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LaPointe S, Lee JC, Nagy ZP, Shapiro DB, Chang HH, Wang Y, Russell AG, Hipp HS, Gaskins AJ. Ambient traffic related air pollution in relation to ovarian reserve and oocyte quality in young, healthy oocyte donors. ENVIRONMENT INTERNATIONAL 2024; 183:108382. [PMID: 38103346 PMCID: PMC10871039 DOI: 10.1016/j.envint.2023.108382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
Studies in mice and older, subfertile women have found that air pollution exposure may compromise female reproduction. Our objective was to evaluate the effects of air pollution on ovarian reserve and outcomes of ovarian stimulation among young, healthy females. We included 472 oocyte donors who underwent 781 ovarian stimulation cycles at a fertility clinic in Atlanta, Georgia, USA (2008-2019). Antral follicle count (AFC) was assessed with transvaginal ultrasonography and total and mature oocyte count was assessed following oocyte retrieval. Ovarian sensitivity index (OSI) was calculated as the total number of oocytes divided by total gonadotrophin dose × 1000. Daily ambient exposure to nitric oxide (NOx), carbon monoxide (CO), and particulate matter ≤ 2.5 (PM2.5) was estimated using a fused regional + line-source model for near-surface releases at a 250 m resolution based on residential address. Generalized estimating equations were used to evaluate the associations of an interquartile range (IQR) increase in pollutant exposure with outcomes adjusted for donor characteristics, census-level poverty, and meteorological factors. The median (IQR) age among oocyte donors was 25.0 (5.0) years, and 31% of the donors were racial/ethnic minorities. The median (IQR) exposure to NOx, CO, and PM2.5 in the 3 months prior to stimulation was 37.7 (32.0) ppb, 612 (317) ppb, and 9.8 (2.9) µg/m3, respectively. Ambient air pollution exposure in the 3 months before AFC was not associated with AFC. An IQR increase in PM2.5 in the 3 months before AFC and during stimulation was associated with -7.5% (95% CI -14.1, -0.4) and -6.4% (95% CI -11.0, -1.6) fewer mature oocytes, and a -1.9 (95% CI -3.2, -0.5) and -1.0 (95% CI -1.8, -0.2) lower OSI, respectively. Our results suggest that lowering the current 24-h PM2.5 standard in the US to 25 µg/m3 may still not adequately protect against the reprotoxic effects of short-term PM2.5 exposure.
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Affiliation(s)
- Sarah LaPointe
- Department of Epidemiology, Emory University Rollins School of Public Heath, Atlanta, GA, United States
| | - Jaqueline C Lee
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Zsolt P Nagy
- Reproductive Biology Associates, Sandy Springs, GA, United States
| | - Daniel B Shapiro
- Reproductive Biology Associates, Sandy Springs, GA, United States
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Yifeng Wang
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Armistead G Russell
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Heather S Hipp
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Audrey J Gaskins
- Department of Epidemiology, Emory University Rollins School of Public Heath, Atlanta, GA, United States.
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Wesselink AK, Hystad P, Kirwa K, Kaufman JD, Willis MD, Wang TR, Szpiro AA, Levy JI, Savitz DA, Rothman KJ, Hatch EE, Wise LA. Air pollution and fecundability in a North American preconception cohort study. ENVIRONMENT INTERNATIONAL 2023; 181:108249. [PMID: 37862861 PMCID: PMC10841991 DOI: 10.1016/j.envint.2023.108249] [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: 06/09/2023] [Revised: 09/18/2023] [Accepted: 10/04/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Animal and epidemiologic studies indicate that air pollution may adversely affect fertility. However, the level of evidence is limited and specific pollutants driving the association are inconsistent across studies. METHODS We used data from a web-based preconception cohort study of pregnancy planners enrolled during 2013-2019 (Pregnancy Study Online; PRESTO). Eligible participants self-identified as female, were aged 21-45 years, resided in the United States (U.S.) or Canada, and were trying to conceive without fertility treatments. Participants completed a baseline questionnaire and bi-monthly follow-up questionnaires until conception or 12 months. We analyzed data from 8,747 participants (U.S.: 7,304; Canada: 1,443) who had been trying to conceive for < 12 cycles at enrollment. We estimated residential ambient concentrations of particulate matter < 2.5 µm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) using validated spatiotemporal models specific to each country. We fit country-specific proportional probabilities regression models to estimate the association between annual average, menstrual cycle-specific, and preconception average pollutant concentrations with fecundability, the per-cycle probability of conception. We calculated fecundability ratios (FRs) and 95% confidence intervals (CIs) and adjusted for individual- and neighborhood-level confounders. RESULTS In the U.S., the FRs for a 5-µg/m3 increase in annual average, cycle-specific, and preconception average PM2.5 concentrations were 0.94 (95% CI: 0.83, 1.08), 1.00 (95% CI: 0.93, 1.07), and 1.00 (95% CI: 0.93, 1.09), respectively. In Canada, the corresponding FRs were 0.92 (95% CI: 0.74, 1.16), 0.97 (95% CI: 0.87, 1.09), and 0.94 (95% CI: 0.80, 1.09), respectively. Likewise, NO2 and O3 concentrations were not strongly associated with fecundability in either country. CONCLUSIONS Neither annual average, menstrual cycle-specific, nor preconception average exposure to ambient PM2.5, NO2, and O3 were appreciably associated with reduced fecundability in this cohort of pregnancy planners.
