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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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Outdoor Air Pollution and Childhood Respiratory Disease: The Role of Oxidative Stress. Int J Mol Sci 2023; 24:ijms24054345. [PMID: 36901776 PMCID: PMC10001616 DOI: 10.3390/ijms24054345] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
The leading mechanisms through which air pollutants exert their damaging effects are the promotion of oxidative stress, the induction of an inflammatory response, and the deregulation of the immune system by reducing its ability to limit infectious agents' spreading. This influence starts in the prenatal age and continues during childhood, the most susceptible period of life, due to a lower efficiency of oxidative damage detoxification, a higher metabolic and breathing rate, and enhanced oxygen consumption per unit of body mass. Air pollution is involved in acute disorders like asthma exacerbations and upper and lower respiratory infections, including bronchiolitis, tuberculosis, and pneumoniae. Pollutants can also contribute to the onset of chronic asthma, and they can lead to a deficit in lung function and growth, long-term respiratory damage, and eventually chronic respiratory illness. Air pollution abatement policies, applied in the last decades, are contributing to mitigating air quality issues, but more efforts should be encouraged to improve acute childhood respiratory disease with possible positive long-term effects on lung function. This narrative review aims to summarize the most recent studies on the links between air pollution and childhood respiratory illness.
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Wu IP, Liao SL, Lai SH, Wong KS. The Respiratory Impacts of Air Pollution in Children: Global and Domestic (Taiwan) Situation. Biomed J 2021; 45:88-94. [PMID: 34929408 PMCID: PMC9133359 DOI: 10.1016/j.bj.2021.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 11/08/2022] Open
Abstract
Air pollution is a global issue that threatens the health of human beings. Epidemiologic reports have shown air pollution exposures to result in millions of deaths annually. Infancy and childhood, the period of organ and lung development, is most susceptible to these environmental hazards; as a result, the risks of respiratory diseases are increased after air pollution exposure. These pollutants can originate from indoor and ambient environment, presenting as vapor or particles, and differ in chemical compositions. This review will give brief introduction to various major pollutants and their origin, as well the correlation with respiratory diseases after exposure. We will also present several current facts in domestic area (Taiwan), regarding the status of local air-pollution, and discuss its impacts on pediatric respiratory health. This report will provide useful information for clinicians and offer advice for policy makers to develop public health guidelines of pollution control and prevention.
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Affiliation(s)
- I-Ping Wu
- Departments of Respiratory Therapy, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Chang Gung University, Taoyuan, Taiwan
| | - Sui-Ling Liao
- Division of Pediatric Pulmonology, Department of Pediatric, Chang Gung Memorial Hospital, Keelung, Taiwan; Chang Gung University, Taoyuan, Taiwan
| | - Shen-Hao Lai
- Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Chang Gung University, Taoyuan, Taiwan.
| | - Kin-Sun Wong
- Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Giudice LC, Llamas-Clark EF, DeNicola N, Pandipati S, Zlatnik MG, Decena DCD, Woodruff TJ, Conry JA. Climate change, women's health, and the role of obstetricians and gynecologists in leadership. Int J Gynaecol Obstet 2021; 155:345-356. [PMID: 34694628 PMCID: PMC9298078 DOI: 10.1002/ijgo.13958] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/16/2021] [Accepted: 09/28/2021] [Indexed: 11/07/2022]
Abstract
Climate change is one of the major global health threats to the world's population. It is brought on by global warming due in large part to increasing levels of greenhouse gases resulting from human activity, including burning fossil fuels (carbon dioxide), animal husbandry (methane from manure), industry emissions (ozone, nitrogen oxides, sulfur dioxide), vehicle/factory exhaust, and chlorofluorocarbon aerosols that trap extra heat in the earth's atmosphere. Resulting extremes of weather give rise to wildfires, air pollution, changes in ecology, and floods. These in turn result in displacement of populations, family disruption, violence, and major impacts on water quality and availability, food security, public health and economic infrastructures, and limited abilities for civil society to maintain citizen safety. Climate change also has direct impacts on human health and well-being. Particularly vulnerable populations are affected, including women, pregnant women, children, the disabled, and the elderly, who comprise the majority of the poor globally. Additionally, the effects of climate change disproportionally affect disadvantaged communities, including low income and communities of color, and lower-income countries that are at highest risk of adverse impacts when disasters occur due to inequitable distribution of resources and their socioeconomic status. The climate crisis is tilting the risk balance unfavorably for women's sexual and reproductive health and rights as well as newborn and child health. Obstetrician/gynecologists have the unique opportunity to raise awareness, educate, and advocate for mitigation strategies to reverse climate change affecting our patients and their families. This article puts climate change in the context of women's reproductive health as a public health issue, a social justice issue, a human rights issue, an economic issue, a political issue, and a gender issue that needs our attention now for the health and well-being of this and future generations. FIGO joins a broad coalition of international researchers and the medical community in stating that the current climate crisis presents an imminent health risk to pregnant people, developing fetuses, and reproductive health, and recognizing that we need society-wide solutions, government policies, and global cooperation to address and reduce contributors, including fossil fuel production, to climate change.
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Affiliation(s)
- Linda C Giudice
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Erlidia F Llamas-Clark
- Department of Obstetrics and Gynecology, Division of Ultrasound, University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Nathaniel DeNicola
- Department of Obstetrics and Gynecology, Johns Hopkins Health System, Washington, District of Columbia, USA
| | - Santosh Pandipati
- Obstetrix Medical Group/Mednax (Maternal-Fetal Medicine), Campbell, California, USA
| | - Marya G Zlatnik
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal Fetal Medicine, Program on Reproductive Health and the Environment, Environmental Research and Translation for Health (EaRTH) Center, University of California, San Francisco, San Francisco, California, USA
| | - Ditas Cristina D Decena
- Departments of Anatomy, Clinical Epidemiology and Public Health International, University of Santo Tomas, Manila, Philippines
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Environmental Research and Translation for Health (EaRTH) Center, University of California, San Francisco, San Francisco, California, USA
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Jiang W, Liu Z, Ni B, Xie W, Zhou H, Li X. Independent and interactive effects of air pollutants and ambient heat exposure on congenital heart defects. Reprod Toxicol 2021; 104:106-113. [PMID: 34311057 DOI: 10.1016/j.reprotox.2021.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/10/2021] [Accepted: 07/19/2021] [Indexed: 12/16/2022]
Abstract
Accumulating studies have been focused on the independent effects of air pollutants and ambient heat exposure on congenital heart defects (CHDs) but with inconsistent results, and their interactive effect remains unclear. A case-control study including 921 cases and 9210 controls was conducted in Changsha, China in warm season in 2015-2018. The gravidas were assigned monthly averages of daily air pollutants and daily maximum temperature using the nearest monitoring station method and city-wide average method, respectively, during the first trimester of pregnancy. Multivariate logistic regression models were used to estimate the independent effects of each air pollutant and different ambient heat exposure indicators. Their additive joint effects were quantified using attribute proportions of interaction (API). Increasing SO2 consistently increased the risk of CHDs in the first trimester of pregnancy, with aORs ranging from 1.78 to 2.04. CO, NO2 and PM2.5 exposure in the first month of pregnancy, and O3 exposure in the second and third month of pregnancy were also associated with elevated risks of CHDs, with aORs ranging from 1.04 to 1.15. Depending on the ambient heat exposure indicator used, air pollutants showed more apparent synergistic effects (API > 0) with less and moderately intense heat exposure. Maternal exposure to CO, NO2, SO2, PM2.5 and O3 during early pregnancy increased risk of CHDs, and ambient heat exposure may enhance these effects. Our findings help to understand the interactive effect of air pollution with ambient heat exposure on CHDs, which is of vital public health significance.
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Affiliation(s)
- Wen Jiang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
| | - Zhiyu Liu
- Maternal and Child Health Care Hospital of Hunan Province, Changsha, China.
| | - Bin Ni
- Maternal and Child Health Care Hospital of Hunan Province, Changsha, China.
| | - Wanqin Xie
- Maternal and Child Health Care Hospital of Hunan Province, Changsha, China.
| | - Haiyan Zhou
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
| | - Xingli Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
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Hung TH, Hsu TY, Tung TH, Tsai CC, Ou CY, Chung FF, Wan GH. The association between maternal exposure to outdoor air pollutants, inflammatory response, and birth weight in healthy women. ENVIRONMENTAL RESEARCH 2021; 196:110921. [PMID: 33639148 DOI: 10.1016/j.envres.2021.110921] [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: 10/26/2020] [Revised: 02/18/2021] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
Increased maternal inflammatory response has been noted in women with pregnancies complicated by preterm birth and small-for-gestational age infants. However, the association between gestational exposure to air pollutants, maternal inflammatory response, and fetal growth remains unclear. In this study, we aimed to investigate the association between exposure to air pollutants during pregnancy and the concentration of inflammatory indicators in maternal and fetal circulations, as well as fetal growth. We recruited 108 healthy pregnant women living in northern (n = 55) and southern (n = 53) areas of Taiwan and prospectively collected information of exposure to outdoor air pollutants throughout gestation. Maternal blood from each trimester and umbilical cord blood after delivery were collected and analyzed for inflammatory indicators including high sensitivity C-reactive protein (hs-CRP), interleukin-1β (IL-1β), and tumor necrosis factor (TNF)-α. Our results showed that exposure to particulate matter less than or equal to 10 μm (PM10) and ozone (O3) during the first trimester had a direct effect on reduction of birth weight, but the direct effect of PM10 mediated by hs-CRP and the direct effect of O3 mediated by TNF-α on fetal birth weight were not significant. Exposure to PM10 and PM2.5 during the second and third trimesters also directly affected birth weight. Furthermore, exposure to sulfur dioxide (SO2) caused changes in the concentrations of TNF-α in maternal blood during the second trimester, which subsequently resulted in reduced fetal weight. Together, these results indicate that exposure to air pollutants may cause both direct and indirect effects on the reduction of fetal weight.
