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Abu Ahmad W, Nirel R, Barges S, Jolles M, Levine H. Meta-analysis of fine particulate matter exposure during pregnancy and birth weight: Exploring sources of heterogeneity. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 934:173205. [PMID: 38754513 DOI: 10.1016/j.scitotenv.2024.173205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/31/2024] [Accepted: 05/11/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Several meta-analyses assessed the relationship between exposure to PM with aerodynamic diameter ≤ 2.5 μm (PM2.5) during pregnancy and birth weight (BW), but results were inconsistent and substantial unexplained heterogeneity was reported. We aimed to investigate the above association and to explore sources of heterogeneity across studies. METHODS We systematically reviewed the current worldwide evidence examining the association between PM2.5 and BW. The review protocol was registered on the PROSPERO website (CRD42020188996) and followed PRISMA guidelines. We extracted association measures for BW and low birth weight (LBW, BW < 2500 g) from each study to evaluate pooled summary measures and to explore sources of between-study heterogeneity. FINDINGS Of the 2677 articles identified, 84 met the inclusion criteria (~42 M births). Our random effects meta-analyses revealed substantial heterogeneity among included studies (I2 = 98.4 % and I2 = 77.7 %, for BW and LBW respectively). For LBW, the heterogeneity decreased (I2 = 59.7 %) after excluding four outlying studies, with a pooled odds ratio 1.07 (95 % confidence interval, CI: 1.05, 1.09) per a 10-μg/m3 increase in mean PM2.5 exposure over the entire pregnancy. Further subgroup analysis revealed geographic heterogeneity with higher association in Europe (1.34, (1.16, 1.55)) compared to Asia (1.06, (1.03, 1.10)) and US (1.07, (1.04, 1.10)). CONCLUSION The association between PM2.5 and birth weight varied depending on several factors. The sources of heterogeneity between studies included modifiers such as study region and period. Hence, it is advisable not to pool summary measures of PM2.5-BW associations and that policy would be informed by local evidence.
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Affiliation(s)
- Wiessam Abu Ahmad
- School of Public Health, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Ronit Nirel
- Department of Statistics and Data Science, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Saleh Barges
- Community Medical Services Division, Clalit Health Services, Tel-Aviv, Israel
| | - Maya Jolles
- School of Public Health, University of Haifa, Haifa, Israel
| | - Hagai Levine
- School of Public Health, Hadassah Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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Park S, Shim M, Lee G, You YA, Kim SM, Hur YM, Ko H, Park MH, Na SH, Kim YH, Cho GJ, Bae JG, Lee SJ, Lee SH, Lee DK, Kim YJ. Urinary metabolite biomarkers of pregnancy complications associated with maternal exposure to particulate matter. Reprod Toxicol 2024; 124:108550. [PMID: 38280687 DOI: 10.1016/j.reprotox.2024.108550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/02/2024] [Accepted: 01/23/2024] [Indexed: 01/29/2024]
Abstract
Particulate matter 2.5 (PM2.5) is associated with reproductive health and adverse pregnancy outcomes. However, studies evaluating biological markers of PM2.5 are lacking, and identifying biomarkers for estimating prenatal exposure to prevent pregnancy complications is essential. Therefore, we aimed to explore urine metabolites that are easy to measure as biomarkers of exposure. In this matched case-control study based on the PM2.5 exposure, 30 high PM2.5 group (>15 μg/m3) and 30 low PM2.5 group (<15 μg/m3) were selected from air pollution on pregnancy outcome (APPO) cohort study. We used a time-weighted average model to estimate individual PM exposure, which used indoor PM2.5 and outdoor PM2.5 concentrations by atmospheric measurement network based on residential addresses. Clinical characteristics and urine samples were collected from participants during the second trimester of pregnancy. Urine metabolites were quantitatively measured using gas chromatography-mass spectrometry following multistep chemical derivatization. Statistical analyses were conducted using SPSS version 21 and MetaboAnalyst 5.0. Small for gestational age and gestational diabetes (GDM) were significantly increased in the high PM2.5 group, respectively (P = 0.042, and 0.022). Fifteen metabolites showed significant differences between the two groups (P < 0.05). Subsequent pathway enrichment revealed that four pathways, including pentose and glucuronate interconversion with three pentose sugars (ribose, arabinose, and xylose; P < 0.05). The concentration of ribose increased preterm births (PTB) and GDM (P = 0.044 and 0.049, respectively), and the arabinose concentration showed a tendency to increase in PTB (P = 0.044). Therefore, we identified urinary pentose metabolites as biomarkers of PM2.5 and confirmed the possibility of their relationship with pregnancy complications.
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Affiliation(s)
- Sunwha Park
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Minki Shim
- College of Pharmacy, Chung-Ang University, Seoul, Korea
| | - Gain Lee
- Graduate program in system health science and engineering, Ewha Womans University, Seoul, Korea
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Soo Min Kim
- Graduate program in system health science and engineering, Ewha Womans University, Seoul, Korea
| | - Young Min Hur
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Hyejin Ko
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea
| | - Mi Hye Park
- Department of Obstetrics and Gynecology, Ewha Womans University Seoul Hospital, Korea
| | - Sung Hun Na
- Department of Obstetrics and Gynecology, Kangwon National University, School of Medicine, Korea
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea
| | - Jin-Gon Bae
- Department of Obstetrics and Gynecology, Keimyung University, School of Medicine, Dongsan Medical Center, Korea
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Korea
| | | | - Dong-Kyu Lee
- College of Pharmacy, Chung-Ang University, Seoul, Korea.
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University, Seoul, Korea; Graduate program in system health science and engineering, Ewha Womans University, Seoul, Korea.
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O'Sharkey K, Xu Y, Cabison J, Rosales M, Yang T, Chavez T, Johnson M, Lerner D, Lurvey N, Corral CMT, Farzan SF, Bastain TM, Breton CV, Habre R. Effects of in-utero personal exposure to PM 2.5 sources and components on birthweight. Sci Rep 2023; 13:21987. [PMID: 38081912 PMCID: PMC10713978 DOI: 10.1038/s41598-023-48920-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
In-utero exposure to fine particulate matter (PM2.5) and specific sources and components of PM2.5 have been linked with lower birthweight. However, previous results have been mixed, likely due to heterogeneity in sources impacting PM2.5 and due to measurement error from using ambient data. Therefore, we investigated the effect of PM2.5 sources and their high-loading components on birthweight using data from 198 women in the 3rd trimester from the MADRES cohort 48-h personal PM2.5 exposure monitoring sub-study. The mass contributions of six major sources of personal PM2.5 exposure were estimated for 198 pregnant women in the 3rd trimester using the EPA Positive Matrix Factorization v5.0 model, along with their 17 high-loading chemical components using optical carbon and X-ray fluorescence approaches. Single- and multi-pollutant linear regressions evaluated the association between personal PM2.5 sources/components and birthweight, adjusting for gestational age, maternal age, race, infant sex, parity, diabetes status, temperature, maternal education, and smoking history. Participants were predominately Hispanic (81%), with a mean (SD) gestational age of 39.1 (1.5) weeks and age of 28.2 (6.0) years. Mean birthweight was 3295.8 g (484.1) and mean PM2.5 exposure was 21.3 (14.4) µg/m3. A 1 SD increase in the mass contribution of the fresh sea salt source was associated with a 99.2 g decrease in birthweight (95% CI - 197.7, - 0.6), and aged sea salt was associated with a 70.1 g decrease in birthweight (95% CI - 141.7, 1.4). Magnesium, sodium, and chlorine were associated with lower birthweight, which remained after adjusting for PM2.5 mass. This study found evidence that major sources of personal PM2.5 including fresh and aged sea salt were negatively associated with birthweight, with the strongest effect on birthweight from Na and Mg. The effect of crustal and fuel oil sources differed by infant sex with negative associations seen in boys compared to positive associations in girls.
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Affiliation(s)
- Karl O'Sharkey
- Department of Population and Public Health Sciences, University of Southern California, 1845 N Soto St., Los Angeles, CA, 90089, USA.