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Affiliation(s)
- Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States.
| | - Perry Hystad
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Kipruto Kirwa
- Department of Environmental & Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
| | - Joel D Kaufman
- Department of Environmental & Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
| | - Mary D Willis
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States; School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Tanran R Wang
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, United States
| | - Jonathan I Levy
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States
| | - David A Savitz
- Department of Epidemiology, Brown University School of Public Health, Providence, MA, United States
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Elizabeth E Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
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Thampy D, Vieira VM. Association between traffic-related air pollution exposure and fertility-assisted births. ENVIRONMENTAL RESEARCH, HEALTH : ERH 2023; 1:021005. [PMID: 37124069 PMCID: PMC10133988 DOI: 10.1088/2752-5309/accd10] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/28/2023] [Accepted: 04/14/2023] [Indexed: 05/02/2023]
Abstract
Previous studies have suggested that traffic-related air pollution is associated with adverse fertility outcomes, such as reduced fecundability and subfertility. The purpose of this research is to investigate if PM2.5 exposure prior to conception or traffic-related exposures (traffic density and distance to nearest major roadway) at birth address is associated with fertility-assisted births. We obtained all live and still births from the Massachusetts state birth registry with an estimated conception date between January 2002 through December 2008. All births requiring fertility drugs or assisted reproductive technology were identified as cases. We randomly selected 2000 infants conceived each year to serve as a common control group. PM2.5 exposure was assessed using 4 km spatial satellite remote sensing, meteorological and land use spatiotemporal models at geocoded birth addresses for the year prior to conception. The mean PM2.5 level was 9.81 µg m-3 (standard deviation = 1.70 µg m-3), with a maximum of 14.27 µg m-3. We calculated crude and adjusted fertility treatment odds ratios (ORs) and 95% confidence intervals (CI) per interquartile range of 1.72 µg m-3 increase in PM2.5 exposure. Our final analyses included 10 748 fertility-assisted births and 12 225 controls. After adjusting for parental age, marital status, race, maternal education, insurance status, parity, and year of birth, average PM2.5 exposure during the year prior to conception was weakly associated with fertility treatment (OR: 1.01; 95% CI: 0.97, 1.05). Fertility-assisted births were inversely associated with traffic density (highest quartile compared to lowest quartile, OR: 0.92; 95% CI: 0.83, 1.02) and positively associated with distance from major roadway (OR per 100 m: 1.01; 95% CI: 1.00, 1.02) in adjusted analyses. We did not find strong evidence to support an adverse relationship between traffic-related air pollution exposure and fertility-assisted births.
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Affiliation(s)
- Daphne Thampy
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, United States of America
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States of America
| | - Verónica M Vieira
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, United States of America
- Author to whom any correspondence should be addressed
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Gutvirtz G, Sheiner E. Airway pollution and smoking in reproductive health. Best Pract Res Clin Obstet Gynaecol 2022; 85:81-93. [PMID: 36333255 DOI: 10.1016/j.bpobgyn.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/04/2022] [Indexed: 12/14/2022]
Abstract
Environmental exposure refers to contact with chemical, biological, or physical substances found in air, water, food, or soil that may have a harmful effect on a person's health. Almost all of the global population (99%) breathe air that contains high levels of pollutants. Smoking is one of the most common forms of recreational drug use and is the leading preventable cause of morbidity and mortality worldwide. The small particles from either ambient (outdoor) pollution or cigarette smoke are inhaled to the lungs and quickly absorbed into the bloodstream. These substances can affect virtually every organ in our body and have been associated with various respiratory, cardiovascular, endocrine, and also reproductive morbidities, including decreased fertility, adverse pregnancy outcomes, and offspring long-term morbidity. This review summarizes the latest literature reporting the reproductive consequences of women exposed to ambient (outdoor) air pollution and cigarette smoking.
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Affiliation(s)
- Gil Gutvirtz
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Soroka University Medical Center (SUMC), Department of Obstetrics and Gynecology B, Beer-Sheva, Israel.
| | - Eyal Sheiner
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Soroka University Medical Center (SUMC), Department of Obstetrics and Gynecology B, Beer-Sheva, Israel
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Segal TR, Giudice LC. Systematic review of climate change effects on reproductive health. Fertil Steril 2022; 118:215-223. [PMID: 35878942 DOI: 10.1016/j.fertnstert.2022.06.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/07/2022] [Indexed: 12/26/2022]
Abstract
Climate change is a major risk factor for overall health, including reproductive health, and well-being. Increasing temperatures, due mostly to increased greenhouse gases trapping excess heat in the atmosphere, result in erratic weather patterns, wildfires, displacement of large communities, and stagnant water resulting in vector-borne diseases that, together, have set the stage for new and devastating health threats across the globe. These conditions disproportionately affect disadvantaged and vulnerable populations, including women, pregnant persons, young children, the elderly, and the disabled. This review reports on the evidence for the adverse impacts of air pollution, wildfires, heat stress, floods, toxic chemicals, and vector-borne diseases on male and female fertility, the developing fetus, and obstetric outcomes. Reproductive health care providers are uniquely positioned and have an unprecedented opportunity to educate patients and policy makers about mitigating the impact of climate change to assure reproductive health in this and future generations.
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Affiliation(s)
- Thalia R Segal
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California
| | - Linda C Giudice
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California.
