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Gu J, Li J, Liu L, Cao M, Tian X, Wang Z, He J. Exploring the association between atmospheric pollutants and preterm birth risk in a river valley city. Front Public Health 2024; 12:1415028. [PMID: 39118970 PMCID: PMC11306079 DOI: 10.3389/fpubh.2024.1415028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/15/2024] [Indexed: 08/10/2024] Open
Abstract
Objective To investigate the association between exposure to atmospheric pollutants and preterm birth in a river valley-type city and its critical exposure windows. Methods A retrospective cohort study was used to collect data from the medical records of preterm and full-term deliveries in two hospitals in urban areas of a typical river valley-type city from January 2018 to December 2019. A total of 7,288 cases were included in the study with general information such as pregnancy times, the number of cesarean sections, occupation, season of conception and regularity of the menstrual cycle. And confounding factors affecting preterm birth were inferred using the chi-square test. The effects of exposure to each pollutant, including particulate matter 2.5 (PM2.5), particulate matter 10 (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone (O3), during pregnancy on preterm birth and the main exposure windows were explored by establishing a logistic regression model with pollutants introduced as continuous variables. Results Maternal age, pregnancy times, number of births, number of cesarean sections, season of conception, complications diseases, comorbidities diseases, hypertension disorder of pregnancy and neonatal low birth weight of the newborn were significantly different between preterm and term pregnant women. Logistic regression analysis after adjusting for the above confounders showed that the risk of preterm birth increases by 0.9, 0.6, 2.4% in T2 and by 1.0, 0.9, 2.5% in T3 for each 10 μg/m3 increase in PM2.5, PM10, NO2 concentrations, respectively. The risk of preterm birth increases by 4.3% in T2 for each 10 μg/m3 increase in SO2 concentrations. The risk of preterm birth increases by 123.5% in T2 and increases by 188.5% in T3 for each 10 mg/m3 increase in CO concentrations. Conclusion Maternal exposure to PM2.5, PM10, NO2, CO was associated with increased risk on preterm birth in mid-pregnancy (T2) and late pregnancy (T3), SO2 exposure was associated with increased risk on preterm birth in mid-pregnancy (T2).
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Affiliation(s)
| | | | | | | | | | | | - Jinwei He
- Medical School of Yan’an University, Yan’an, China
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2
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Grabowski B, Feduniw S, Orzel A, Drab M, Modzelewski J, Pruc M, Gaca Z, Szarpak L, Rabijewski M, Baran A, Scholz A. Does Exposure to Ambient Air Pollution Affect Gestational Age and Newborn Weight?-A Systematic Review. Healthcare (Basel) 2024; 12:1176. [PMID: 38921290 PMCID: PMC11203000 DOI: 10.3390/healthcare12121176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
Current evidence suggests that airborne pollutants have a detrimental effect on fetal growth through the emergence of small for gestational age (SGA) or term low birth weight (TLBW). The study's objective was to critically evaluate the available literature on the association between environmental pollution and the incidence of SGA or TLBW occurrence. A comprehensive literature search was conducted across Pubmed/MEDLINE, Web of Science, Cochrane Library, EMBASE, and Google Scholar using predefined inclusion and exclusion criteria. The methodology adhered to the PRISMA guidelines. The systematic review protocol was registered in PROSPERO with ID number: CRD42022329624. As a result, 69 selected papers described the influence of environmental pollutants on SGA and TLBW occurrence with an Odds Ratios (ORs) of 1.138 for particulate matter ≤ 10 μm (PM10), 1.338 for particulate matter ≤ 2.5 μm (PM2.5), 1.173 for ozone (O3), 1.287 for sulfur dioxide (SO2), and 1.226 for carbon monoxide (CO). All eight studies analyzed validated that exposure to volatile organic compounds (VOCs) is a risk factor for SGA or TLBW. Pregnant women in the high-risk group of SGA occurrence, i.e., those living in urban areas or close to sources of pollution, are at an increased risk of complications. Understanding the exact exposure time of pregnant women could help improve prenatal care and timely intervention for fetuses with SGA. Nevertheless, the pervasive air pollution underscored in our findings suggests a pressing need for adaptive measures in everyday life to mitigate worldwide environmental pollution.
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Affiliation(s)
- Bartlomiej Grabowski
- Department of Urology, Military Institute of Medicine, Szaserow 128, 04-349 Warsaw, Poland;
| | - Stepan Feduniw
- Department of Gynecology, University Hospital Zürich, Frauenklinikstrasse 10, 8091 Zürich, Switzerland
| | - Anna Orzel
- I Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (A.O.); (M.D.); (A.B.)
| | - Marcin Drab
- I Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (A.O.); (M.D.); (A.B.)
| | - Jan Modzelewski
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland; (J.M.); (M.R.); (A.S.)
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland; (M.P.); (Z.G.)
- Department of Public Health, International European University, 03187 Kyiv, Ukraine
- Department of Clinical Research and Development, LUXMED Group, 02-676 Warsaw, Poland;
| | - Zuzanna Gaca
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland; (M.P.); (Z.G.)
| | - Lukasz Szarpak
- Department of Clinical Research and Development, LUXMED Group, 02-676 Warsaw, Poland;
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Michal Rabijewski
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland; (J.M.); (M.R.); (A.S.)
| | - Arkadiusz Baran
- I Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland; (A.O.); (M.D.); (A.B.)
| | - Anna Scholz
- Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland; (J.M.); (M.R.); (A.S.)