| | - Yan Xu
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
| | - Jane Cabison
- Department of Population and Public Health Sciences, University of Southern California, 1845 N Soto St., Los Angeles, CA, 90089, USA
| | - Marisela Rosales
- Department of Population and Public Health Sciences, University of Southern California, 1845 N Soto St., Los Angeles, CA, 90089, USA
| | - Tingyu Yang
- Department of Population and Public Health Sciences, University of Southern California, 1845 N Soto St., Los Angeles, CA, 90089, USA
| | - Thomas Chavez
- Department of Population and Public Health Sciences, University of Southern California, 1845 N Soto St., Los Angeles, CA, 90089, USA
| | - Mark Johnson
- Department of Population and Public Health Sciences, University of Southern California, 1845 N Soto St., Los Angeles, CA, 90089, USA
| | | | | | - Claudia M Toledo Corral
- Department of Population and Public Health Sciences, University of Southern California, 1845 N Soto St., Los Angeles, CA, 90089, USA
- Department of Health Sciences, California State University Northridge, Northridge, CA, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, University of Southern California, 1845 N Soto St., Los Angeles, CA, 90089, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, University of Southern California, 1845 N Soto St., Los Angeles, CA, 90089, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, University of Southern California, 1845 N Soto St., Los Angeles, CA, 90089, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, University of Southern California, 1845 N Soto St., Los Angeles, CA, 90089, USA
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
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Park S, Kwon E, Lee G, You YA, Kim SM, Hur YM, Jung S, Jee Y, Park MH, Na SH, Kim YH, Cho GJ, Bae JG, Lee SJ, Lee SH, Kim YJ. Effect of Particulate Matter 2.5 on Fetal Growth in Male and Preterm Infants through Oxidative Stress. Antioxidants (Basel) 2023; 12:1916. [PMID: 38001768 PMCID: PMC10669397 DOI: 10.3390/antiox12111916] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Particulate matter 2.5 (PM2.5) levels are associated with adverse pregnancy outcomes. In this retrospective cohort study, we examined whether the concentration of indoor PM2.5 affected pregnancy outcomes. Additionally, we evaluated biomarkers of pregnancy-related complications caused by fine dust. We collected clinical information and data based on residential addresses from the Air Korea database to assess PM2.5 exposure levels. As a multicenter prospective cohort study, we measured the indoor PM2.5 concentration and inflammatory and oxidative stress markers. The PM2.5 concentration of the low-birth-weight (LBW) delivery group was 27.21 μg/m3, which was significantly higher than that of the normal-birth-weight (NBW) group (26.23 μg/m3) (p = 0.02). When the newborns were divided by sex, the PM2.5 concentration of the LBW group was 27.89 μg/m3 in male infants, which was significantly higher than that of the NBW group (26.26 μg/m3) (p = 0.01). In the prospective study, 8-hydroxy-2-deoxyguanosine significantly increased in the high-concentration group (113.55 ng/mL, compared with 92.20 ng/mL in the low-concentration group); in the high-concentration group, the rates of preterm birth (PTB) and small size for gestational age significantly increased (p < 0.01, p = 0.01). This study showed an association between PM2.5, oxidative stress, and fetal growth, with the PTB group being more vulnerable.
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Affiliation(s)
- Sunwha Park
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
| | - Eunjin Kwon
- Division of Allergy and Respiratory Disease Research, Department of Chronic Disease Convergence Research, Korea National Institute of Health, Cheongju-si 28159, Republic of Korea;
| | - Gain Lee
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07985, Republic of Korea; (G.L.); (S.M.K.)
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
| | - Soo Min Kim
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07985, Republic of Korea; (G.L.); (S.M.K.)
| | - Young Min Hur
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
| | - Sooyoung Jung
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
| | - Yongho Jee
- Advanced Biomedical Research Institute, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea;
| | - Mi Hye Park
- Department of Obstetrics and Gynecology, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea;
| | - Sung Hun Na
- Department of Obstetrics and Gynecology, School of Medicine, Kangwon National University, Chuncheon-si 24289, Republic of Korea;
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea;
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul 02841, Republic of Korea;
| | - Jin-Gon Bae
- Department of Obstetrics and Gynecology, School of Medicine, Keimyung University, Dongsan Medical Center, Daegu 42601, Republic of Korea;
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, College of Medicine, Ulsan University, Ulsan 44610, Republic of Korea;
| | - Sun Hwa Lee
- Seegene Medical Foundation, Seoul 04805, Republic of Korea;
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea; (S.P.); (Y.-A.Y.); (Y.M.H.); (S.J.)
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07985, Republic of Korea; (G.L.); (S.M.K.)
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5
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O'Sharkey K, Xu Y, Cabison J, Rosales M, Yang T, Chavez T, Johnson M, Lerner D, Lurvey N, Toledo Corral CM, Farzan SF, Bastain TM, Breton CV, Habre R. Effects of In-Utero Personal Exposure to PM2.5 Sources and Components on Birthweight. RESEARCH SQUARE 2023:rs.3.rs-3026552. [PMID: 37333108 PMCID: PMC10274950 DOI: 10.21203/rs.3.rs-3026552/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Background In-utero exposure to fine particulate matter (PM2.5) and specific sources and components of PM2.5 have been linked with lower birthweight. However, previous results have been mixed, likely due to heterogeneity in sources impacting PM2.5 and due to measurement error from using ambient data. Therefore, we investigated the effect of PM2.5 sources and their high-loading components on birthweight using data from 198 women in the 3rd trimester from the MADRES cohort 48-hour personal PM2.5 exposure monitoring sub-study. Methods The mass contributions of six major sources of personal PM2.5 exposure were estimated for 198 pregnant women in the 3rd trimester using the EPA Positive Matrix Factorization v5.0 model, along with their 17 high-loading chemical components using optical carbon and X-ray fluorescence approaches. Single- and multi-pollutant linear regressions were used to evaluate the association between personal PM2.5 sources and birthweight. Additionally, high-loading components were evaluated with birthweight individually and in models further adjusted for PM2.5 mass. Results Participants were predominately Hispanic (81%), with a mean (SD) gestational age of 39.1 (1.5) weeks and age of 28.2 (6.0) years. Mean birthweight was 3,295.8g (484.1) and mean PM2.5 exposure was 21.3 (14.4) μg/m3. A 1 SD increase in the mass contribution of the fresh sea salt source was associated with a 99.2g decrease in birthweight (95% CI: -197.7, -0.6), while aged sea salt was associated with lower birthweight (β =-70.1; 95% CI: -141.7, 1.4). Magnesium sodium, and chlorine were associated with lower birthweight, which remained after adjusting for PM2.5 mass. Conclusions This study found evidence that major sources of personal PM2.5 including fresh and aged sea salt were negatively associated with birthweight, with the strongest effect on birthweight from Na and Mg. The effect of crustal and fuel oil sources differed by infant sex with negative associations seen in boys compared to positive associations in girls.
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Affiliation(s)
| | - Yan Xu
- University of Southern California
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Downward GS, Vermeulen R. Ambient Air Pollution and All-Cause and Cause-Specific Mortality in an Analysis of Asian Cohorts. Res Rep Health Eff Inst 2023; 2016:1-53. [PMID: 37424069 PMCID: PMC7266370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
INTRODUCTION Much of what is currently known about the adverse effects of ambient air pollution comes from studies conducted in high-income regions, with relatively low air pollution levels. The aim of the current project is to examine the relationship between exposure to ambient air pollution (as predicted from satellite-based models) and all-cause and cause-specific mortality in several Asian cohorts. METHODS Cohorts were recruited from the Asia Cohort Consortium (ACC). The geocoded residences of participants were assigned levels of ambient particulate material with aerodynamic diameter of 2.5 μm or less (PM2.5) and nitrogen dioxide (NO2) utilizing global satellite-derived models and assigned for the year of enrollment (or closest available year). The association between ambient exposure and mortality was established with Cox proportional hazard models, after adjustment for common confounders. Both single- and two-pollutant models were generated. Model robustness was evaluated, and hazard ratios were calculated for each cohort separately and combined via random effect meta-analysis for pooled risk estimates. RESULTS Six cohort studies from the ACC participated: the Community-based Cancer Screening Program (CBCSCP, Taiwan), the Golestan Cohort Study (Iran), the Health Effects for Arsenic Longitudinal Study (HEALS, Bangladesh), the Japan Public Health Center-based Prospective Study (JPHC), the Korean Multi-center Cancer Cohort Study (KMCC), and the Mumbai Cohort Study (MCS, India). The cohorts represented over 340,000 participants. Mean exposures to PM2.5 ranged from 8 to 58 μg/m3. Mean exposures to NO2 ranged from 7 to 23 ppb. For PM2.5, a positive, borderline nonsignificant relationship was observed between PM2.5 and cardiovascular mortality. Other relationships with PM2.5 tended toward the null in meta-analysis. For NO2, an overall positive relationship was observed between exposure to NO2 and all cancers and lung cancer. A borderline association between NO2 and nonmalignant lung disease was also observed. The findings within individual cohorts remained consistent across a variety of subgroups and alternative analyses, including two-pollutant models. CONCLUSIONS In a pooled examination of cohort studies across Asia, ambient PM2.5 exposure appears to be associated with an increased risk of cardiovascular mortality and ambient NO2 exposure is associated with an increased cancer (and lung cancer) mortality. This project has shown that satellite-derived models of pollution can be used in examinations of mortality risk in areas with either incomplete or missing air pollution monitoring.
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Affiliation(s)
- G S Downward
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | - R Vermeulen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
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O’Sharkey K, Xu Y, Chavez T, Johnson M, Cabison J, Rosales M, Grubbs B, Toledo-Corral CM, Farzan SF, Bastain T, Breton CV, Habre R. In-utero personal exposure to PM 2.5 impacted by indoor and outdoor sources and birthweight in the MADRES cohort. ENVIRONMENTAL ADVANCES 2022; 9:100257. [PMID: 36778968 PMCID: PMC9912940 DOI: 10.1016/j.envadv.2022.100257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND In-utero exposure to outdoor particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) is linked with low birthweight. However, previous results are mixed, likely due to measurement error introduced by estimating personal exposure from ambient data. This study investigated the effect of total personal PM2.5 exposure on birthweight and whether it differed when it was more heavily impacted by sources of indoor vs outdoor origin in the MADRES cohort study. METHODS Personal PM2.5 exposure was measured in 205 pregnant women in the 3rd trimester using 48 h integrated, filter-based sampling. Linear regression was used to test the association between personal PM2.5 exposure and birthweight, adjusting for key covariates. Interactions of PM2.5 with variables representing indoor sources of PM2.5, home ventilation, or time spent indoors tested whether the effect of total PM2.5 on birthweight varied when it was more impacted by sources of indoor vs outdoor origin. RESULTS In a sample of largely Hispanic (81%) pregnant women, total personal PM2.5 was not significantly associated with birthweight (β = 38.6 per 1SD increase in PM2.5; 95% CI:-21.1, 98.2). This association however, differed by home type (single family home: 156.9 (26.9, 287.0), 2-4 attached units:-16.6 (-111.9, 78.7), 5+ units:-62.6 (-184.9, 59.6), missing: 145.4 (-4.1, 294.9), interaction p = 0.028) and by household air conditioner use (none of the time: -27.6 (-101.5, 46.3) vs. some of the time: 139.9 (42.9, 237.0), interaction p = 0.008) Additionally, the effect of personal PM2.5 on birthweight varied by time spent indoors (none or little of the time: - 45.1 (-208.3, 118.1) vs. most or all of the time: 57.1 (-7.3, 121.6), interaction p = 0.255). CONCLUSIONS While no significant association between total personal PM2.5 exposure and birthweight was found, there was evidence that multi-unit housing (vs. single-family homes), candle and/or incense smoke, and greater outdoor source contributions to personal PM2.5 were more strongly associated with lower birthweight.