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Siegel EL, Ghassabian A, Hipwell AE, Factor-Litvak P, Zhu Y, Steinthal HG, Focella C, Battaglia L, Porucznik CA, Collingwood SC, Klein-Fedyshin M, Kahn LG. Indoor and outdoor air pollution and couple fecundability: a systematic review. Hum Reprod Update 2022; 29:45-70. [PMID: 35894871 PMCID: PMC9825271 DOI: 10.1093/humupd/dmac029] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 05/27/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Air pollution is both a sensory blight and a threat to human health. Inhaled environmental pollutants can be naturally occurring or human-made, and include traffic-related air pollution (TRAP), ozone, particulate matter (PM) and volatile organic compounds, among other substances, including those from secondhand smoking. Studies of air pollution on reproductive and endocrine systems have reported associations of TRAP, secondhand smoke (SHS), organic solvents and biomass fueled-cooking with adverse birth outcomes. While some evidence suggests that air pollution contributes to infertility, the extant literature is mixed, and varying effects of pollutants have been reported. OBJECTIVE AND RATIONALE Although some reviews have studied the association between common outdoor air pollutants and time to pregnancy (TTP), there are no comprehensive reviews that also include exposure to indoor inhaled pollutants, such as airborne occupational toxicants and SHS. The current systematic review summarizes the strength of evidence for associations of outdoor air pollution, SHS and indoor inhaled air pollution with couple fecundability and identifies gaps and limitations in the literature to inform policy decisions and future research. SEARCH METHODS We performed an electronic search of six databases for original research articles in English published since 1990 on TTP or fecundability and a number of chemicals in the context of air pollution, inhalation and aerosolization. Standardized forms for screening, data extraction and study quality were developed using DistillerSR software and completed in duplicate. We used the Newcastle-Ottawa Scale to assess risk of bias and devised additional quality metrics based on specific methodological features of both air pollution and fecundability studies. OUTCOMES The search returned 5200 articles, 4994 of which were excluded at the level of title and abstract screening. After full-text screening, 35 papers remained for data extraction and synthesis. An additional 3 papers were identified independently that fit criteria, and 5 papers involving multiple routes of exposure were removed, yielding 33 articles from 28 studies for analysis. There were 8 papers that examined outdoor air quality, while 6 papers examined SHS exposure and 19 papers examined indoor air quality. The results indicated an association between outdoor air pollution and reduced fecundability, including TRAP and specifically nitrogen oxides and PM with a diameter of ≤2.5 µm, as well as exposure to SHS and formaldehyde. However, exposure windows differed greatly between studies as did the method of exposure assessment. There was little evidence that exposure to volatile solvents is associated with reduced fecundability. WIDER IMPLICATIONS The evidence suggests that exposure to outdoor air pollutants, SHS and some occupational inhaled pollutants may reduce fecundability. Future studies of SHS should use indoor air monitors and biomarkers to improve exposure assessment. Air monitors that capture real-time exposure can provide valuable insight about the role of indoor air pollution and are helpful in assessing the short-term acute effects of pollutants on TTP.
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Affiliation(s)
- Eva L Siegel
- Columbia University, Mailman School of Public Health, New York, NY, USA
| | | | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Pam Factor-Litvak
- Columbia University, Mailman School of Public Health, New York, NY, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | | | - Carolina Focella
- New York University Grossman School of Medicine, New York, NY, USA
| | - Lindsey Battaglia
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | | | - Linda G Kahn
- Correspondence address. E-mail: https://orcid.org/0000-0002-6512-6160
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Davidson S, Jahnke S, Jung AM, Burgess JL, Jacobs ET, Billheimer D, Farland LV. Anti-Müllerian Hormone Levels among Female Firefighters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5981. [PMID: 35627519 PMCID: PMC9141260 DOI: 10.3390/ijerph19105981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 02/04/2023]
Abstract
Female firefighters have occupational exposures which may negatively impact their reproductive health. Anti-müllerian hormone (AMH) is a clinical marker of ovarian reserve. We investigated whether AMH levels differed in female firefighters compared to non-firefighters and whether there was a dose-dependent relationship between years of firefighting and AMH levels. Female firefighters from a pre-existing cohort completed a cross-sectional survey regarding their occupational and health history and were asked to recruit a non-firefighter friend or relative. All participants provided a dried blood spot (DBS) for AMH analysis. Linear regression was used to assess the relationship between firefighting status and AMH levels. Among firefighters, the influence of firefighting-related exposures was evaluated. Firefighters (n = 106) and non-firefighters (n = 58) had similar age and BMI. Firefighters had a lower mean AMH compared to non-firefighters (2.93 ng/mL vs. 4.37 ng/mL). In multivariable adjusted models, firefighters had a 33% lower AMH value than non-firefighters (-33.38%∆ (95% CI: -54.97, -1.43)). Years of firefighting was not associated with a decrease in AMH. Firefighters in this study had lower AMH levels than non-firefighters. More research is needed to understand the mechanisms by which firefighting could reduce AMH and affect fertility.
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Affiliation(s)
- Samantha Davidson
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
| | - Sara Jahnke
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA;
| | - Alesia M. Jung
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
| | - Jefferey L. Burgess
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
| | - Elizabeth T. Jacobs
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
| | - Dean Billheimer
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
| | - Leslie V. Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
- Department of Obstetrics and Gynecology, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA
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Ambient Air Pollution Exposure Assessments in Fertility Studies: a Systematic Review and Guide for Reproductive Epidemiologists. CURR EPIDEMIOL REP 2022; 9:87-107. [DOI: 10.1007/s40471-022-00290-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Abstract
Purpose of Review
We reviewed the exposure assessments of ambient air pollution used in studies of fertility, fecundability, and pregnancy loss.
Recent Findings
Comprehensive literature searches were performed in the PUBMED, Web of Science, and Scopus databases. Of 168 total studies, 45 met the eligibility criteria and were included in the review. We find that 69% of fertility and pregnancy loss studies have used one-dimensional proximity models or surface monitor data, while only 35% have used the improved models, such as land-use regression models (4%), dispersion/chemical transport models (11%), or fusion models (20%). No published studies have used personal air monitors.