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Ahmed A, Rahman AE, Ahmed S, Rahman F, Sujan HM, Ahmmed F, Hossain AT, Sayeed A, Hossain S, Huq NL, Quaiyum MA, Reichenbach L, El Arifeen S. Effect of low-cost kitchen with improved cookstove on birthweight of neonates in Shahjadpur, Bangladesh: a cluster-randomised controlled trial. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 25:100342. [PMID: 39021478 PMCID: PMC467075 DOI: 10.1016/j.lansea.2023.100342] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 04/01/2023] [Accepted: 12/12/2023] [Indexed: 07/20/2024]
Abstract
Background Smoke from biomass fuels used for cooking in traditional cookstoves contains a variety of health-damaging pollutants. Inhalation of these pollutants by pregnant women has been linked to abnormal foetal development and adverse pregnancy outcomes, including low birthweight (LBW). There is a dearth of data on environmental interventions that have the potential to reduce exposure to biomass fuel during pregnancy and improve birth outcomes. International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) therefore, designed a low-cost kitchen with an improved cookstove and examined the impact of this intervention on the birthweight of neonates. Methods icddr,b conducted a cluster-randomised controlled trial of a 'low-cost kitchen with improved cookstove' intervention among 1,267 pregnant women who used traditional cookstoves in a rural sub-district of Bangladesh. All participants were enrolled during the first trimester of pregnancy among 104 randomly selected clusters after obtaining informed consent. The model kitchens were installed in 628 participants' households of the intervention group, and 639 participants continued to use traditional cookstoves as the control group. The primary outcome was the proportion of LBW neonates between the intervention and control groups. The study also examined if the intervention would reduce CO exposure, measured by the differences in maternal blood carbon monoxide saturation (SpCO) levels and prevalence of LBW in neonates. We performed a generalized structural equation model for jointly assessing the simultaneous relationships of biomass fuel exposure to LBW of neonates and the relationships of LBW of neonates to maternal blood SpCO level. This trial was registered with ClinicalTrials.gov (NCT02923882). Findings We found that in the intervention group using 'low-cost kitchen with improved cookstove', the risk of LBW reduced by 37% (adjusted risk ratio: 0.63, 95% CI [0.45, 0.89]). Between the second and third trimester, the mean maternal blood SpCO level was significantly reduced from 10.4% to 8.9% (p-value <0.01) in the intervention group but remained unchanged in the control group (11.6% and 11.5%). Of the total effects of the intervention on the risk of LBW, 48.3% was mediated through maternal blood SpCO level. Interpretation The risk of LBW among rural neonates was reduced in the intervention group using 'low-cost kitchen with improved cookstove', which may be attributed to the reduction in maternal blood SpCO level. Additional research is needed to identify other mechanisms through which biomass fuel exposure might lead to adverse pregnancy outcomes. Funding Grand Challenges Canada: Rising Stars in Global Health Programme.
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Affiliation(s)
- Anisuddin Ahmed
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ahmed Ehsanur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Saifuddin Ahmed
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Fariya Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Hasan Mahmud Sujan
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Faisal Ahmmed
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Aniqa Tasnim Hossain
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Abu Sayeed
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shahed Hossain
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Nafisa Lira Huq
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | | | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Noghanibehambari H, Bagheri H, Salari M, Tavassoli N, Javid R, Toranji M. Breathing in the future: prenatal exposure to air pollution and infants' health outcomes in the USA. Public Health 2023; 225:198-205. [PMID: 37939461 PMCID: PMC10842113 DOI: 10.1016/j.puhe.2023.10.012] [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: 06/03/2023] [Revised: 09/04/2023] [Accepted: 10/05/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES This study aimed to investigate the impact of air pollution on birth outcomes in the USA over several decades. STUDY DESIGN Approximately 70 million birth records were assessed for the years 1980-2020. This study focussed on seven measures of birth outcomes, including birth weight, low birth weight, very low birth weight, full-term birth weight, foetal growth, gestational age and very premature birth. METHODS An instrumental variable identification strategy was used that exploited within county-month and within month-year of birth variations in exposure to precipitation-induced changes in air pollution. RESULTS Air pollution was found to have negative and large effects on a wide range of birth outcomes. The study findings suggest that a one-standard-deviation increase in ozone was associated with a 6.4% and 12.8% increase (from the mean) in the proportion of low birth weight and very preterm birth infants, respectively. Further analyses suggest that these effects were heterogeneous across trimesters of pregnancy and reveal larger impacts during the second and third trimesters. CONCLUSIONS The results suggest that the ordinary least square estimates of previous studies considerably underestimate the true effects of pollution on birth outcomes. Policies that aim to improve the health capital of future generations should allocate more resources and initiatives to improving environmental air quality.
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Affiliation(s)
- H Noghanibehambari
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI 53706, USA.
| | - H Bagheri
- Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - M Salari
- Department of Accounting, Finance, and Economics, California State University Dominguez Hills, Carson, CA 90747, USA.
| | - N Tavassoli
- Department of Economics, University of Wisconsin Milwaukee, Milwaukee, WI 53211, USA.
| | - R Javid
- School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
| | - M Toranji
- Department of Economics, University of Tehran, Tehran, Iran.
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Menon R, Muglia LJ, Levin LH. Review on new approach methods to gain insight into the feto-maternal interface physiology. Front Med (Lausanne) 2023; 10:1304002. [PMID: 38098843 PMCID: PMC10720461 DOI: 10.3389/fmed.2023.1304002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
Non-human animals represent a large and important feature in the history of biomedical research. The validity of their use, in terms of reproducible outcomes and translational confidence to the human situation, as well as ethical concerns surrounding that use, have been and remain controversial topics. Over the last 10 years, the communities developing microphysiological systems (MPS) have produced new approach method (NAMs) such as organoids and organs-on-a-chip. These alternative methodologies have shown indications of greater reliability and translatability than animal use in some areas, represent more humane substitutions for animals in these settings, and - with continued scientific effort - may change the conduct of basic research, clinical studies, safety testing, and drug development. Here, we present an introduction to these more human-relevant methodologies and suggest how a suite of pregnancy associated feto-maternal interface system-oriented NAMs may be integrated as reliable partial-/full animal replacements for investigators, significantly aid animal-/environmental welfare, and improve healthcare outcomes.
