,000 excess deaths, exceeding the average of 24 immediate deaths reported in government statistics6,7. Tracking the effects of 501 historical storms, we compute that the TC climate of CONUS imposes an undocumented mortality burden that explains a substantial fraction of the higher mortality rates along the Atlantic coast and is equal to roughly 3.2-5.1% of all deaths. These findings suggest that the TC climate, previously thought to be unimportant for broader public health outcomes, is a meaningful underlying driver for the distribution of mortality risk in CONUS, especially among infants (less than 1 year of age), people 1-44 years of age, and the Black population. Understanding why TCs induce this excess mortality is likely to yield substantial health benefits.

Prenatal exposure to particulate matter and infant birth outcomes: Evidence from a population-wide database

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.

The causal impact of fetal exposure to PM2.5 on birth outcomes: Evidence from rural China

This paper investigates the causal impact of fetal exposure to PM2.5 on birth outcomes, including birth weight, the incidence of low birth weight (LBW), and small for gestational age (SGA), based on a nationally representative birth record dataset in a developing country setting. We employed thermal inversion as the instrument variable (IV) for PM2.5 and leveraged the distinctive characteristics of rural China in the 1990 s to address identification challenges. Our IV estimates indicate that higher fetal PM2.5 exposure leads to lower birth weight and elevated probabilities of LBW and SGA. Due to the mortality selection in utero, weak male fetuses were more likely to be screened out by PM2.5 exposure, resulting in a comparatively lower vulnerability among the surviving male infants. Furthermore, infants born to less educated mothers exhibited increased susceptibility, a phenomenon not entirely explained by the sorting behaviors associated with the preference for cleaner air based on socioeconomic status.

Dust to Feed, Dust to Gray: The Effect of in Utero Exposure to the Dust Bowl on Old-Age Longevity

Intensive agriculture and deep plowing caused topsoil erosion and dust storms during the 1930s, affecting agricultural income and land values for years. Given the growing literature on the relevance of in utero and early-life exposures, it is surprising that studies focusing on links between the Dust Bowl and later-life health have produced inconclusive and mixed results. We reevaluate this literature and study the long-term effects of in utero and early-life exposure to topsoil erosion caused by the 1930s Dust Bowl on old-age longevity. Specifically, using Social Security Administration death records linked with the full-count 1940 census, we conduct event studies with difference-in-differences designs to compare the longevity of individuals in high- versus low-topsoil-erosion counties before versus after 1930. We find intent-to-treat reductions in longevity of approximately 0.85 months for those born in high-erosion counties after 1930. We show that these effects are not an artifact of preexisting trends in longevity. Additional analyses suggest that the effects are more pronounced among children raised in farm households, females, and those whose mothers had lower education. We also provide suggestive evidence that reductions in adulthood income are a likely mechanism for the effects we document.

The Siren Song of Cicadas: Early-Life Pesticide Exposure and Later-Life Male Mortality

This paper studies the long-term effects of in-utero and early-life exposure to pesticide use on adulthood and old-age longevity. We use the cyclical emergence of cicadas in the eastern half of the United States as a shock that raises the pesticide use among tree crop growing farmlands. We implement a difference-in-difference framework and employ Social Security Administration death records over the years 1975-2005 linked to the complete count 1940 census. We find that males born in top-quartile tree-crop counties and exposed to a cicada event during fetal development and early-life live roughly 2.2 months shorted lives; those with direct farm exposure face a reduction of nearly a year. We provide empirical evidence to examine mortality selection before adulthood, endogenous fertility, and differential data linkage rates. Additional analyses suggests that reductions in education and income during adulthood are potential mechanisms of impact. Our findings add to our understanding of the relevance of early-life insults for old-age health and mortality.

Leave for where? The impact of air quality on migration: Evidence at the city-pair level in China

We comprehensively explore the question of "Leave for where?" by utilizing city-pair level data of China spanning from 2011 to 2017. Our investigation focuses on the impact of disparities in air quality between city pairs on migration. we find that a 1% increase in the difference air quality between inflow and outflow locations raises the number of people migrating from the outflow to the inflow location by approximately 0.07%. This finding is robust after overcoming possible endogeneity problems with average wind speed as an instrumental variable. In addition, we conducted a heterogeneity analysis in terms of intention to migrate and individual characteristics, finding that individuals who migrated for work and family are more sensitive to differences in air quality between city pairs, whereas those who moved for business are not sensitive to differences in air quality. Regarding individual characteristics, differences in air quality between city pairs have a greater impact on the migration decisions of low-educated, female, and younger migrants. Further, a mechanistic analysis by constructing cohort dummy variables reveals that poor air quality is more motivational than the desire for good air quality and the crowding-out effect of air pollution on migration is more pronounced.

Breathing in the future: prenatal exposure to air pollution and infants' health outcomes in the USA

OBJECTIVES

This study aimed to investigate the impact of air pollution on birth outcomes in the USA over several decades.

STUDY DESIGN

Approximately 70 million birth records were assessed for the years 1980-2020. This study focussed on seven measures of birth outcomes, including birth weight, low birth weight, very low birth weight, full-term birth weight, foetal growth, gestational age and very premature birth.

METHODS

An instrumental variable identification strategy was used that exploited within county-month and within month-year of birth variations in exposure to precipitation-induced changes in air pollution.

RESULTS

Air pollution was found to have negative and large effects on a wide range of birth outcomes. The study findings suggest that a one-standard-deviation increase in ozone was associated with a 6.4% and 12.8% increase (from the mean) in the proportion of low birth weight and very preterm birth infants, respectively. Further analyses suggest that these effects were heterogeneous across trimesters of pregnancy and reveal larger impacts during the second and third trimesters.

CONCLUSIONS

The results suggest that the ordinary least square estimates of previous studies considerably underestimate the true effects of pollution on birth outcomes. Policies that aim to improve the health capital of future generations should allocate more resources and initiatives to improving environmental air quality.

Short-term exposure to air pollution and infant mortality: A systematic review and meta-analysis

BACKGROUND AND AIM

Infant mortality is a widely reported indicator of population health and a leading public health concern. In this systematic review and meta-analysis, we review the available literature for epidemiologic evidence of the association between short-term air pollution exposure and infant mortality.

METHODS

Relevant publications were identified through PubMed and Web of Science databases using comprehensive search terms and screened using predefined inclusion/exclusion criteria. We extracted data from included studies and applied a systematic rubric for evaluating study quality across domains including participant selection, outcome, exposure, confounding, analysis, selective reporting, sensitivity, and overall quality. We performed meta-analyses, using both fixed and random-effect methods, and estimated pooled odds ratios (ORs) and 95 % confidence intervals (95%CI) for pollutants (nitrogen dioxide (NO2), sulfur dioxide (SO2), coarse particulate matter (PM10), fine particulate matter (PM2.5), ozone (O3), carbon monoxide (CO)) and infant mortality, neonatal mortality, or postneonatal mortality.