Summary
While air pollution exposure models have vastly improved over the past decade from a simple, one-dimensional distance or air monitor data to models that incorporate physiochemical properties leading to better predictive accuracy, precision, and increased spatiotemporal variability and resolution, the fertility literature has yet to fully incorporate these new methods. We provide descriptions of each of these air pollution exposure models and assess the strengths and limitations of each model, while summarizing the findings of the literature on ambient air pollution and fertility that apply each method.
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Optimizing natural fertility: a committee opinion. Fertil Steril 2021; 117:53-63. [PMID: 34815068 DOI: 10.1016/j.fertnstert.2021.10.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/08/2021] [Accepted: 10/08/2021] [Indexed: 01/08/2023]
Abstract
This committee opinion provides practitioners with suggestions for optimizing the likelihood of achieving pregnancy in couples or individuals attempting conception who have no evidence of infertility. This document replaces the document of the same name previously published in 2013 (Fertil Steril 2013;100:631-7).
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Affiliation(s)
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- The American Society for Reproductive Medicine, Birmingham, Alabama
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González-Comadran M, Jacquemin B, Cirach M, Lafuente R, Cole-Hunter T, Nieuwenhuijsen M, Brassesco M, Coroleu B, Checa MA. The effect of short term exposure to outdoor air pollution on fertility. Reprod Biol Endocrinol 2021; 19:151. [PMID: 34615529 PMCID: PMC8493680 DOI: 10.1186/s12958-021-00838-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/24/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND There is evidence to suggest that long term exposure to air pollution could be associated with decreased levels of fertility, although there is controversy as to how short term exposure may compromise fertility in IVF patients and what windows of exposure during the IVF process patients could be most vulnerable. METHODS This prospective cohort study aimed to evaluate the impact of acute exposure that air pollution have on reproductive outcomes in different moments of the IVF process. Women undergoing IVF living in Barcelona were recruited. Individual air pollution exposures were modelled at their home address 15 and 3 days before embryo transfer (15D and 3D, respectively), the same day of transfer (D0), and 7 days after (D7). The pollutants modelled were: PM2.5 [particulate matter (PM) ≤2.5 μm], PMcoarse (PM between 2.5 and 10μm), PM10 (PM≤10 μm), PM2.5 abs, and NO2 and NOx. Outcomes were analyzed using multi-level regression models, with adjustment for co-pollutants and confouding factors. Two sensitivity analyses were performed. First, the model was adjusted for subacute exposure (received 15 days before ET). The second analysis was based on the first transfer performed on each patient aiming to exclude patients who failed previous transfers. RESULTS One hundred ninety-four women were recruited, contributing with data for 486 embryo transfers. Acute and subacute exposure to PMs showed a tendency in increasing miscarriage rate and reducing clinical pregnancy rate, although results were not statistically significant. The first sensitivity analysis, showed a significant risk of miscarriage for PM2.5 exposure on 3D after adjusting for subacute exposure, and an increased risk of achieving no pregnancy for PM2.5, PMcoarse and PM10 on 3D. The second sensitivity analysis showed a significant risk of miscarriage for PM2.5 exposure on 3D, and a significant risk of achieving no pregnancy for PM2.5, PMcoarse and PM10 particularly on 3D. No association was observed for nitrogen dioxides on reproductive outcomes. CONCLUSIONS Exposure to particulate matter has a negative impact on reproductive outcomes in IVF patients. Subacute exposure seems to increase the harmful effect of the acute exposure on miscarriage and pregnancy rates. Nitrogen dioxides do not modify significantly the reproductive success.
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Affiliation(s)
- Mireia González-Comadran
- Department of Obstetrics and Gynecology, Hospital del Mar, Barcelona, Spain
- Barcelona Research Infertility Group, IMIM Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Bénédicte Jacquemin
- Univ Rennes 1, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
- Institute for Global Health (ISGlobal), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marta Cirach
- Institute for Global Health (ISGlobal), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rafael Lafuente
- Centro de Infertilidad y Reproducción Humana (CIRH), Barcelona, Spain
| | - Thomas Cole-Hunter
- Institute for Global Health (ISGlobal), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mark Nieuwenhuijsen
- Institute for Global Health (ISGlobal), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mario Brassesco
- Centro de Infertilidad y Reproducción Humana (CIRH), Barcelona, Spain
| | | | - Miguel Angel Checa
- Department of Obstetrics and Gynecology, Hospital del Mar, Barcelona, Spain.
- Barcelona Research Infertility Group, IMIM Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.
- Universidad Autónoma de Barcelona, Barcelona, Spain.
- Fertty, ClÍnica de ReproducciÓn Asistida, Barcelona, Spain.
- Reproductive Medicine Division at Hospital del Mar de Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain.