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Affiliation(s)
- Ramkumar Menon
- Department of Obstetrics and Gynecology, Division of Basic Science and Translational Research, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Louis J. Muglia
- The Burroughs Wellcome Fund, Research Triangle Park, NC, United States
- Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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Margiana R, Yousefi H, Afra A, Agustinus A, Abdelbasset WK, Kuznetsova M, Mansourimoghadam S, Ajam Ekrami H, Mohammadi MJ. The effect of toxic air pollutants on fertility men and women, fetus and birth rate. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 38:565-576. [PMID: 35724665 DOI: 10.1515/reveh-2022-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Human health is affected by various factors such as air pollutants. Exposure to toxic air pollutants is impaired fertility in men and women. The purpose of this review study was investigation of the effect of toxic air pollutants on fertility and birth rate. Databases used to for searched were the PubMed, Web of Science, Springer and Science Direct (Scopus) and Google Scholar. Identify all relevant studies published 1999-2022. In this study, according to databases five hundred articles were retrieved. 33 studies were screened after review and 19 full-text articles entered into the analysis process. Finally, 11 articles were selected in this study. The literature signs a notable health effects from toxic air pollutants and increase risk of infertility in men and women and having a variety of reproductive system cancers such as prostate, bladder, ovary, kidney and uterus. According to the finding toxic air pollutants can increase the risk infertility in men and women, incidence of cancers of reproductive system and decrease the birth rate. Activities that play an important role in reducing the health effects of toxic air pollutants such as infertility in men and women and reducing the population rate of communities are improving the quality of fuel used in the home, car, industries, changing production processes in large industries, installing catalysts to reduce emissions in cars, use more public transportation, plant trees and increase green space per capita, increase public awareness about various effects of toxic air pollutants and protective measures.
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Affiliation(s)
- Ria Margiana
- Department of Anatomy, Faculty of Medicine, Universitas Indonesia, Surabaya, Indonesia
- Andrology Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Homayon Yousefi
- Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Arghavan Afra
- Department of Nursing, Faculty of Nursing, Abadan University of Medical Sciences, Abadan, Iran
| | - Agustinus Agustinus
- Andrology Program-Department of Biology Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Walid Kamal Abdelbasset
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia
- Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Mariya Kuznetsova
- Department of Propaedeutics of Dental Diseases, Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Hafez Ajam Ekrami
- Student research komiteh, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Javad Mohammadi
- Department of Environmental Health Engineering, School of Public Health AND Environmental Technology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Caron-Beaudoin É, Subramanian A, Daley C, Lakshmanan S, Whitworth KW. Estimation of exposure to particulate matter in pregnant individuals living in an area of unconventional oil and gas operations: Findings from the EXPERIVA study. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2023; 86:383-396. [PMID: 37154018 DOI: 10.1080/15287394.2023.2208594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Northeastern British Columbia (Canada) is an area of oil and gas exploitation, which may result in release of fine (PM2.5) and inhalable (PM10) particulate matter. The aims of this study were to: 1) apply extrapolation methods to estimate exposure to PM2.5 and PM10 concentrations among EXPERIVA (Exposures in the Peace River Valley study) participants using air quality data archives; and 2) conduct exploratory analyses to investigate correlation between PM exposure and metrics of oil and gas wells density, proximity, and activity. Gestational exposure to PM2.5 and PM10 of the EXPERIVA participants (n = 85) was estimated by averaging the concentrations measured at the closest or three closest air monitoring stations during the pregnancy period. Drilling metrics were calculated based upon the density and proximity of conventional and unconventional oil and gas wells to each participant's residence. Phase-specific metrics were determined for unconventional wells. The correlations (ρ) between exposure to PM2.5 and PM10 and metrics of well density/proximity were determined using Spearman's rank correlation test. Estimated PM ambient air concentrations ranged between 4.73 to 12.13 µg/m3 for PM2.5 and 7.14 to 26.61 µg/m3 for PM10. Conventional wells metrics were more strongly correlated with PM10 estimations (ρ between 0.28 and 0.79). Unconventional wells metrics for all phases were positively correlated with PM2.5 estimations (ρ between 0.23 and 0.55). These results provide evidence of a correlation between density and proximity of oil and gas wells and estimated PM exposure in the EXPERIVA participants.
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Affiliation(s)
- Élyse Caron-Beaudoin
- Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada
- Department of Physical and Environmental Sciences, University of Toronto Scarborough, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Clinical Epidemiology and Evaluation, University of British Columbia, Vancouver, British Columbia, Canada
| | - Amrita Subramanian
- Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Coreen Daley
- Department of Physical and Environmental Sciences, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Siddharthan Lakshmanan
- Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Kristina W Whitworth
- Department of Medicine, Section of Epidemiology and Population Sciences, Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA
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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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9
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Impact assessment of particulate pollution on maternal mortality in Nigeria. Sci Rep 2022; 12:19669. [PMID: 36385256 PMCID: PMC9668819 DOI: 10.1038/s41598-022-19518-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Recently, the World Health Organization reported that 20% of all global maternal deaths happened in Nigeria between 2005 and 2015. In developing countries, these maternal deaths are mainly from air pollution. Due to poor facilities and documentation, the extent of danger is not known. This research seeks to estimate the available pollutants and its direct and indirect impact on maternal mortality. Ten (10) years (2010-2019) datasets of black carbon, sulfur dioxide, dust, carbon monoxide, organic carbon particulates, sea-salts, and sulphate particulates were obtained from the second modern-era retrospective analysis for research and applications (MERRA-2). The dataset was obtained for the six geopolitical zones of Nigeria and analyzed using statistical tool, models, spatial interpolation, and risk analysis. The volumetric and radioecological risk was also analyzed. It was observed the dust content had minute volume of heavy metal and/or radionuclide particles that may be unharmful in the short term but lethal in the long term. The risk quotient and total dose rate per organism are given as 0.00000396 and 0.0000396 µGy h-1. The result in this manuscript corroborates existing data on maternal mortality in Nigeria. It is recommended that the safety of pregnant woman depends on significant efforts of authorities to enact and enforce environmental laws to mitigate air pollution.