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Affiliation(s)
- Tai-Ho Hung
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Te-Yao Hsu
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Tao-Hsin Tung
- Department of Medical Research and Education, Cheng-Hsin General Hospital, Taipei, Taiwan
| | - Ching-Chang Tsai
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chia-Yu Ou
- Department of Obstetrics, Po-Zen Hospital, Kaohsiung, Taiwan
| | - Fen-Fang Chung
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Department of Nursing, Linkuo Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Gwo-Hwa Wan
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan; Center for Environmental Sustainability and Human Health, Ming Chi University of Technology, Taishan, New Taipei, Taiwan.
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Li C, Yang M, Zhu Z, Sun S, Zhang Q, Cao J, Ding R. Maternal exposure to air pollution and the risk of low birth weight: A meta-analysis of cohort studies. ENVIRONMENTAL RESEARCH 2020; 190:109970. [PMID: 32763280 DOI: 10.1016/j.envres.2020.109970] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/07/2020] [Accepted: 07/16/2020] [Indexed: 05/14/2023]
Abstract
Previous studies have evaluated the relationship between prenatal air pollution exposure and low birth weight, but the results are inconsistent. The purpose of this meta-analysis is to quantitatively analyze the relationship between maternal air pollutant exposure and low birth weight (LBW). PubMed and Web of Science databases were searched to obtain the studies on the relationship between the prenatal exposure of air pollutants and LBW that published as of June 2020. The pooled effects of air pollutant exposure and LBW were calculated using random-effect model (for studies with significant heterogeneity) or fixed-effect model (for studies without significant heterogeneity). Totally, 54 studies were included in this meta-analysis. The pooled effect of PM2.5, PM10, NO2, CO, SO2, and O3 exposure on LBW were 1.081 (95% CI: 1.043, 1.120), 1.053 (95% CI: 1.030, 1.076), 1.030 (95% CI: 1.008, 1.053), 1.007 (95% CI: 1.001, 1.014), 1.125 (95% CI: 1.017, 1.244), and 1.045 (95% CI: 1.005, 1.086), respectively. NO2 (per 10 ppb increase) and CO (per 100 ppb increase) exposure in the first trimester were positively correlated with LBW, of which the pooled effect was 1.022 (95% CI: 1.009, 1. 035) and 1.008 (95% CI: 1.004, 1.012), respectively. PM2.5 (per 10 μg/m3 increase) exposure in the third trimester significantly affected the LBW, of which the pooled effect was 1.053 (95% CI: 1.010, 1.097). In addition, PM10 (per 10 μg/m3 increase) exposure in the second trimester also significantly affected the LBW, with the pooled effect of 1.011 (95% CI: 1.005, 1.017). Prenatal exposure of the major air pollutants during the entire pregnancy could increase the risk of LBW, while the susceptible window of the pollutants varied.
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Affiliation(s)
- Changlian Li
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Mei Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Zijian Zhu
- Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Shu Sun
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Qi Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Jiyu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China; Department of Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Rui Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
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Tsamou M, Nawrot TS, Carollo RM, Trippas AJ, Lefebvre W, Vanpoucke C, Vrijens K. Prenatal particulate air pollution exposure and expression of the miR-17/92 cluster in cord blood: Findings from the ENVIRONAGE birth cohort. ENVIRONMENT INTERNATIONAL 2020; 142:105860. [PMID: 32599355 DOI: 10.1016/j.envint.2020.105860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/27/2020] [Accepted: 05/29/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Air pollution exposure during pregnancy is an important environmental health issue. Epigenetics mediate the effects of prenatal exposure and could increase disease predisposition in later life. The oncogenic miR-17/92 cluster is involved in normal development and disease. OBJECTIVES Here, for the first time the potential prenatal effects of particulate matter with a diameter<2.5 μm (PM2.5) exposure on expression of the miR-17/92 cluster in cord blood are explored. METHODS In 370 mother-newborn pairs from the ENVIRONAGE birth cohort, expression of three members of the miR-17/92 cluster was measured in cord blood by qRT-PCR. Expression of C-MYC and CDKN1A, a cluster activator and a target gene, respectively, was also analyzed. Multivariable linear regression models were used to associate the relative m(i)RNA expression with prenatal PM2.5 exposure. RESULTS PM2.5 exposure averaged (10th-90th percentile) 11.7 (9.0-14.4) µg/m3 over the entire pregnancy. In cord blood, miR-17 and miR-20a showed a -45.0% (95%CI: -55.9 to -31.4, p < 0.0001) and a -33.7% (95%CI: -46.9 to -17.2, p = 0.0003), decrease in expression in association with first trimester PM2.5 exposure, and a -32.5% (95%CI: -45.6 to -16.3, p = 0.0004) and -23.3% (95%CI: -38.1 to -4.8, p = 0.02), respectively, decrease in expression in association with PM2.5 exposure during the entire pregnancy. In association with third trimester PM2.5 exposure, a reduction of -25.8% (95%CI: -40.2 to -8.0, p = 0.007) and -14.2% (95%CI: -27.7 to 1.9, p = 0.08), for miR-20a and miR-92a expression, respectively, was identified. Only miR-92a expression (-15.7%, 95%CI: -27.3 to -2.4, p = 0.02) was associated with PM2.5 exposure during the last month of pregnancy. C-MYC expression was downregulated in cord blood in association with prenatal PM2.5 exposure during the first trimester and the entire pregnancy, in the adjusted model. DISCUSSION Lower expression levels of the miR-17/92 cluster in cord blood in association with increased prenatal PM2.5 exposure were observed. Whether this oncogenic microRNA cluster plays a role in trans-placental carcinogenesis remains to be elucidated.
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Affiliation(s)
- Maria Tsamou
- Center for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Tim S Nawrot
- Center for Environmental Sciences, Hasselt University, Hasselt, Belgium; Department of Public Health, Environment & Health Unit, Leuven University (KU Leuven), Leuven, Belgium
| | | | - Ann-Julie Trippas
- Center for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Wouter Lefebvre
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | - Karen Vrijens
- Center for Environmental Sciences, Hasselt University, Hasselt, Belgium.
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Interaction of Air Pollutants and Meteorological Factors on Birth Weight in Shenzhen, China. Epidemiology 2020; 30 Suppl 1:S57-S66. [PMID: 31181007 DOI: 10.1097/ede.0000000000000999] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND This study aimed to assess if air pollutants and meteorological factors synergistically affect birth outcomes in Shenzhen, China. METHODS A total of 1,206,158 singleton live births between 2005 and 2012 were identified from a birth registry database. Daily average measurements of particulate matter ≤10 µm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ambient air temperature (T), and dew point temperature (Td), a marker of humidity, were collected. Multivariable logistic regression models were used to evaluate associations between air pollution and small for gestational age (SGA), and full-term low birth weight (TLBW). We classified births into those conceived in the warm (May-October) and cold seasons (November-April) and then estimated interactions between air pollutants and meteorological factors. RESULTS An interquartile range (IQR) increase in PM10 exposure during the first trimester (23.1 µg/m) and NO2 during both the first and second trimesters (15.1 and 13.4 µg/m) was associated with SGA and TLBW risk; odds ratios ranged from 1.01 (95% confidence interval [CI] = 1.00, 1.02) to 1.09 (1.07, 1.12). We observed interactive effects of both air temperature and humidity on PM10 and SGA for newborns conceived in the warm season. Each IQR increase in PM10 (11.1 µg/m) increased SGA risk by 90% (95% CI = 19%, 205%), 29% (23, 34%), 61% (10, 38%), and 26% (21, 32%) when T < 5th percentile, 5th < T < 95th percentile, Td < 5th percentile, and 5th < Td < 95th percentile, respectively. CONCLUSIONS Our study found evidence of an interactive effect of air temperature and humidity on the relationship between PM10 exposure and SGA among newborns conceived in the warm season (May-October). Relatively low air temperature or humidity exacerbated the effects of PM10.
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Lu C, Zhang W, Zheng X, Sun J, Chen L, Deng Q. Combined effects of ambient air pollution and home environmental factors on low birth weight. CHEMOSPHERE 2020; 240:124836. [PMID: 31561165 DOI: 10.1016/j.chemosphere.2019.124836] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/29/2019] [Accepted: 09/10/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Low birth weight (LBW) remains a major public health problem worldwide, yet its crucial environmental risk factors are still unclear. OBJECTIVE To examine the association between LBW (term and preterm LBW) and prenatal exposure to ambient air pollution and home environmental factors as well as their combination, in order to identify critical time window for exposure and key outdoor and indoor factors in LBW development. METHODS A cohort study of 3509 preschool children was performed in Changsha, China during the period 2011-2012. A questionnaire was conducted to survey each child's birth outcome and each mother's exposure to home environmental factors including parental smoking, new furniture, redecoration, mold/damp stains, window pane condensation, and household pets during pregnancy. Maternal exposure to inhalable particulate matter (PM10), industrial air pollutant (SO2), and traffic air pollutant (NO2) was estimated during different time windows of gestation, including conception month, three trimesters, birth month, and whole gestation. Associations of term and preterm LBW with ambient air pollutants and home environmental factors were assessed by multiple logistic regression models in terms of odds ratio (OR) with 95% confidence interval (CI). RESULTS Term LBW (TLBW) was significantly associated with exposure to ambient PM10 during pregnancy, with OR (95% CI) = 1.47 (1.00-2.14) for per IQR increase after adjustment for the covariates and home environmental factors. Specifically, we identified the significant association in early phase of pregnancy including conception month (1.90, 1.09-3.30) and the first trimester (1.72, 1.10-2.69). We further found that TLBW was significantly related with parental smoking at home, OR (95% CI) = 2.17 (1.09-4.33). However, no association was observed for preterm LBW (PLBW). The TLBW risk of ambient air pollution and home environmental factors was independent each other and hence the combined exposure to ambient PM10 and indoor parental smoking caused the highest risk. Sensitivity analysis suggested that foetus with younger mothers were significantly more susceptible to risk of indoor parental smoking, while those with smaller house and cockroaches were more sensitive to risk of outdoor PM10 exposure. CONCLUSION Prenatal exposure to combined outdoor and indoor air pollution, particularly in critical window(s) during early pregnancy, significantly increases the risk of term LBW.
