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Ling X. The effect of ambient air pollution on birth outcomes in Norway. BMC Public Health 2023; 23:2248. [PMID: 37964290 PMCID: PMC10647155 DOI: 10.1186/s12889-023-16957-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 10/11/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Ambient air pollution can be harmful to the fetus even in countries with relatively low levels of pollution. Most of the established literature estimates the association between air pollution and health rather than causality. In this paper, I examine the causal effects of ambient air pollution on birth outcomes in Norway. METHODS With the large sample size and geographic division of sub-postal codes in Norway, I can control for a rich set of spatio-temporal fixed effects to overcome most of the endogeneity problems caused by the choice of residential area and date of delivery. After controlling for a rich set of spatio-temporal fixed effects, my paper uses the variance in ambient air pollutant concentrations over narrow time intervals and in a small geographic area of Norway to determine how prenatal air pollution exposure affects birth outcomes. My data contain extensive information about parents as well as meteorological conditions that can be used to control for potential confounding factors. RESULTS I find that prenatal exposure to ambient nitric oxide in the last trimester causes significant birth weight and birth length loss under the same sub-postcode fixed effects and calendar month fixed effects, whereas other ambient air pollutants such as nitrogen dioxide and sulfur dioxide appear to be at safe levels for the fetus in Norway. In addition, the marginal adverse effect of ambient nitric oxide is larger for newborns with disadvantaged parents. Both average concentrations of nitric oxide and occasional high concentration events can adversely affect birth outcomes. CONCLUSIONS Prenatal exposure to NO pollution has an adverse effect on birth outcomes. This suggests that government and researchers should pay more attention to examining NO pollution and that health care providers need to advise pregnant women about the risks of air pollution during pregnancy.
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Affiliation(s)
- Xiaoguang Ling
- Department of Economics, University of Oslo, Oslo, Norway.
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2
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Tang ASO, Cheah KC, Leong TS, Chew LP. Methaemoglobinaemia in pregnancy: Real world experience in a single centre in Malaysia. PROCEEDINGS OF SINGAPORE HEALTHCARE 2022. [DOI: 10.1177/20101058221111575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The literature on methaemoglobinaemia in pregnancy is scarce, imposing clinical challenges to both obstetricians and haematologists. We report a total of nine pregnancies with methaemoglobinaemia treated in our centre. Their methaemoglobin levels, mode of delivery, pregnancy management and outcome were summarized.
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Affiliation(s)
- Andy Sing Ong Tang
- Haematology Unit, Department of Internal Medicine, Sarawak General Hospital, Sarawak, Malaysia
| | - Kok Choon Cheah
- Haematology Unit, Department of Internal Medicine, Sarawak General Hospital, Sarawak, Malaysia
| | - Tze Shin Leong
- Haematology Unit, Department of Internal Medicine, Sarawak General Hospital, Sarawak, Malaysia
| | - Lee Ping Chew
- Haematology Unit, Department of Internal Medicine, Sarawak General Hospital, Sarawak, Malaysia
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3
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Buterin T, Doričić R, Broznić D, Ćorić T, Muzur A. The Labin Region, an ecologically vulnerable geographical area in Croatia: Mortality characteristics in an area polluted by industrial over a 40-year period. GEOSPATIAL HEALTH 2022; 17. [PMID: 35579247 DOI: 10.4081/gh.2022.1082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/28/2022] [Indexed: 06/15/2023]
Abstract
The history of the Labin region in Croatia includes intensive industrial development with repercussions of pollution on environment and health. Assuming that prolonged exposure to polluted environments causes qualitative changes in mortality, the aim was to analyse the mortality characteristics of the population of the Labin Region for the 1968-2008 period based on data from the Croatian Bureau of Statistics. Public health and social opportunities in this geographical area carry a long-term burden of exposure to an industrial polluted environment with outcomes expressed by mortality or/and morbidity in the population. This study includes data on 11,903 deaths, most of which due to diseases of the circulatory, respiratory and digestive systems as well as neoplasms. In the third and fourth decade of the study period, a group of neoplasms showed significant increases, while the increase in respiratory diseases were more gradual. The female population died mostly from diseases of the circulatory and endocrine system as well as neoplasms, while the male population mainly died from diseases of the digestive system and external causes. This research provides guidelines that could create better public health, raising the quality of life and contribute to a future environmental protection in local communities by targeted policies.
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Affiliation(s)
- Toni Buterin
- Faculty of Medicine, University of Rijeka, Rijeka.
| | | | | | - Tanja Ćorić
- Andrija Štampar Teaching Institute of Public Health, Zagreb.
| | - Amir Muzur
- Faculty of Medicine, University of Rijeka, Rijeka; Faculty of Health Studies, University of Rijeka, Rijeka.
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Amster E. Public health impact of coal-fired power plants: a critical systematic review of the epidemiological literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:558-580. [PMID: 31617747 DOI: 10.1080/09603123.2019.1674256] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 09/25/2019] [Indexed: 06/10/2023]
Abstract
Coal-based energy production is the most utilized method of electricity production worldwide and releases the highest concentration of gaseous, particulate, and metallic pollutants. Toxicological research has shown that coal combustion by-products are carcinogens, endocrine disruptors, and cardiorespiratory toxins. This article aims to systematically review the epidemiological literature on the impact emissions from coal-based power production has on morbidity and mortality worldwide. Two thousand one hundred and fifty-two articles were retrieved based on search criteria. Word search of abstract and article text filtered the results to 95 articles. Forty articles were included after screening. The literature indicates a significant adverse effect from particulate matter and polyaromatic hydrocarbon emissions on morbidity and mortality. There is a lack of consistency of exposure assessment and inadequate control of significant potential confounders such as social economic status. Future research should focus on improving exposure assessment models, specifically source-apportionment and geographic information system methods to model power plant-specific emissions.