RESULTS

Our search returned 549 studies. We excluded 490 studies in the abstract screening phase and an additional 37 studies in the full text screening phase, leaving 22 studies for inclusion. Among these 22 studies, 14 included effect estimates for PM10, 13 for O3, 11 for both NO2 and CO, 8 for SO2, and 3 for PM2.5. We did not calculate a pooled OR for PM2.5 due to the limited number of studies available and demonstrated heterogeneity in the effect estimates. The pooled ORs (95%CI) with the greatest magnitudes were for a 10-ppb increase in SO2 or NO2 concentration in the days before death (1.07 [95%CI: 1.02, 1.12], 1.04 [95%CI: 1.01, 1.08], respectively). The pooled OR for PM10 was 1.02 (95%CI: 1.00, 1.03), and the pooled ORs for CO and O3 were 1.01 (95%CI: 1.00, 1.02) and 0.99 (95%CI: 0.97, 1.01).

CONCLUSIONS

Increased exposure to SO2, NO2, PM10, or CO is associated with infant mortality across studies.

Beyond particulate matter: New evidence on the causal effects of air pollution on mortality

The increasing demand for electricity worldwide has caused a corresponding rise in the consumption of coal, leading to an increase in sulfur dioxide (SO2) pollution levels. Despite the severity of the issue, there is a lack of conclusive evidence establishing a causal link between SO2 pollution and health, particularly in developing countries. We leverage a large national environmental regulation policy, implemented in China to reduce SO2 emissions, to estimate the impacts of SO2 pollution on mortality. We find that 1-μg/m3 reduction in SO2 concentrations leads to 18 fewer cardiovascular deaths per 100,000 people aged 60 years and above (0.9% decrease) and 2 fewer deaths per 100,000 children under the age of 5 (1.5% decrease) annually. A back-of-the-envelope calculation suggests that the total health benefits of the environmental policy outweigh its economic costs. The results are consistent across various robustness checks.

The effect of "smoky" coal bans on chronic lung disease among older people in Ireland

Globally, coal is still widely used for heating. However, there are concerns about its effect on ambient air quality and health. We estimated the effect of bans prohibiting the sale and use of so-called "smoky coal" on the prevalence of chronic lung disease in older people. Our identification strategy relied on the phased extension of smoky coal bans to Irish towns after 2010. We examined five waves of The Irish Longitudinal Study on Ageing (TILDA), a large nationally representative survey containing detailed information on health, housing, and socio-economic status. Controlling for relevant factors, smoky coal bans reduced the probability that an older person reports being diagnosed with chronic lung disease by between three and five percentage points. In models where we estimated the effect of the ban on the incidence of new cases of chronic lung disease, rather than existing cases, we found the effect was between -0.96 and -2.5 percentage points. Our findings were robust to estimating the model using different sub-samples and control variables. Furthermore, to address potential endogeneity of the ban, we examined subsamples defined by whether participants lived in towns within a range of the population threshold at which the ban was imposed. Estimating our model using these subsamples showed a consistently negative effect of the ban. We also showed parallel trends in health outcomes before the treatment, and that the treatment did not affect attrition from the sample.

Air pollution exposure and social responsiveness in childhood: The cincinnati combined childhood cohorts

Autism Spectrum Disorder (ASD) affects about 1 in 44 children and environmental exposures may contribute to disease onset. Air pollution has been associated with adverse neurobehavioral outcomes, yet little research has examined its association with autistic-like behaviors. Therefore, our objective was to examine the association between exposure to air pollution, including NO2 and PM2.5, during pregnancy and the first year of life to ASD-like behaviors during childhood. Participants (n = 435) enrolled in the Cincinnati Childhood Allergy and Air Pollution Study and the Health Outcomes and Measures of the Environment Study were included in the analysis. Daily exposures to NO2 and PM2.5 at the residential addresses of participants were estimated using validated spatiotemporal models and averaged to obtain prenatal and first year exposure estimates. ASD-like behaviors were assessed via the Social Responsiveness Scale (SRS) questionnaire at age 12. Linear regression models adjusting for confounders were applied to estimate the association between pollutants and SRS scores. After adjusting for covariates, the association between NO2 and PM2.5 and SRS scores remained positive but were no longer statistically significant. Prenatal and first year exposure to NO2 were associated with total SRS T-scores with an estimated 0.4 point increase (95% CI: -0.7, 1.6) per 5.2 ppb increase in NO2 exposure and 0.7 point (95% CI: -0.3, 1.6) per 4.2 ppb increase in NO2 exposure, respectively. For PM2.5, a 2.6 μg/m3 increase in prenatal exposure was associated with a 0.1 point increase (95% CI: -1.1, 1.4) in SRS Total T-scores and a 1.3 μg/m3 increase first year of life was associated with a 1 point increase (95% CI: -0.2, 2.3). In summary, exposure to NO2 and PM2.5 during pregnancy and the first year of life were not significantly associated with higher autistic-like behaviors measured with SRS scores after adjustment of covariates. Additional research is warranted given prior studies suggesting air pollution contributes to ASD.

From the Perspectives of Pollution Governance and Public Health: A Research of China's Fiscal Expenditure on Energy Conservation and Environmental Protection

Improving the scale and effectiveness of China's energy conservation and environmental protection fiscal expenditure is crucial to enhancing the capacity of ecological and environmental governance of China, considering the dual perspectives of pollution governance and public health. This article first explains the mechanism by which national energy conservation and environmental protection fiscal expenditure can improve pollution control and promote public health. Secondly, this article scrutinizes the current status and limitations of China's fiscal expenditure, highlighting the contribution of fiscal expenditure in the construction of ecological civilization from the standpoints of environmental governance and public health. Additionally, this study empirically uses DEA to measure the efficiency of the government's fiscal expenditure. Conclusions found that: First, environmental protection fiscal expenditure is mainly focused on technological transformation and pollution control, while relatively little is spent on public health protection. Second, the efficiency of environmental protection fiscal funds is relatively low. These suggestions aim to optimize the positive impact of energy conservation and environmental protection fiscal expenditure for improving pollution governance and promoting public health.