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, China; Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University, Changsha, China.
| | - Weishe Zhang
- Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University, Changsha, China; Department of Obstetrics, XiangYa Hospital, Central South University, Changsha, China
| | - Xiangrong Zheng
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China
| | - Jingchi Sun
- Department of Obstetrics, XiangYa Hospital, Central South University, Changsha, China
| | - Lv Chen
- XiangYa School of Public Health, Central South University, Changsha, China
| | - Qihong Deng
- XiangYa School of Public Health, Central South University, Changsha, China; Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University, Changsha, China; School of Architecture and Art, Central South University, Changsha, China.
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Li R, Hopke PK, Dozier A, Thurston SW, Thevenet-Morrison K, Croft D, Masiol M, Squizzato S, Chalupa D, Rich DQ. Term birth weight and ambient air pollutant concentrations during pregnancy, among women living in Monroe County, New York. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:500-509. [PMID: 30940881 PMCID: PMC6592743 DOI: 10.1038/s41370-019-0131-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 02/23/2019] [Accepted: 02/23/2019] [Indexed: 06/02/2023]
Abstract
Increased ambient air pollutant concentrations during pregnancy have been associated with reduced birth weight, but the etiologically relevant pregnancy time window(s) is/are unclear. In 76,500 singleton births in Monroe County, NY (2005-2016), who were 37-42 gestational weeks at delivery, we used generalized linear models to regress term birth weight against mean gestational month pollutant concentrations, adjusting for mean temperature, and maternal, infant, and medical service use characteristics. Overall, there were no clear patterns of term birth weight change associated with increased concentrations of any pollutant across gestational months. However, among Hispanic women only, increases in all pollutants, except O3, in multiple gestational months, were associated with decreased term birth weight. Each 3.25 µg/m3 increase in PM2.5 concentration in the 6th gestational month was associated with a -20.4 g (95% CI = -34.0, -6.8) reduction in term birth weight among Hispanic women, but a 4.1 g (95% CI = -2.5, 10.8) increase among non-Hispanic mothers (p for interaction < 0.001). Although ambient air pollutant concentrations during pregnancy were not associated with reduced term birth weight among women of all ethnicities living in Monroe County, this observed association in Hispanic mothers may be a result of less exposure misclassification and bias (due to closer residential proximity to the monitoring site).
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Affiliation(s)
- Rui Li
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Philip K Hopke
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Ann Dozier
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Sally W Thurston
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Kelly Thevenet-Morrison
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Daniel Croft
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Mauro Masiol
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Stefania Squizzato
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - David Chalupa
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - David Q Rich
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA.
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA.
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12
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Environmental Contaminants Exposure and Preterm Birth: A Systematic Review. TOXICS 2019; 7:toxics7010011. [PMID: 30832205 PMCID: PMC6468584 DOI: 10.3390/toxics7010011] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/04/2019] [Accepted: 02/25/2019] [Indexed: 12/31/2022]
Abstract
Preterm birth is an obstetric condition associated with a high risk of infant mortality and morbidities in both the neonatal period and later in life, which has also a significant public health impact because it carries an important societal economic burden. As in many cases the etiology is unknown, it is important to identify environmental factors that may be involved in the occurrence of this condition. In this review, we report all the studies published in PubMed and Scopus databases from January 1992 to January 2019, accessible as full-text articles, written in English, including clinical studies, original studies, and reviews. We excluded articles not written in English, duplicates, considering inappropriate populations and/or exposures or irrelevant outcomes and patients with known risk factors for preterm birth (PTB). The aim of this article is to identify and summarize the studies that examine environmental toxicants exposure associated with preterm birth. This knowledge will strengthen the possibility to develop strategies to reduce the exposure to these toxicants and apply clinical measures for preterm birth prevention.
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13
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Chen G, Guo Y, Abramson MJ, Williams G, Li S. Exposure to low concentrations of air pollutants and adverse birth outcomes in Brisbane, Australia, 2003-2013. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 622-623:721-726. [PMID: 29223898 DOI: 10.1016/j.scitotenv.2017.12.050] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 12/04/2017] [Accepted: 12/04/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND It's unclear whether exposures to low-level air pollution have adverse effects on birth outcomes, and which trimester-specific pregnant exposure is sensitive. OBJECTIVES To investigate the effects of maternal exposure during each trimester and the whole pregnancy to particles with aerodynamic diameter<2.5μm (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) on preterm birth (PTB) and low birth weight (LBW). METHODS Daily data on birth records, air quality, and weather conditions were collected in Brisbane, Australia during 2003-2013. Mean concentrations of air pollutants were calculated for each trimester of pregnancy. Cox proportional hazards models were used to examine the associations between air pollution and birth outcomes. Multi-pollutant models and stratified analyses by ambient temperature were performed. RESULTS Exposures to PM2.5, SO2, NO2, and O3 during the whole pregnancy were associated with increased risk of PTB [IQR HRs (hazard ratios with an interquartile range increase in air pollutants) and 95% confidence intervals (CIs): 1.05 (1.02, 1.08), 1.12 (1.09, 1.16), 1.07 (1.01, 1.13), and 1.13 (1.10, 1.16), respectively] and LBW [IQR HRs and 95% CIs: 1.06 (1.02, 1.10), 1.12 (1.08, 1.16), 1.11 (1.03, 1.18), and 1.13 (1.09, 1.17), respectively]. Highest HRs were observed during trimester 3, and lowest in trimester 1. For each air pollutant, stronger effects on PTB and LBW were present for exposure to low and moderate temperatures than exposure to high ambient temperature. CONCLUSIONS Exposures to low-level air pollutants are related to adverse birth outcomes. More effective policies for air quality control could contribute to improving neonatal health.
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Affiliation(s)
- Gongbo Chen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Gail Williams
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
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14
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Koman PD, Hogan KA, Sampson N, Mandell R, Coombe CM, Tetteh MM, Hill-Ashford YR, Wilkins D, Zlatnik MG, Loch-Caruso R, Schulz AJ, Woodruff TJ. Examining Joint Effects of Air Pollution Exposure and Social Determinants of Health in Defining "At-Risk" Populations Under the Clean Air Act: Susceptibility of Pregnant Women to Hypertensive Disorders of Pregnancy. WORLD MEDICAL & HEALTH POLICY 2018; 10:7-54. [PMID: 30197817 PMCID: PMC6126379 DOI: 10.1002/wmh3.257] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Pregnant women are uniquely susceptible to adverse effects of air pollution exposure due to vulnerabilities and health consequences during pregnancy (e.g., hypertensive disorders of pregnancy [HDP]) compared to the general population. Because the Clean Air Act (CAA) creates a duty to protect at-risk groups, the regulatory assessment of at-risk populations has both policy and scientific foundations. Previously, pregnant women have not been specially protected in establishing the margin of safety for the ozone and particulate matter (PM) standards. Due to physiological changes, pregnant women can be at greater risk of adverse effects of air pollution and should be considered an at-risk population. Women with preexisting conditions, women experiencing poverty, and groups that suffer systematic discrimination may be particularly susceptible to cardiac effects of air pollutants during pregnancy. We rigorously reviewed 11 studies of over 1.3 million pregnant women in the United States to characterize the relationship between ozone or PM exposure and HDP. Findings were generally mixed, with a few studies reporting a joint association between ozone or PM and social determinants or pre-existing chronic health conditions related to HDP. Adequate evidence associates exposure to PM with an adverse effect of HDP among pregnant women not evident among non-gravid populations.
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Affiliation(s)
- Patricia D Koman
- University of Michigan School of Public Health, Environmental Health Sciences Department in Ann Arbor, Michigan
| | - Kelly A Hogan
- University of Michigan School of Public Health, Environmental Health Sciences Department in Ann Arbor, Michigan, and presently a research fellow in the Department of Biochemistry and Molecular Biology and the Robert and Arlene Kogod Center on Aging at Mayo Clinic, Rochester, Minnesota
| | - Natalie Sampson
- University of Michigan-Dearborn, Department of Health & Human Services in Dearborn, Michigan
| | - Rebecca Mandell
- Arbor Research Collaborative for Health in Ann Arbor, Michigan
| | - Chris M Coombe
- University of Michigan School of Public Health, Department of Health Behavior & Health Education in Ann Arbor, Michigan
| | - Myra M Tetteh
- University of Michigan School of Public Health, Department of Health Behavior & Health Education in Ann Arbor, Michigan
| | | | | | - Marya G Zlatnik
- University of California San Francisco, Department of Obstetrics, Gynecology and Reproductive Sciences in San Francisco, California
| | - Rita Loch-Caruso
- University of Michigan School of Public Health, Environmental Health Sciences Department and director of the Michigan Center on Lifestage Environmental Exposures and Disease and director of the Environmental Toxicology and Epidemiology Program in Ann Arbor, Michigan
| | - Amy J Schulz
- Department of Health Behavior and Health Education, associate director for the Center for Research on Ethnicity, Culture and Health, and co-lead for the Community Engagement Core for the Michigan Center on Lifestage Environmental Exposures and Disease at the University of Michigan School of Public Health
| | - Tracey J Woodruff
- University of California, San Francisco in the Department of Obstetrics, Gynecology, and Reproductive Sciences and Philip R. Lee Institute for Health Policy Studies and the director of the Program on Reproductive Health and the Environment in San Francisco, California
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15
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Douglas P, Freni-Sterrantino A, Leal Sanchez M, Ashworth DC, Ghosh RE, Fecht D, Font A, Blangiardo M, Gulliver J, Toledano MB, Elliott P, de Hoogh K, Fuller GW, Hansell AL. Estimating Particulate Exposure from Modern Municipal Waste Incinerators in Great Britain. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2017; 51:7511-7519. [PMID: 28621543 PMCID: PMC6117747 DOI: 10.1021/acs.est.6b06478] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 05/04/2017] [Accepted: 05/08/2017] [Indexed: 05/21/2023]
Abstract
Municipal Waste Incineration (MWI) is regulated through the European Union Directive on Industrial Emissions (IED), but there is ongoing public concern regarding potential hazards to health. Using dispersion modeling, we estimated spatial variability in PM10 concentrations arising from MWIs at postcodes (average 12 households) within 10 km of MWIs in Great Britain (GB) in 2003-2010. We also investigated change points in PM10 emissions in relation to introduction of EU Waste Incineration Directive (EU-WID) (subsequently transposed into IED) and correlations of PM10 with SO2, NOx, heavy metals, polychlorinated dibenzo-p-dioxins/furan (PCDD/F), polycyclic aromatic hydrocarbon (PAH) and polychlorinated biphenyl (PCB) emissions. Yearly average modeled PM10 concentrations were 1.00 × 10-5 to 5.53 × 10-2 μg m-3, a small contribution to ambient background levels which were typically 6.59-2.68 × 101 μg m-3, 3-5 orders of magnitude higher. While low, concentration surfaces are likely to represent a spatial proxy of other relevant pollutants. There were statistically significant correlations between PM10 and heavy metal compounds (other heavy metals (r = 0.43, p = <0.001)), PAHs (r = 0.20, p = 0.050), and PCBs (r = 0.19, p = 0.022). No clear change points were detected following EU-WID implementation, possibly as incinerators were operating to EU-WID standards before the implementation date. Results will be used in an epidemiological analysis examining potential associations between MWIs and health outcomes.