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10
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Zheng P, Chen Z, Shi J, Xue Y, Bai Y, Kang Y, Xu H, Jia G, Wang T. Association between ambient air pollution and blood sex hormones levels in men. ENVIRONMENTAL RESEARCH 2022; 211:113117. [PMID: 35304116 DOI: 10.1016/j.envres.2022.113117] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 06/14/2023]
Abstract
Concerns are growing over time on the adverse health effects of air pollution. However, the association between ambient air pollution and blood sex hormones in men is poorly understood. We included 72,917 men aged 20-55 years from February 2014 to December 2019 in Beijing, China in this study. Blood testosterone, follicle stimulating hormone, luteinizing hormone, estradiol, and prolactin levels of each participant were measured. We collected exposure data of daily ambient levels of particulate matter ≤10 μm (PM10) and ≤2.5 μm (PM2.5), nitrogen dioxide, sulfur dioxide (SO2), carbon monoxide, and ozone. Generalized linear mixed models were used to analyze the potential association between ambient air pollution exposure and blood sex hormone levels. The results showed that both immediate and short-term cumulative PM2.5, PM10, and SO2 exposure was related to altered serum sex hormone levels in men, especially testosterone. An increase of 10 μg/m3 in PM2.5 and PM10 in the current day was related to a 1.6% (95% confidence interval [CI]: 0.9%-2.3%) and 1.1% (95% CI: 0.5%-1.6%) decrease in testosterone, respectively, and a decreasing tendency of accumulated effects persisted within lag 0-30 days. The present study demonstrated that it is important to control ambient air pollution exposure to reduce effects on the reproductive health of men.
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Affiliation(s)
- Pai Zheng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Zhangjian Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Jiaqi Shi
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Yuting Xue
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Yi Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Yulin Kang
- Institute of Environmental Information, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Huiyu Xu
- Center for Reproductive Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Guang Jia
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China.
| | - Tiancheng Wang
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing, 100191, China.
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Wing SE, Larson TV, Hudda N, Boonyarattaphan S, Del Rosario I, Fruin S, Ritz B. Aircraft noise and vehicle traffic-related air pollution interact to affect preterm birth risk in Los Angeles, California. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 829:154678. [PMID: 35314238 DOI: 10.1016/j.scitotenv.2022.154678] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Air pollution has been linked to preterm birth (PTB) while findings for noise exposure have been mixed. Few studies - none considering airports - have investigated combined exposures. We explore the relationship between joint exposure to airport-related noise, airport ultrafine particles (UFP), and vehicle traffic-related air pollution (TRAP) on risk of PTB near Los Angeles International Airport (LAX). METHODS We used comprehensive birth data for mothers living ≤15 km from LAX from 2008 to 2016 (n = 174,186) Noise data were generated by monitor-validated models. NO2 was used as a TRAP proxy, estimated with a seasonally-adjusted, validated land-use regression model. We estimated the effects of exposure to airport-related noise and TRAP on PTB employing logistic regression models that adjusted for known maternal risk factors for PTB as well as aircraft-origin UFP and neighborhood characteristics. RESULTS The adjusted odds ratio (aOR) for PTB from high noise exposure (i.e. > 65 dB) was 1.10 (95% CI: 1.01-1.19). Relative to the first quartile, the aORs for PTB in the second, third, and fourth TRAP quartiles were 1.10 (95% CI: 1.05-1.16), 1.11 (95% CI: 1.05-1.16), and 1.15 (95% CI: 1.10-1.22), respectively. When stratifying by increasing TRAP quartiles, the aORs for PTB with high airport-related noise were 1.04 (95% CI: 0.91-1.18), 1.02 (95% CI: 0.88-1.19), 1.24 (95% CI: 1.03-1.48), and 1.44 (95% CI: 1.08-1.91) (p-interaction = 0.06). CONCLUSION Our results suggest a potential synergism between airport-related noise and TRAP exposures on increasing the risk of PTB in this metropolitan area.
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Affiliation(s)
- Sam E Wing
- Department of Epidemiology, University of California Los Angeles, 650 Charles E. Young Drive South, 71-254 Center for Health Sciences, Los Angeles, CA 90095, United States.
| | - Timothy V Larson
- Departments of Civil & Environmental Engineering and Occupational & Environmental Health Sciences, University of Washington, 201 More Hall, Box 352700, Seattle, WA 98195-2700, United States.
| | - Neelakshi Hudda
- Department of Civil & Environmental Engineering, Tufts University, 200 College Avenue, Medford, MA 02155, United States.
| | - Sarunporn Boonyarattaphan
- Departments of Civil & Environmental Engineering and Occupational & Environmental Health Sciences, University of Washington, 201 More Hall, Box 352700, Seattle, WA 98195-2700, United States
| | - Irish Del Rosario
- Department of Epidemiology, University of California Los Angeles, 650 Charles E. Young Drive South, 71-254 Center for Health Sciences, Los Angeles, CA 90095, United States.
| | - Scott Fruin
- Division of Environmental Health, University of Southern California, 2001 N. Soto St., Los Angeles, CA 90033, United States
| | - Beate Ritz
- Department of Epidemiology, University of California Los Angeles, 650 Charles E. Young Drive South, 71-254 Center for Health Sciences, Los Angeles, CA 90095, United States.