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Shi W, Sun C, Chen Q, Ye M, Niu J, Meng Z, Bukulmez O, Chen M, Teng X. Association between ambient air pollution and pregnancy outcomes in patients undergoing in vitro fertilization in Shanghai, China: A retrospective cohort study. ENVIRONMENT INTERNATIONAL 2021; 148:106377. [PMID: 33482441 DOI: 10.1016/j.envint.2021.106377] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/13/2020] [Accepted: 01/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The effects of ambient air pollutants on adverse pregnancy outcomes have been reported. However, studies about air pollutants exposure and pregnancy outcomes in patients undergoing IVF were limited and inconclusive. To date Shanghai has been the only city in China to implement a compulsory single embryo transfer policy for all patients undergoing their first embryo transfer procedure effective from January 2019. We aimed to investigate the associations between exposure to ambient air pollutants and biochemical pregnancy and live births, and to identify potential vulnerability characteristics of patients undergoing IVF in Shanghai, China. METHODS A retrospective cohort study was conducted on 2766 infertile patients aged ≤ 45 years who underwent first fresh or frozen-thawed cleavage stage embryo transfer in the Shanghai First Maternity and Infant Hospital during April 2016 and December 2019. Daily average ambient levels of six air pollutants (PM2.5, PM10, NO2, SO2, CO and O3 max-8h) were obtained from fixed air monitors located in closest proximity to patients' residences. The cumulative average level was calculated during three different exposure periods (period1: three months before oocyte retrieval to serum hCG test; period 2: from serum hCG test to live birth outcome; period 3: from three months before oocyte retrieval to live birth). Multiple logistic regression model was performed to investigate associations between exposure to ambient air pollutants and pregnancy outcomes. Stratified analyses were conducted to explore the potential effects modifier. RESULTS The biochemical pregnancy rate and live birth rate were 54.2% and 36.4%, respectively. The ambient NO2 exposure was significantly associated with a 14% lower pregnancy rate during period 1 (aOR = 0.86, 95%CI: 0.75-0.99). The ambient PM10 was related to significantly increased risk of lowering live birth rate among the patients during period 3 [aOR = 0.88(0.79-0.99)]. Stratified analysis showed that ambient PM10 was also significantly associated with a reduced pregnancy rate (aOR = 0.82, 95% CI: 0.69-0.97) in patients who underwent single embryo transfer during period 1. Subjects who underwent single embryo transfer also had a decreased likelihood of a live birth when exposed to ambient SO2 and O3 during period 3 [aOR = 0.74(0.57-0.95), and 0.92 (0.83-0.98), respectively]. Moreover, O3 exposure was associated with decreased live birth rates in patients living in non-urban areas. Sensitivity analyses indicated robust negative association between PM10 exposure and live birth outcomes. CONCLUSIONS Our study suggested that exposure to ambient air pollutants, in particular NO2 and PM10, was associated with an increased risk of lower rates of pregnancy and live birth respectively in patients undergoing IVF. Stratified analyses indicated that ambient SO2 and O3 levels were related to adverse pregnancy outcomes in some subgroups of IVF patients in this study. Notably, patients who underwent single embryo transfer were more susceptible to ambient air pollution exposure. Thus, prospective cohort studies are needed to investigate the underlying mechanisms and the susceptibility windows for women undergoing IVF treatment.
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Affiliation(s)
- Wenming Shi
- Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, 201204 Shanghai, China
| | - Chunyan Sun
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China
| | - Qiaoyu Chen
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China
| | - Mingming Ye
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China
| | - Jianing Niu
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China
| | - Zhenzhen Meng
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China
| | - Orhan Bukulmez
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Miaoxin Chen
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China.
| | - Xiaoming Teng
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China; School of Life Sciences and Technology, Tongji University, Shanghai 200092, China.
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12
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Residential proximity to major roads and fecundability in a preconception cohort. Environ Epidemiol 2020; 4:e112. [PMID: 33778352 PMCID: PMC7941774 DOI: 10.1097/ee9.0000000000000112] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/07/2020] [Indexed: 02/06/2023] Open
Abstract
Supplemental Digital Content is available in the text. Emerging evidence from animal and human studies indicates that exposure to traffic-related air pollution may adversely affect fertility.
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13
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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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Niederberger C, Pellicer A, Simon C, Kathrins M, Goldstein M, Sigman M, Schlegel PN, Munné S, Gardner DK, Cobo A, Coutifaris C, Donnez J, Taylor HS, Giudice LC, Fauser BC, Lindheim SR, Rosenwaks Z, Casper RF, de Ziegler D, Gibbons WE, Paulson RJ, Laufer N, Klock SC, Mendola P, Sauer MV. 25 historic papers: an ASRM 75th birthday gift from Fertility and Sterility. Fertil Steril 2019; 112:e2-e27. [DOI: 10.1016/j.fertnstert.2019.08.099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Gaskins AJ, Mínguez-Alarcón L, Fong KC, Abu Awad Y, Di Q, Chavarro JE, Ford JB, Coull BA, Schwartz J, Kloog I, Attaman J, Hauser R, Laden F. Supplemental Folate and the Relationship Between Traffic-Related Air Pollution and Livebirth Among Women Undergoing Assisted Reproduction. Am J Epidemiol 2019; 188:1595-1604. [PMID: 31241127 PMCID: PMC6736414 DOI: 10.1093/aje/kwz151] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/15/2019] [Accepted: 04/18/2019] [Indexed: 01/07/2023] Open
Abstract
Traffic-related air pollution has been linked to higher risks of infertility and miscarriage. We evaluated whether folate intake modified the relationship between air pollution and livebirth among women using assisted reproductive technology (ART). Our study included 304 women (513 cycles) presenting to a fertility center in Boston, Massachusetts (2005-2015). Diet and supplements were assessed by food frequency questionnaire. Spatiotemporal models estimated residence-based daily nitrogen dioxide (NO2), ozone, fine particulate, and black carbon concentrations in the 3 months before ART. We used generalized linear mixed models with interaction terms to evaluate whether the associations between air pollutants and livebirth were modified by folate intake, adjusting for age, body mass index, race, smoking, education, infertility diagnosis, and ART cycle year. Supplemental folate intake significantly modified the association of NO2 exposure and livebirth (P = 0.01). Among women with supplemental folate intakes of <800 μg/day, the odds of livebirth were 24% (95% confidence interval: 2, 42) lower for every 20-parts-per-billion increase in NO2 exposure. There was no association among women with intakes of ≥800 μg/day. There was no effect modification of folate on the associations between other air pollutants and livebirth. High supplemental folate intake might protect against the adverse reproductive consequences of traffic-related air pollution.