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Affiliation(s)
- Philippa Douglas
- UK
Small Area Health Statistics Unit, MRC-PHE Centre for Environment
and Health, Imperial College London, London W2 1PG, United Kingdom
| | - Anna Freni-Sterrantino
- UK
Small Area Health Statistics Unit, MRC-PHE Centre for Environment
and Health, Imperial College London, London W2 1PG, United Kingdom
| | - Maria Leal Sanchez
- UK
Small Area Health Statistics Unit, MRC-PHE Centre for Environment
and Health, Imperial College London, London W2 1PG, United Kingdom
| | - Danielle C. Ashworth
- UK
Small Area Health Statistics Unit, MRC-PHE Centre for Environment
and Health, Imperial College London, London W2 1PG, United Kingdom
| | - Rebecca E. Ghosh
- UK
Small Area Health Statistics Unit, MRC-PHE Centre for Environment
and Health, Imperial College London, London W2 1PG, United Kingdom
| | - Daniela Fecht
- UK
Small Area Health Statistics Unit, MRC-PHE Centre for Environment
and Health, Imperial College London, London W2 1PG, United Kingdom
| | - Anna Font
- Environment
Research Group, MRC-PHE Centre for Environment and Health, King’s College London, London SE1 9NH, United Kingdom
| | - Marta Blangiardo
- UK
Small Area Health Statistics Unit, MRC-PHE Centre for Environment
and Health, Imperial College London, London W2 1PG, United Kingdom
| | - John Gulliver
- UK
Small Area Health Statistics Unit, MRC-PHE Centre for Environment
and Health, Imperial College London, London W2 1PG, United Kingdom
| | - Mireille B. Toledano
- UK
Small Area Health Statistics Unit, MRC-PHE Centre for Environment
and Health, Imperial College London, London W2 1PG, United Kingdom
| | - Paul Elliott
- UK
Small Area Health Statistics Unit, MRC-PHE Centre for Environment
and Health, Imperial College London, London W2 1PG, United Kingdom
| | - Kees de Hoogh
- UK
Small Area Health Statistics Unit, MRC-PHE Centre for Environment
and Health, Imperial College London, London W2 1PG, United Kingdom
- Swiss Tropical and
Public Health Institute, Basel CH-4051, Switzerland
- University of
Basel, Basel, CH-4001, Switzerland
| | - Gary W. Fuller
- Environment
Research Group, MRC-PHE Centre for Environment and Health, King’s College London, London SE1 9NH, United Kingdom
| | - Anna L. Hansell
- UK
Small Area Health Statistics Unit, MRC-PHE Centre for Environment
and Health, Imperial College London, London W2 1PG, United Kingdom
- Directorate
of Public Health and Primary Care, Imperial
College Healthcare NHS Trust, London, W2 1NY, United Kingdom
- Phone: +44 (0)20 7594 3344. E-mail: . Corresponding
author address: UK Small Area Health Statistics Unit (SAHSU), Department
of Epidemiology and Biostatistics School of Public Health, Imperial
College London, St. Mary’s Campus, Norfolk Place, London W2
1PG, U.K
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16
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Ferguson KK, Chin HB. Environmental chemicals and preterm birth: Biological mechanisms and the state of the science. CURR EPIDEMIOL REP 2017; 4:56-71. [PMID: 28944158 PMCID: PMC5608103 DOI: 10.1007/s40471-017-0099-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE OF REVIEW Preterm birth is a significant worldwide health problem of uncertain origins. The extant body of literature examining environmental contaminant exposures in relation to preterm birth is extensive but results remain ambiguous for most organic pollutants, metals and metalloids, and air pollutants. In the present review we examine recent epidemiologic studies investigating these associations, and identify recent advances and the state of the science. Additionally, we highlight biological mechanisms of action in the pathway between chemical exposures and preterm birth, including inflammation, oxidative stress, and endocrine disruption, that deserve more attention in this context. RECENT FINDINGS Important advances have been made in the study of the environment and preterm birth, particularly in regard to exposure assessment methods, exploration of effect modification by co-morbidities and exposures, and in identification of windows of vulnerability during gestation. There is strong evidence for an association between maternal exposure to some persistent pesticides, lead, and fine particulate matter, but data on other contaminants is sparse and only suggestive trends can be noted with the current data. SUMMARY Beyond replicating current findings, further work must be done to improve understanding of mechanisms underlying the associations observed between environmental chemical exposures and preterm birth. By examining windows of vulnerability, disaggregating preterm birth by phenotypes, and measuring biomarkers of mechanistic pathways in these epidemiologic studies we can improve our ability to detect associations with exposure, provide additional evidence for causality in an observational setting, and identify opportunities for intervention.
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Affiliation(s)
- Kelly K. Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Helen B. Chin
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
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17
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Balsa AI, Caffera M, Bloomfield J. Exposures to Particulate Matter from the Eruptions of the Puyehue Volcano and Birth Outcomes in Montevideo, Uruguay. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:1816-1822. [PMID: 27152597 PMCID: PMC5089889 DOI: 10.1289/ehp235] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 10/29/2015] [Accepted: 04/26/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND The ashes and dust resulting from the 2011 eruptions of the Puyehue volcano in Chile more than doubled monthly averages of PM10 concentrations in Montevideo, Uruguay. Few studies have taken advantage of natural experiments to assess the relationship between ambient air pollutant concentrations and birth outcomes. OBJECTIVES In this study we explored the effect of particulate matter with diameter of ≤ 10 μm (PM10) on perinatal outcomes in Uruguay, a middle-income country in South America with levels of PM10 that in general do not exceed the recommended thresholds. The analyzed outcomes are preterm birth, term birth weight, and term low birth weight. METHODS We took advantage of the sharp variation in PM10 concentrations due to the Puyehue eruptions to estimate the associations between mother's exposure to PM10 in each trimester of pregnancy and perinatal outcomes. We use birth registries for 2010-2013 and control for covariates, including maternal and pregnancy characteristics, weather, co-pollutants, and calendar quarter and hospital indicators. RESULTS A 10-μg/m3 increase in exposure to PM10 during the third trimester was associated with a higher likelihood of a preterm birth [odds ratio (OR) = 1.10; 95% CI: 1.03, 1.19]. The association was robust to different model specifications, and increased with categorical exposure levels (OR for third-trimester PM10 ≥ 70 vs. < 30 μg/m3 = 5.24; 95% CI: 3.40, 8.08). Exposures were not consistently associated with birth weight or low birth weight among term births, though second-trimester exposures were associated with higher birth weight, contrary to expectations. CONCLUSIONS Taking advantage of a natural experiment, we found evidence that exposure to high levels of PM10 during the third trimester of pregnancy may have increased preterm births among women in Montevideo, Uruguay. Citation: Balsa AI, Caffera M, Bloomfield J. 2016. Exposures to particulate matter from the eruptions of the Puyehue Volcano and birth outcomes in Montevideo, Uruguay. Environ Health Perspect 124:1816-1822; http://dx.doi.org/10.1289/EHP235.
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Affiliation(s)
- Ana Ines Balsa
- Department of Economics, University of Montevideo, Montevideo, Uruguay
| | - Marcelo Caffera
- Department of Economics, University of Montevideo, Montevideo, Uruguay
| | - Juanita Bloomfield
- Tinbergen Institute, University of Amsterdam, Amsterdam, the Netherlands
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18
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Veras MM, de Oliveira Alves N, Fajersztajn L, Saldiva P. Before the first breath: prenatal exposures to air pollution and lung development. Cell Tissue Res 2016; 367:445-455. [PMID: 27726025 DOI: 10.1007/s00441-016-2509-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 09/13/2016] [Indexed: 12/14/2022]
Abstract
Various environmental contaminants are known to impair the growth trajectories of major organs, indirectly (gestational exposure) or directly (postnatal exposure). Evidence associates pre-gestational and gestational exposure to air pollutants with adverse birth outcomes (e.g., low birth weight, prematurity) and with a wide range of diseases in childhood and later in life. In this review, we explore the way that pre-gestational and gestational exposure to air pollution affects lung development. We present results in topics underlining epidemiological and toxicological evidence. We also provide a summary of the biological mechanisms by which air pollution exposure possibly leads to adverse respiratory outcomes. We conclude that gestational and early life exposure to air pollutants are linked to alterations in lung development and function and to other negative respiratory conditions in childhood (wheezing, asthma) that may last into adulthood. Plausible mechanisms encompass changes in maternal physiology (e.g., hypoxia, oxidative stress and inflammation) and DNA alterations in the fetus. Evidence for pre-gestational and gestational effects on the lung is scarce compared with that on early life exposure and further studies are needed. However, the suggested mechanisms are credible and the evidence of pre-gestational and gestational air pollution exposure is robust for adverse birth outcomes. Air pollutants might change lung developmental trajectories of the unborn child predisposing it to diseases later in life highlighting the urgent need for controls on urban air pollution levels worldwide.