Air pollution and infant mortality: Evidence from China

Using a newly assembled prefecture-city level dataset from 2004 to 2015, this paper examines the impact of air pollution on child mortality in China. To identify the causal effect, we exploit ventilation coefficient as the instrument for urban air pollution. We find that a 10 μg/m³ increase in annual PM_2.5 concentration causes 163 infant deaths per 100,000 live births per year in a city.

The long-run effects of fetal PM2.5 exposure on mental health: evidence from China

This paper investigates the long-run effects of PM_2.5 exposure in utero on the mental health of adolescents. Using nationally representative survey data from China, we instrument the PM_2.5 exposure with wind speed to tackle the possible endogeneity problem. Our results show that mothers' PM_2.5 exposure during their pregnancy negatively affects the mental health of their children aged between 10 and 15 years. A 1 µg/m³ increase in PM_2.5 exposure in utero increases the probability of having a severe mental illness for adolescents by 0.6%. Our evidence supports the "fetal origins" hypothesis. We also find that fetal PM_2.5 exposure leads adolescents to be more likely to be absent from school and quarrel with their parents, implying that fetal PM_2.5 exposure may affect individuals' behavior when they grow up.

Environmental Governance, Public Health Expenditure, and Economic Growth: Analysis in an OLG Model

This article studies the relationship between environmental governance, public health expenditure, and economic growth by introducing human health status into a three-period overlapping generation dynamic general equilibrium (OLG-DGE) model and conducting a policy simulation analysis in a Chinese scenario. The main findings are generalized as follows: (i) The increase in pollution emissions per unit of output will not only lead to the deterioration of public health but also hinder long-term economic growth, while the efficiency of pollution control will improve health and output per labor unit; (ii) Although levying environmental tax will improve health status and life expectancy, it has a non-linear impact on pollution emissions and output per labor unit, which means that there are trade-offs among environmental governance, public health improvement, and economic output; and (iii) Although the increase in the proportion of public health expenditure will improve health status, its impact on life expectancy and economic output is affected by the level of environmental tax. Only when the environmental tax rate is relatively low, will increasing the proportion of public health expenditure extend life expectancy and output per labor unit.

The local health impacts of natural resource booms

This paper uses novel micro-data on natural resources and administrative health data in Brazil to study how economic booms in minerals affect health at birth. By implementing a reduced-form estimation of shift-share research designs, the identification strategy relies on the exogeneity of global commodity prices to municipality-specific health outcomes. I find that, following changes in international prices, municipalities with historically more endowments have a higher number of premature births and births with low Appearance, Pulse, Grimace, Activity, Respiration scores. The impacts are primarily driven by metallic minerals. Instead, industrial minerals do not appear to have any effect on birth outcomes. Even though booms in metallic minerals generate benefits through resource windfalls-by increasing wealth and generating economic opportunities-the investigation of mechanisms reveals that they also result in costs-due to pollution-which seem to prevail. Hence, some metallic minerals remain a curse more than a blessing.

Can Universal Cash Transfer Save Newborns' Birth Weight During the Pandemic?

Birth weight is a key human biological characteristic as a measure of prenatal development and a variable related to later quality of life. Studies have firmly established that a stressful situation in utero adversely affects newborns' birth weight. Using birth statistics provided by Statistics Korea, this study examined how universal cash transfer during the COVID-19 crisis affected newborns' birth weight in South Korea. Given that the normal gestation period is nearly 10 months, we chose newborns without a self-selection issue by utilizing information on birthdate and total pregnancy period from the dataset, subsequently applying difference-in-differences estimation. Results showed that universal cash transfer offset newborns' weight loss amid the COVID-19 pandemic. The effects differed according to households' sociodemographic characteristics, with effects being more pronounced for girls; more pronounced for households with more than two children; more pronounced in local districts severely affected during the initial stage of the pandemic, but less significant in metropolitan regions; and more among middle-class families. This study presents evidence that governmental cash transfer during the pandemic has improved newborns' health and that continuing such a policy would positively impact future generations from a health perspective.

Concentrated poverty, ambient air pollution, and child cognitive development

Why does growing up in a poor neighborhood impede cognitive development? Although a large volume of evidence indicates that neighborhood poverty negatively affects child outcomes, little is known about the mechanisms that might explain these effects. In this study, we outline and test a theoretical model of neighborhood effects on cognitive development that highlights the mediating role of early life exposure to neurotoxic air pollution. To evaluate this model, we analyze data from a national sample of American infants matched with information on their exposure to more than 50 different pollutants known or suspected to harm the central nervous system. Integrating methods of causal inference with supervised machine learning, we find that living in a high-poverty neighborhood increases exposure to many different air toxics during infancy, that it reduces cognitive abilities measured later at age 4 by about one-tenth of a standard deviation, and that about one-third of this effect can be attributed to disparities in air quality.

Can Marketization of Environmental Governance Improve Public Health?-Empirical Analysis Based on the Emission Trading System

To deal with the pollution issue caused by long-term economic development, China has introduced a number of environmental governance measures and made some progress. In the context of the strategy of developing a "Healthy China", the Chinese government proposed to include health in the formulation and implementation of environmental regulation policies, which places a higher demand on the implementation effect of environmental policies. This study attempts to clarify the causal link between market-based environmental governance and public health, and quantify the implementation effects of market-oriented environmental governance, so as to provide accurate assessments for addressing environmental degradation and improving public health. Based on the CHNS database and provincial panel data from 2000 to 2015, this paper constructs a binary logit-based difference-in-difference model to investigate the effects of the emission trading system (ETS) pilot policy on public health measured by the incidence of respiratory diseases, heart disease, and other diseases. The results show that ETS significantly reduces the incidence of respiratory and other diseases but has no significant impact on the incidence of heart diseases. The improvement effects of ETS on public health mainly come from the reduction of SO₂ under the principle of total volume control. However, heterogeneity analysis reveals that the health-improving effects of ETS are not as expected. Although ETS can enhance the health of vulnerable populations, such as workers near pollution sources and rural residents, it has no discernible impact on the health of those far from pollution sources and urban residents.

COVID-19 and Indigenous health in the Brazilian Amazon

We test whether the COVID-19 pandemic has an ethnicity-differentiated (Indigenous vs non-Indigenous) effect on infant health in the Brazilian Amazon. Using vital statistics data we find that Indigenous infants born during the pandemic are 0.5% more likely to have very low birth weights. Access to health care contributes to health gaps. Thirteen percent of mothers travel to deliver their babies. For traveling mothers, having an Indigenous baby during the pandemic increases the probability of very low birth weight by 3%. Indigenous mothers are 7.5% less likely to receive adequate prenatal care. Mothers that travel long distances to deliver their babies and give birth during the pandemic are 35% less likely to receive proper prenatal care. We also find evidence that the pandemic shifts medical resources from rural to urban areas, which disproportionately benefits non-Indigenous mothers. These results highlight the need for policies to reduce health inequalities in the Amazon.