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Affiliation(s)
- Audrey J Gaskins
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Rollins School of Public Health at Emory University, Atlanta, Georgia
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kelvin C Fong
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Yara Abu Awad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Qian Di
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jennifer B Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Joel Schwartz
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Itai Kloog
- Department of Environmental Geography, Ben Gurion University of the Negev, Beersheva, Israel
| | - Jill Attaman
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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16
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Gaskins AJ, Fong KC, Abu Awad Y, Di Q, Mínguez-Alarcón L, Chavarro JE, Ford JB, Coull BA, Schwartz J, Kloog I, Souter I, Hauser R, Laden F. Time-Varying Exposure to Air Pollution and Outcomes of in Vitro Fertilization among Couples from a Fertility Clinic. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:77002. [PMID: 31268361 PMCID: PMC6792363 DOI: 10.1289/ehp4601] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND A few studies suggest that air pollution may decrease fertility, but prospective studies and examinations of windows of susceptibility remain unclear. OBJECTIVE We aimed to examine the association between time-varying exposure to nitrogen dioxide ([Formula: see text]), ozone ([Formula: see text]), fine particulate matter [Formula: see text] ([Formula: see text]), and black carbon (BC) on in vitro fertilization (IVF) outcomes. METHODS We included 345 women (522 IVF cycles) for the [Formula: see text], [Formula: see text], and [Formula: see text] analyses and 339 women (512 IVF cycles) for the BC analysis enrolled in a prospective cohort at a Boston fertility center (2004–2015). We used validated spatiotemporal models to estimate daily residential exposure to [Formula: see text], [Formula: see text], [Formula: see text], and BC. Multivariable discrete time Cox proportional hazards models with four periods [ovarian stimulation (OS), oocyte retrieval to embryo transfer (ET), ET to implantation, implantation to live birth] estimated odds ratios (OR) and 95% confidence intervals (CI) of failing at IVF. Time-dependent interactions were used to identify vulnerable periods. RESULTS An interquartile range (IQR) increase in [Formula: see text], [Formula: see text], and BC throughout the IVF cycle was associated with an elevated odds of failing at IVF prior to live birth ([Formula: see text], 95% CI: 0.95, 1.23 for [Formula: see text]; [Formula: see text], 95% CI: 0.88, 1.28 for [Formula: see text]; and [Formula: see text], 95% CI: 0.96, 1.41 for BC). This relationship significantly varied across the IVF cycle such that the association with higher exposure to air pollution during OS was strongest for early IVF failures. An IQR increase in [Formula: see text], [Formula: see text], and BC exposure during OS was associated with 1.42 (95% CI: 1.20, 1.69), 1.26 (95% CI: 0.96, 1.67), and 1.23 (95% CI: 0.96, 1.59) times the odds of failing prior to oocyte retrieval, and 1.32 (95% CI: 1.13, 1.54), 1.27 (95% CI: 0.98, 1.65), and 1.32 (95% CI: 1.10, 1.59) times the odds of failing prior to ET. CONCLUSION Increased exposure to traffic-related pollutants was associated with higher odds of early IVF failure. https://doi.org/10.1289/EHP4601.
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Affiliation(s)
- Audrey J Gaskins
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Kelvin C Fong
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Yara Abu Awad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Qian Di
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jennifer B Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Joel Schwartz
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Itai Kloog
- Department of Environmental Geography, Ben Gurion University of the Negev, Beersheba, Israel
| | - Irene Souter
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Environmental Geography, Ben Gurion University of the Negev, Beersheba, Israel
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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17
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Choe SA, Jun YB, Lee WS, Yoon TK, Kim SY. Association between ambient air pollution and pregnancy rate in women who underwent IVF. Hum Reprod 2019; 33:1071-1078. [PMID: 29659826 DOI: 10.1093/humrep/dey076] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 03/16/2018] [Indexed: 02/06/2023] Open
Abstract
STUDY QUESTION Are the concentrations of five criteria air pollutants associated with probabilities of biochemical pregnancy loss and intrauterine pregnancy in women? SUMMARY ANSWER Increased concentrations of ambient particulate matter (PM10), nitrogen dioxide (NO2), carbon monoxide (CO) during controlled ovarian stimulation (COS) and after embryo transfer were associated with a decreased probability of intrauterine pregnancy. WHAT IS KNOWN ALREADY Exposure to high ambient air pollution was suggested to be associated with low fertility and high early pregnancy loss in women. STUDY DESIGN, SIZE, DURATION Using a retrospective cohort study design, we analysed 6621 cycles of 4581 patients who underwent one or more fresh IVF cycles at a fertility centre from January 2006 to December 2014, and lived in Seoul at the time of IVF treatment. PARTICIPANTS/MATERIALS, SETTING, METHODS To estimate patients' individual exposure to air pollution, we computed averages of hourly concentrations of five air pollutants including PM10, NO2, CO, sulphur dioxide (SO2) and ozone (O3) measured at 40 regulatory monitoring sites in Seoul for each of the four exposure periods: period 1 (start of COS to oocyte retrieval), period 2 (oocyte retrieval to embryo transfer), period 