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Kim S, Richardson L, Radnaa E, Chen Z, Rusyn I, Menon R, Han A. Molecular mechanisms of environmental toxin cadmium at the feto-maternal interface investigated using an organ-on-chip (FMi-OOC) model. JOURNAL OF HAZARDOUS MATERIALS 2022; 422:126759. [PMID: 34391970 PMCID: PMC8595660 DOI: 10.1016/j.jhazmat.2021.126759] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/17/2021] [Accepted: 07/25/2021] [Indexed: 05/17/2023]
Abstract
Human labor is associated with feto-maternal-derived signals that coordinate to initiate delivery. Exposure to environmental chemicals can prematurely trigger labor-initiating signals at the feto-maternal interface (FMi: decidua, amniochorion), leading to spontaneous preterm birth (PTB). Testing the association between environmental chemical exposure and PTB is difficult due to many limitations in vivo or in vitro. Physiological organ-on-chips (OOCs) are potential alternatives for studying mechanisms leading to PTB. The presented study tested the effect of maternal exposure to cadmium (Cd), an environmental toxin, using the FMi-OOC that incorporates maternal decidua cells and three different fetal cells (chorion, amnion mesenchymal, and amnion epithelial cells). Cd transport through the FMi and its impact on cell cycle, cell death, and inflammation were analyzed. Cd treatment resulted in significant cell death and a pro-inflammatory environment in the maternal decidua, but had minimal effect on the fetal chorion cells, and no effect in the fetal amnion cells compared to controls. The maternal response, but lack of fetal response, indicates that Cd-mediated adverse effects originate from maternal pathophysiology rather than fetal-derived triggers of preterm labor. This study demonstrates that the FMi-OOC can indeed predict the response of FMi upon exposure to chemicals, opening the possibility for using OOC models for environmental toxin screens.
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Affiliation(s)
- Sungjin Kim
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA
| | - Lauren Richardson
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA; Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine & Perinatal Research, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX 77555-1062, USA
| | - Enkhtuya Radnaa
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine & Perinatal Research, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX 77555-1062, USA
| | - Zunwei Chen
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Ivan Rusyn
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Ramkumar Menon
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine & Perinatal Research, The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX 77555-1062, USA.
| | - Arum Han
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA.
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Spatially and Temporally Resolved Ambient PM 2.5 in Relation to Preterm Birth. TOXICS 2021; 9:toxics9120352. [PMID: 34941786 PMCID: PMC8708619 DOI: 10.3390/toxics9120352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/02/2021] [Accepted: 12/10/2021] [Indexed: 12/25/2022]
Abstract
Growing evidence suggests that maternal exposure to ambient fine particulate matter (PM2.5) during pregnancy is associated with preterm birth; however, few studies have examined critical windows of exposure, which can help elucidate underlying biologic mechanisms and inform public health messaging for limiting exposure. Participants included 891 mother-newborn pairs enrolled in a U.S.-based pregnancy cohort study. Daily residential PM2.5 concentrations at a 1 × 1 km2 resolution were estimated using a satellite-based hybrid model. Gestational age at birth was abstracted from electronic medical records and preterm birth (PTB) was defined as <37 completed weeks of gestation. We used Critical Window Variable Selection to examine weekly PM2.5 exposure in relation to the odds of PTB and examined sex-specific associations using stratified models. The mean ± standard deviation PM2.5 level averaged across pregnancy was 8.13 ± 1.10 µg/m3. PM2.5 exposure was not associated with an increased odds of PTB during any gestational week. In sex-stratified models, we observed a marginal increase in the odds of PTB with exposure occurring during gestational week 16 among female infants only. This study does not provide strong evidence supporting an association between weekly exposure to PM2.5 and preterm birth.
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Song H, Xu L, Chen M, Cui Y, Wu CE, Qiu J, Xu L, Cheng G, Hu X. Recent progresses in the synthesis of MnO 2 nanowire and its application in environmental catalysis. RSC Adv 2021; 11:35494-35513. [PMID: 35493136 PMCID: PMC9043261 DOI: 10.1039/d1ra06497e] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/27/2021] [Indexed: 12/27/2022] Open
Abstract
Nanostructured MnO2 with various morphologies exhibits excellent performance in environmental catalysis owing to its large specific surface area, low density, and adjustable chemical properties. The one-dimensional MnO2 nanowire has been proved to be the dominant morphology among various nanostructures, such as nanorods, nanofibers, nanoflowers, etc. The syntheses and applications of MnO2-based nanowires also have become a research hotspot in environmental catalytic materials over the last two decades. With the continuous deepening of the research, the control of morphology and crystal facet exposure in the synthesis of MnO2 nanowire materials have gradually matured, and the catalytic performance also has been greatly improved. Differences in the crystalline phase structure, preferably exposed crystal facets, and even the length of the MnO2 nanowires will evidently affect the final catalytic performances. Besides, the modifications by doping or loading will also significantly affect their catalytic performances. This review carefully summarizes the synthesis strategies of MnO2 nanowires developed in recent years as well as the influences of the phase structure, crystal facet, morphology, dopant, and loading amount on the catalytic performance. Besides, the cutting-edge applications of MnO2 nanowires in the field of environmental catalysis, such as CO oxidation, the removal of VOCs, denitrification, etc., have been also summarized. The application of MnO2 nanowire in environmental catalysis is still in the early exploratory stage. The gigantic gap between theoretical investigation and industrial application is still a great challenge. Compared with noble metal based traditional environmental catalytic materials, the lower cost of MnO2 has injected new momentum and promising potential into this research field.