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Affiliation(s)
- Karl O’Sharkey
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Yan Xu
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, United States
| | - Thomas Chavez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Mark Johnson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Jane Cabison
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Marisela Rosales
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Brendan Grubbs
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Claudia M. Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
- Department of Health Sciences, California State University Northridge, Northridge, CA, United States
| | - Shohreh F. Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Theresa Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St Rm 102M, Los Angeles, CA 90089, United States
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, United States
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Gong C, Wang J, Bai Z, Rich DQ, Zhang Y. Maternal exposure to ambient PM 2.5 and term birth weight: A systematic review and meta-analysis of effect estimates. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 807:150744. [PMID: 34619220 DOI: 10.1016/j.scitotenv.2021.150744] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/18/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
Effect estimates of prenatal exposure to ambient PM2.5 on change in grams (β) of birth weight among term births (≥37 weeks of gestation; term birth weight, TBW) vary widely across studies. We present the first systematic review and meta-analysis of evidence regarding these associations. Sixty-two studies met the eligibility criteria for this review, and 31 studies were included in the meta-analysis. Random-effects meta-analysis was used to assess the quantitative relationships. Subgroup analyses were performed to gain insight into heterogeneity derived from exposure assessment methods (grouped by land use regression [LUR]-models, aerosol optical depth [AOD]-based models, interpolation/dispersion/Bayesian models, and data from monitoring stations), study regions, and concentrations of PM2.5 exposure. The overall pooled estimate involving 23,925,941 newborns showed that TBW was negatively associated with PM2.5 exposure (per 10 μg/m3 increment) during the entire pregnancy (β = -16.54 g), but with high heterogeneity (I2 = 95.6%). The effect estimate in the LUR-models subgroup (β = -16.77 g) was the closest to the overall estimate and with less heterogeneity (I2 = 18.3%) than in the other subgroups of AOD-based models (β = -41.58 g; I2 = 95.6%), interpolation/dispersion models (β = -10.78 g; I2 = 86.6%), and data from monitoring stations (β = -11.53 g; I2 = 97.3%). Even PM2.5 exposure levels of lower than 10 μg/m3 (the WHO air quality guideline value) had adverse effects on TBW. The LUR-models subgroup was the only subgroup that obtained similar significant of negative associations during the three trimesters as the overall trimester-specific analyses. In conclusion, TBW was negatively associated with maternal PM2.5 exposures during the entire pregnancy and each trimester. More studies based on relatively standardized exposure assessment methods need to be conducted to further understand the precise susceptible exposure time windows and potential mechanisms.
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Affiliation(s)
- Chen Gong
- Department of Family Planning, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Jianmei Wang
- Department of Family Planning, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhipeng Bai
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China; Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - David Q Rich
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Yujuan Zhang
- Department of Family Planning, The Second Hospital of Tianjin Medical University, Tianjin, China; State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China.
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9
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Coker ES, Martin J, Bradley LD, Sem K, Clarke K, Sabo-Attwood T. A time series analysis of the ecologic relationship between acute and intermediate PM2.5 exposure duration on neonatal intensive care unit admissions in Florida. ENVIRONMENTAL RESEARCH 2021; 196:110374. [PMID: 33131682 DOI: 10.1016/j.envres.2020.110374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/12/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
Admissions of newborn infants into Neonatal Intensive Care Units (NICU) has increased in the US over the last decade yet the role of environmental exposures as a risk factor for NICU admissions is under studied. Our study aims to determine the ecologic association between acute and intermediate ambient PM2.5 exposure durations and rates of NICU admissions, and to explore whether this association differs by area-level social stressors and meteorological factors. We conducted an ecologic time-series analysis of singleton neonates (N = 1,027,797) born in Florida hospitals between December 26, 2011 to April 30, 2019. We used electronic medical records (EMRs) in the OneFlorida Data Trust and included infants with a ZIP code in a Metropolitan Statistical Areas (MSA) and excluded extreme preterm births (<24wks gestation). The study outcome is the number of daily NICU admission at 28 days old or younger for each ZIP code in the study area. The exposures of interest are average same day, 1- and 2-day lags, and 1-3 weeks ambient PM2.5 concentration at the ZIP code-level estimated using inverse distance weighting (IDW) for each day of the study period. We used a zero-inflated Poisson regression mixed effects models to estimate adjusted associations between acute and intermediate PM2.5 exposure durations and NICU admissions rates. NICU admissions rates increased over time during the study period. Ambient 7-day average PM2.5 concentrations was significantly associated with incidence of NICU admissions, with an interquartile range (IQR = 2.37 μg/m3) increase associated with a 1.4% (95% CI: 0.4%, 2.4%) higher adjusted incidence of daily NICU admissions. No other exposure duration metrics showed a significant association with daily NICU admission rates. The magnitude of the association between PM2.5 7-day average concentrations with NICU admissions was significantly (p < 0.05) higher among ZIP codes with higher proportions of non-Hispanic Blacks, ZIP codes with household incomes in the lowest quartile, and on days with higher relative humidity. Our data shows a positive relationship between acute (7-day average) PM2.5 concentrations and daily NICU admissions in Metropolitan Statistical Areas of Florida. The observed associations were stronger in socioeconomically disadvantaged areas, areas with higher proportions with non-Hispanic Blacks, and on days with higher relative humidity. Further research is warranted to study other air pollutants and multipollutant effects and identify health conditions that are driving these associations with NICU admissions.
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Affiliation(s)
- Eric S Coker
- University of Florida, College of Public Health and Health Professions, Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA.
| | - James Martin
- University of Florida, College of Public Health and Health Professions, Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA
| | - Lauren D Bradley
- University of Florida, College of Agricultural and Life Sciences, University of Florida, Gainesville, FL, USA
| | - Karen Sem
- University of Florida, College of Engineering, University of Florida, Gainesville, FL, USA
| | - Kayan Clarke
- University of Florida, College of Public Health and Health Professions, Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA
| | - Tara Sabo-Attwood
- University of Florida, College of Public Health and Health Professions, Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA; University of Florida, Center for Environmental and Human Toxicology, University of Florida, Gainesville, FL, USA
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Uwak I, Olson N, Fuentes A, Moriarty M, Pulczinski J, Lam J, Xu X, Taylor BD, Taiwo S, Koehler K, Foster M, Chiu WA, Johnson NM. Application of the navigation guide systematic review methodology to evaluate prenatal exposure to particulate matter air pollution and infant birth weight. ENVIRONMENT INTERNATIONAL 2021; 148:106378. [PMID: 33508708 PMCID: PMC7879710 DOI: 10.1016/j.envint.2021.106378] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/11/2020] [Accepted: 01/04/2021] [Indexed: 05/04/2023]
Abstract
Low birth weight is an important risk factor for many co-morbidities both in early life as well as in adulthood. Numerous studies report associations between prenatal exposure to particulate matter (PM) air pollution and low birth weight. Previous systematic reviews and meta-analyses report varying effect sizes and significant heterogeneity between studies, but did not systematically evaluate the quality of individual studies or the overall body of evidence. We conducted a new systematic review to determine how prenatal exposure to PM2.5, PM10, and coarse PM (PM2.5-10) by trimester and across pregnancy affects infant birth weight. Using the Navigation Guide methodology, we developed and applied a systematic review protocol [CRD42017058805] that included a comprehensive search of the epidemiological literature, risk of bias (ROB) determination, meta-analysis, and evidence evaluation, all using pre-established criteria. In total, 53 studies met our inclusion criteria, which included evaluation of birth weight as a continuous variable. For PM2.5 and PM10, we restricted meta-analyses to studies determined overall as "low" or "probably low" ROB; none of the studies evaluating coarse PM were rated as "low" or "probably low" risk of bias, so all studies were used. For PM2.5, we observed that for every 10 µg/m3 increase in exposure to PM2.5 in the 2nd or 3rd trimester, respectively, there was an associated 5.69 g decrease (I2: 68%, 95% CI: -10.58, -0.79) or 10.67 g decrease in birth weight (I2: 84%, 95% CI: -20.91, -0.43). Over the entire pregnancy, for every 10 µg/m3 increase in PM2.5 exposure, there was an associated 27.55 g decrease in birth weight (I2: 94%, 95% CI: -48.45, -6.65). However, the quality of evidence for PM2.5 was rated as "low" due to imprecision and/or unexplained heterogeneity among different studies. For PM10, we observed that for every 10 µg/m3 increase in exposure in the 3rd trimester or the entire pregnancy, there was a 6.57 g decrease (I2: 0%, 95% CI: -10.66, -2.48) or 8.65 g decrease in birth weight (I2: 84%, 95% CI: -16.83, -0.48), respectively. The quality of evidence for PM10 was rated as "moderate," as heterogeneity was either absent or could be explained. The quality of evidence for coarse PM was rated as very low/low (for risk of bias and imprecision). Overall, while evidence for PM2.5 and course PM was inadequate primarily due to heterogeneity and risk of bias, respectively, our results support the existence of an inverse association between prenatal PM10 exposure and low birth weight.