Does the environmental inequality matter? A literature review

The environmental inequality theory reveals that the risk of environmental pollution exposure varies among regions and groups and that particular groups face a higher threat of environmental pollution. In recent years, studies on the environmental inequality issue in developed countries have been increasing, while related literature on developing countries is very scarce. It has been found that some factors, such as race and economic status, have a close relationship with the risk of environmental pollution exposure faced by individuals. For the first time, this paper provides an extensive review of existing theoretical and empirical studies on environmental inequality. We review, in detail, the evolution of the environmental inequality theory, including the definition and measurement of environmental inequality. Further, we provide a systematic refresher on the main performance of environmental inequality, including health, education, labor productivity, and real estate prices. We also identify several causes of environmental inequality, such as ethnic differences, economic status, human capital, and household registration systems. Finally, we discuss prospects for the future research on this issue.

The spillover effect of fiscal environmental protection spending on residents' medical and healthcare expenditure: evidence from China

The Chinese government has not only been increasing investments in environmental protection, improving the quality of the ecological environment, but has also been focusing on curbing the excessive growth of medical and healthcare expenses so as to ease the economic burden of China's residents. Both aspects are significant concerns worldwide and have received much research attention individually, but the relationship between government environmental protection expenditure and residents' medical and healthcare expenditure remains unclear. Based on panel data from 31 provinces in China from 2007 to 2019, this paper empirically reveals that fiscal environmental protection expenditure is significantly negatively correlated with per capita medical and healthcare expenditure of residents (including outpatient expenditure and inpatient expenditure). This study shows that increasing the fiscal environmental protection expenditure can help curb the rising level of residents' medical and healthcare expenditure. In addition, the results of heterogeneity analysis indicate that the above relationship is stronger in provinces with a relatively low level of economic development or low proportion of the population over 65 years old. Management implications are discussed.

Carbon dioxide emission and health outcomes: is there really a nexus for the Nigerian case?

Health outcomes in sub-Saharan Africa are characteristically poor and Nigeria is no exception. Despite the recorded decline in infant and under five mortality rates in Nigeria, they still remain relatively high showing a poor status of the population's health. Carbon dioxide emission continues to fluctuate at high levels probably due to the increasing use of non renewable energy forms for economic activities mostly requiring energy consumption. This study examines the health consequences of environmental quality due to carbon dioxide emission in Nigeria for the period 1980 to 2016. Using two health outcome measures and decomposing carbon dioxide emission by sector and type of fuel consumed, a bound cointegration approach and an autoregressive distributed lag model were also employed. The results and a sensitivity analysis revealed that aggregate carbon dioxide emission significantly explained both infant mortality and under five mortality rates. However, when disaggregated, carbon dioxide emission from solid fuel had the greatest contribution to poor health outcomes.

Prenatal air pollution exposure and neonatal health

Air pollution has been shown to have adverse effects on many health outcomes including respiratory effects, cardiovascular effects, and mortality. However, evidence on the effects of prenatal exposure is still limited. We investigate the causal impact of prenatal exposure to air pollution on neonatal health in Italy in the 2000s. We exploit variation in rainfall shocks to instrument for non-random air pollution exposure. Our empirical setting combines detailed information on mother's residential location from birth certificates with PM₁₀ concentrations from air pollution monitors. Ten additional units in the average PM₁₀ level (approximately one standard deviation) would decrease birth weight by about 0.5% and gestational age by 0.16%; it would increase the prevalence of low birth weight by 22% and of preterm birth by 16%. The effects are stronger in magnitude for third trimester exposure and for less educated mothers. These findings suggest that the health impacts of air pollution on newborns are unequally distributed in the population.

Does air pollution increase child mortality? Evidence from 58 developing countries

This study aims to investigate the effects of air quality on child mortality in developing countries. We consider annual data covering the period from 2010 to 2016 of 58 countries and estimate the empirical models using recently developed panel quantile regression with the method of moments (MM-QR). It is found that outdoor air quality (measured by the concentration of PM_2.5 in the air) has a positive and significant effect on total child mortality, post-neonatal mortality, and under-five child mortality. However, its effect on neonatal mortality is not statistically significant at lower quantiles. Furthermore, Household air pollution (HAP) also has a positive and significant effect on total child mortality, neonatal mortality, and under-five child mortality. The effect of HAP on post-neonatal mortality is not significant in most cases. Overall, the adverse effect of HAP is larger than the PM_2.5. For instance, a 1% increase of PM_2.5 concentration in the outdoor causes 0.231% total child mortality due to respiratory diseases at [Formula: see text], while a 1% increase of HAP causes 0.532% total child mortality at the same quantile. In many cases, the coefficients of PM_2.5 and HAP increase at the higher quantiles, supporting asymmetric effects of pollutants on child mortality. However, per capita income, access to basic drinking water and sanitation facilities, and domestic and external health expenditures significantly reduce child mortality. On the contrary, open defecation increases mortality. Consequently, policymakers should take adequate measures to improve indoor and outdoor air quality to combat child mortality due to respiratory diseases in developing countries. They should also take initiatives to enhance per capita income, basic drinking water, and sanitation facilities, domestic and external health expenditures, and public awareness against open defecation.

Intergenerational health effects of Medicaid

This paper investigates the effects of the introduction of Medicaid during the 1960s on next generations' birth outcomes. A federal mandate that all states must widen the coverage to all cash welfare recipients generated cross-state variations in Medicaid eligibility, specifically among nonwhites who largely overrepresented the target population. I implement a reduced-form difference-in-differences strategy that compares the birth outcomes of mothers born in states with higher cash welfare recipiency versus low welfare recipiency and different years relative to the Medicaid implementation year. Using Natality data (1970-2004), I find that Medicaid significantly improves birth outcomes. The effects are considerably larger among nonwhites, specifically blacks. The effects do not appear to be driven by preexisting trends in birth outcomes, preexisting trends in households' socioeconomic characteristics, changes in other welfare expenditures, and selective fertility. A back-of-an-envelope calculation points to a minimum of 3.9% social externality of Medicaid through income rises due to next generations' improvements in birth outcomes.