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Affiliation(s)
- Eric Amster
- Faculty of Social Welfare and Health Sciences, School of Public Health, University of Haifa, Haifa, Israel
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Sarizadeh R, Dastoorpoor M, Goudarzi G, Simbar M. The Association Between Air Pollution and Low Birth Weight and Preterm Labor in Ahvaz, Iran. Int J Womens Health 2020; 12:313-325. [PMID: 32440227 PMCID: PMC7211085 DOI: 10.2147/ijwh.s227049] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 02/20/2020] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Pregnant women and fetuses are sensitive to air pollution due to physiological changes in pregnancy. The aim of this study was to determine the relationship between exposure to air pollution, low birth weight and preterm labor in Ahvaz. METHODS This research was a time-series study. The research sample consisted of all data about low birth weight and preterm labor pregnant women from Imam Khomeini Hospital and Razi Hospital in Ahvaz city. Air pollutant data including O3, NO, NO2, SO2, CO, PM10 and PM2.5 and climate data were collected from the Environmental Protection Agency and the Khuzestan Province during a 10-year period from 2008 to 2018. The generalized additive models (GAMs) with different air pollutant lags up to 6 days were used. RESULTS The results of multiple GAM model have shown that there is a direct and significant relationship between exposure to PM10 at 0-6-day lag, SO2 at 2- and 3-day lag and low birth weight. In addition, there was a direct and significant correlation between exposure to NO2, NO, CO and PM2.5 at 0-6-day lag and preterm labor. CONCLUSION The results indicate the effect of air pollutants on low birth weight and preterm labor. Therefore, pregnant women should be informed about the negative consequences of air pollution and avoid exposure to polluted air during pregnancy.
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Affiliation(s)
- Reihaneh Sarizadeh
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholamreza Goudarzi
- Department of Environmental Health Engineering, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran
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Drago G, Ruggieri S, Bianchi F, Sampino S, Cibella F. Birth Cohorts in Highly Contaminated Sites: A Tool for Monitoring the Relationships Between Environmental Pollutants and Children's Health. Front Public Health 2020; 8:125. [PMID: 32411642 PMCID: PMC7198735 DOI: 10.3389/fpubh.2020.00125] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 03/27/2020] [Indexed: 12/15/2022] Open
Abstract
Industrial areas are characterized by the dispersion of environmental stressors that could possibly have long-term detrimental effects on both human health and the environment. Environmental contamination has been indicated to be one of the major risks for reproductive health. In this context, the effects of environmental pollution on pregnant women living in heavily polluted areas is of special interest. In fact, fetal development is a crucial phase due to the dynamic interaction between the maternal/external environments and the developing organs and tissues. Moreover, following Barker's postulate of the intrauterine origin of health and disease, the events occurring in this time window could affect future health. Birth cohorts provide the most suitable design for assessing the association between early-life and possible long-term health outcomes in highly contaminated sites. By providing an assessment of the early life environment throughout the collection of biological samples, birth cohorts offer the opportunity to study in-depth several possible confounders and outcomes by means of questionnaires and follow-ups based on clinical evaluations and bio-specimen samplings. The exposome comprises the totality of exposures from conception onwards; the birth cohort approach allows the integration of the exposures as a whole, including those related to socioeconomic status, with "omics" data from biological samples collected at birth and throughout life. In the characterization of the "fetal exposome," the placenta represents a highly informative and scarcely considered organ. For this purpose, the "Neonatal Environment and Health Outcomes" (NEHO) birth cohort has been established by enrolling pregnant women residing in contaminated sites and in surrounding areas.
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Affiliation(s)
- Gaspare Drago
- National Research Council of Italy, Institute for Biomedical Research and Innovation, Palermo, Italy
| | - Silvia Ruggieri
- National Research Council of Italy, Institute for Biomedical Research and Innovation, Palermo, Italy
| | - Fabrizio Bianchi
- National Research Council of Italy, Institute of Clinical Physiology, Pisa, Italy
| | - Silvestre Sampino
- Department of Experimental Embryology, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Fabio Cibella
- National Research Council of Italy, Institute for Biomedical Research and Innovation, Palermo, Italy
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Fu L, Chen Y, Yang X, Yang Z, Liu S, Pei L, Feng B, Cao G, Liu X, Lin H, Li X, Ye Y, Zhang B, Sun J, Xu X, Liu T, Ma W. The associations of air pollution exposure during pregnancy with fetal growth and anthropometric measurements at birth: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:20137-20147. [PMID: 31111384 DOI: 10.1007/s11356-019-05338-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 05/01/2019] [Indexed: 06/09/2023]
Abstract
Fetal growth has been demonstrated to be an important predictor of perinatal and postnatal health. Although the effects of maternal exposure to air pollution during pregnancy on fetal growth have been investigated using ultrasound in many previous studies, the results were inconsistent and disputable. We aimed to qualitatively and quantitatively investigate the associations of air pollution exposure during different periods of pregnancy with fetal growth and anthropometric measurements at birth. We searched for all studies investigating the associations of air pollution exposure during pregnancy with fetal growth and birth anthropometric measurements in English and Chinese databases published before July 31, 2017. A random-effects model was employed in the meta-analysis to estimate the pooled effects of each 10 μg/m3 increment in air pollutant exposure. The ACROBAT-NRSI tool was applied to assess the quality of each included study, and the GRADE tool was employed to assess the overall quality of the meta-analysis. Maternal PM2.5 exposure (10 μg/m3) during the entire pregnancy was negatively associated with head circumference at birth (β = - 0.30 cm, 95% CI - 0.49, - 0.10), and NO2 exposure during the entire pregnancy was significantly linked to shorter length at birth (β = - 0.03 cm, 95% CI - 0.05, - 0.02). Maternal exposure to higher NO2 and PM2.5 during pregnancy may impair neonatal head circumference and length development, respectively. More studies are needed to confirm the effects of NO2 and PM2.5 and to identify the sources and major toxic components of PMs.