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Affiliation(s)
- Inyang Uwak
- Department of Environmental and Occupational Health. Texas A&M University, College Station, TX, USA
| | - Natalie Olson
- Department of Veterinary Integrative Biosciences. Texas A&M University, College Station, TX, USA
| | - Angelica Fuentes
- Department of Veterinary Integrative Biosciences. Texas A&M University, College Station, TX, USA
| | - Megan Moriarty
- Department of Environmental and Occupational Health. Texas A&M University, College Station, TX, USA
| | - Jairus Pulczinski
- Department of Environmental Health and Engineering. Johns Hopkins University, Baltimore, MD, USA
| | - Juleen Lam
- Department of Health Sciences, California State University, East Bay, Hayward, CA USA
| | - Xiaohui Xu
- Department of Epidemiology and Biostatistics. Texas A&M University, College Station, TX, USA
| | - Brandie D Taylor
- Department of Epidemiology and Biostatistics. Temple University, Philadelphia, PA, USA
| | - Samuel Taiwo
- Department of Environmental and Occupational Health. Texas A&M University, College Station, TX, USA
| | - Kirsten Koehler
- Department of Environmental Health and Engineering. Johns Hopkins University, Baltimore, MD, USA
| | - Margaret Foster
- Medical Sciences Library. Texas A&M University, College Station, TX, USA
| | - Weihsueh A Chiu
- Department of Veterinary Integrative Biosciences. Texas A&M University, College Station, TX, USA
| | - Natalie M Johnson
- Department of Environmental and Occupational Health. Texas A&M University, College Station, TX, USA.
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11
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Yuan L, Zhang Y, Wang W, Chen R, Liu Y, Liu C, Kan H, Gao Y, Tian Y. Critical windows for maternal fine particulate matter exposure and adverse birth outcomes: The Shanghai birth cohort study. CHEMOSPHERE 2020; 240:124904. [PMID: 31550593 DOI: 10.1016/j.chemosphere.2019.124904] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/02/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Prenatal exposure to ambient levels of air pollution has been reported to adversely affect birth outcomes, yet few studies have investigated refined susceptible windows for adverse birth outcomes. OBJECTIVES The study aimed at estimating associations between maternal exposure to ambient fine particulate matter (PM2.5; particles with an aerodynamic diameter ≤ 2.5 μm) and birth outcomes, including birth weight, low birth weight (LBW) and preterm birth (PTB), and identify specific susceptible windows. METHODS A total of 3692 singleton live births were enrolled between 2013 and 2016 in Shanghai Birth Cohort, China. Based on mothers' residential addresses, weekly mean concentrations of PM2.5 over gestation were estimated based on an incorporated evaluating approach combining satellite-based estimates and ground-level measurements. Distributed lag non-liner models (DLNMs) were fitted by incorporating with multiple liner models and Cox proportional hazard models to evaluate weekly-as well as trimester-exposure-lag-response associations between average PM2.5 level and birth weight, LBW and PTB, and to identify critical windows. RESULTS In this study, gestational exposure to PM2.5 was associated with adverse birth outcomes in infants, and critical windows were identified as 31st-34th gestational weeks for reduced birth weight, 38th-42 nd weeks for LBW and 27th-30th weeks for PTB, respectively. Trimester-specific associations were found for all birth outcomes during the third trimester. CONCLUSIONS Ambient PM2.5 exposure exhibited adverse impacts on multiple outcomes including reduced birth weight, LBW and PTB in the late pregnancy. The study provides further evidence supporting harmful effects of maternal PM2.5 exposure on birth outcomes and identifying critical windows.
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Affiliation(s)
- Lei Yuan
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Zhang
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weidong Wang
- Department of Environmental Health, School of Public Health, Fudan University School of Medicine, Shanghai, China
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Fudan University School of Medicine, Shanghai, China
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Cong Liu
- Department of Environmental Health, School of Public Health, Fudan University School of Medicine, Shanghai, China
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University School of Medicine, Shanghai, China.
| | - Yu Gao
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ying Tian
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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12
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Sears CG, Mueller-Leonhard C, Wellenius GA, Chen A, Ryan P, Lanphear BP, Braun JM. Early-life exposure to traffic-related air pollution and child anthropometry. Environ Epidemiol 2019; 3:e061. [PMID: 32885129 PMCID: PMC7461703 DOI: 10.1097/ee9.0000000000000061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/22/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Early-life exposure to traffic-related air pollution may decrease fetal growth and increase childhood obesity risk. Our objective was to evaluate the relationship of early-life exposure to traffic-related air pollution with birthweight in term newborns and obesity at age 7-8 years in two prospective birth cohorts in Cincinnati, OH (the Health Outcomes and Measures of the Environment (HOME) Study and Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS)). METHODS We estimated elemental carbon attributable to traffic (ECAT) exposure at residential addresses during pregnancy with a validated land use regression model. We assessed birthweight among term infants using birth records or parent report (HOME Study n= 333 and CCAAPS n=590). We measured children's weight and height at 7-8 years, and calculated age- and sex-specific BMI z-scores (HOME Study n= 198 and CCAAPS n=459). Using multivariable linear regression, we estimated the difference in term birthweight and BMI z-score per interquartile range (IQR) increase in ECAT concentrations in each cohort separately and in the pooled sample. RESULTS In adjusted models, ECAT exposure was not associated with lower birthweight (pooled sample β: 30g; 95% CI: -6, 66), or with higher BMI z-score (pooled sample β: -0.04; 95% CI: -0.15, 0.08). Infant sex modified the association between ECAT and birthweight (p=0.05). Among male newborns, higher ECAT concentrations were associated with higher birthweight (β: 61g; 95% CI: 9, 113), but we observed no association among female newborns (β: -9g; 95% CI: -58, 41). CONCLUSIONS In contrast to some prior studies, early-life traffic-related air pollution exposure was not associated with lower birthweight or increased childhood adiposity in these two cohorts.
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Affiliation(s)
- Clara G Sears
- Department of Epidemiology, Brown University, Providence, RI, United States
| | | | | | - Aimin Chen
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Patrick Ryan
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, United States
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, United States
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13
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Yuan L, Zhang Y, Gao Y, Tian Y. Maternal fine particulate matter (PM 2.5) exposure and adverse birth outcomes: an updated systematic review based on cohort studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:13963-13983. [PMID: 30891704 DOI: 10.1007/s11356-019-04644-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 02/19/2019] [Indexed: 04/16/2023]
Abstract
Exposure to ambient air pollutants during pregnancy may be associated with numerous side health effects and adverse birth outcomes. Growing numbers of studies have explored a possible linkage between prenatal exposure to PM2.5 (particulate matter with aerodynamic diameter ≤ 2.5 μm) and impacts on fetal development. We aimed to conduct a systematic review based on published cohort studies to summarize evidence regarding the association between maternal PM2.5 exposure and birth outcomes, including birth weight, low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). Eligible studies meeting the following criterion were selected: PM2.5 exposure during pregnancy and live birth singletons, certain presentation of sample sizes, and quantitative evaluation of the associations between exposure and outcomes. Among the 42 selected studies, 23 evaluated the impact of prenatal PM2.5 exposure on birth weight of infants while 12 of them provided a significantly negative association for exposure and birth weight. Twenty-one studies aimed to identify the possible relationship between maternal exposure and LBW and 8 studies proved significant associations. Among 18 studies that explored the correlation between prenatal exposure and PTB, 9 reached a consistent conclusion that gestational exposure would add to the risk of PTB. Nine studies assessed the impact of PM2.5 on SGA and 5 of them demonstrated a significant effect. So far, linkages between maternal PM2.5 exposure during varied gestational stages and multiple adverse birth outcomes have been observed in many studies. A summary of them will be meaningful for further research on maternal exposure and adverse birth outcomes.
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Affiliation(s)
- Lei Yuan
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai, 200025, China
| | - Yan Zhang
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai, 200025, China
| | - Yu Gao
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai, 200025, China.
| | - Ying Tian
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai, 200025, China.
- MOE and Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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14
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Klepac P, Locatelli I, Korošec S, Künzli N, Kukec A. Ambient air pollution and pregnancy outcomes: A comprehensive review and identification of environmental public health challenges. ENVIRONMENTAL RESEARCH 2018; 167:144-159. [PMID: 30014896 DOI: 10.1016/j.envres.2018.07.008] [Citation(s) in RCA: 211] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 05/19/2023]
Abstract
There is a growing number of studies on the association between ambient air pollution and adverse pregnancy outcomes, but their results have been inconsistent. Consequently, a comprehensive review of this research area is needed. There was a wide variability in studied pregnancy outcomes, observed gestational windows of exposure, observed ambient air pollutants, applied exposure assessment methods and statistical analysis methods Gestational duration, preterm birth, (low) birth weight, and small for gestational age/intrauterine growth restriction were most commonly investigated pregnancy outcomes. Gestational windows of exposure typically included were whole pregnancy period, 1st, 2nd, 3rd trimester, first and last gestational months. Preterm birth was the outcome most extensively studied across various gestational windows, especially at the beginning and at the end of pregnancy. Particulate matter, nitrogen dioxide, ozone, and carbon monoxide were the most commonly used markers of ambient air pollution. Continuous monitoring data were frequently combined with spatially more precisely modelled estimates of exposure. Exposure to particulate matter and ozone over the entire pregnancy was significantly associated with higher risk for preterm birth: the pooled effect estimates were 1.09 (1.03-1.16) per 10 μg/m3 increase in particulate matter with an aerodynamic diameter of 10 µm or less (PM10),1.24 (1.08-1.41) per 10 μg/m3 increase in particulate matter with an aerodynamic diameter of 2.5 µm or less (PM2.5), and 1.03 (1.01-1.04) per 10 ppb increase in ozone. For pregnancy outcomes other than PTB, ranges of observed effect estimates were reported due to smaller number of studies included in each gestational window of exposure. Further research is needed to link the routine pregnancy outcome data with spatially and temporally resolved ambient air pollution data, while adjusting for commonly defined confounders. Methods for assessing exposure to mixtures of pollutants, indoor air pollution exposure, and various other environmental exposures, need to be developed.