Spatial and dynamic effects of air pollution on under-five children's lower respiratory infections: an evidence from China 2006 to 2017

Air pollution has been a deeply concerned issue posing an immediate and profound threat to human's lower respiratory health in China. The health of children under 5 years old, regarded as a key index of public health progress in a country, is closely related to the long-term human capital development. Hence, it is vital to investigate the potential association between air pollution and children's lower respiratory health outcomes and to explore related policy implications regarding the public health and the pollution regulation. As air pollutants diffuse across adjacent regions rather easily, considering the spatial spillover effect is meaningful in course of acquiring the aforementioned association. Based on the proposed province-level panel dataset of China during 2006-2017, this study constructs a dynamic spatial panel Durbin model to investigate the impact of air pollution on under-five children's lower respiratory infections. As a result, (1) both air pollution and children's respiratory health have obvious spatial spillover effects, and the latter has an outstanding characteristic of path dependence in time. (2) In the short term, air pollution presents significant negative impact on children's respiratory health, while in the long run, the impact decreases dramatically. (3) Regional comparison indicates that children in the western China are the most susceptible to air pollution followed by children in the central and eastern regions. (4) Other control variables have significant and varying impacts both in the short and long term. Particularly, this paper proves the existence of "siphon effect" in children healthcare system in China. From a broader and more comprehensive perspective, this study provides effective and constructive basis for policy making, in favor of improving children's health under air pollution and promoting sustainable development in China.

Theoretical Model and Actual Characteristics of Air Pollution Affecting Health Cost: A Review

BACKGROUND

The impact of environmental pollution (such as air pollution) on health costs has received a great deal of global attention in the last 20 years.

METHODS

This review aims to summarize the theoretical analysis model of air pollution affecting health costs, and further explore the actual characteristics of the impact of air pollution on health costs. The following main databases were taken into account: Web of Science Core Collection, Medline, SCOPUS, PubMed, and CNKI (China). As of 30 March 2021, we retrieved a total of 445 papers and ended up with 52 articles.

RESULTS

This review mainly expounds clarification of the concept of air pollution and health costs, the theoretical model and the actual characteristics of air pollution affecting health costs. In addition, it also discusses other related factors affecting health costs.

CONCLUSION

Our conclusion is that, while academic research on the relationship between air pollution and health costs has made some progress, there are still some shortcomings, such as insufficient consideration of individual avoidance behavior and rural-urban and international mobility. Therefore, the simple use of the original data obtained in the statistical yearbook of the health cost caused by air pollution is also the reason for the errors in the empirical results. In addition, the choice of proxy variables of environmental pollution by scholars is relatively simple, mainly focusing on air pollutants, while the impact of water quality or soil pollution safety on health costs is becoming increasingly prominent, and will become the focus of future research.

Health Benefits of Air Quality Improvement: Empirical Research Based on Medical Insurance Reimbursement Data

Measuring the health benefits of air quality improvement is a new perspective for evaluating government investment in pollution control. Improving air quality can reduce the burden on medical insurance funds and patients themselves; however, patients with higher reimbursement rates are more affected by air quality changes. This study calculated health benefits using medical insurance reimbursement data from a sample city in China. The results show that for every 10 μg/m3 decrease in PM2.5, patients' average medical cost will decrease by CNY 1,699 (USD 263.6), and the loss of ordinary working and living time will decrease by 1.24 days. PM2.5 has a more significant impact on patients with chronic respiratory diseases and inpatients with circulatory diseases. Suppose the city's annual PM2.5 concentration drops to the national standard of 35 μg/m3. In that case, it will bring more than CNY 1.28 billion (USD 198 million) in health benefits, accounting for 18% of the city's annual investment in environmental protection.

Health and the Megacity: Urban Congestion, Air Pollution, and Birth Outcomes in Brazil

We studied the health effects of economic development in heavily urbanized areas, where congestion poses a challenge to environmental conditions. We employed detailed data from air pollution and birth records around the metropolitan area of São Paulo, Brazil, between 2002 and 2009. During this period, the megacity experienced sustained growth marked by the increases in employment rates and ownership of durable goods, including automobiles. While better economic conditions are expected to improve infant health, air pollution that accompanies it is expected to do the opposite. To untangle these two effects, we focused on episodes of thermal inversion—meteorological phenomena that exogenously lock pollutants closer to the ground—to estimate the causal effects of in utero exposure to air pollution. Auxiliary results confirmed a positive relationship between thermal inversions and several air pollutants, and we ultimately found that exposure to inversion episodes during the last three months of pregnancy led to sizable reductions in birth weight and increases in the incidence of preterm births. Increased pollution exposure induced by inversions also has a significant impact over fetal survival as measured by the size of live-birth cohorts.

The Asian Games, air pollution and birth outcomes in South China: An instrumental variable approach

We estimate the effects of air-pollution exposure on low birthweight, birthweight, and prematurity risk in South China, for all expectant mothers and by maternal age group and child sex. We do so by exploiting exogenous improvement in air quality during the 2010 Guangzhou Asian Games, when strict regulations were mandated to assure better air quality. We use daily air-pollution levels collected from monitoring stations in Guangzhou, the Asian Games host city, and Shenzhen, a nearby control city, between 2009 and 2011. We first show that air quality during the Asian Games significantly improved in Guangzhou, relative to Shenzhen. Next, using birth-certificate data for both cities for 2009-2011 and using expected pregnancy overlap with the Asian Games as an instrumental variable, we study the effects of three pollutants (PM₁₀, SO₂, and NO₂) on birth outcomes. Four main conclusions emerge: 1) air pollutants significantly reduce average birthweight and increase preterm risk; 2) for birthweight, late pregnancy is most sensitive to PM₁₀ exposure, but there is not consistent evidence of a sensitive period for other pollutants and outcomes; 3) for birthweight, babies of mothers who are at least 35 years old show more vulnerability to all three air pollutants; and 4) male babies show more vulnerability than female babies to PM₁₀ and SO₂, but birthweights of female babies are more sensitive than those of male babies to NO₂.

Understanding the Pathways from Prenatal and Post-Birth PM2.5 Exposure to Infant Death: An Observational Analysis Using US Vital Records (2011-2013)

We studied the relationship of prenatal and post-birth exposure to particulate matter < 2.5 μm in diameter (PM_2.5) with infant mortality for all births between 2011 and 2013 in the conterminous United States. Prenatal exposure was defined separately for each trimester, post-birth exposure was defined in the 12 months following the prenatal period, and infant mortality was defined as death in the first year of life. For the analysis, we merged over 10 million cohort-linked live birth-infant death records with daily, county-level PM_2.5 concentration data and then fit a Structural Equation Model controlling for several individual- and county-level confounders. We estimated direct paths from the two exposures to infant death as well as indirect paths from the prenatal exposure to the outcome through preterm birth and low birth weight. Prenatal PM_2.5 exposure was positively associated with infant death across all trimesters, although the relationship was strongest in the third trimester. The direct pathway from the prenatal exposure to the outcome accounted for most of this association. Estimates for the post-birth PM_2.5-infant death relationship were less precise. The results from our study add to a growing literature that provides evidence in favor of the potential harmful effects on human health of low levels of air pollution.