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Affiliation(s)
- Mariana Matera Veras
- Laboratory of Environmental Air Pollution, LIM05, Department of Pathology, University of Sao Paulo School of Medicine, Av. Dr. Arnaldo 455 (1st floor, Room 1220), 01246-903, Sao Paulo, SP, Brazil.
- Department of Surgery, Sector of Anatomy, Faculty of Veterinary Medicine and Animal Sciences, University of Sao Paulo, Sao Paulo, Brazil.
| | - Nilmara de Oliveira Alves
- Laboratory of Environmental Air Pollution, LIM05, Department of Pathology, University of Sao Paulo School of Medicine, Av. Dr. Arnaldo 455 (1st floor, Room 1220), 01246-903, Sao Paulo, SP, Brazil
| | - Lais Fajersztajn
- Laboratory of Environmental Air Pollution, LIM05, Department of Pathology, University of Sao Paulo School of Medicine, Av. Dr. Arnaldo 455 (1st floor, Room 1220), 01246-903, Sao Paulo, SP, Brazil
- Advanced Study Institute, University of Sao Paulo (IEA-USP), Sao Paulo, Brazil
| | - Paulo Saldiva
- Laboratory of Environmental Air Pollution, LIM05, Department of Pathology, University of Sao Paulo School of Medicine, Av. Dr. Arnaldo 455 (1st floor, Room 1220), 01246-903, Sao Paulo, SP, Brazil
- Advanced Study Institute, University of Sao Paulo (IEA-USP), Sao Paulo, Brazil
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19
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Clemente DB, Casas M, Vilahur N, Begiristain H, Bustamante M, Carsin AE, Fernández MF, Fierens F, Gyselaers W, Iñiguez C, Janssen BG, Lefebvre W, Llop S, Olea N, Pedersen M, Pieters N, Santa Marina L, Souto A, Tardón A, Vanpoucke C, Vrijheid M, Sunyer J, Nawrot TS. Prenatal Ambient Air Pollution, Placental Mitochondrial DNA Content, and Birth Weight in the INMA (Spain) and ENVIRONAGE (Belgium) Birth Cohorts. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:659-65. [PMID: 26317635 PMCID: PMC4858384 DOI: 10.1289/ehp.1408981] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 08/25/2015] [Indexed: 05/18/2023]
Abstract
BACKGROUND Mitochondria are sensitive to environmental toxicants due to their lack of repair capacity. Changes in mitochondrial DNA (mtDNA) content may represent a biologically relevant intermediate outcome in mechanisms linking air pollution and fetal growth restriction. OBJECTIVE We investigated whether placental mtDNA content is a possible mediator of the association between prenatal nitrogen dioxide (NO2) exposure and birth weight. METHODS We used data from two independent European cohorts: INMA (n = 376; Spain) and ENVIRONAGE (n = 550; Belgium). Relative placental mtDNA content was determined as the ratio of two mitochondrial genes (MT-ND1 and MTF3212/R3319) to two control genes (RPLP0 and ACTB). Effect estimates for individual cohorts and the pooled data set were calculated using multiple linear regression and mixed models. We also performed a mediation analysis. RESULTS Pooled estimates indicated that a 10-μg/m3 increment in average NO2 exposure during pregnancy was associated with a 4.9% decrease in placental mtDNA content (95% CI: -9.3, -0.3%) and a 48-g decrease (95% CI: -87, -9 g) in birth weight. However, the association with birth weight was significant for INMA (-66 g; 95% CI: -111, -23 g) but not for ENVIRONAGE (-20 g; 95% CI: -101, 62 g). Placental mtDNA content was associated with significantly higher mean birth weight (pooled analysis, interquartile range increase: 140 g; 95% CI: 43, 237 g). Mediation analysis estimates, which were derived for the INMA cohort only, suggested that 10% (95% CI: 6.6, 13.0 g) of the association between prenatal NO2 and birth weight was mediated by changes in placental mtDNA content. CONCLUSION Our results suggest that mtDNA content can be one of the potential mediators of the association between prenatal air pollution exposure and birth weight. CITATION Clemente DB, Casas M, Vilahur N, Begiristain H, Bustamante M, Carsin AE, Fernández MF, Fierens F, Gyselaers W, Iñiguez C, Janssen BG, Lefebvre W, Llop S, Olea N, Pedersen M, Pieters N, Santa Marina L, Souto A, Tardón A, Vanpoucke C, Vrijheid M, Sunyer J, Nawrot TS. 2016. Prenatal ambient air pollution, placental mitochondrial DNA content, and birth weight in the INMA (Spain) and ENVIRONAGE (Belgium) birth cohorts. Environ Health Perspect 124:659-665; http://dx.doi.org/10.1289/ehp.1408981.
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Affiliation(s)
- Diana B.P. Clemente
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Maribel Casas
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Nadia Vilahur
- Institute for environmental medicine (IMM), Karolinska Institutet, Sweden
| | | | - Mariona Bustamante
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Center for Genomic Regulation (CRG), Barcelona, Spain
| | - Anne-Elie Carsin
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Mariana F. Fernández
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Department of Radiology, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, ibs.GRANADA, Hospital Universitario San Cecilio, Granada, Spain
| | - Frans Fierens
- Belgian Interregional Environment Agency, Brussels, Belgium
| | | | - Carmen Iñiguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- University of Valencia, Valencia, Spain
| | - Bram G. Janssen
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Wouter Lefebvre
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Sabrina Llop
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Nicolás Olea
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Department of Radiology, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, ibs.GRANADA, Hospital Universitario San Cecilio, Granada, Spain
| | - Marie Pedersen
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- INSERM (National Institute of Health and Medical Research), U823, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute Albert Bonniot, Grenoble, France
| | - Nicky Pieters
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Loreto Santa Marina
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Center for Genomic Regulation (CRG), Barcelona, Spain
| | - Ana Souto
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Molecular Epidemiology of Cancer Unit, University Institute of Oncology, University of Oviedo, Oviedo, Spain
| | - Adonina Tardón
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Molecular Epidemiology of Cancer Unit, University Institute of Oncology, University of Oviedo, Oviedo, Spain
| | | | - Martine Vrijheid
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Health Research Institute (BIODONOSTIA), Gipuzkoa, Spain
| | - Jordi Sunyer
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Health Research Institute (BIODONOSTIA), Gipuzkoa, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | - Tim S. Nawrot
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
- Department of Public Health & Primary Care, Unit Environment & Health, Leuven University, Leuven, Belgium
- Address correspondence to T.S. Nawrot, Center for Environmental Sciences, Hasselt University, Agoralaan gebouw D, 3590 Diepenbeek, Belgium. Telephone: 32-11-268382. E-mail:
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Li L, Laurent O, Wu J. Spatial variability of the effect of air pollution on term birth weight: evaluating influential factors using Bayesian hierarchical models. Environ Health 2016; 15:14. [PMID: 26850268 PMCID: PMC4744429 DOI: 10.1186/s12940-016-0112-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 02/01/2016] [Indexed: 05/05/2023]
Abstract
BACKGROUND Epidemiological studies suggest that air pollution is adversely associated with pregnancy outcomes. Such associations may be modified by spatially-varying factors including socio-demographic characteristics, land-use patterns and unaccounted exposures. Yet, few studies have systematically investigated the impact of these factors on spatial variability of the air pollution's effects. This study aimed to examine spatial variability of the effects of air pollution on term birth weight across Census tracts and the influence of tract-level factors on such variability. METHODS We obtained over 900,000 birth records from 2001 to 2008 in Los Angeles County, California, USA. Air pollution exposure was modeled at individual level for nitrogen dioxide (NO2) and nitrogen oxides (NOx) using spatiotemporal models. Two-stage Bayesian hierarchical non-linear models were developed to (1) quantify the associations between air pollution exposure and term birth weight within each tract; and (2) examine the socio-demographic, land-use, and exposure-related factors contributing to the between-tract variability of the associations between air pollution and term birth weight. RESULTS Higher air pollution exposure was associated with lower term birth weight (average posterior effects: -14.7 (95 % CI: -19.8, -9.7) g per 10 ppb increment in NO2 and -6.9 (95 % CI: -12.9, -0.9) g per 10 ppb increment in NOx). The variation of the association across Census tracts was significantly influenced by the tract-level socio-demographic, exposure-related and land-use factors. Our models captured the complex non-linear relationship between these factors and the associations between air pollution and term birth weight: we observed the thresholds from which the influence of the tract-level factors was markedly exacerbated or attenuated. Exacerbating factors might reflect additional exposure to environmental insults or lower socio-economic status with higher vulnerability, whereas attenuating factors might indicate reduced exposure or higher socioeconomic status with lower vulnerability. CONCLUSIONS Our Bayesian models effectively combined a priori knowledge with training data to infer the posterior association of air pollution with term birth weight and to evaluate the influence of the tract-level factors on spatial variability of such association. This study contributes new findings about non-linear influences of socio-demographic factors, land-use patterns, and unaccounted exposures on spatial variability of the effects of air pollution.