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Affiliation(s)
- Petra Klepac
- National institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia.
| | - Igor Locatelli
- University of Ljubljana, Faculty of Pharmacy, Aškerčeva 7, 1000 Ljubljana, Slovenia.
| | - Sara Korošec
- Department of Obstetrics and Gynecology, Reproductive Unit, University Medical Centre Ljubljana, Zaloška 3, 1525 Ljubljana, Slovenia.
| | - Nino Künzli
- Swiss Tropical and Public Health Institute (SwissTPH), Socinstrasse 57, 4002 Basel, Switzerland; University of Basel, Petersplatz 1, 4001 Basel, Switzerland.
| | - Andreja Kukec
- National institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia; University of Ljubljana, Faculty of Medicine, Vrazov trg 2, 1000 Ljubljana, Slovenia.
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15
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Han Y, Ji Y, Kang S, Dong T, Zhou Z, Zhang Y, Chen M, Wu W, Tang Q, Chen T, Wang Y, Xia Y. Effects of particulate matter exposure during pregnancy on birth weight: A retrospective cohort study in Suzhou, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 615:369-374. [PMID: 28988071 DOI: 10.1016/j.scitotenv.2017.09.236] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 09/22/2017] [Accepted: 09/22/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Recent studies have identified that exposure to particulate matter during pregnancy could result in adverse birth outcomes, but the effects of exposure at trimester-specific intervals are inconsistent. OBJECTIVE Our primary goal was to investigate whether particulate matter exposure during pregnancy could affect birth weight and gestational age of neonates. METHODS A retrospective cohort study was conducted to examine the relationship between maternal particulate matter exposure and neonatal birth weight. We collected 14,455 births records linked to hospital admission records (delivery and antenatal) from January 2013 to December 2015 in Suzhou Municipal Hospital. Air monitoring data in the same timeframe were also collected from Suzhou Environmental Protection Agency. The risk of low birth weight due to the exposure to PM2.5 (with median aerodynamic diameter≤2.5μm) and PM10 (with median aerodynamic diameter≤10μm) at each trimester and throughout the entire pregnancy were assessed. Linear regression models were applied and potential confounding factors were adjusted for data analysis. Gestational age, which was another important birth outcome, and its association with maternal particulate matter exposure were also studied. RESULTS The final analysis included 10,915 singleton live births. Using multiple linear regression models, we found that gestational exposure to PM2.5 and PM10 at 10μg/m3 increments in the second trimester led to decreases in birth weight of 4.94g (95% confidence interval: -9.828, -0.046) and 5.65g (95% confidence interval: -10.110, -1.188), respectively. However, gestational age was not significantly associated with maternal particulate matter exposure in term neonates. CONCLUSION These findings indicate that pregnant women might be more susceptible to particulate matter during the second trimester which may lead to decreased neonatal birth weight.
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Affiliation(s)
- Yingying Han
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing 211166, China
| | - Yinwen Ji
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing 211166, China
| | - Suya Kang
- Suzhou Affiliated Hospital of Nanjing Medical University, 26 Daoqian Road, Suzhou 215002, JiangSu Province, China
| | - Tianyu Dong
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing 211166, China
| | - Zhu Zhou
- Department of Pharmaceutics and Medicinal Chemistry, University of the Pacific, Stockton 95211, USA
| | - Yuqing Zhang
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing 211166, China
| | - Minjian Chen
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing 211166, China
| | - Wei Wu
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing 211166, China
| | - Qiuqin Tang
- Nanjing Maternal and Child Health Medical Institute, Nanjing Maternal and Child Health Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing 210004, China
| | - Ting Chen
- Nanjing Maternal and Child Health Medical Institute, Nanjing Maternal and Child Health Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing 210004, China
| | - Yun Wang
- Suzhou Affiliated Hospital of Nanjing Medical University, 26 Daoqian Road, Suzhou 215002, JiangSu Province, China
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing 211166, China.
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16
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Balakrishnan K, Ghosh S, Thangavel G, Sambandam S, Mukhopadhyay K, Puttaswamy N, Sadasivam A, Ramaswamy P, Johnson P, Kuppuswamy R, Natesan D, Maheshwari U, Natarajan A, Rajendran G, Ramasami R, Madhav S, Manivannan S, Nargunanadan S, Natarajan S, Saidam S, Chakraborty M, Balakrishnan L, Thanasekaraan V. Exposures to fine particulate matter (PM 2.5) and birthweight in a rural-urban, mother-child cohort in Tamil Nadu, India. ENVIRONMENTAL RESEARCH 2018; 161:524-531. [PMID: 29227900 DOI: 10.1016/j.envres.2017.11.050] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 11/21/2017] [Accepted: 11/28/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Exposure to PM2.5 (fine particulate matter <less than 2.5µm in aerodynamic diameter) related to ambient and household air pollution has been associated with low birthweight. Few of these studies, however, have been conducted in high exposure settings that are commonly encountered in low and middle income countries (LMICs). OBJECTIVES We examined whether PM2.5 exposures during pregnancy were associated with birthweight in an integrated rural-urban, mother-child cohort in the state of Tamil Nadu, India. METHODS We recruited 1285 pregnant women in the first trimester of pregnancy from primary health care centers and urban health posts and followed them until birth to collect antenatal care data and birthweight. We estimated pregnancy period PM 2.5 exposures through direct serial measurements of 24-h household PM2.5 concentrations, performed across each trimester. Mothers also completed detailed questionnaires to provide data on covariates related to household, socio-economic, demographic and maternal health characteristics. The association between PM2.5 exposures and birth weight was assessed using linear and logistic regression models that controlled for potential confounders. RESULTS A 10-μg/m3 increase in pregnancy period PM2.5 exposures was associated with a 4g (95% CI: 1.08g, 6.76g) decrease in birthweight and 2% increase in prevalence of low birthweight [odds ratio(OR) = 1.02; 95%CI:1.005,1.041] after adjusting for gestational age, infant sex, maternal BMI, maternal age, history of a previous low birth weight child, birth order and season of conception. CONCLUSIONS The study provides some of the first quantitative effects estimates for linking rural-urban PM2.5 exposures and birthweight in India, adding important evidence for this association from high exposure settings in LMICs, that also experience dual health burdens from ambient and household air pollution. Study results also point to the need for considering maternal PM2.5 exposures alongside other risk factors for low birthweight in India.
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Affiliation(s)
- Kalpana Balakrishnan
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India.
| | - Santu Ghosh
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Gurusamy Thangavel
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Sankar Sambandam
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Krishnendu Mukhopadhyay
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Naveen Puttaswamy
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Arulselvan Sadasivam
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Padmavathi Ramaswamy
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Priscilla Johnson
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Rajarajeswari Kuppuswamy
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Durairaj Natesan
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Uma Maheshwari
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Amudha Natarajan
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Gayathri Rajendran
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Rengaraj Ramasami
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Sathish Madhav
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Saraswathy Manivannan
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Srinivasan Nargunanadan
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Srinivasan Natarajan
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Sudhakar Saidam
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Moumita Chakraborty
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Lingeswari Balakrishnan
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
| | - Vijayalakshmi Thanasekaraan
- SRU-ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra University, Chennai, India
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Gong X, Zhan FB, Brender JD, Langlois PH, Lin Y. Validity of the Emission Weighted Proximity Model in estimating air pollution exposure intensities in large geographic areas. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 563-564:478-485. [PMID: 27152989 DOI: 10.1016/j.scitotenv.2016.04.088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 04/12/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Accurate estimates of air pollution exposure intensities are important to support environmental epidemiology analyses that require data covering large geographic areas over multiple years. The Emission Weighted Proximity Model (EWPM) and the National-Scale Air Toxics Assessment (NATA) are two viable approaches for obtaining estimate exposure intensities. The advantages of the EWPM include its simplicity and significantly lower costs of implementation. However, very limited data are available regarding the validity of the results from the EWPM and how these results would fare when compared with those from the NATA. METHODS This study evaluates the validity of the estimated exposure intensities from the EWPM through a correlation analysis with ground monitoring data obtained by the Texas Commission on Environmental Quality (TCEQ). The monitoring data used in the comparison included 27 non-criteria air pollutants at 48 monitoring sites in Texas in 2005. In addition, this study compares the results from the EWPM with those from NATA using the TCEQ data as a gold standard. RESULTS Analysis results suggest that estimated exposure intensities from the EWPM and the NATA were comparable when the intensities from both approaches are used to categorize environmental exposure intensities into different levels in relative terms. CONCLUSION These findings suggest that the EWPM is a valid alternative approach to the NATA in situations where epidemiological analysis requires both environmental data and health outcome data that cover a large geographic area over multiple years.