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Affiliation(s)
- Li Fu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, 511430, China
| | - Yi Chen
- Guangzhou Panyu Central Hospital, Guangzhou, 511400, China
| | - Xinyi Yang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, 511430, China
| | - Zuyao Yang
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, 999000, Hong Kong, China
| | - Sha Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, 511430, China
| | - Lei Pei
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, 511430, China
| | - Baixiang Feng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, 511430, China
| | - Ganxiang Cao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, 511430, China
| | - Xin Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, 511430, China
| | - Hualiang Lin
- Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, 511430, China
| | - Yufeng Ye
- Guangzhou Panyu Central Hospital, Guangzhou, 511400, China
| | - Bo Zhang
- Center for Food Safety and Health, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, 510080, China
| | - Jiufeng Sun
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, 511430, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, 511430, China.
- General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, 528200, Guangdong, China.
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, 511430, China.
- General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, 528200, Guangdong, China.
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Amster E, Lew Levy C. Impact of Coal-fired Power Plant Emissions on Children's Health: A Systematic Review of the Epidemiological Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16112008. [PMID: 31195672 PMCID: PMC6604200 DOI: 10.3390/ijerph16112008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 05/28/2019] [Accepted: 05/31/2019] [Indexed: 11/20/2022]
Abstract
Coal-based energy production is the most utilized method of electricity production worldwide and releases the highest concentration of gaseous, particulate, and metallic pollutants. This article aims to systematically review the public health impact of coal-fired power plant emissions on children’s health. PubMed, Web of Science, and Toxline databases were queried for the past 20 years. Inclusion criteria included original scientific articles with (a) coal-fired power plant exposure assessment, (b) at least one primary pediatric health outcome, and (c) assessment of potential sources of confounding and bias. Only morbidity and mortality studies were included; economic analysis and risk assessment studies without a primary health outcome were not included. Of 513 articles initially retrieved, 17 epidemiological articles were included in the final systematic review after screening and eligibility. The articles reviewed showed a statistically significant adverse effect on pediatric neurodevelopment; birth weight and pediatric respiratory morbidity was associated with exposure to coal-fired power plant emissions, primarily particulate matter and polyaromatic hydrocarbon exposure. There is a lack of consistency of exposure assessment and inadequate control of significant potential confounders such as social economic status. Future research should focus on improving exposure assessment models with an emphasis on source-apportionment and geographic information system methods to model power plant-specific emissions.
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Affiliation(s)
- Eric Amster
- Department of Environmental and Occupational Health, University of Haifa School of Public Health, Haifa 3498838, Israel.
- Department of Occupational Medicine, Meuhedet Healthcare Organization, Tel Aviv 6777401, Israel.
| | - Clara Lew Levy
- Department of Environmental and Occupational Health, University of Haifa School of Public Health, Haifa 3498838, Israel.
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Desai G, Chu L, Guo Y, Myneni AA, Mu L. Biomarkers used in studying air pollution exposure during pregnancy and perinatal outcomes: a review. Biomarkers 2017; 22:489-501. [PMID: 28581828 DOI: 10.1080/1354750x.2017.1339294] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE This review focuses on studies among pregnant women that used biomarkers to assess air pollution exposure, or to understand the mechanisms by which it affects perinatal outcomes. METHODS We searched PubMed and Google scholar databases to find articles. RESULTS AND CONCLUSIONS We found 29 articles, mostly consisting of cohort studies. Interpolation models were most frequently used to assess exposure. The most consistent positive association was between polycyclic aromatic hydrocarbon (PAH) exposure during entire pregnancy and cord blood PAH DNA adducts. Exposure to particulate matter (PM) and nitrogen dioxide (NO2) showed consistent inverse associations with mitochondrial DNA (mtDNA) content, particularly in the third trimester of pregnancy. No single pollutant showed strong associations with all the biomarkers included in this review. C-reactive proteins (CRPs) and oxidative stress markers increased, whereas telomere length decreased with increasing air pollution exposure. Placental global DNA methylation and mtDNA methylation showed contrasting results with air pollution exposure, the mechanism behind which is unclear. Most studies except those on PAH DNA adducts and mtDNA content provided insufficient evidence for characterizing a critical exposure window. Further research using biomarkers is warranted to understand the relationship between air pollution and perinatal outcomes.