3 (embryo transfer to hCG test), and period 4 (start of COS to hCG test). Hazard ratios (HRs) from the time-varying Cox-proportional hazards model were used to estimate probabilities of biochemical pregnancy loss and intrauterine pregnancy for an interquartile range (IQR) increase in each air pollutant concentration during each period, after adjusting for individual characteristics. We tested the robustness of the result using generalised linear mixed model, accounting for within-woman correlation. MAIN RESULTS AND THE ROLE OF CHANCE Mean age of the women was 35 years. Average BMI was 20.9 kg/m2 and the study population underwent 1.4 IVF cycles on average. Cumulative pregnancy rate in multiple IVF cycles was 51.3% per person. Survival analysis showed that air pollution during periods 1 and 3 was generally associated with IVF outcomes. Increased NO2 (adjusted HR = 0.93, 95% CI: 0.87, 0.99) and CO (0.94, 95% CI: 0.89, 1.00) during period 1 were associated with decreased probability of intrauterine pregnancy. PM10 (0.92, 95% CI: 0.85, 0.99), NO2 (0.93, 95% CI = 0.86, 1.00) and CO (0.93, 95% CI: 0.87, 1.00) levels during period 3 were also inversely associated with intrauterine pregnancy. Both PM10 (1.17, 95% CI: 1.04 1.33) and NO2 (1.18, 95% CI: 1.03, 1.34) during period 3 showed positive associations with biochemical pregnancy loss. LIMITATIONS, REASONS FOR CAUTION The district-specific ambient air pollution treated as an individual exposure may not represent the actual level of each woman's exposure to air pollution. Smoking, working status, parity or gravidity of women, and semen analysis data were not included in the analysis. WIDER IMPLICATIONS OF THE FINDINGS This study provided evidence of an association between increased ambient concentrations of PM10, NO2 and CO and reduced probabilities for achieving intrauterine pregnancy using multiple IVF cycle data. Specifically, our results indicated that lower intrauterine pregnancy rates in IVF cycles may be linked to ambient air pollution during COS and the post-transfer period. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2013 R1A6A3A04059017, 2016 R1D1A1B03933410 and 2018 R1A2B6004608) and the National Cancer Center of Korea (NCC-1810220-01). The authors report no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- S A Choe
- Department of Obstetrics and Gynecology, School of Medicine, CHA University.,CHA fertility center, Seoul station, Jung-gu, Seoul 04637, Korea
| | - Y B Jun
- Department of Statistics, Seoul National University, Gwanak-gu, Seoul 08826, Korea
| | - W S Lee
- Department of Obstetrics and Gynecology, School of Medicine, CHA University.,Fertility Center of CHA Gangnam Medical Center, Gangnam-gu, Seoul 06135, Korea
| | - T K Yoon
- Department of Obstetrics and Gynecology, School of Medicine, CHA University.,CHA fertility center, Seoul station, Jung-gu, Seoul 04637, Korea
| | - S Y Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, 10408, Korea
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18
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Nobles CJ, Schisterman EF, Ha S, Buck Louis GM, Sherman S, Mendola P. Time-varying cycle average and daily variation in ambient air pollution and fecundability. Hum Reprod 2019; 33:166-176. [PMID: 29136143 DOI: 10.1093/humrep/dex341] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 10/20/2017] [Indexed: 01/01/2023] Open
Abstract
STUDY QUESTION Does ambient air pollution affect fecundability? SUMMARY ANSWER While cycle-average air pollution exposure was not associated with fecundability, we observed some associations for acute exposure around ovulation and implantation with fecundability. WHAT IS KNOWN ALREADY Ambient air pollution exposure has been associated with adverse pregnancy outcomes and decrements in semen quality. STUDY DESIGN, SIZE, DURATION The LIFE study (2005-2009), a prospective time-to-pregnancy study, enrolled 501 couples who were followed for up to one year of attempting pregnancy. PARTICIPANTS/MATERIALS, SETTING, METHODS Average air pollutant exposure was assessed for the menstrual cycle before and during the proliferative phase of each observed cycle (n = 500 couples; n = 2360 cycles) and daily acute exposure was assessed for sensitive windows of each observed cycle (n = 440 couples; n = 1897 cycles). Discrete-time survival analysis modeled the association between fecundability and an interquartile range increase in each pollutant, adjusting for co-pollutants, site, age, race/ethnicity, parity, body mass index, smoking, income and education. MAIN RESULTS AND THE ROLE OF CHANCE Cycle-average air pollutant exposure was not associated with fecundability. In acute models, fecundability was diminished with exposure to ozone the day before ovulation and nitrogen oxides 8 days post ovulation (fecundability odds ratio [FOR] 0.83, 95% confidence interval [CI]: 0.72, 0.96 and FOR 0.84, 95% CI: 0.71, 0.99, respectively). However, particulate matter ≤10 microns 6 days post ovulation was associated with greater fecundability (FOR 1.25, 95% CI: 1.01, 1.54). LIMITATIONS, REASONS FOR CAUTION Although our study was unlikely to be biased due to confounding, misclassification of air pollution exposure and the moderate study size may have limited our ability to detect an association between ambient air pollution and fecundability. WIDER IMPLICATIONS OF THE FINDINGS While no associations were observed for cycle-average ambient air pollution exposure, consistent with past research in the United States, exposure during critical windows of hormonal variability was associated with prospectively measured couple fecundability, warranting further investigation. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Longitudinal Investigation of Fertility and the Environment study contract nos. #N01-HD-3-3355, NO1-HD-#-3356, N01-HD-3-3358 and the Air Quality and Reproductive Health Study Contract No. HHSN275200800002I, Task Order No. HHSN27500008). We declare no conflict of interest.