Pollution at schools and children's aerobic capacity

Poor respiratory health is a major cause of mortality and morbidity worldwide, and children are especially vulnerable. Existing research in economics has documented the effect of pollution on severe health outcomes, such as hospitalizations for asthma and infant death. However, evidence on the effect of air pollution on less extreme measures of respiratory health is limited, because these effects are difficult to measure. Using a more sensitive measure, aerobic capacity ( VO2max ), I study the impact of air pollution on respiratory performance of children. I combine school-grade level data from the California Physical Fitness Test from 2009 to 2017 with local air pollution and weather data to estimate the impact on student aerobic capacity of fluctuations in air pollution levels on testing days. Ozone affects child aerobic capacity at levels even below the Environmental Protection Agency thresholds.

Nonprofits: A Public Policy Tool for the Promotion of Community Subjective Well-being

Looking to supplement common economic indicators, politicians and policymakers are increasingly interested in how to measure and improve the subjective well-being of communities. Theories about nonprofit organizations suggest that they represent a potential policy-amenable lever to increase community subjective well-being. Using longitudinal cross-lagged panel models with IRS and Twitter data, this study explores whether communities with higher numbers of nonprofits per capita exhibit greater subjective well-being in the form of more expressions of positive emotion, engagement, and relationships. We find associations, robust to sample bias concerns, between most types of nonprofit organizations and decreases in negative emotions, negative sentiments about relationships, and disengagement. We also find an association between nonprofit presence and the proportion of words tweeted in a county that indicate engagement. These findings contribute to our theoretical understanding of why nonprofit organizations matter for community-level outcomes and how they should be considered an important public policy lever.

Air Pollution during Pregnancy and Childhood Autism Spectrum Disorder in Taiwan

Air pollutants have been linked to some diseases in humans, but their effects on the nervous system were less frequently evaluated. Autism spectrum disorder (ASD) is a group of neurondevelopmental disorders of which the etiology is still unknown. We conducted a study in Taiwan to evaluate the possible associations between prenatal exposure to air pollutants and ASD. From a random sample of one million people in the National Insurance Research Database, we identified all the infants born between 1996 and 2000. We followed them till the end of 2013 and identified cases of ASD. We traced back the mothers’ residence and assessed the exposure to air pollutants using the data obtained from the air quality monitoring database maintained by the government, which included ozone (O₃), carbon monoxide (CO), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and particulate matters with diameter less than 10 µm (PM₁₀). Cox proportional hazard models were constructed to evaluate the associations between childhood ASD and exposures to the pollutants in the three trimesters and the whole gestation. We identified a total of 63,376 newborns and included 62,919 as the study cohort. After adjusting for other risk factors, we observed trimester-specific associations between levels of CO, NO₂, and PM₁₀ and the risk of childhood ASD. An increase of 1 ppm of CO in the first, second, and third trimester was associated with a hazard ratio (HR) of 1.93 (95% confidence interval [CI]: 1.55–2.39), 1.77 (95%CI: 1.41–2.22), and 1.75 (95%CI: 1.39–2.21), respectively. An increase of 10 ppb in the level of NO₂ in the first, second, and third trimester was associated with an HR of 1.39 (95%CI: 1.22–1.58), 1.25 (95%CI: 1.10–1.42), and 1.18 (95%CI: 1.03–1.34), respectively. In conclusion, we found that exposures to CO and NO₂ in all three trimesters were associated with increased risks of developing ASD.

Why are pollution damages lower in developed countries? Insights from high-Income, high-particulate matter Hong Kong

Conventional wisdom suggests that marginal damages from particulate matter pollution are high in less-developed countries because they are highly polluted. Using administrative data on the universe of births and deaths, we explore birthweight and mortality effects of gestational particulate matter exposure in high-pollution yet high-income Hong Kong. The marginal effects of particulates on birthweight are large but we fail to detect an effect on neonatal mortality. We interpret our stark mortality results in a comparative analysis of pollution-mortality relationships across studies. We provide early evidence that marginal mortality damages from pollution are high in less-developed countries because they are less developed, not because they are more polluted.

Is personality linked to season of birth?

The environment is a very significant factor in early childhood development. Season of birth (SOB) is a proxy viable for the environment to which the babies are exposed, thus also significant in early development. This study investigates the association between SOB and personality. A total 2,962 college students were included as study participants. The participants were classified into four seasonal groups based on their birth month and underwent a personality assessment using the Temperament and Character Inventory (TCI). Statistical analysis was performed using one-way analysis of variance (ANOVA) and multinomial logistic regression analysis. The male participants born in autumn scored high on the Disorderliness (NS4) subscale (β = 0.055, P = 0.042) and the male participants born in summer and winter scored high on the Extravagance (NS3) subscale (summer: β = 0.072, P = 0.01, winter: β = 0.078, P = 0.003). The difference observed indicates a relationship between the SOB and temperament, especially NS. Our findings suggest that environmental factors may affect temperament in early development, although further research is likely needed to clarify the causality between them.

Impact of air pollution on human activities: Evidence from nine million mobile phone users

To measure the effects of air pollution on human activities, this study applies statistical/econometric modeling to hourly data of 9 million mobile phone users from six cities in China’s Zhejiang Province from December 18 to 21, 2013. Under a change in air quality from “Good” (Air Quality Index, or AQI, between 51 and 100) to “Heavily Polluted” (AQI between 201 to 300), the following effects are demonstrated. (i) Consistent with the literature, for every one million people, 1, 482 fewer individuals are observed at parks, 95% confidence interval or CI (−2, 229, −735), which represents a 15% decrease. (ii) The number of individuals at shopping malls has no statistically significant change. (iii) Home is the most important location under worsening air quality, and for every one million people, 63, 088 more individuals are observed at home, 95% CI (47, 815, 78, 361), which represents a 19% increase. (iv) Individuals are on average 633 meters closer to their home, 95% CI (529, 737); as a benchmark, the median distance from home ranges from 300 to 1900 meters across the cities in our sample. These effects are not due to weather or government regulations. We also provided provisional evidence that individuals engage in inter-temporal activity substitutions within a day, which leads to mitigated (but not nullified) effects of air pollution on daily activities.