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Affiliation(s)
- Gauri Desai
- a Department of Epidemiology and Environmental Health, School of Public Health and Health Professions , The State University of New York (SUNY) at Buffalo , Buffalo , NY , USA
| | - Li Chu
- b Department of Obstetrics and Gynecology , Anzhen Hospital , Beijing , China
| | - Yanjun Guo
- c Department of Obstetrics and Gynecology , Hang Tian General Hospital , Beijing , China
| | - Ajay A Myneni
- a Department of Epidemiology and Environmental Health, School of Public Health and Health Professions , The State University of New York (SUNY) at Buffalo , Buffalo , NY , USA
| | - Lina Mu
- a Department of Epidemiology and Environmental Health, School of Public Health and Health Professions , The State University of New York (SUNY) at Buffalo , Buffalo , NY , USA
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Medunić G, Ahel M, Mihalić IB, Srček VG, Kopjar N, Fiket Ž, Bituh T, Mikac I. Toxic airborne S, PAH, and trace element legacy of the superhigh-organic-sulphur Raša coal combustion: Cytotoxicity and genotoxicity assessment of soil and ash. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 566-567:306-319. [PMID: 27232961 DOI: 10.1016/j.scitotenv.2016.05.096] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/13/2016] [Accepted: 05/14/2016] [Indexed: 06/05/2023]
Abstract
This paper presents the levels of sulphur, polycyclic aromatic hydrocarbons (PAHs), and potentially toxic trace elements in soils surrounding the Plomin coal-fired power plant (Croatia). It used domestic superhigh-organic-sulphur Raša coal from 1970 until 2000. Raša coal was characterised by exceptionally high values of S, up to 14%, making the downwind southwest (SW) area surrounding the power plant a significant hotspot. The analytical results show that the SW soil locations are severely polluted with S (up to 4%), and PAHs (up to 13,535ng/g), while moderately with Se (up to 6.8mg/kg), and Cd (up to 4.7mg/kg). The composition and distribution pattern of PAHs in the polluted soils indicate that their main source could be airborne unburnt coal particles. The atmospheric dispersion processes of SO2 and ash particles have influenced the composition and distribution patterns of sulphur and potentially toxic trace elements in studied soils, respectively. A possible adverse impact of analysed soil on the local karstic environment was evaluated by cytotoxic and genotoxic methods. The cytotoxicity effects of soil and ash water extracts on the channel catfish ovary (CCO) cell line were found to be statistically significant in the case of the most polluted soil and ash samples. However, the primary DNA-damaging potential of the most polluted soil samples on the CCO cells was found to be within acceptable boundaries.
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Affiliation(s)
- Gordana Medunić
- University of Zagreb, Faculty of Science, Department of Geology, Horvatovac 95, Zagreb, Croatia.
| | - Marijan Ahel
- Ruđer Bošković Institute, Division for Marine and Environmental Research, Zagreb, Croatia
| | | | - Višnja Gaurina Srček
- University of Zagreb, Faculty of Food Technology and Biotechnology, Zagreb, Croatia
| | - Nevenka Kopjar
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Željka Fiket
- Ruđer Bošković Institute, Division for Marine and Environmental Research, Zagreb, Croatia
| | - Tomislav Bituh
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Iva Mikac
- Ruđer Bošković Institute, Division for Marine and Environmental Research, Zagreb, Croatia
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11
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Estarlich M, Ballester F, Davdand P, Llop S, Esplugues A, Fernández-Somoano A, Lertxundi A, Guxens M, Basterrechea M, Tardón A, Sunyer J, Iñiguez C. Exposure to ambient air pollution during pregnancy and preterm birth: A Spanish multicenter birth cohort study. ENVIRONMENTAL RESEARCH 2016; 147:50-8. [PMID: 26851724 DOI: 10.1016/j.envres.2016.01.037] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 12/29/2015] [Accepted: 01/25/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND AND OBJECTIVE Preterm birth is a major determinant of infant mortality and morbidity. Air pollution has been suggested as a risk factor for preterm delivery; however, the scientific evidence on this impact remains inconsistent. We assessed the association between residential exposure to air pollution during pregnancy and preterm birth (gestational age at delivery <37 weeks) in Spain. METHODS This study was based on 2409 pregnant women participating in the INMA birth cohorts in Asturias, Gipuzkoa, Sabadell and Valencia. Ambient levels of nitrogen dioxide (NO2) and benzene were estimated for each woman's residence for each trimester and for the whole pregnancy, using temporally adjusted land-use regression models. The association between air pollution exposure and preterm birth was assessed for each cohort separately by means of logistic regression models controlling for potential confounders, under single- and two-pollutant models, for all the women in the study and for those spending more than 15h/day at home. Combined estimates of the association across cohorts were obtained through meta-analysis. RESULTS Throughout the whole sample, suggestive but no statistically significant associations were found between exposure and preterm birth. For pregnant women spending more time at home significant associations were found for both pollutants, under single- and two-pollutant models. Under the last ones, NO2 exposure during the second trimester and the whole pregnancy was associated with a higher risk of preterm delivery (OR=1.58, (95%CI: 1.04-2.42) per 10μg/m(3) increase). Benzene exposure during the third trimester was also associated with preterm birth in that subsample (OR=1.45, (95%CI: 1.00-2.09) per 1μg/m(3) increase). CONCLUSION We found suggestive associations between NO2 and benzene exposure during pregnancy and preterm birth. Estimates of the association were higher among women who spent more time at home, probably reflecting a better exposure assessment in this group.