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Affiliation(s)
- Lianfa Li
- Program in Public Health, College of Health Sciences, University of California, Anteater Instruction & Research Bldg (AIRB) # 2034, 653 East Peltason Drive, Irvine, CA 92697-3957 USA
- State Key Lab of Resources and Environmental Information Systems, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, A11 Datun Road, Anwai, Chaoyang, Beijing, 100101 China
| | - Olivier Laurent
- Program in Public Health, College of Health Sciences, University of California, Anteater Instruction & Research Bldg (AIRB) # 2034, 653 East Peltason Drive, Irvine, CA 92697-3957 USA
| | - Jun Wu
- Program in Public Health, College of Health Sciences, University of California, Anteater Instruction & Research Bldg (AIRB) # 2034, 653 East Peltason Drive, Irvine, CA 92697-3957 USA
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Abstract
A substantial proportion of the global burden of disease is directly or indirectly attributable to exposure to air pollution. Exposures occurring during the periods of organogenesis and rapid lung growth during fetal development and early post-natal life are especially damaging. In this State of the Art review, we discuss air toxicants impacting on children's respiratory health, routes of exposure with an emphasis on unique pathways relevant to young children, methods of exposure assessment and their limitations and the adverse health consequences of exposures. Finally, we point out gaps in knowledge and research needs in this area. A greater understanding of the adverse health consequences of exposure to air pollution in early life is required to encourage policy makers to reduce such exposures and improve human health.
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Affiliation(s)
- Fiona C Goldizen
- Queensland Children's Medical Research Institute, Brisbane, Queensland, Australia.,Children's Health and Environment Program, Children's Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter D Sly
- Queensland Children's Medical Research Institute, Brisbane, Queensland, Australia.,Children's Health and Environment Program, Children's Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Luke D Knibbs
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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22
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Snowden JM, Mortimer KM, Dufour MSK, Tager IB. Population intervention models to estimate ambient NO2 health effects in children with asthma. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2015; 25:567-73. [PMID: 25182844 PMCID: PMC4565777 DOI: 10.1038/jes.2014.60] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 06/26/2014] [Indexed: 05/05/2023]
Abstract
Health effects of ambient air pollution are most frequently expressed in individual studies as responses to a standardized unit of air pollution changes (e.g., an interquartile interval), which is thought to enable comparison of findings across studies. However, this approach does not necessarily convey health effects in terms of a real-world air pollution scenario. In the present study, we use population intervention modeling to estimate the effect of an air pollution intervention that makes explicit reference to the observed exposure data and is identifiable in those data. We calculate the association between ambient summertime nitrogen dioxide (NO2) and forced expiratory flow between 25% and 75% of forced vital capacity (FEF25-75) in a cohort of children with asthma in Fresno, California. We scale the effect size to reflect NO2 abatement on a majority of summer days. The effect estimates were small, imprecise, and consistently indicated improved pulmonary function with decreased NO2. The effects ranged from -0.8% of mean FEF25-75 (95% confidence interval (CI): -3.4, 1.7) to -3.3% (95% CI: -7.5, 0.9). We conclude by discussing the nature and feasibility of the exposure change analyzed here given the observed air pollution profile, and we propose additional applications of population intervention models in environmental epidemiology.
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Affiliation(s)
- Jonathan M. Snowden
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon, USA
- Division of Epidemiology, School of Public Health, University of California, Berkeley, California, USA
| | - Kathleen M. Mortimer
- Division of Epidemiology, School of Public Health, University of California, Berkeley, California, USA
| | - Mi-Suk Kang Dufour
- Division of Epidemiology, School of Public Health, University of California, Berkeley, California, USA
- Center for AIDS Prevention Studies, University of California, San Francisco, California, USA
| | - Ira B. Tager
- Division of Epidemiology, School of Public Health, University of California, Berkeley, California, USA
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23
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Coker E, Ghosh J, Jerrett M, Gomez-Rubio V, Beckerman B, Cockburn M, Liverani S, Su J, Li A, Kile ML, Ritz B, Molitor J. Modeling spatial effects of PM(2.5) on term low birth weight in Los Angeles County. ENVIRONMENTAL RESEARCH 2015. [PMID: 26196780 DOI: 10.1016/j.envres.2015.06.044] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Air pollution epidemiological studies suggest that elevated exposure to fine particulate matter (PM2.5) is associated with higher prevalence of term low birth weight (TLBW). Previous studies have generally assumed the exposure-response of PM2.5 on TLBW to be the same throughout a large geographical area. Health effects related to PM2.5 exposures, however, may not be uniformly distributed spatially, creating a need for studies that explicitly investigate the spatial distribution of the exposure-response relationship between individual-level exposure to PM2.5 and TLBW. Here, we examine the overall and spatially varying exposure-response relationship between PM2.5 and TLBW throughout urban Los Angeles (LA) County, California. We estimated PM2.5 from a combination of land use regression (LUR), aerosol optical depth from remote sensing, and atmospheric modeling techniques. Exposures were assigned to LA County individual pregnancies identified from electronic birth certificates between the years 1995-2006 (N=1,359,284) provided by the California Department of Public Health. We used a single pollutant multivariate logistic regression model, with multilevel spatially structured and unstructured random effects set in a Bayesian framework to estimate global and spatially varying pollutant effects on TLBW at the census tract level. Overall, increased PM2.5 level was associated with higher prevalence of TLBW county-wide. The spatial random effects model, however, demonstrated that the exposure-response for PM2.5 and TLBW was not uniform across urban LA County. Rather, the magnitude and certainty of the exposure-response estimates for PM2.5 on log odds of TLBW were greatest in the urban core of Central and Southern LA County census tracts. These results suggest that the effects may be spatially patterned, and that simply estimating global pollutant effects obscures disparities suggested by spatial patterns of effects. Studies that incorporate spatial multilevel modeling with random coefficients allow us to identify areas where air pollutant effects on adverse birth outcomes may be most severe and policies to further reduce air pollution might be most effective.
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Affiliation(s)
- Eric Coker
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
| | - Jokay Ghosh
- School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Michael Jerrett
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | | | - Bernardo Beckerman
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Myles Cockburn
- Preventive Medicine and Spatial Sciences, University of Southern California, Los Angeles, CA, USA
| | - Silvia Liverani
- Department of Mathematics, Brunel University, London, United Kingdom
| | - Jason Su
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Arthur Li
- Department of Information Science, City of Hope National Cancer Center, Duarte, CA, USA
| | - Molly L Kile
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Beate Ritz
- School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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Claxton LD. The history, genotoxicity, and carcinogenicity of carbon-based fuels and their emissions: Part 5. Summary, comparisons, and conclusions. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2015; 763:103-47. [DOI: 10.1016/j.mrrev.2014.10.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 10/04/2014] [Accepted: 10/06/2014] [Indexed: 12/19/2022]
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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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The shared pathoetiological effects of particulate air pollution and the social environment on fetal-placental development. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2014; 2014:901017. [PMID: 25574176 PMCID: PMC4276595 DOI: 10.1155/2014/901017] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 10/21/2014] [Indexed: 01/09/2023]
Abstract
Exposure to particulate air pollution and socioeconomic risk factors are shown to be independently associated with adverse pregnancy outcomes; however, their confounding relationship is an epidemiological challenge that requires understanding of their shared etiologic pathways affecting fetal-placental development. The purpose of this paper is to explore the etiological mechanisms associated with exposure to particulate air pollution in contributing to adverse pregnancy outcomes and how these mechanisms intersect with those related to socioeconomic status. Here we review the role of oxidative stress, inflammation and endocrine modification in the pathoetiology of deficient deep placentation and detail how the physical and social environments can act alone and collectively to mediate the established pathology linked to a spectrum of adverse pregnancy outcomes. We review the experimental and epidemiological literature showing that diet/nutrition, smoking, and psychosocial stress share similar pathways with that of particulate air pollution exposure to potentially exasperate the negative effects of either insult alone. Therefore, socially patterned risk factors often treated as nuisance parameters should be explored as potential effect modifiers that may operate at multiple levels of social geography. The degree to which deleterious exposures can be ameliorated or exacerbated via community-level social and environmental characteristics needs further exploration.
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Farhi A, Boyko V, Almagor J, Benenson I, Segre E, Rudich Y, Stern E, Lerner-Geva L. The possible association between exposure to air pollution and the risk for congenital malformations. ENVIRONMENTAL RESEARCH 2014; 135:173-180. [PMID: 25277865 DOI: 10.1016/j.envres.2014.08.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 07/21/2014] [Accepted: 08/11/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Over the last decade, there is growing evidence that exposure to air pollution may be associated with increased risk for congenital malformations. OBJECTIVES To evaluate the possible association between exposures to air pollution during pregnancy and congenital malformations among infants born following spontaneously conceived (SC) pregnancies and assisted reproductive technology (ART) pregnancies. METHODS This is an historical cohort study comprising 216,730 infants: 207,825 SC infants and 8905 ART conceived infants, during the periods 1997-2004. Air pollution data including sulfur dioxide (SO2), particulate matter <10 µm (PM10), nitrogen oxides (NOx) and ozone (O3) were obtained from air monitoring stations database for the study period. Using a geographic information system (GIS) and the Kriging procedure, exposure to air pollution during the first trimester and the entire pregnancy was assessed for each woman according to her residential location. Logistic regression models with generalized estimating equation (GEE) approach were used to evaluate the adjusted risk for congenital malformations. RESULTS In the study cohort increased concentrations of PM10 and NOx pollutants in the entire pregnancy were associated with slightly increased risk for congenital malformations: OR 1.06(95% CI, 1.01-1.11) for 10 µg/m(3) increase in PM10 and OR 1.03(95% CI, 1.01-1.04) for 10 ppb increase in NOx. Specific malformations were evident in the circulatory system (for PM10 and NOx exposure) and genital organs (for NOx exposure). SO2 and O3 pollutants were not significantly associated with increased risk for congenital malformations. In the ART group higher concentrations of SO2 and O3 in entire pregnancy were associated (although not significantly) with an increased risk for congenital malformations: OR 1.06(95% CI, 0.96-1.17) for 1 ppb increase in SO2 and OR 1.15(95% CI, 0.69-1.91) for 10 ppb increase in O3. CONCLUSIONS Exposure to higher levels of PM10 and NOx during pregnancy was associated with an increased risk for congenital malformations. Specific malformations were evident in the circulatory system and genital organs. Among ART pregnancies possible adverse association of SO2 and O3 exposure was also observed. Further studies are warranted, including more accurate exposure assessment and a larger sample size for ART pregnancies, in order to confirm these findings.