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Affiliation(s)
- Xi Gong
- Texas State University, Texas Center for Geographic Information Science, Department of Geography, San Marcos, TX 78666, USA.
| | - F Benjamin Zhan
- Texas State University, Texas Center for Geographic Information Science, Department of Geography, San Marcos, TX 78666, USA.
| | - Jean D Brender
- Texas A&M Health Science Center School of Public Health, Department of Epidemiology & Biostatistics, College Station, TX 77843-1266, USA.
| | - Peter H Langlois
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, PO Box 149347, MC 1964, Austin, TX 78714-9347, USA.
| | - Yan Lin
- South Dakota State University, Department of Geography, Brookings, SD 57007, USA.
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Zhu X, Liu Y, Chen Y, Yao C, Che Z, Cao J. Maternal exposure to fine particulate matter (PM2.5) and pregnancy outcomes: a meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2015; 22:3383-96. [PMID: 25163563 DOI: 10.1007/s11356-014-3458-7] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 08/14/2014] [Indexed: 05/04/2023]
Abstract
A growing body of evidence has investigated the association between maternal exposure to PM2.5 (particulate matter with aerodynamic diameter 2.5 μm) during pregnancy and adverse pregnancy outcomes. However, the results of those studies are not consistent. To synthetically quantify the relationship between maternal exposure to PM2.5 during pregnancy and pregnancy outcomes (the change in birth weight, low birth weight (LBW), preterm birth (PTB), small for gestational age (SGA), and stillbirth), a meta-analysis of 25 published observational epidemiological studies that met our selection criteria was conducted. Results suggested a 10 μg/m(3) increase in PM2.5 was positively associated with LBW (odds ratio (OR) = 1.05; 95 % confidence interval (CI), 1.02-1.07), PTB (OR = 1.10; 95 % CI, 1.03-1.18), and SGA (OR = 1.15; 95 % CI, 1.10-1.20) based on entire pregnancy exposure, and pooled estimate of decrease in birth weight was 14.58 g (95 % CI, 9.86-19.31); however, there was no evidence of a statistically significant effect of per 10 μg/m(3) increase in PM2.5 exposure on the risk of stillbirth (OR = 1.18; 95 % CI, 0.69-2.04). With respect to three different gestation periods, no significant risks were found in PTB, stillbirth, and the first trimester on the change of birth weight with a 10 μg/m(3) increase in PM2.5. In this study, a comprehensive quantitative analysis of the results show that PM2.5 can increase the risk of LBW, PTB, and SGA; pregnant women need to take effective measures to reduce PM2.5 exposure.
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Affiliation(s)
- Xiaoxia Zhu
- Department of Occupational and Environmental, School of Public Health, Anhui Medical University, Meishan Road, Hefei, Anhui, China
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Edwards S, Maxson P, Sandberg N, Miranda ML. Air Pollution and Pregnancy Outcomes. MOLECULAR AND INTEGRATIVE TOXICOLOGY 2015. [DOI: 10.1007/978-1-4471-6669-6_3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Lamichhane DK, Leem JH, Lee JY, Kim HC. A meta-analysis of exposure to particulate matter and adverse birth outcomes. ENVIRONMENTAL HEALTH AND TOXICOLOGY 2015; 30:e2015011. [PMID: 26796890 PMCID: PMC4722965 DOI: 10.5620/eht.e2015011] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 11/02/2015] [Indexed: 05/20/2023]
Abstract
OBJECTIVES The objective of this study was to conduct a systematic review to provide summarized evidence on the association between maternal exposure to particulate air pollution and birth weight (BW) and preterm birth (PTB) after taking into consideration the potential confounding effect of maternal smoking. METHODS We systematically searched all published cohort and case-control studies examining BW and PTB association with particulate matter (PM, less than or equal to 2.5μm and 10.0 μm in diameter, PM2.5 and PM10, respectively) from PubMed and Web of Science, from January 1980 to April 2015. We extracted coefficients for continuous BW and odds ratio (OR) for PTB from each individual study, and meta-analysis was used to combine the coefficient and OR of individual studies. The methodological quality of individual study was assessed using a standard protocol proposed by Downs and Black. Forty-four studies met the inclusion criteria. RESULTS In random effects meta-analyses, BW as a continuous outcome was negativelyassociated with 10 μg/m(3) increase in PM10 (-10.31 g; 95% confidence interval [CI], -13.57 to -3.13 g; I-squared=0%, p=0.947) and PM2.5 (-22.17 g; 95% CI, -37.93 to -6.41 g; I-squared=92.3%, p <0.001) exposure during entire pregnancy, adjusted for maternal smoking. A significantly increased risk of PTB per 10 μg/m(3) increase in PM10 (OR, 1.23; 95% CI, 1.04 to 1.41; I-squared=0%, p =0.977) and PM2.5 (OR, 1.14; 95% CI, 1.06 to 1.22; I-squared=92.5%, p <0.001) exposure during entire pregnancy was observed. Effect size of change in BW per 10 μg/m(3) increase in PM tended to report stronger associations after adjustment for maternal smoking. CONCLUSIONS While this systematic review supports an adverse impact of maternal exposure to particulate air pollution on birth outcomes, variation in effects by exposure period and sources of heterogeneity between studies should be further explored.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Jong-Han Leem
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Korea
- Correspondence: Jong-Han Leem 27 Inhang-ro Jung-gu, Incheon 22332,Korea Tel: +82-32-890-3539 Fax: +82-32-890-2859 E-mail:
| | - Ji-Young Lee
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Korea
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Ebisu K, Belanger K, Bell ML. The Association between Airborne PM 2.5 Chemical Constituents and Birth Weight-Implication of Buffer Exposure Assignment. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2014. [PMID: 26594233 DOI: 10.1088/1748-9326/9z8/084007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Several papers reported associations between airborne fine particulate matter (PM2.5) and birth weight, though findings are inconsistent across studies. Conflicting results might be due to (1) different PM2.5 chemical structure across locations, and (2) various exposure assignment methods across studies even among the studies that use ambient monitors to assess exposure. We investigated associations between birth weight and PM2.5 chemical constituents, considering issues arising from choice of buffer size (i.e. distance between residence and pollution monitor). We estimated the association between each pollutant and term birth weight applying buffers of 5 to 30km in Connecticut (2000-2006), in the New England region of the U.S. We also investigated the implication of the choice of buffer size in relation to population characteristics, such as socioeconomic status. Results indicate that some PM2.5 chemical constituents, such as nitrate, are associated with lower birth weight and appear more harmful than other constituents. However, associations vary with buffer size and the implications of different buffer sizes may differ by pollutant. A homogeneous pollutant level within a certain distance is a common assumption in many environmental epidemiology studies, but the validity of this assumption may vary by pollutant. Furthermore, we found that areas close to monitors reflect more minority and lower socio-economic populations, which implies that different exposure approaches may result in different types of study populations. Our findings demonstrate that choosing an exposure method involves key tradeoffs of the impacts of exposure misclassification, sample size, and population characteristics.
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Affiliation(s)
- Keita Ebisu
- School of Forestry and Environmental Studies, Yale University, 195 Prospect Street, New Haven, CT 06511 USA
| | - Kathleen Belanger
- School of Public Health, Yale University, 60 College Street, New Haven, CT 06520 USA
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, 195 Prospect Street, New Haven, CT 06511 USA
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Ebisu K, Belanger K, Bell ML. The Association between Airborne PM 2.5 Chemical Constituents and Birth Weight-Implication of Buffer Exposure Assignment. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2014; 9:084007. [PMID: 26594233 PMCID: PMC4651451 DOI: 10.1088/1748-9326/9/8/084007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Several papers reported associations between airborne fine particulate matter (PM2.5) and birth weight, though findings are inconsistent across studies. Conflicting results might be due to (1) different PM2.5 chemical structure across locations, and (2) various exposure assignment methods across studies even among the studies that use ambient monitors to assess exposure. We investigated associations between birth weight and PM2.5 chemical constituents, considering issues arising from choice of buffer size (i.e. distance between residence and pollution monitor). We estimated the association between each pollutant and term birth weight applying buffers of 5 to 30km in Connecticut (2000-2006), in the New England region of the U.S. We also investigated the implication of the choice of buffer size in relation to population characteristics, such as socioeconomic status. Results indicate that some PM2.5 chemical constituents, such as nitrate, are associated with lower birth weight and appear more harmful than other constituents. However, associations vary with buffer size and the implications of different buffer sizes may differ by pollutant. A homogeneous pollutant level within a certain distance is a common assumption in many environmental epidemiology studies, but the validity of this assumption may vary by pollutant. Furthermore, we found that areas close to monitors reflect more minority and lower socio-economic populations, which implies that different exposure approaches may result in different types of study populations. Our findings demonstrate that choosing an exposure method involves key tradeoffs of the impacts of exposure misclassification, sample size, and population characteristics.