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Affiliation(s)
- Marisa Estarlich
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Avenida de Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ferran Ballester
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Avenida de Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Payam Davdand
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Center for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain; Experimental and Health Sciences, Pompeu Fabra University, 08003 Barcelona, Catalonia, Spain
| | - Sabrina Llop
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Avenida de Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ana Esplugues
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Avenida de Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ana Fernández-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; University of Oviedo, Oviedo, Spain
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; University of the Basque Country, EHU/UPV, Spain; Health Research Institute (BIODONOSTIA), Spain
| | - Mònica Guxens
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Center for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain; Experimental and Health Sciences, Pompeu Fabra University, 08003 Barcelona, Catalonia, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Mikel Basterrechea
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Public Health Division of Gipuzkoa, Basque Government, San Sebastián, Spain; Health Research Institute (BIODONOSTIA), Spain
| | - Adonina Tardón
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; University of Oviedo, Oviedo, Spain
| | - Jordi Sunyer
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Center for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain; Experimental and Health Sciences, Pompeu Fabra University, 08003 Barcelona, Catalonia, Spain
| | - Carmen Iñiguez
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Avenida de Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Estarlich M, Ballester F, Aguilera I, Fernández-Somoano A, Lertxundi A, Llop S, Freire C, Tardón A, Basterrechea M, Sunyer J, Iñiguez C. Residential exposure to outdoor air pollution during pregnancy and anthropometric measures at birth in a multicenter cohort in Spain. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:1333-8. [PMID: 21429861 PMCID: PMC3230392 DOI: 10.1289/ehp.1002918] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 03/23/2011] [Indexed: 05/18/2023]
Abstract
BACKGROUND A growing body of research suggests that prenatal exposure to air pollution may be harmful to fetal development. We assessed the association between exposure to air pollution during pregnancy and anthropometric measures at birth in four areas within the Spanish Children's Health and Environment (INMA) mother and child cohort study. METHODS Exposure to ambient nitrogen dioxide (NO2) and benzene was estimated for the residence of each woman (n = 2,337) for each trimester and for the entire pregnancy. Outcomes included birth weight, length, and head circumference. The association between residential outdoor air pollution exposure and birth outcomes was assessed with linear regression models controlled for potential confounders. We also performed sensitivity analyses for the subset of women who spent more time at home during pregnancy. Finally, we performed a combined analysis with meta-analysis techniques. RESULTS In the combined analysis, an increase of 10 µg/m3 in NO2 exposure during pregnancy was associated with a decrease in birth length of -0.9 mm [95% confidence interval (CI), -1.8 to -0.1 mm]. For the subset of women who spent ≥ 15 hr/day at home, the association was stronger (-0.16 mm; 95% CI, -0.27 to -0.04). For this same subset of women, a reduction of 22 g in birth weight was associated with each 10-µg/m3 increase in NO2 exposure in the second trimester (95% CI, -45.3 to 1.9). We observed no significant relationship between benzene levels and birth outcomes. CONCLUSIONS NO2 exposure was associated with reductions in both length and weight at birth. This association was clearer for the subset of women who spent more time at home.
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Affiliation(s)
- Marisa Estarlich
- Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain.
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Lavezzi AM, Mohorovic L, Alfonsi G, Corna MF, Matturri L. Brain iron accumulation in unexplained fetal and infant death victims with smoker mothers--the possible involvement of maternal methemoglobinemia. BMC Pediatr 2011; 11:62. [PMID: 21733167 PMCID: PMC3146836 DOI: 10.1186/1471-2431-11-62] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Accepted: 07/06/2011] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Iron is involved in important vital functions as an essential component of the oxygen-transporting heme mechanism. In this study we aimed to evaluate whether oxidative metabolites from maternal cigarette smoke could affect iron homeostasis in the brain of victims of sudden unexplained fetal and infant death, maybe through the induction of maternal hemoglobin damage, such as in case of methemoglobinemia. METHODS Histochemical investigations by Prussian blue reaction were made on brain nonheme ferric iron deposits, gaining detailed data on their localization in the brainstem and cerebellum of victims of sudden death and controls. The Gless and Marsland's modification of Bielschowsky's was used to identify neuronal cell bodies and neurofilaments. RESULTS Our approach highlighted accumulations of blue granulations, indicative of iron positive reactions, in the brainstem and cerebellum of 33% of victims of sudden death and in none of the control group. The modified Bielschowsky's method confirmed that the cells with iron accumulations were neuronal cells. CONCLUSIONS We propose that the free iron deposition in the brain of sudden fetal and infant death victims could be a catabolic product of maternal methemoglobinemia, a biomarker of oxidative stress likely due to nicotine absorption.
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Affiliation(s)
- Anna M Lavezzi
- "Lino Rossi" Research Center for The Study and Prevention of Unexpected Perinatal Death and SIDS, Department of Surgical, Reconstructive and Diagnostic Sciences, University of Milan, Italy
| | - Lucijan Mohorovic
- Department of Environmental Medicine, University of Rijeka School of Medicine, Rijeka, Croatia
| | - Graziella Alfonsi
- "Lino Rossi" Research Center for The Study and Prevention of Unexpected Perinatal Death and SIDS, Department of Surgical, Reconstructive and Diagnostic Sciences, University of Milan, Italy
| | - Melissa F Corna
- "Lino Rossi" Research Center for The Study and Prevention of Unexpected Perinatal Death and SIDS, Department of Surgical, Reconstructive and Diagnostic Sciences, University of Milan, Italy
| | - Luigi Matturri
- "Lino Rossi" Research Center for The Study and Prevention of Unexpected Perinatal Death and SIDS, Department of Surgical, Reconstructive and Diagnostic Sciences, University of Milan, Italy
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Mohorovic L, Petrovic O, Haller H, Micovic V. Pregnancy loss and maternal methemoglobin levels: an indirect explanation of the association of environmental toxics and their adverse effects on the mother and the fetus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2010; 7:4203-12. [PMID: 21318003 PMCID: PMC3037049 DOI: 10.3390/ijerph7124203] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 11/29/2010] [Accepted: 12/04/2010] [Indexed: 11/16/2022]
Abstract
The aim of this epidemiologic study was to point out a relationship between the exposure to products of coal combustion, and complications in pregnancy where one third of causes of stillbirth are still unknown. In the town of Labin (Croatia) a coal-powered thermoelectric power plant is the single major air polluter. We compared the records of miscarriages, premature births and stillbirths in two periods: the control and the exposure period. Data on reproductive loss was based on the records of pregnant women visiting for regular monthly pregnancy checkups. At the time of the epidemiological prospective study, 260 women (n = 138 in the clean period and n = 122 in the dirty period) were considered representative. The data were processed using Chi square and correlation tests. The frequencies of miscarriages and stillbirths were significantly lower in the control than in the exposure period (p < 0.05). Methemoglobinemia and stillbirths recorded over the "exposure" period are significantly higher than in the "control" period (p = 0.0205). The level of methemoglobin in the bloodstream is an worthy biomarker, predictor and precursor of environmental toxics' adverse effects on the mother and fetus, and can indirectly explain the unrecognized level of fetal methemoglobin. Methemoglobin and heme, having prooxidant properties, also cause the early and late endothelial dysfunction of vital organs. Despite our retrospective epidemiological study findings, we emphasize that the rate of reproductive loss represents a hypothetical risk, which needs to be confirmed with further fetal clinical and anatomopatholgical researches about the effects of methemoglobin catabolism products on the fetal CNS.