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Affiliation(s)
- Huikang Song
- Collaborative Innovation Centre of the Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control Nanjing 210044 P. R. China
| | - Leilei Xu
- Collaborative Innovation Centre of the Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control Nanjing 210044 P. R. China
| | - Mindong Chen
- Collaborative Innovation Centre of the Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control Nanjing 210044 P. R. China
| | - Yan Cui
- Collaborative Innovation Centre of the Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control Nanjing 210044 P. R. China
| | - Cai-E Wu
- College of Light Industry and Food Engineering, Nanjing Forestry University Nanjing 210037 P. R. China
| | - Jian Qiu
- Jiangsu ShuangLiang Environmental Technology Co., Ltd Jiangyin 214400 P. R. China
| | - Liang Xu
- Jiangsu ShuangLiang Environmental Technology Co., Ltd Jiangyin 214400 P. R. China
| | - Ge Cheng
- Collaborative Innovation Centre of the Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control Nanjing 210044 P. R. China
| | - Xun Hu
- School of Material Science and Engineering, University of Jinan Jinan 250022 P. R. China
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Ghosh R, Causey K, Burkart K, Wozniak S, Cohen A, Brauer M. Ambient and household PM2.5 pollution and adverse perinatal outcomes: A meta-regression and analysis of attributable global burden for 204 countries and territories. PLoS Med 2021; 18:e1003718. [PMID: 34582444 PMCID: PMC8478226 DOI: 10.1371/journal.pmed.1003718] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 07/01/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Particulate matter <2.5 micrometer (PM2.5) is associated with adverse perinatal outcomes, but the impact on disease burden mediated by this pathway has not previously been included in the Global Burden of Disease (GBD), Mortality, Injuries, and Risk Factors studies. We estimated the global burden of low birth weight (LBW) and preterm birth (PTB) and impacts on reduced birth weight and gestational age (GA), attributable to ambient and household PM2.5 pollution in 2019. METHODS AND FINDINGS We searched PubMed, Embase, and Web of Science for peer-reviewed articles in English. Study quality was assessed using 2 tools: (1) Agency for Healthcare Research and Quality checklist; and (2) National Institute of Environmental Health Sciences (NIEHS) risk of bias questions. We conducted a meta-regression (MR) to quantify the risk of PM2.5 on birth weight and GA. The MR, based on a systematic review (SR) of articles published through April 4, 2021, and resulting uncertainty intervals (UIs) accounted for unexplained between-study heterogeneity. Separate nonlinear relationships relating exposure to risk were generated for each outcome and applied in the burden estimation. The MR included 44, 40, and 40 birth weight, LBW, and PTB studies, respectively. Majority of the studies were of retrospective cohort design and primarily from North America, Europe, and Australia. A few recent studies were from China, India, sub-Saharan Africa, and South America. Pooled estimates indicated 22 grams (95% UI: 12, 32) lower birth weight, 11% greater risk of LBW (1.11, 95% UI: 1.07, 1.16), and 12% greater risk of PTB (1.12, 95% UI: 1.06, 1.19), per 10 μg/m3 increment in ambient PM2.5. We estimated a global population-weighted mean lowering of 89 grams (95% UI: 88, 89) of birth weight and 3.4 weeks (95% UI: 3.4, 3.4) of GA in 2019, attributable to total PM2.5. Globally, an estimated 15.6% (95% UI: 15.6, 15.7) of all LBW and 35.7% (95% UI: 35.6, 35.9) of all PTB infants were attributable to total PM2.5, equivalent to 2,761,720 (95% UI: 2,746,713 to 2,776,722) and 5,870,103 (95% UI: 5,848,046 to 5,892,166) infants in 2019, respectively. About one-third of the total PM2.5 burden for LBW and PTB could be attributable to ambient exposure, with household air pollution (HAP) dominating in low-income countries. The findings should be viewed in light of some limitations such as heterogeneity between studies including size, exposure levels, exposure assessment method, and adjustment for confounding. Furthermore, studies did not separate the direct effect of PM2.5 on birth weight from that mediated through GA. As a consequence, the pooled risk estimates in the MR and likewise the global burden may have been underestimated. CONCLUSIONS Ambient and household PM2.5 were associated with reduced birth weight and GA, which are, in turn, associated with neonatal and infant mortality, particularly in low- and middle-income countries.
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Affiliation(s)
- Rakesh Ghosh
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America
- * E-mail:
| | - Kate Causey
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Katrin Burkart
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Sara Wozniak
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Aaron Cohen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
- Boston University School of Public Health, Boston, Massachusetts, United States of America
- Health Effects Institute, Boston, Massachusetts, United States of America
| | - Michael Brauer
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
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Rappazzo KM, Nichols JL, Rice RB, Luben TJ. Ozone exposure during early pregnancy and preterm birth: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2021; 198:111317. [PMID: 33989623 PMCID: PMC8221456 DOI: 10.1016/j.envres.2021.111317] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 06/12/2023]
Abstract
Exposure to ozone has been linked to reproductive outcomes, including preterm birth. In this systematic review, we summarize published epidemiologic cohort and case-control studies examining ozone exposures (estimated on a continuous scale) in early pregnancy (1st and 2nd trimesters (T1, T2)) and preterm birth using ratio measures, and perform a meta-analysis to evaluate the potential relationship between them. Studies were identified by searching PubMed and Web of Science, screened according to predefined inclusion/exclusion criteria, and evaluated for study quality. We extracted study data including effect estimates, confidence limits, study location, study years, ozone exposure assessment method, and mean or median ozone concentrations. Nineteen studies were identified and included, of which 18 examined T1 exposure (17 reported effect estimates), and 15 examined T2 exposure. Random effects meta-analysis was performed in the metafor package, R 3.5.3. The pooled OR (95% CI) for a 10 ppb increase in ozone exposure in T1 was 1.06 (1.03, 1.10) with a 95% prediction interval of 0.95, 1.19; for T2 it was 1.05 (1.02, 1.08) with a 95% prediction interval of 0.95, 1.16. Effect estimates for both exposure periods showed high heterogeneity. In meta-regression analyses of study characteristics, study location (continent) explained some (~20%) heterogeneity for T1 exposure studies, but no characteristic explained a substantial amount of heterogeneity for T2 exposure studies. Increased ozone exposure during early pregnancy is associated with preterm birth across studies.