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Affiliation(s)
- Keita Ebisu
- School of Forestry and Environmental Studies, Yale University, 195 Prospect Street, New Haven, CT 06511 USA
| | - Kathleen Belanger
- School of Public Health, Yale University, 60 College Street, New Haven, CT 06520 USA
| | - Michelle L. Bell
- School of Forestry and Environmental Studies, Yale University, 195 Prospect Street, New Haven, CT 06511 USA
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Vinikoor-Imler LC, Davis JA, Meyer RE, Messer LC, Luben TJ. Associations between prenatal exposure to air pollution, small for gestational age, and term low birthweight in a state-wide birth cohort. ENVIRONMENTAL RESEARCH 2014; 132:132-9. [PMID: 24769562 DOI: 10.1016/j.envres.2014.03.040] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 03/24/2014] [Accepted: 03/25/2014] [Indexed: 05/12/2023]
Abstract
A range of health effects, including adverse pregnancy outcomes, have been associated with exposure to ambient concentrations of particulate matter (PM) and ozone (O3). The objective of this study was to determine whether maternal exposure to fine particulate matter (PM2.5) and O3 during pregnancy is associated with the risk of term low birthweight and small for gestational age infants in both single and co-pollutant models. Term low birthweight and small for gestational age were determined using all birth certificates from North Carolina from 2003 to 2005. Ambient air concentrations of PM2.5 and O3 were predicted using a hierarchical Bayesian model of air pollution that combined modeled air pollution estimates from the EPA׳s Community Multi-Scale Air Quality (CMAQ) model with air monitor data measured by the EPA׳s Air Quality System. Binomial regression, adjusted for multiple potential confounders, was performed. In adjusted single-pollutant models for the third trimester, O3 concentration was positively associated with small for gestational age and term low birthweight births [risk ratios for an interquartile range increase in O3: 1.16 (95% CI 1.11, 1.22) for small for gestational age and 2.03 (95% CI 1.80, 2.30) for term low birthweight]; however, inverse or null associations were observed for PM2.5 [risk ratios for an interquartile range increase in PM2.5: 0.97 (95% CI 0.95, 0.99) for small for gestational age and 1.01 (95% CI 0.97, 1.06) for term low birthweight]. Findings were similar in co-pollutant models and linear models of birthweight. These results suggest that O3 concentrations in both urban and rural areas may be associated with an increased risk of term low birthweight and small for gestational age births.
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Affiliation(s)
- Lisa C Vinikoor-Imler
- National Center for Environmental Assessment (NCEA), U.S. Environmental Protection Agency (EPA), 109 T.W. Alexander Drive, Attn: MD B243-01, Research Triangle Park, NC 27711, USA.
| | - J Allen Davis
- National Center for Environmental Assessment (NCEA), U.S. Environmental Protection Agency (EPA), 109 T.W. Alexander Drive, Attn: MD B243-01, Research Triangle Park, NC 27711, USA
| | - Robert E Meyer
- North Carolina Birth Defects Monitoring Program, State Center for Health Statistics, Raleigh, NC 27699, USA
| | - Lynne C Messer
- School of Community Health, College of Urban and Public Affairs, Portland State University, Portland, OR 97207, USA
| | - Thomas J Luben
- National Center for Environmental Assessment (NCEA), U.S. Environmental Protection Agency (EPA), 109 T.W. Alexander Drive, Attn: MD B243-01, Research Triangle Park, NC 27711, USA
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Savitz DA, Bobb JF, Carr JL, Clougherty JE, Dominici F, Elston B, Ito K, Ross Z, Yee M, Matte TD. Ambient fine particulate matter, nitrogen dioxide, and term birth weight in New York, New York. Am J Epidemiol 2014; 179:457-66. [PMID: 24218031 DOI: 10.1093/aje/kwt268] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Building on a unique exposure assessment project in New York, New York, we examined the relationship of particulate matter with aerodynamic diameter less than 2.5 μm and nitrogen dioxide with birth weight, restricting the population to term births to nonsmokers, along with other restrictions, to isolate the potential impact of air pollution on growth. We included 252,967 births in 2008-2010 identified in vital records, and we assigned exposure at the residential location by using validated models that accounted for spatial and temporal factors. Estimates of association were adjusted for individual and contextual sociodemographic characteristics and season, using linear mixed models to quantify the predicted change in birth weight in grams related to increasing pollution levels. Adjusted estimates for particulate matter with aerodynamic diameter less than 2.5 μm indicated that for each 10-µg/m(3) increase in exposure, birth weights declined by 18.4, 10.5, 29.7, and 48.4 g for exposures in the first, second, and third trimesters and for the total pregnancy, respectively. Adjusted estimates for nitrogen dioxide indicated that for each 10-ppb increase in exposure, birth weights declined by 14.2, 15.9, 18.0, and 18.0 g for exposures in the first, second, and third trimesters and for the total pregnancy, respectively. These results strongly support the association of urban air pollution exposure with reduced fetal growth.
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Gray SC, Edwards SE, Schultz BD, Miranda ML. Assessing the impact of race, social factors and air pollution on birth outcomes: a population-based study. Environ Health 2014; 13:4. [PMID: 24476365 PMCID: PMC3922656 DOI: 10.1186/1476-069x-13-4] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 07/31/2013] [Indexed: 05/04/2023]
Abstract
BACKGROUND Both air pollution exposure and socioeconomic status (SES) are important indicators of children's health. Using highly resolved modeled predictive surfaces, we examine the joint effects of air pollution exposure and measures of SES in a population level analysis of pregnancy outcomes in North Carolina (NC). METHODS Daily measurements of particulate matter <2.5 μm in aerodynamic diameter (PM2.5) and ozone (O3) were calculated through a spatial hierarchical Bayesian model which produces census-tract level point predictions. Using multilevel models and NC birth data from 2002-2006, we examine the association between pregnancy averaged PM2.5 and O3, individual and area-based SES indicators, and birth outcomes. RESULTS Maternal race and education, and neighborhood household income were associated with adverse birth outcomes. Predicted concentrations of PM2.5 and O3 were also associated with an additional effect on reductions in birth weight and increased risks of being born low birth weight and small for gestational age. CONCLUSIONS This paper builds on and complements previous work on the relationship between pregnancy outcomes and air pollution exposure by using 1) highly resolved air pollution exposure data; 2) a five-year population level sample of pregnancies; and 3) including personal and areal level measures of social determinants of pregnancy outcomes. Results show a stable and negative association between air pollution exposure and adverse birth outcomes. Additionally, the more socially disadvantaged populations are at a greater risk; controlling for both SES and environmental stressors provides a better understanding of the contributing factors to poor children's health outcomes.
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Affiliation(s)
- Simone C Gray
- U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - Sharon E Edwards
- Children’s Environmental Health Initiative, School of Natural Resources and Environment, University of Michigan, Ann Arbor, Michigan, USA
| | - Bradley D Schultz
- U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - Marie Lynn Miranda
- Children’s Environmental Health Initiative, School of Natural Resources and Environment, University of Michigan, Ann Arbor, Michigan, USA
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
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Gray SC, Edwards SE, Miranda ML. Race, socioeconomic status, and air pollution exposure in North Carolina. ENVIRONMENTAL RESEARCH 2013; 126:152-8. [PMID: 23850144 DOI: 10.1016/j.envres.2013.06.005] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 03/07/2013] [Accepted: 06/13/2013] [Indexed: 05/18/2023]
Abstract
BACKGROUND Although studies suggest that exposure to pollutants is associated with race/ethnicity and socio-economic status (SES), many studies are limited to the geographic regions where monitoring stations are located. OBJECTIVES This study uses modeled predictive surfaces to examine the relationship between air pollution exposure, race/ethnicity, and measures of SES across the entire State of North Carolina. METHODS The daily predictions of particulate matter <2.5 µm in aerodynamic diameter (PM2.5) and ozone (O3) were determined using a spatial model that fused data from two sources: point air monitoring data and gridded numerical output. These daily predicted pollution levels for 2002 were linked with Census data. We examine the relationship between the census-tract level predicted concentration measures, SES, and racial composition. RESULTS SES and race/ethnicity were related to predicted concentrations of both PM2.5 and O3 for census tracts in North Carolina. Lower SES and higher proportion minority population were associated with higher levels of PM2.5. An interquartile range (IQR) increase of median household income reduced the predicted average PM2.5 level by 0.10 µg/m3. The opposite relationship was true for O3. An IQR increase of median household income increased the predicted average O3 measure by 0.11 ppb. CONCLUSIONS The analyses demonstrate that SES and race/ethnicity are related to predicted estimates of PM2.5 and O3 for census tracts in North Carolina. These findings offer a baseline for future exposure modeling work involving SES and air pollution for the entire state and not just among the populations residing near monitoring networks.
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Affiliation(s)
- Simone C Gray
- Children's Environmental Health Initiative, School of Natural Resources and Environment, University of Michigan, Ann Arbor, MI, USA.
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Polichetti G, Capone D, Grigoropoulos K, Tarantino G, Nunziata A, Gentile A. Effects of Ambient Air Pollution on Birth Outcomes: An Overview. CRITICAL REVIEWS IN ENVIRONMENTAL SCIENCE AND TECHNOLOGY 2013. [DOI: 10.1080/10643389.2011.644214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Stieb DM, Chen L, Eshoul M, Judek S. Ambient air pollution, birth weight and preterm birth: a systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2012; 117:100-11. [PMID: 22726801 DOI: 10.1016/j.envres.2012.05.007] [Citation(s) in RCA: 543] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 05/07/2012] [Accepted: 05/16/2012] [Indexed: 05/19/2023]
Abstract
Low birth weight and preterm birth have a substantial public health impact. Studies examining their association with outdoor air pollution were identified using searches of bibliographic databases and reference lists of relevant papers. Pooled estimates of effect were calculated, heterogeneity was quantified, meta-regression was conducted and publication bias was examined. Sixty-two studies met the inclusion criteria. The majority of studies reported reduced birth weight and increased odds of low birth weight in relation to exposure to carbon monoxide (CO), nitrogen dioxide (NO(2)) and particulate matter less than 10 and 2.5 microns (PM(10) and PM(2.5)). Effect estimates based on entire pregnancy exposure were generally largest. Pooled estimates of decrease in birth weight ranged from 11.4 g (95% confidence interval -6.9-29.7) per 1 ppm CO to 28.1g (11.5-44.8) per 20 ppb NO(2), and pooled odds ratios for low birth weight ranged from 1.05 (0.99-1.12) per 10 μg/m(3) PM(2.5) to 1.10 (1.05-1.15) per 20 μg/m(3) PM(10) based on entire pregnancy exposure. Fewer effect estimates were available for preterm birth and results were mixed. Pooled odds ratios based on 3rd trimester exposures were generally most precise, ranging from 1.04 (1.02-1.06) per 1 ppm CO to 1.06 (1.03-1.11) per 20 μg/m(3) PM(10). Results were less consistent for ozone and sulfur dioxide for all outcomes. Heterogeneity between studies varied widely between pollutants and outcomes, and meta-regression suggested that heterogeneity could be partially explained by methodological differences between studies. While there is a large evidence base which is indicative of associations between CO, NO(2), PM and pregnancy outcome, variation in effects by exposure period and sources of heterogeneity between studies should be further explored.