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Affiliation(s)
- Lucijan Mohorovic
- Department of Environmental Medicine, University of Rijeka School of Medicine, Creska 2, 52221 Rabac, Croatia; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: 385-52-872-559; Fax: 385-52-885-026
| | - Oleg Petrovic
- Department of Gynaecology and Obstetrics, University Hospital Center Rijeka, 51000 Rijeka, Croatia; E-Mails: (O.P.); (H.H.)
| | - Herman Haller
- Department of Gynaecology and Obstetrics, University Hospital Center Rijeka, 51000 Rijeka, Croatia; E-Mails: (O.P.); (H.H.)
| | - Vladimir Micovic
- Department of Environmental Medicine, University of Rijeka School of Medicine, Creska 2, 52221 Rabac, Croatia; E-Mail:
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Al-Aubaidy HA, Jelinek HF. 8-Hydroxy-2-deoxy-guanosine identifies oxidative DNA damage in a rural prediabetes cohort. Redox Rep 2010; 15:155-60. [PMID: 20663291 DOI: 10.1179/174329210x12650506623681] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Rising levels of oxidative stress play an important role in the pathogenesis of type 2 diabetes mellitus. Therefore, we investigated the serum level of 8-hydroxy-2-deoxy-guanosine (8-OHdG) as an early oxidative stress marker in patients with prediabetes and with type 2 diabetes mellitus. SUBJECTS AND METHODS Convenience sampling from people attending a diabetes screening clinic. Participants at the rural diabetes screening clinic had their medical history recorded as well as body mass index, blood glucose, cholesterol, glutathione, malondialdehyde, fasting blood glucose and 8-OHdG measured. Statistical analysis was performed using ANOVA followed by Sheffe posthoc test for between-group differences. RESULTS The 8-OHdG level was significantly greater in the prediabetes (516.5 +/- 260 pg/ml) compared to control group (177.8 +/- 91 pg/ml; P < 0.01). The diabetes group (1926.9 +/- 1197 pg/ml) had the highest level of 8-OHdG, being approximately four times greater compared to the prediabetes group (P < 0.001). No significant change in the cholesterol profile, MDA level indicative of lipid peroxidation and antioxidant activity as measured by erythrocyte reduced glutathione was observed in the prediabetes group compared to the control group (P > 0.05). CONCLUSIONS 8-OHdG levels in both the prediabetes and diabetes group were increased from control values suggesting a role for 8-OHdG as an early disease marker that may be more sensitive compared to cholesterol, MDA and erythrocyte reduced glutathione levels, which were within normal limits. This is of clinical significance as 8-OHdG is a strong indicator of oxidative stress related DNA damage within blood vessel walls and other tissue that increases the risk of cardiovascular disease.
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Affiliation(s)
- Hayder A Al-Aubaidy
- Faculty of Science, Charles Sturt University, Albury, New South Wales, Australia.
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16
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Manassaram DM, Backer LC, Messing R, Fleming LE, Luke B, Monteilh CP. Nitrates in drinking water and methemoglobin levels in pregnancy: a longitudinal study. Environ Health 2010; 9:60. [PMID: 20946657 PMCID: PMC2967503 DOI: 10.1186/1476-069x-9-60] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Accepted: 10/14/2010] [Indexed: 05/14/2023]
Abstract
BACKGROUND Private water systems are more likely to have nitrate levels above the maximum contaminant level (MCL). Pregnant women are considered vulnerable to the effects of exposure to high levels of nitrates in drinking water due to their altered physiological states. The level of methemoglobin in the blood is the biomarker often used in research for assessing exposure to nitrates. The objective of this study was to assess methemoglobin levels and examine how various factors affected methemoglobin levels during pregnancy. We also examined whether differences in water use practices existed among pregnant women based on household drinking water source of private vs. public supply. METHODS A longitudinal study of 357 pregnant women was conducted. Longitudinal regression models were used to examine changes and predictors of the change in methemoglobin levels over the period of gestation. RESULTS Pregnant women showed a decrease in methemoglobin levels with increasing gestation although <1% had levels above the physiologic normal of 2% methemoglobin, regardless of the source of their drinking water. The multivariable analyses did not show a statistically significant association between methemoglobin levels and the estimated nitrate intake from tap water among pregnant women around 36 weeks gestation (β = 0.046, p = 0.986). Four women had tap water nitrate levels above the MCL of 10 mg/L. At enrollment, a greater proportion of women who reported using water treatment devices were private wells users (66%) compared to public system users (46%) (p < 0.0001). Also, a greater proportion of private well users (27%) compared to public system users (13%) were using devices capable of removing nitrate from water (p < 0.0001). CONCLUSION Pregnant women potentially exposed to nitrate levels primarily below the MCL for drinking water were unlikely to show methemoglobin levels above the physiologic normal. Water use practices such as the use of treatment devices to remove nitrates varied according to water source and should be considered in the assessment of exposure to nitrates in future studies.