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Affiliation(s)
- Kristen M Rappazzo
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, USA.
| | - Jennifer L Nichols
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, USA
| | - R Byron Rice
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, USA
| | - Thomas J Luben
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, USA
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Reducing Prenatal Exposure to Toxic Environmental Agents: ACOG Committee Opinion, Number 832. Obstet Gynecol 2021; 138:e40-e54. [PMID: 34259492 DOI: 10.1097/aog.0000000000004449] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
ABSTRACT There is emerging evidence that links exposure to toxic environmental agents and adverse reproductive and developmental health outcomes. Toxic exposures related to reproductive and developmental health primarily have been associated with infertility and miscarriage, obstetric outcomes such as preterm birth and low birth weight, neurodevelopmental delay such as autism and attention deficit hyperactivity disorder, and adult and childhood cancer. Although there is substantial overlap in the type of exposure and the associated health outcomes, for the purposes of this document, exposures generally can be grouped into the following categories: toxic chemicals, air pollution, and climate change-related exposures. Obstetric care clinicians do not need to be experts in environmental health science to provide useful information to patients and refer patients to appropriate specialists, if needed, when a hazardous exposure is identified. It is important for obstetrician-gynecologists and other obstetric care clinicians to become knowledgeable about toxic environmental exposures that are endemic to their specific geographic areas, such as local water safety advisories (eg, lead-contaminated water), local air quality levels, and patients' proximity to power plants and fracking sites. Although exposure to toxic environmental agents is widespread across populations, many environmental factors that are harmful to reproductive health disproportionately affect underserved populations and are subsumed in issues of environmental justice. Clinical encounters offer an opportunity to screen and counsel patients during the prepregnancy and prenatal periods-particularly individuals most disproportionately affected-about opportunities to reduce toxic environmental health exposures. This Committee Opinion is revised to integrate more recent literature regarding reducing prepregnancy and prenatal toxic environmental exposures.
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Coker ES, Martin J, Bradley LD, Sem K, Clarke K, Sabo-Attwood T. A time series analysis of the ecologic relationship between acute and intermediate PM2.5 exposure duration on neonatal intensive care unit admissions in Florida. ENVIRONMENTAL RESEARCH 2021; 196:110374. [PMID: 33131682 DOI: 10.1016/j.envres.2020.110374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/12/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
Admissions of newborn infants into Neonatal Intensive Care Units (NICU) has increased in the US over the last decade yet the role of environmental exposures as a risk factor for NICU admissions is under studied. Our study aims to determine the ecologic association between acute and intermediate ambient PM2.5 exposure durations and rates of NICU admissions, and to explore whether this association differs by area-level social stressors and meteorological factors. We conducted an ecologic time-series analysis of singleton neonates (N = 1,027,797) born in Florida hospitals between December 26, 2011 to April 30, 2019. We used electronic medical records (EMRs) in the OneFlorida Data Trust and included infants with a ZIP code in a Metropolitan Statistical Areas (MSA) and excluded extreme preterm births (<24wks gestation). The study outcome is the number of daily NICU admission at 28 days old or younger for each ZIP code in the study area. The exposures of interest are average same day, 1- and 2-day lags, and 1-3 weeks ambient PM2.5 concentration at the ZIP code-level estimated using inverse distance weighting (IDW) for each day of the study period. We used a zero-inflated Poisson regression mixed effects models to estimate adjusted associations between acute and intermediate PM2.5 exposure durations and NICU admissions rates. NICU admissions rates increased over time during the study period. Ambient 7-day average PM2.5 concentrations was significantly associated with incidence of NICU admissions, with an interquartile range (IQR = 2.37 μg/m3) increase associated with a 1.4% (95% CI: 0.4%, 2.4%) higher adjusted incidence of daily NICU admissions. No other exposure duration metrics showed a significant association with daily NICU admission rates. The magnitude of the association between PM2.5 7-day average concentrations with NICU admissions was significantly (p < 0.05) higher among ZIP codes with higher proportions of non-Hispanic Blacks, ZIP codes with household incomes in the lowest quartile, and on days with higher relative humidity. Our data shows a positive relationship between acute (7-day average) PM2.5 concentrations and daily NICU admissions in Metropolitan Statistical Areas of Florida. The observed associations were stronger in socioeconomically disadvantaged areas, areas with higher proportions with non-Hispanic Blacks, and on days with higher relative humidity. Further research is warranted to study other air pollutants and multipollutant effects and identify health conditions that are driving these associations with NICU admissions.
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Affiliation(s)
- Eric S Coker
- University of Florida, College of Public Health and Health Professions, Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA.
| | - James Martin
- University of Florida, College of Public Health and Health Professions, Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA
| | - Lauren D Bradley
- University of Florida, College of Agricultural and Life Sciences, University of Florida, Gainesville, FL, USA
| | - Karen Sem
- University of Florida, College of Engineering, University of Florida, Gainesville, FL, USA
| | - Kayan Clarke
- University of Florida, College of Public Health and Health Professions, Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA
| | - Tara Sabo-Attwood
- University of Florida, College of Public Health and Health Professions, Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA; University of Florida, Center for Environmental and Human Toxicology, University of Florida, Gainesville, FL, USA
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Prenatal exposure to ambient air pollution and adverse pregnancy outcomes in Ahvaz, Iran: a generalized additive model. Int Arch Occup Environ Health 2020; 94:309-324. [PMID: 32936369 DOI: 10.1007/s00420-020-01577-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 09/01/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE There is some evidence about the short-term effects of air pollutants on adverse pregnancy outcomes. The aim of this study was to determine the association between air pollutants and spontaneous abortion, stillbirth, gestational hypertension, preeclampsia, gestational diabetes and macrosomia in Ahvaz, which is one of the most polluted cities in the Middle East. METHODS Data on adverse pregnancy outcomes and air pollutants including ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), particles with a diameter of less than 10 µm (PM10) and particles with a diameter less than 2.5 µm (PM2.5) were inquired from the Health Department of Ahvaz Jundishapur University of Medical Sciences and the Environmental Protection Agency of Khuzestan Province for the years 2008-2018. A time series analysis using the generalized additive model (GAM) with up to 6-day lags was used. RESULTS The results showed that the SO2 pollutant on 0, 1, 3, 4, and 6-day lags and PM10 on lag 0 had direct and significant associations with spontaneous abortion. NO, NO2 and CO on 0-6-day lags, and O3 on 6-day lags showed direct and significant associations with preeclampsia. NO and NO2 pollutants showed significant and direct associations with gestational diabetes, during 0- and 6-day lags. NO on 0-, 3- and 4-day lags, CO in all 0-6-day lags and PM2.5 on 1-, 3-, 5-, and 6-day lags showed direct and significant associations with macrosomia. None of the pollutants showed significant associations with stillbirth or gestational hypertension. CONCLUSIONS The results of this study suggest that some air pollutants are associated with spontaneous abortion, preeclampsia, gestational diabetes and macrosomia. This study further emphasizes the need to control ambient air pollution.