Using Crowd-Sourced Data to Assess the Temporal and Spatial Relationship between Indoor and Outdoor Particulate Matter

Using hourly measures across a full year of crowd-sourced data from over 1000 indoor and outdoor pollution monitors in the state of California, we explore the temporal and spatial relationship between outdoor and indoor particulate matter (PM) concentrations for different particle sizes. The scale of this study offers new insight into both average penetration rates and drivers of heterogeneity in the outdoor-indoor relationship. We find that an increase in the daily outdoor PM concentration of 10% leads to an average increase of 4.2-6.1% in indoor concentrations. The penetration of outdoor particles to the indoor environment occurs rapidly and almost entirely within 5 h. We also provide evidence showing that penetration rates are associated with building age and climatic conditions in the vicinity of the monitor. Since people spend a substantial amount of each day indoors, our findings fill a critical knowledge gap and have significant implications for government policies to improve public health through reductions in exposure to ambient air pollution.

The Impact of Prenatal Exposure to Ramadan on Child Anthropomorphic Outcomes in Pakistan

OBJECTIVES

This study analyzes the intent-to-treat effect of prenatal exposure to Ramadan (the Islamic month of fasting) on outcomes including stunting and underweight for children under age 5 years in Pakistan born between 2003 and 2018.

METHODS

The study uses observational data from four rounds of the UN-supported Multiple Indicator Cluster Survey (MICS) data collected on 204,186 children under-5 from Punjab, Pakistan in 2007-2008, 2010-2011, 2013-2014, and 2017-2018. Excluding data on outliers and observations with incomplete data, multivariate logistic regression analysis was conducted on the appended cross-sectional data of 179,943 children under-5 to assess the risk of stunting or underweight according to the month of gestation coinciding with Ramadan.

RESULTS

We observe a significant increase in the risk of stunting and underweight associated with exposure to Ramadan following an inverted-U pattern. The peak impact of Ramadan exposure on a child being underweight occurs in the third month of pregnancy, where the probability of being underweight is 20 percent higher as compared to children whose gestation did not coincide with Ramadan. The peak impact of Ramadan exposure on stunting occurs in the fourth month of pregnancy, where the probability of stunting is 22 percent higher as compared to children whose gestation did not coincide with Ramadan. These results vary little by gender. In contrast, exposure to Ramadan in the ninth month of gestation is associated with a reduction in the risk of stunting for boys and underweight for both boys and girls.

CONCLUSIONS FOR PRACTICE

Our analysis indicates that prenatal exposure to Ramadan during the first two trimesters have negative implications for children's growth. The study highlights the critical role of maternal habits during early pregnancy, especially nutritional intake, for the long-term physical development of children.

Effect of PM2.5 pollution on perinatal mortality in China

Using ArcGIS to analyze satellite derived PM_2.5 estimates, this paper obtains the average concentration and maximum concentration of fine particulate matter (PM_2.5) in China's 31 provinces from 2002 to 2015. We adopt fixed effects model and spatial Durbin model to investigate the association between PM_2.5 and perinatal mortality rates. The results indicate that PM_2.5 has a significantly positive association with perinatal mortality rates. A 1% increase of log-transformed average concentration and maximum concentrations of PM_2.5 is associated with 1.76‰ and 2.31‰ increase of perinatal mortality rates, respectively. In spatial econometrics analysis, we find PM_2.5 has significant spatial autocorrelation characteristics. The concentrations of log-transformed average and maximum PM_2.5 increase 1% is associated with a 2.49% increase in a 2.49‰ and 2.19‰ increase of perinatal mortality rates, respectively. The potential mechanism is that air pollution has an impact on infant weight to impact perinatal mortality rates.

The Effect of Coal-Fired Power Plant Closures on Emergency Department Visits for Asthma-Related Conditions Among 0- to 4-Year-Old Children in Chicago, 2009-2017

Objectives. To investigate the effects of coal-fired power plant closures on zip code-level rates of emergency department visits for asthma-related conditions among 0- to 4-year-old children in Chicago, Illinois.Methods. We used data on wind, population, PM_2.5 (particulates measuring ≤ 2.5 µm in diameter), and zip code-level rates of emergency department visits for asthma-related conditions among 0- to 4-year-old children between 2009 and 2017 in Chicago. The difference-in-differences research design compared rates of emergency department visits in zip codes near 3 coal-fired power plants before and after their closures to rates in zip codes farther away during the same time period.Results. We found that emergency department visits for asthma-related conditions among 0- to 4-year-old children decreased by 12% in zip codes near the 3 coal-fired power plants following their closures relative to rates in zip codes farther away during the same period. The crude and age-specific rates of emergency department visits decreased by 2.41 visits per ten thousand inhabitants and 35.63 visits per ten thousand children aged 0 to 4 years, respectively.Conclusions. Our findings demonstrate that closing coal-fired power plants can lead to improvements in the respiratory health of young children.

Air Pollution's Impact on the Economic, Social, Medical, and Industrial Injury Environments in China

In this era of rapid economic development, it is inevitable that economic activities eventually cause serious damage to the environment’s air quality, making it the focus of global public health. If the treatment efficiency of medical accidents can be improved, then this can significantly stabilize society and improve production efficiency. Past research has mainly focused on work safety and health issues, seldom discussing economic, social, medical, and environmental pollution issues together, and, most generally, adopted static methods that fail to recognize how air pollution affects the overall economy, society, medical care, and external environment. In order to more deeply understand the changes among social, economic activities, and environmental issues due to air pollution, this study proposes a meta-two-stage undesirable dynamic DDF (Direction Distance Function) that, under an exogenous model, divides the 30 provinces of China into high-income regions and middle-income regions and explores the economic, social, medical, and environmental efficiencies between the two areas to resolve the lack of related static analyses. The empirical results are as follows. (1) The AQI (air quality index) significantly impacts the efficiency of medical injuries in various regions. (2) When the AQI is considered, the medical insurance expenditure efficiency score value of high-income areas is lower than the value without the AQI. (3) When the AQI is considered, the efficiency value of the number of work injury insurance benefits in the middle-income area is lower than the efficiency value without the AQI.

Low emission zones and population health

Air pollution has a detrimental impact on population health, but the effectiveness of policy measures targeting pollution is underexplored. I exploit the natural experiment generated by the staggered implementation of low emission zones in large cities across Germany to assess their impact on health. Using register data on outpatient and inpatient health care, I find that low emission zones reduce the number of patients with cardiovascular disease by 2-3%. This effect is particularly pronounced for those over the age of 65. The findings suggest that low emission zones can be an effective way to reduce air pollution and improve health.

Exploring Asymmetric Nexus Between CO2 Emissions, Environmental Pollution, and Household Health Expenditure in China

Objective

This study investigates the nexus between household health expenditure, CO₂ emissions and environmental pollution in China. We analyzed the asymmetric dynamic relationship between CO₂ emissions, environmental pollution and household health expenditure for the period 1990 to 2019 in China.