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Affiliation(s)
- Deana M Manassaram
- Centers for Disease Control and Prevention, National Center for Environmental Health, Health Studies Branch. 4770 Buford Highway, MS F-57 Chamblee, GA 30341, USA
- University of Miami, Department of Epidemiology and Public Health, 1120 NW 14th Street Miami, FL 33136, USA
| | - Lorraine C Backer
- Centers for Disease Control and Prevention, National Center for Environmental Health, Health Studies Branch. 4770 Buford Highway, MS F-57 Chamblee, GA 30341, USA
| | - Rita Messing
- Minnesota Department of Health, Division of Environmental Health, 625 N. Robert St. St. Paul, MN 55155, USA
| | - Lora E Fleming
- University of Miami, Department of Epidemiology and Public Health, 1120 NW 14th Street Miami, FL 33136, USA
| | - Barbara Luke
- University of Miami, Department of Epidemiology and Public Health, 1120 NW 14th Street Miami, FL 33136, USA
| | - Carolyn P Monteilh
- Centers for Disease Control and Prevention, National Center for Environmental Health, Health Studies Branch. 4770 Buford Highway, MS F-57 Chamblee, GA 30341, USA
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Ballester F, Estarlich M, Iñiguez C, Llop S, Ramón R, Esplugues A, Lacasaña M, Rebagliato M. Air pollution exposure during pregnancy and reduced birth size: a prospective birth cohort study in Valencia, Spain. Environ Health 2010; 9:6. [PMID: 20113501 PMCID: PMC2845572 DOI: 10.1186/1476-069x-9-6] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Accepted: 01/29/2010] [Indexed: 05/18/2023]
Abstract
BACKGROUND Maternal exposure to air pollution has been related to fetal growth in a number of recent scientific studies. The objective of this study was to assess the association between exposure to air pollution during pregnancy and anthropometric measures at birth in a cohort in Valencia, Spain. METHODS Seven hundred and eighty-five pregnant women and their singleton newborns participated in the study. Exposure to ambient nitrogen dioxide (NO2) was estimated by means of land use regression. NO2 spatial estimations were adjusted to correspond to relevant pregnancy periods (whole pregnancy and trimesters) for each woman. Outcome variables were birth weight, length, and head circumference (HC), along with being small for gestational age (SGA). The association between exposure to residential outdoor NO2 and outcomes was assessed controlling for potential confounders and examining the shape of the relationship using generalized additive models (GAM). RESULTS For continuous anthropometric measures, GAM indicated a change in slope at NO2 concentrations of around 40 microg/m3. NO2 exposure >40 microg/m3 during the first trimester was associated with a change in birth length of -0.27 cm (95% CI: -0.51 to -0.03) and with a change in birth weight of -40.3 grams (-96.3 to 15.6); the same exposure throughout the whole pregnancy was associated with a change in birth HC of -0.17 cm (-0.34 to -0.003). The shape of the relation was seen to be roughly linear for the risk of being SGA. A 10 microg/m3 increase in NO2 during the second trimester was associated with being SGA-weight, odds ratio (OR): 1.37 (1.01-1.85). For SGA-length the estimate for the same comparison was OR: 1.42 (0.89-2.25). CONCLUSIONS Prenatal exposure to traffic-related air pollution may reduce fetal growth. Findings from this study provide further evidence of the need for developing strategies to reduce air pollution in order to prevent risks to fetal health and development.
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Affiliation(s)
- Ferran Ballester
- Center for Public Health Research (CSISP), Conselleria de Sanitat, Avda Catalunya 21, 46020, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Doctor Aiguader 88, 08003, Barcelona, Spain
- School of Nursing, Universitat de València, C Jaume Roig s/n 46010, Valencia, Spain
| | - Marisa Estarlich
- Center for Public Health Research (CSISP), Conselleria de Sanitat, Avda Catalunya 21, 46020, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Carmen Iñiguez
- Center for Public Health Research (CSISP), Conselleria de Sanitat, Avda Catalunya 21, 46020, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Sabrina Llop
- Center for Public Health Research (CSISP), Conselleria de Sanitat, Avda Catalunya 21, 46020, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Rosa Ramón
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Doctor Aiguader 88, 08003, Barcelona, Spain
- General Directorate of Public Health. Conselleria de Sanitat, Avda Catalunya 21, 46020, Valencia, Spain
| | - Ana Esplugues
- Center for Public Health Research (CSISP), Conselleria de Sanitat, Avda Catalunya 21, 46020, Valencia, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Marina Lacasaña
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Doctor Aiguader 88, 08003, Barcelona, Spain
- Andalusian School of Public Health (EASP), Campus de la Cartuja s/n, Granada, Spain
| | - Marisa Rebagliato
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Doctor Aiguader 88, 08003, Barcelona, Spain
- Department of Public Health, Rey Juan Carlos University, 28922, Alcorcón, Madrid, Spain
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18
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Rudra CB, Williams MA, Schiff MA, Koenig JQ, Dills R, Yu J. A prospective study of maternal carboxyhaemoglobin and pre-eclampsia risk. Paediatr Perinat Epidemiol 2010; 24:35-44. [PMID: 20078828 PMCID: PMC2808632 DOI: 10.1111/j.1365-3016.2009.01076.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We aimed to measure the relationship between early-pregnancy maternal carboxyhaemoglobin and subsequent pre-eclampsia risk. A nested case-control analysis was conducted using data from a western Washington State cohort study (1996-2004). We measured maternal whole blood carboxyhaemoglobin in 128 women who developed pre-eclampsia and 419 normotensive controls (mean gestational age at blood draw, 14.8 weeks). After adjustment for confounders, high (>/=1%) vs. low (<0.7%) carboxyhaemoglobin odds ratios [OR] and 95% confidence intervals [CI] were 4.09 [1.30, 12.9] in multiparous women, 0.53 [0.23, 1.26] in primiparae and 1.11 [0.55, 2.25] in the overall study population (parity interaction P = 0.01). The influence of parity on the association was unexpected. The association between high carboxyhaemoglobin and pre-eclampsia risk in multiparae implicates hypoxia at the fetal-maternal interface as a pathogenic mechanism. These results also suggest that the aetiology of the disease may differ according to parity.