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Affiliation(s)
- Carrie J Nobles
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive Room 3119, MSC 7004, Bethesda, MD 20817, USA; The Emmes Corporation, Rockville, MD 20850, USA
| | - Enrique F Schisterman
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive Room 3119, MSC 7004, Bethesda, MD 20817, USA; The Emmes Corporation, Rockville, MD 20850, USA
| | - Sandie Ha
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive Room 3119, MSC 7004, Bethesda, MD 20817, USA; The Emmes Corporation, Rockville, MD 20850, USA
| | - Germaine M Buck Louis
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive Room 3119, MSC 7004, Bethesda, MD 20817, USA; The Emmes Corporation, Rockville, MD 20850, USA
| | - Seth Sherman
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive Room 3119, MSC 7004, Bethesda, MD 20817, USA; The Emmes Corporation, Rockville, MD 20850, USA
| | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive Room 3119, MSC 7004, Bethesda, MD 20817, USA; The Emmes Corporation, Rockville, MD 20850, USA
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19
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Gaskins AJ, Hart JE, Mínguez-Alarcón L, Chavarro JE, Laden F, Coull BA, Ford JB, Souter I, Hauser R. Residential proximity to major roadways and traffic in relation to outcomes of in vitro fertilization. ENVIRONMENT INTERNATIONAL 2018; 115:239-246. [PMID: 29605676 PMCID: PMC5970056 DOI: 10.1016/j.envint.2018.03.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/19/2018] [Accepted: 03/19/2018] [Indexed: 05/05/2023]
Abstract
BACKGROUND Emerging data from animal and human studies suggest that traffic-related air pollution adversely affects early pregnancy outcomes; however evidence is limited. OBJECTIVE We examined whether residential proximity to major roadways and traffic, as proxies for traffic-related air pollution, are associated with in vitro fertilization (IVF) outcomes. METHODS This analysis included 423 women enrolled in the Environment and Reproductive Health (EARTH) Study, a prospective cohort study, who underwent 726 IVF cycles (2004-2017). Using geocoded residential addresses collected at study entry, we calculated the distance to nearest major roadway and the traffic density within a 100 m radius. IVF outcomes were abstracted from electronic medical records. We used multivariable generalized linear mixed models to evaluate the associations between residential proximity to major roadways and traffic density and IVF outcomes adjusting for maternal age, body mass index, race, education level, smoking status, and census tract median income. RESULTS Closer residential proximity to major roadways was statistically significantly associated with lower probability of implantation and live birth following IVF. The adjusted percentage of IVF cycles resulting in live birth for women living ≥400 m from a major roadway was 46% (95% CI 36, 56%) compared to 33% (95% CI 26, 40%) for women living <50 m (p-for-comparison, 0.04). Of the intermediate outcomes, there were suggestive associations between living closer to major roadways and slightly higher estradiol trigger concentrations (p-trend = 0.16) and lower endometrial thickness (p-trend = 0.06). Near-residence traffic density was not associated with outcomes of IVF. CONCLUSION Closer residential proximity to major roadways was related to reduced likelihood of live birth following IVF.
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Affiliation(s)
- Audrey J Gaskins
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jennifer B Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Irene Souter
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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20
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Casey JA, Gemmill A, Karasek D, Ogburn EL, Goin DE, Morello-Frosch R. Increase in fertility following coal and oil power plant retirements in California. Environ Health 2018; 17:44. [PMID: 29720194 PMCID: PMC5932773 DOI: 10.1186/s12940-018-0388-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 04/24/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Few studies have explored the relationship between air pollution and fertility. We used a natural experiment in California when coal and oil power plants retired to estimate associations with nearby fertility rates. METHODS We used a difference-in-differences negative binomial model on the incident rate ratio scale to analyze the change in annual fertility rates among California mothers living within 0-5 km and 5-10 km of 8 retired power plants between 2001 and 2011. The difference-in-differences method isolates the portion of the pre- versus post-retirement contrast in the 0-5 km and 5-10 km bins, respectively, that is due to retirement rather than secular trends. We controlled for secular trends with mothers living 10-20 km away. Adjusted models included fixed effects for power plant, proportion Hispanic, Black, high school educated, and aged > 30 years mothers, and neighborhood poverty and educational attainment. RESULTS Analyses included 58,909 live births. In adjusted models, we estimated that after power plant retirement annual fertility rates per 1000 women aged 15-44 years increased by 8 births within 5 km and 2 births within 5-10 km of power plants, corresponding to incident rate ratios of 1.2 (95% CI: 1.1-1.4) and 1.1 (95% CI: 1.0-1.2), respectively. We implemented a negative exposure control by randomly selecting power plants that did not retire and repeating our analysis with those locations using the retirement dates from original 8 power plants. There was no association, suggesting that statewide temporal trends may not account for results. CONCLUSIONS Fertility rates among nearby populations appeared to increase after coal and oil power plant retirements. Our study design limited the possibility that our findings resulted from temporal trends or changes in population composition. These results require confirmation in other populations, given known methodological limitations of ecologic study designs.
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Affiliation(s)
- Joan A. Casey
- Division of Environmental Health Sciences, University of California, Berkeley School of Public Health, 13B University Hall, Berkeley, CA 94729 USA
| | - Alison Gemmill
- Program in Public Health, Department of Family, Population and Preventive Medicine, Stony Brook University, HSC, Level 3, Room 071, Stony Brook, NY 11794-8338 USA
| | - Deborah Karasek
- Preterm Birth Initiative, University of California, San Francisco, CA, 550 16th Street, San Francisco, CA 94158 USA
| | - Elizabeth L. Ogburn
- Department of Biostatistics, Johns Hopkins University, 615 N. Wolfe Street, Room E3620, Baltimore, MD 21205 USA
| | - Dana E. Goin
- Division of Epidemiology, University of California, Berkeley School of Public Health, 50 University Hall, Berkeley, CA 94729 USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy & Management and the University of California, Berkeley School of Public Health, 130 Mulford Hall, Berkeley, Berkeley, CA 94720 USA
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