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Affiliation(s)
- Adel Farhi
- (a)Women and children׳s Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research Ltd., Israel.
| | - Valentina Boyko
- (a)Women and children׳s Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research Ltd., Israel
| | - Jonatan Almagor
- (b)Department of Geography and Human Environment, Tel Aviv University, Israel
| | - Itzhak Benenson
- (b)Department of Geography and Human Environment, Tel Aviv University, Israel
| | - Enrico Segre
- (c)Department of Earth and Planetary Sciences, Weizmann Institute of Science, Israel
| | - Yinon Rudich
- (c)Department of Earth and Planetary Sciences, Weizmann Institute of Science, Israel
| | - Eli Stern
- (d)Center for Risk Analysis, Gertner Institute for Epidemiology and Health Policy Research Ltd., Israel
| | - Liat Lerner-Geva
- (e)School of public health, Sackler Faculty of Medicine, Tel Aviv University, Israel; (e)School of public health, Sackler Faculty of Medicine, Tel Aviv University, Israel
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30
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Trasande L, Wong K, Roy A, Savitz DA, Thurston G. Exploring prenatal outdoor air pollution, birth outcomes and neonatal health care utilization in a nationally representative sample. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2013; 23:315-21. [PMID: 23340702 PMCID: PMC4391972 DOI: 10.1038/jes.2012.124] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 11/14/2012] [Indexed: 05/28/2023]
Abstract
The impact of air pollution on fetal growth remains controversial, in part, because studies have been limited to sub-regions of the United States with limited variability. No study has examined air pollution impacts on neonatal health care utilization. We performed descriptive, univariate and multivariable analyses on administrative hospital record data from 222,359 births in the 2000, 2003 and 2006 Kids Inpatient Database linked to air pollution data drawn from the US Environmental Protection Agency's Aerometric Information Retrieval System. In this study, air pollution exposure during the birth month was estimated based on birth hospital address. Although air pollutants were not individually associated with mean birth weight, a three-pollutant model controlling for hospital characteristics, demographics, and birth month identified 9.3% and 7.2% increases in odds of low birth weight and very low birth weight for each μg/m(3) increase in PM(2.5) (both P<0.0001). PM(2.5) and NO(2) were associated with -3.0% odds/p.p.m. and +2.5% odds/p.p.b. of preterm birth, respectively (both P<0.0001). A four-pollutant multivariable model indicated a 0.05 days/p.p.m. NO(2) decrease in length of the birth hospitalization (P=0.0061) and a 0.13 days increase/p.p.m. CO (P=0.0416). A $1166 increase in per child costs was estimated for the birth hospitalization per p.p.m. CO (P=0.0002) and $964 per unit increase in O(3) (P=0.0448). A reduction from the 75th to the 25th percentile in the highest CO quartile for births predicts annual savings of $134.7 million in direct health care costs. In a national, predominantly urban, sample, air pollutant exposures during the month of birth are associated with increased low birth weight and neonatal health care utilization. Further study of this database, with enhanced control for confounding, improved exposure assessment, examination of exposures across multiple time windows in pregnancy, and in the entire national sample, is supported by these initial investigations.
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Affiliation(s)
- Leonardo Trasande
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA.
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Smarr MM, Vadillo-Ortega F, Castillo-Castrejon M, O'Neill MS. The use of ultrasound measurements in environmental epidemiological studies of air pollution and fetal growth. Curr Opin Pediatr 2013. [PMID: 23399571 DOI: 10.1097/mop.0b013e32835ele74] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
PURPOSE OF REVIEW Recently, several international research groups have suggested that studies about environmental contaminants and adverse pregnancy outcomes should be designed to elucidate potential underlying biological mechanisms. The purpose of this review is to examine the epidemiological studies addressing maternal exposure to air pollutants and fetal growth during gestation as assessed by ultrasound measurements. RECENT FINDINGS The six studies published to date found that exposure to certain ambient air pollutants during pregnancy is negatively associated with the growth rates and average attained size of fetal parameters belonging to the growth profile. Fetal parameters may respond to maternal air pollution exposures uniquely, and this response may vary by pollutant and timing of gestational exposure. Current literature suggests that mean changes in head circumference, abdominal circumference, femur length, and biparietal diameter are negatively associated with early-pregnancy exposures to ambient and vehicle-related air pollution. SUMMARY The use of more longitudinal studies, employing ultrasound measures to assess fetal outcomes, may assist with the better understanding of mechanisms responsible for air pollution-related pregnancy outcomes.
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Affiliation(s)
- Melissa M Smarr
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-2029, USA.
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Lee PC, Roberts JM, Catov JM, Talbott EO, Ritz B. First trimester exposure to ambient air pollution, pregnancy complications and adverse birth outcomes in Allegheny County, PA. Matern Child Health J 2013; 17:545-55. [PMID: 22544506 PMCID: PMC3636771 DOI: 10.1007/s10995-012-1028-5] [Citation(s) in RCA: 161] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Despite numerous studies of air pollution and adverse birth outcomes, few studies have investigated preeclampsia and gestational hypertension, two pregnancy disorders with serious consequences for both mother and infant. Relying on hospital birth records, we conducted a cohort study identifying 34,705 singleton births delivered at Magee-Women's Hospital in Pittsburgh, PA between 1997 and 2002. Particle (<10 μm-PM10; <2.5 μm-PM2.5) and ozone (O3) exposure concentrations in the first trimester of pregnancy were estimated using the space-time ordinary Kriging interpolation method. We employed multiple logistic regression estimate associations between first trimester exposures and preeclampsia, gestational hypertension, preterm delivery, and small for gestational age (SGA) infants. PM2.5 and O3 exposures were associated with preeclampsia (adjusted OR = 1.15, 95% CI = 0.96-1.39 per 4.0 μg/m(3) increase in PM2.5; adjusted OR = 1.12, 95% CI = 0.89-1.42 per 16.8 ppb increase in O3), gestational hypertension (for PM2.5 OR = 1.11, 95 % CI = 1.00-1.23; for O3 OR = 1.12, 95 % CI = 0.97-1.29), and preterm delivery (for PM2.5 ORs = 1.10, 95% CI = 1.01-1.20; for O3 ORs = 1.23, 95% CI = 1.01-1.50). Smaller 5-8 % increases in risk were also observed for PM10 with gestational hypertension and SGA, but not preeclampsia. Our data suggest that first trimester exposure to particles, mostly PM2.5, and ozone, may increase the risk of developing preeclampsia and gestational hypertension, as well as preterm delivery and SGA.
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Affiliation(s)
- Pei-Chen Lee
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; Department of Epidemiology, School of Public Health, University of California at Los Angeles, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA
| | - James M. Roberts
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; Department of Obstetrics and Gynecology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA;
| | - Janet M. Catov
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; Department of Obstetrics and Gynecology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA;
| | - Evelyn O. Talbott
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA;
| | - Beate Ritz
- Department of Epidemiology, School of Public Health, University of California at Los Angeles, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA;
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Abstract
PURPOSE OF REVIEW Recently, several international research groups have suggested that studies about environmental contaminants and adverse pregnancy outcomes should be designed to elucidate potential underlying biological mechanisms. The purpose of this review is to examine the epidemiological studies addressing maternal exposure to air pollutants and fetal growth during gestation as assessed by ultrasound measurements. RECENT FINDINGS The six studies published to date found that exposure to certain ambient air pollutants during pregnancy is negatively associated with the growth rates and average attained size of fetal parameters belonging to the growth profile. Fetal parameters may respond to maternal air pollution exposures uniquely, and this response may vary by pollutant and timing of gestational exposure. Current literature suggests that mean changes in head circumference, abdominal circumference, femur length, and biparietal diameter are negatively associated with early-pregnancy exposures to ambient and vehicle-related air pollution. SUMMARY The use of more longitudinal studies, employing ultrasound measures to assess fetal outcomes, may assist with the better understanding of mechanisms responsible for air pollution-related pregnancy outcomes.
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Dadvand P, Parker J, Bell ML, Bonzini M, Brauer M, Darrow LA, Gehring U, Glinianaia SV, Gouveia N, Ha EH, Leem JH, van den Hooven EH, Jalaludin B, Jesdale BM, Lepeule J, Morello-Frosch R, Morgan GG, Pesatori AC, Pierik FH, Pless-Mulloli T, Rich DQ, Sathyanarayana S, Seo J, Slama R, Strickland M, Tamburic L, Wartenberg D, Nieuwenhuijsen MJ, Woodruff TJ. Maternal exposure to particulate air pollution and term birth weight: a multi-country evaluation of effect and heterogeneity. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:267-373. [PMID: 23384584 PMCID: PMC3621183 DOI: 10.1289/ehp.1205575] [Citation(s) in RCA: 296] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 12/28/2012] [Indexed: 05/18/2023]
Abstract
BACKGROUND A growing body of evidence has associated maternal exposure to air pollution with adverse effects on fetal growth; however, the existing literature is inconsistent. OBJECTIVES We aimed to quantify the association between maternal exposure to particulate air pollution and term birth weight and low birth weight (LBW) across 14 centers from 9 countries, and to explore the influence of site characteristics and exposure assessment methods on between-center heterogeneity in this association. METHODS Using a common analytical protocol, International Collaboration on Air Pollution and Pregnancy Outcomes (ICAPPO) centers generated effect estimates for term LBW and continuous birth weight associated with PM(10) and PM(2.5) (particulate matter ≤ 10 and 2.5 µm). We used meta-analysis to combine the estimates of effect across centers (~ 3 million births) and used meta-regression to evaluate the influence of center characteristics and exposure assessment methods on between-center heterogeneity in reported effect estimates. RESULTS In random-effects meta-analyses, term LBW was positively associated with a 10-μg/m3 increase in PM10 [odds ratio (OR) = 1.03; 95% CI: 1.01, 1.05] and PM(2.5) (OR = 1.10; 95% CI: 1.03, 1.18) exposure during the entire pregnancy, adjusted for maternal socioeconomic status. A 10-μg/m3 increase in PM(10) exposure was also negatively associated with term birth weight as a continuous outcome in the fully adjusted random-effects meta-analyses (-8.9 g; 95% CI: -13.2, -4.6 g). Meta-regressions revealed that centers with higher median PM(2.5) levels and PM(2.5):PM(10) ratios, and centers that used a temporal exposure assessment (compared with spatiotemporal), tended to report stronger associations. CONCLUSION Maternal exposure to particulate pollution was associated with LBW at term across study populations. We detected three site characteristics and aspects of exposure assessment methodology that appeared to contribute to the variation in associations reported by centers.