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Affiliation(s)
- Carole B. Rudra
- Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo NY.,Center for Perinatal Studies, Swedish Medical Center, Seattle WA
| | - Michelle A. Williams
- Center for Perinatal Studies, Swedish Medical Center, Seattle WA.,Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle WA
| | - Melissa A. Schiff
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle WA.,Harborview Injury Prevention and Research Center, Harborview Medical Center, Seattle WA
| | - Jane Q. Koenig
- Department of Environmental and Occupational Health Sciences, School of Public Health and Community Medicine, University of Washington, Seattle WA
| | - Russell Dills
- Department of Environmental and Occupational Health Sciences, School of Public Health and Community Medicine, University of Washington, Seattle WA
| | - Jianbo Yu
- Department of Environmental and Occupational Health Sciences, School of Public Health and Community Medicine, University of Washington, Seattle WA
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Mohorovic L, Materljan E, Brumini G. Consequences of methemoglobinemia in pregnancy in newborns, children, and adults: issues raised by new findings on methemoglobin catabolism. J Matern Fetal Neonatal Med 2009; 23:956-9. [DOI: 10.3109/14767050903410656] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Udonwa NE, Uko EK, Ikpeme BM, Ibanga IA, Okon BO. Exposure of petrol station attendants and auto mechanics to premium motor sprit fumes in Calabar, Nigeria. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2009; 2009:281876. [PMID: 19936128 PMCID: PMC2778824 DOI: 10.1155/2009/281876] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Revised: 04/21/2009] [Accepted: 05/29/2009] [Indexed: 11/18/2022]
Abstract
A population-based-cross-sectional survey was carried out to investigate the potential risk of exposure to premium motor spirit (PMS) fumes in Calabar, Nigeria, among Automobile Mechanics (AM), Petrol Station Attendants (PSA) and the general population. Structured questionnaire was administered on the randomly chosen subjects to elicit information on their exposure to PMS. Duration of exposure was taken as the length of work in their various occupations. Venous blood was taken for methaemoglobin (MetHb) and packed cells volume (PCV). Mean MetHb value was higher in AM (7.3%) and PSA (5.8%) than in the subjects from the general population (2.7%). PCV was lower in PSA (30.8%), than AM (33.3%) and the subjects from the general population (40.8%). MetHb level was directly proportional, and PCV inversely related, to the duration of exposure. The study suggested increased exposure to petrol fumes among AM, PSA, and MetHb as a useful biomarker in determining the level of exposure to benzene in petrol vapour.
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Affiliation(s)
- N E Udonwa
- Department of Family Medicine, University of Calabar Teaching Hospital, Calabar 1278, Cross River State, Nigeria.
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Mohorovic L. The role of methemoglobinemia in early and late complicated pregnancy. Med Hypotheses 2006; 68:1114-9. [PMID: 17112681 DOI: 10.1016/j.mehy.2006.09.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2006] [Accepted: 09/10/2006] [Indexed: 11/26/2022]
Abstract
The objective of this review was to direct attention about methemoglobin as a biomarker which has an important role in the detection of adverse effects of the oxidative stress, misbalanced production of ROS, RNS and RSS. According to our hypothesis, a pregnant woman continuously inhaling environmental toxics as fuel burning products, will traverse three, not two from current thought, distinct stages. The main difference among present three-stage hypothesis and other hypotheses is the assertion that, in the pathogenesis of early and late complicated pregnancy, methemoglobin takes on an important role. Secondly, we also observed the utero-placental changes as "locus manifesting minoris resistentiae" in complicated pregnancy are not the causes but a consequence of increased systemic oxidative stress. Methemoglobin and hemolysis both occur as a result of oxidative stress, but the prevalent difference between them is that methemoglobin is a reversible phenomenon (oxidant-antioxidant balance) whereas hemolysis, which occurs as a result of oxidative stress on the erythrocyte membrane, is an irreversible event. Methemoglobinemia can additionally exacerbate an existing anemia, stimulating hypoxia that may be dangerous for both mother and fetus. Own prospective study of methemoglobin in pregnancy, revealed a significant rise in the level of methemoglobin >1.5 g/L (r=0.72, p<0.01) in the exposure period, which can be explained on the basis of an oxidant-antioxidant imbalance, resulting in methemoglobinemia. Methemoglobinemia and stillbirth recorded throughout exposure period are significantly higher than those recorded in the control period (p=0.0205), and the frequencies of reproductive loss were significantly lower in the control than in the exposure period (p<0.05). Results suggest that methemoglobin as individual indicator of oxidative stress is an early marker of the identification of women with a pregnancy risk. It has the advantage of being applicable some time before ultrasonic examination becomes feasible. Further support for this assumption will require further investigations that may lead to the supposition that increasing level of methemoglobin is related to environmental toxicities complicated pregnancy and IUGR, preeclampsia, and a high percentage of perinatal mortality and morbidity.
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Affiliation(s)
- Lucijan Mohorovic
- Obstetric and Gynecologic Primary Care, Creska 2, 52221 Rabac, Labin, Croatia.
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