Methods

This study adopted nonlinear autoregressive distributed lag (NARDL) and Granger causality following the diagnostic test. Furthermore, we applied Dickey-Fuller (ADF), PP unit root tests, Zivot and Andrews test for structural breaks in our analysis. The NARDL is the most suitable econometric technique for estimations, especially if the asymmetric relationship exists among the variables. NARDL technique is capable to explore the dynamic relationship between CO₂ emissions, environmental pollution and household health expenditure.

Results

The empirical results verify the asymmetric nexus between CO₂ emissions, environmental pollution and household health expenditure in the context of China. The outcomes revealed that in the short run and long run positive shocks of CO₂ emissions and environmental pollution positively affecting health expenditure, while negative shocks reduce health spendings. The results also demonstrate bi-directional causality among household health spendings, CO₂ emissions and environmental pollution.

Conclusion

Our results support many previous studies, documenting that CO₂ emissions positively contribute to the amount of household health expenditure, confirming the asymmetric relationship between CO₂ emissions and household health expenditure. The results also confirm the statistically significant and asymmetrically positive relationship between environmental pollution and household health expenditure. This implies that Chinese residents have to bear more household health expenditure, in the case of more CO₂ emissions and a greater amount of environmental pollution.

Heterogeneous Influences of Social Support on Physical and Mental Health: Evidence from China

Employing a national representative survey (the China Labor-force Dynamics Survey 2016, CLDS2016) data (N = 14246), this paper examines the heterogeneous influences of social support on individual physical and mental health in China. Social support is characterized by four dimensions: emotional support, tangible or instrumental support, interaction or exchange support, and community support. Physical health is measured by self-rated health and body mass index (BMI), while mental health is measured by depression, hopelessness, failure, fear, loneliness, and meaninglessness. The results indicate that different dimensions of social support have heterogeneous effects on individual physical and mental health. Specifically, the correlation between emotional support and individual physical health is not significant, but emotional support is significantly related to some mental health variables. Tangible or instrumental support is significantly related to individual self-rated physical health but not to BMI or mental health. Interaction or exchange support is significantly correlated with individual self-rated health and some mental health variables. In general, there are significant correlations between community support, and individual physical and mental health. The results also suggest that the influences of social support on physical and mental health of individuals at different ages (<60 years and ≥60 years) are heterogeneous. The results of this study provide direction for the dimension selection of social support to promote individual health.

Impacts of air pollution on health: evidence from longitudinal cohort data of patients with cardiovascular diseases

This study uses longitudinal cohort data to estimate the impacts of air pollution on health outcomes among people first hospitalised with heart diseases. Despite the generally low level of pollution in Australia, we find that acute exposure to pollution increases readmissions to hospitals within 3-12 months after discharge and is more evident among those suffering from heart failure. We further show that chronic exposure to air pollution increases the risk of death within 72 months, hospital admissions and general practitioner (GP) visits. Patients with coronary heart disease or cerebrovascular disease are the most affected groups. Finally, a cost saving of $1.3 billion will be generated to the health sector, if the monthly concentration of PM₁₀ and CO was lowered to 15.49 µg/m³ and 122.99 µg/m³, respectively. The findings from our study emphasize the need for policies that target significant reduction in ambient PM₁₀ and CO to decrease the demand for scarce healthcare resources for cardiac diseases.

Military training exercises, pollution, and their consequences for health

Militaries around the world perform training exercises in preparation for war. We study the relationship between in utero exposure to military exercises (bombing) and early-life health outcomes, combining data on naval bombing exercises in Vieques, Puerto Rico, and the universe of births from 1990 to 2003. Using a differences-in-differences design, we find that the sudden end of bombing practices is associated with a 56-79% decrease in the incidence of congenital anomalies. The evidence is generally consistent with the channel of environmental pollution through increases in contaminant levels in waters surrounding the live impact area.

Developmental exposure to near roadway pollution produces behavioral phenotypes relevant to neurodevelopmental disorders in juvenile rats

Epidemiological studies consistently implicate traffic-related air pollution (TRAP) and/or proximity to heavily trafficked roads as risk factors for developmental delays and neurodevelopmental disorders (NDDs); however, there are limited preclinical data demonstrating a causal relationship. To test the effects of TRAP, pregnant rat dams were transported to a vivarium adjacent to a major freeway tunnel system in northern California where they were exposed to TRAP drawn directly from the face of the tunnel or filtered air (FA). Offspring remained housed under the exposure condition into which they were born and were tested in a variety of behavioral assays between postnatal day 4 and 50. To assess the effects of near roadway exposure, offspring of dams housed in a standard research vivarium were tested at the laboratory. An additional group of dams was transported halfway to the facility and then back to the laboratory to control for the effect of potential transport stress. Near roadway exposure delayed growth and development of psychomotor reflexes and elicited abnormal activity in open field locomotion. Near roadway exposure also reduced isolation-induced 40-kHz pup ultrasonic vocalizations, with the TRAP group having the lowest number of call emissions. TRAP affected some components of social communication, evidenced by reduced neonatal pup ultrasonic calling and altered juvenile reciprocal social interactions. These findings confirm that living in close proximity to highly trafficked roadways during early life alters neurodevelopment.

Saharan sand and dust storms and neonatal mortality: Evidence from Burkina Faso

West African populations are exposed to the longest and harshest dust storms on the planet, the Saharan sand and dust storms (SDS). Nonetheless, little is known about the effects of the severe storms on early-life health in West Africa. This study investigated the association of the risk of neonatal mortality, an indicator of the population's early-life health, with potential prenatal and neonatal exposure to the Saharan SDS. Data on 30,552 under-five children from Burkina Faso's 1993, 2003, and 2010 demographic and health surveys were matched to the particulate matters (PM) and terrestrial air temperature and precipitation forecasts. Exposure to dust events was measured by the number of days with average PM10 and PM2.5 concentrations above a series of threshold. Intensity-dependent patterns of associations between neonatal mortality and both prenatal and birth month exposure to dust events were identified. There was no association if average daily PM10 and PM2.5 levels were <60 and 30 μg/m³, respectively. However, strong associations, which increase almost linearly with the intensity of exposure, were identified when daily PM10 and PM2.5 levels ranged from 70 to 150 and from 40 to 70 μg/m³, respectively. At the higher PM levels, the association for the gestation period decreased, but that for the birth month remained mostly unresponsive to changes in the PM levels. Larger associations were identified when siblings were compared.