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Affiliation(s)
- Payam Dadvand
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
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Laurent O, Wu J, Li L, Chung J, Bartell S. Investigating the association between birth weight and complementary air pollution metrics: a cohort study. Environ Health 2013; 12:18. [PMID: 23413962 PMCID: PMC3599912 DOI: 10.1186/1476-069x-12-18] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 02/13/2013] [Indexed: 05/18/2023]
Abstract
BACKGROUND Exposure to air pollution is frequently associated with reductions in birth weight but results of available studies vary widely, possibly in part because of differences in air pollution metrics. Further insight is needed to identify the air pollution metrics most strongly and consistently associated with birth weight. METHODS We used a hospital-based obstetric database of more than 70,000 births to study the relationships between air pollution and the risk of low birth weight (LBW, <2,500 g), as well as birth weight as a continuous variable, in term-born infants. Complementary metrics capturing different aspects of air pollution were used (measurements from ambient monitoring stations, predictions from land use regression models and from a Gaussian dispersion model, traffic density, and proximity to roads). Associations between air pollution metrics and birth outcomes were investigated using generalized additive models, adjusting for maternal age, parity, race/ethnicity, insurance status, poverty, gestational age and sex of the infants. RESULTS Increased risks of LBW were associated with ambient O(3) concentrations as measured by monitoring stations, as well as traffic density and proximity to major roadways. LBW was not significantly associated with other air pollution metrics, except that a decreased risk was associated with ambient NO(2) concentrations as measured by monitoring stations. When birth weight was analyzed as a continuous variable, small increases in mean birth weight were associated with most air pollution metrics (<40 g per inter-quartile range in air pollution metrics). No such increase was observed for traffic density or proximity to major roadways, and a significant decrease in mean birth weight was associated with ambient O3 concentrations. CONCLUSIONS We found contrasting results according to the different air pollution metrics examined. Unmeasured confounders and/or measurement errors might have produced spurious positive associations between birth weight and some air pollution metrics. Despite this, ambient O(3) was associated with a decrement in mean birth weight and significant increases in the risk of LBW were associated with traffic density, proximity to roads and ambient O(3). This suggests that in our study population, these air pollution metrics are more likely related to increased risks of LBW than the other metrics we studied. Further studies are necessary to assess the consistency of such patterns across populations.
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Affiliation(s)
- Olivier Laurent
- Program in Public Health, University of California, Irvine, CA, USA
| | - Jun Wu
- Program in Public Health, University of California, Irvine, CA, USA
| | - Lianfa Li
- Program in Public Health, University of California, Irvine, CA, USA
- State Key Lab of Resources and Environmental Information Systems, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Judith Chung
- Division of Maternal Fetal Medicine, University of California, Irvine, CA, USA
| | - Scott Bartell
- Program in Public Health, University of California, Irvine, CA, USA
- Department of Epidemiology, University of California, Irvine, CA, USA
- Department of Statistics, University of California, Irvine, CA, 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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Janssen BG, Munters E, Pieters N, Smeets K, Cox B, Cuypers A, Fierens F, Penders J, Vangronsveld J, Gyselaers W, Nawrot TS. Placental mitochondrial DNA content and particulate air pollution during in utero life. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:1346-52. [PMID: 22626541 PMCID: PMC3440109 DOI: 10.1289/ehp.1104458] [Citation(s) in RCA: 174] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 05/24/2012] [Indexed: 05/19/2023]
Abstract
BACKGROUND Studies emphasize the importance of particulate matter (PM) in the formation of reactive oxygen species and inflammation. We hypothesized that these processes can influence mitochondrial function of the placenta and fetus. OBJECTIVE We investigated the influence of PM₁₀ exposure during pregnancy on the mitochondrial DNA content (mtDNA content) of the placenta and umbilical cord blood. METHODS DNA was extracted from placental tissue (n = 174) and umbilical cord leukocytes (n = 176). Relative mtDNA copy numbers (i.e., mtDNA content) were determined by real-time polymerase chain reaction. Multiple regression models were used to link mtDNA content and in utero exposure to PM₁₀ over various time windows during pregnancy. RESULTS In multivariate-adjusted analysis, a 10-µg/m³ increase in PM₁₀ exposure during the last month of pregnancy was associated with a 16.1% decrease [95% confidence interval (CI): -25.2, -6.0%, p = 0.003] in placental mtDNA content. The corresponding effect size for average PM₁₀ exposure during the third trimester was 17.4% (95% CI: -31.8, -0.1%, p = 0.05). Furthermore, we found that each doubling in residential distance to major roads was associated with an increase in placental mtDNA content of 4.0% (95% CI: 0.4, 7.8%, p = 0.03). No association was found between cord blood mtDNA content and PM₁₀ exposure. CONCLUSIONS Prenatal PM₁₀ exposure was associated with placental mitochondrial alterations, which may both reflect and intensify oxidative stress production. The potential health consequences of decreased placental mtDNA content in early life must be further elucidated.
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Affiliation(s)
- Bram G Janssen
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
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Proietti E, Röösli M, Frey U, Latzin P. Air pollution during pregnancy and neonatal outcome: a review. J Aerosol Med Pulm Drug Deliv 2012; 26:9-23. [PMID: 22856675 DOI: 10.1089/jamp.2011.0932] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
There is increasing evidence of the adverse impact of prenatal exposure to air pollution. This is of particular interest, as exposure during pregnancy--a crucial time span of important biological development--may have long-term implications. The aims of this review are to show current epidemiological evidence of known effects of prenatal exposure to air pollution and present possible mechanisms behind this process. Harmful effects of exposure to air pollution during pregnancy have been shown for different birth outcomes: higher infant mortality, lower birth weight, impaired lung development, increased later respiratory morbidity, and early alterations in immune development. Although results on lower birth weight are somewhat controversial, evidence for higher infant mortality is consistent in studies published worldwide. Possible mechanisms include direct toxicity of particles due to particle translocation across tissue barriers or particle penetration across cellular membranes. The induction of specific processes or interaction with immune cells in either the pregnant mother or the fetus may be possible consequences. Indirect effects could be oxidative stress and inflammation with consequent hemodynamic alterations resulting in decreased placental blood flow and reduced transfer of nutrients to the fetus. The early developmental phase of pregnancy is thought to be very important in determining long-term growth and overall health. So-called "tracking" of somatic growth and lung function is believed to have a huge impact on long-term morbidity, especially from a public health perspective. This is particularly important in areas with high levels of outdoor pollution, where it is practically impossible for an individual to avoid exposure. Especially in these areas, good evidence for the association between prenatal exposure to air pollution and infant mortality exists, clearly indicating the need for more stringent measures to reduce exposure to air pollution.
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Affiliation(s)
- Elena Proietti
- Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland
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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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Bell ML, Belanger K, Ebisu K, Gent JF, Leaderer BP. Relationship between birth weight and exposure to airborne fine particulate potassium and titanium during gestation. ENVIRONMENTAL RESEARCH 2012; 117:83-9. [PMID: 22705336 PMCID: PMC3418490 DOI: 10.1016/j.envres.2012.05.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 05/10/2012] [Accepted: 05/14/2012] [Indexed: 05/21/2023]
Abstract
Airborne particles are linked to numerous health impacts, including adverse pregnancy outcomes. Most studies of particles examined total mass, although the chemical structure of particles varies widely. We investigated whether mother's exposure to potassium (K) and titanium (Ti) components of airborne fine particulate matter (PM(2.5)) during pregnancy was associated with birth weight or risk of low birth weight (<2500 g) for term infants. The study population was 76,788 infants born in four counties in Connecticut and Massachusetts, US, for August 2000-February 2004. Both K and Ti were associated with birth weight. An interquartile range (IQR) increase K was associated with an 8.75% (95% confidence interval (CI): 1.24-16.8%) increase in risk of low birth weight. An IQR increase in Ti was associated with a 12.1% (95% CI: 3.55-21.4%) increase in risk of low birth weight, with an estimate of 6.41% (95% CI: -5.80-20.2%) for males and 16.4% (95% CI: 5.13-28.9%) for females. Results were robust to sensitivity analysis of first births only, but not adjustment by co-pollutants. Disentangling the effects of various chemical components is challenging because of the covariance among some components due to similar sources. Central effect estimates for infants of African-American mothers were higher than those of white mothers, although the confidence intervals overlapped. Our results indicate that exposure to airborne potassium and titanium during pregnancy is associated with lower birth weight. Associations may relate to chemical components of sources producing K and Ti.
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Affiliation(s)
- Michelle L. Bell
- Yale University, School of Forestry and Environmental Studies, 195 Prospect St., New Haven, CT 06511, USA
| | - Kathleen Belanger
- Yale University, Yale Center for Perinatal, Pediatric and Environmental Epidemiology, 1 Church Street, 6th Floor, New Haven CT 06511, USA
| | - Keita Ebisu
- Yale University, School of Forestry and Environmental Studies, 195 Prospect St., New Haven, CT 06511, USA
| | - Janneane F. Gent
- Yale University, Yale Center for Perinatal, Pediatric and Environmental Epidemiology, 1 Church Street, 6th Floor, New Haven CT 06511, USA
| | - Brian P. Leaderer
- Yale University, Yale Center for Perinatal, Pediatric and Environmental Epidemiology, 1 Church Street, 6th Floor, New Haven CT 06511, USA
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