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Affiliation(s)
- David M Stieb
- Environmental Health Science and Research Bureau, Health Canada, 3rd floor, 269 Laurier Ave. W., Ottawa, ON, Canada K1A 0K9.
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Chang HH, Reich BJ, Miranda ML. A spatial time-to-event approach for estimating associations between air pollution and preterm birth. J R Stat Soc Ser C Appl Stat 2012; 62:167-79. [PMID: 24353351 DOI: 10.1111/j.1467-9876.2012.01056.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The paper describes a Bayesian spatial discrete time survival model to estimate the effect of air pollution on the risk of preterm birth. The standard approach treats prematurity as a binary outcome and cannot effectively examine time varying exposures during pregnancy. Time varying exposures can arise either in short-term lagged exposures due to seasonality in air pollution or long-term cumulative exposures due to changes in length of exposure. Our model addresses this challenge by viewing gestational age as time-to-event data where each pregnancy becomes at risk at a prespecified time (e.g. the 28th week). The pregnancy is then followed until either a birth occurs before the 37th week (preterm), or it reaches the 37th week, and a full-term birth is expected. The model also includes a flexible spatially varying baseline hazard function to control for unmeasured spatial confounders and to borrow information across areal units. The approach proposed is applied to geocoded birth records in Mecklenburg County, North Carolina, for the period 2001-2005.We examine the risk of preterm birth that is associated with total cumulative and 4-week lagged exposure to ambient fine particulate matter.
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Malik I, Danek M, Marchwińska-Wyrwał E, Danek T, Wistuba M, Krąpiec M. Scots Pine (Pinus sylvestris L.) Growth Suppression and Adverse Effects on Human Health Due to Air Pollution in the Upper Silesian Industrial District (USID), Southern Poland. WATER, AIR, AND SOIL POLLUTION 2012; 223:3345-3364. [PMID: 22707804 PMCID: PMC3368106 DOI: 10.1007/s11270-012-1114-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Accepted: 02/14/2012] [Indexed: 05/26/2023]
Abstract
Air pollution emissions were not continually monitored in the Upper Silesian Industrial District (USID), southern Poland, and data is only available for the last 20 years. Long-lasting and severe tree ring reductions in pines growing 5-20 km north of the USID area recorded particularly high levels of air pollution emissions in the period 1950-1990. Especially high amounts of reductions and many missing rings were found in the period 1964-1981. At the same time, pines growing 60 km west of the USID do not record deep ring reductions; this proves that the phenomenon is of a regional nature. Increases in infant mortality and lung, bronchial, and tracheal cancer morbidity rates among males were also recorded in the USID during periods of high air pollution. Infant mortality rates increased several years after the tree ring reductions. Therefore, it may be possible to use tree ring reductions as an early indicator of the occurrence of adverse effects on human health.
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Affiliation(s)
- Ireneusz Malik
- Faculty of Earth Sciences, University of Silesia, Będzińska 60, 41-200 Sosnowiec, Poland
| | - Małgorzata Danek
- Faculty of Geology, Geophysics and Environmental Protection, AGH-University of Science and Technology, al. Mickiewicza 30, 30-059 Krakow, Poland
| | - Ewa Marchwińska-Wyrwał
- Department of Environmental Health, Medical University of Silesia, Piekarska 18, 41-902 Bytom, Poland
| | - Tomasz Danek
- Faculty of Geology, Geophysics and Environmental Protection, AGH-University of Science and Technology, al. Mickiewicza 30, 30-059 Krakow, Poland
| | - Małgorzata Wistuba
- Faculty of Earth Sciences, University of Silesia, Będzińska 60, 41-200 Sosnowiec, Poland
| | - Marek Krąpiec
- Faculty of Geology, Geophysics and Environmental Protection, AGH-University of Science and Technology, al. Mickiewicza 30, 30-059 Krakow, Poland
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Vinikoor-Imler LC, Gray SC, Edwards SE, Miranda ML. The effects of exposure to particulate matter and neighbourhood deprivation on gestational hypertension. Paediatr Perinat Epidemiol 2012; 26:91-100. [PMID: 22324494 DOI: 10.1111/j.1365-3016.2011.01245.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Gestational hypertension, pre-eclampsia and eclampsia are conditions that affect the health of both mothers and infants during and after pregnancy. Recent research indicates the importance of considering environmental, social and individual contributors to poor pregnancy outcomes. Our research examined particulate matter (PM) concentrations as one measure of environmental exposure and neighbourhood quality as one measure of the social environment. We used these measures, as well as maternal characteristics, to predict the risk of gestational hypertension (including pre-eclampsia and eclampsia). North Carolina Detailed Birth Record data for 2000-2003 were obtained and geocoded for all singleton births. Levels of PM(10) and PM(2.5) were determined using air quality data from the US Environmental Protection Agency. Information on a woman's residential neighbourhood was determined from 2000 Census data. Modified Poisson regression models clustered by tract were used to examine the associations between PM levels, neighbourhood deprivation and maternal characteristics with gestational hypertension. Analysis was restricted to women residing within 20 km of a PM monitor. Both PM(10) and PM(2.5) were associated with gestational hypertension; the risk ratios for an interquartile range (IQR) increase in exposure were 1.07 [95% confidence interval (CI) 1.04, 1.11] for PM(10) (IQR: 3.92 µg/m(3)) and 1.11 [95% CI 1.08, 1.15] for PM(2.5) (IQR: 2.24 µg/m(3)). Living in a neighbourhood with increased levels of deprivation was also associated with gestational hypertension. Any smoking during pregnancy, younger age and higher level of education were inversely associated with risk of gestational hypertension. Compared with non-Hispanic White women, non-Hispanic Black women were at higher risk of gestational hypertension, whereas Hispanic women were at lower risk. Increased levels of PM and neighbourhood deprivation, as well as certain individual characteristics, were associated with higher risk of gestational hypertension.
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Affiliation(s)
- Lisa C Vinikoor-Imler
- National Center for Environmental Assessment, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
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Miranda ML, Edwards SE, Keating MH, Paul CJ. Making the environmental justice grade: the relative burden of air pollution exposure in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:1755-71. [PMID: 21776200 PMCID: PMC3137995 DOI: 10.3390/ijerph8061755] [Citation(s) in RCA: 147] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 05/06/2011] [Indexed: 11/23/2022]
Abstract
This paper assesses whether the Clean Air Act and its Amendments have been equally successful in ensuring the right to healthful air quality in both advantaged and disadvantaged communities in the United States. Using a method to rank air quality established by the American Lung Association in its 2009 State of the Air report along with EPA air quality data, we assess the environmental justice dimensions of air pollution exposure and access to air quality information in the United States. We focus on the race, age, and poverty demographics of communities with differing levels of ozone and particulate matter exposure, as well as communities with and without air quality information. Focusing on PM2.5 and ozone, we find that within areas covered by the monitoring networks, non-Hispanic blacks are consistently overrepresented in communities with the poorest air quality. The results for older and younger age as well as poverty vary by the pollution metric under consideration. Rural areas are typically outside the bounds of air quality monitoring networks leaving large segments of the population without information about their ambient air quality. These results suggest that substantial areas of the United States lack monitoring data, and among areas where monitoring data are available, low income and minority communities tend to experience higher ambient pollution levels.
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Affiliation(s)
- Marie Lynn Miranda
- Children’s Environmental Health Initiative, Nicholas School of the Environment, Duke University, Box 90328, Durham, NC 27708, USA; E-Mails: (S.E.E.); (C.J.P.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-919-613-8723; Fax: +1-919-684-3227
| | - Sharon E. Edwards
- Children’s Environmental Health Initiative, Nicholas School of the Environment, Duke University, Box 90328, Durham, NC 27708, USA; E-Mails: (S.E.E.); (C.J.P.)
| | - Martha H. Keating
- Keating Environmental, 7508 Thunder Mountain, Efland, NC 27243, USA; E-Mail:
| | - Christopher J. Paul
- Children’s Environmental Health Initiative, Nicholas School of the Environment, Duke University, Box 90328, Durham, NC 27708, USA; E-Mails: (S.E.E.); (C.J.P.)
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Gray SC, Gelfand AE, Miranda ML. Hierarchical spatial modeling of uncertainty in air pollution and birth weight study. Stat Med 2011; 30:2187-98. [DOI: 10.1002/sim.4234] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Accepted: 02/15/2011] [Indexed: 11/10/2022]
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