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Vowles M, Kerry R, Ingram B, Mason L. Investigation of the Environmental and Socio-Economic Characteristics of Counties with a High Asthma Burden to Focus Asthma Action in Utah. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145251. [PMID: 32708146 PMCID: PMC7400464 DOI: 10.3390/ijerph17145251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/07/2020] [Accepted: 07/16/2020] [Indexed: 11/17/2022]
Abstract
Rising adult asthma prevalence (AAP) rates and asthma emergency room (AER) visits constitute a large burden on public health in Utah (UT), a high-altitude state in the Great Basin Desert, USA. This warrants an investigation of the characteristics of the counties with the highest asthma burden within UT to improve allocation of health resources and for planning. The relations between several predictor environmental, health behavior and socio-economic variables and two health outcome variables, AAP and AER visits, were investigated for UT’s 29 counties. Non-parametric statistical comparison tests, correlation and linear regression analysis were used to determine the factors significantly associated with AER visits and AAP. Regression kriging with Utah small area data (USAD) as well as socio-economic and pollution data enabled local Moran’s I cluster analysis and the investigation of moving correlations between health outcomes and risk factors. Results showed the importance of desert/mining dust and socio-economic status as AAP and AER visits were greatest in the south of the state, highlighting a marked north–south divide in terms of these factors within the state. USAD investigations also showed marked differences in pollution and socio-economic status associated with AAP within the most populous northern counties. Policies and interventions need to address socio-economic inequalities within counties and between the north and south of the state. Fine (PM2.5) and coarse (PM10) particulate matter monitors should be installed in towns in central and southern UT to monitor air quality as these are sparse, but in the summer, air quality can be worse here. Further research into spatiotemporal variation in air quality within UT is needed to inform public health interventions such as expanding clean fuel programs and targeted land-use policies. Efforts are also needed to examine barriers to routine asthma care.
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Affiliation(s)
- Maureen Vowles
- Department of Public Health and Policy, University of Liverpool, Liverpool L69 3GB, UK
- Correspondence:
| | - Ruth Kerry
- Department of Geography, Brigham Young University, Provo, UT 84602, USA;
| | - Ben Ingram
- Faculty of Engineering, Universidad de Talca, Curicó 3460000, Chile;
| | - Linda Mason
- Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK;
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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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Wing SE, Larson TV, Hudda N, Boonyarattaphan S, Fruin S, Ritz B. Preterm Birth among Infants Exposed to in Utero Ultrafine Particles from Aircraft Emissions. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:47002. [PMID: 32238012 PMCID: PMC7228090 DOI: 10.1289/ehp5732] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 02/24/2020] [Accepted: 03/04/2020] [Indexed: 05/22/2023]
Abstract
INTRODUCTION Ambient air pollution is a known risk factor for adverse birth outcomes, but the role of ultrafine particles (UFPs) is not well understood. Aircraft-origin UFPs adversely affect air quality over large residential areas downwind of airports, but their reproductive health burden remains uninvestigated. OBJECTIVES This analysis evaluated whether UFPs from jet aircraft emissions are associated with increased rates of preterm birth (PTB) among pregnant mothers living downwind of Los Angeles International Airport (LAX). METHODS This population-based study used birth records, provided by the California Department of Public Health, to ascertain birth outcomes and a novel, validated geospatial UFP dispersion model approach to estimate in utero exposures. All mothers who gave birth from 2008 to 2016 while living within 15km of LAX were included in this analysis (N=174,186; including 15,134 PTBs). RESULTS In utero exposure to aircraft-origin UFPs was positively associated with PTB. The odds ratio (OR) per interquartile range (IQR) increase [9,200 particles per cubic centimeter (cc)] relative UFP exposure was 1.04 [95% confidence interval (CI): 1.02, 1.06]. When comparing the fourth quartile of UFP exposure to the first quartile, the OR for PTB was 1.14 (95% CI: 1.08, 1.20), adjusting for maternal demographic characteristics, exposure to traffic-related air pollution, and airport-related noise. CONCLUSION Our results suggest that emissions from aircraft play an etiologic role in PTBs, independent of noise and traffic-related air pollution exposures. These findings are of public health concern because UFP exposures downwind of airfields are common and may affect large, densely populated residential areas. https://doi.org/10.1289/EHP5732.
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Affiliation(s)
- Sam E. Wing
- Department of Epidemiology, University of California, Los Angeles, Los Angeles, California, USA
| | - Timothy V. Larson
- Departments of Civil & Environmental Engineering and Occupational & Environmental Health Sciences, University of Washington, Seattle, Washington, USA
| | - Neelakshi Hudda
- Department of Civil & Environmental Engineering, Tufts University, Medford, Massachusetts, USA
| | - Sarunporn Boonyarattaphan
- Departments of Civil & Environmental Engineering and Occupational & Environmental Health Sciences, University of Washington, Seattle, Washington, USA
| | - Scott Fruin
- Division of Environmental Health, University of Southern California, Los Angeles, California, USA
| | - Beate Ritz
- Department of Epidemiology, University of California, Los Angeles, Los Angeles, California, USA
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23
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Pregnancy, childbirth, and puerperium outcomes in female firefighters in Korea. Ann Occup Environ Med 2020; 32:e8. [PMID: 32082590 PMCID: PMC7008587 DOI: 10.35371/aoem.2020.32.e8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 01/20/2020] [Indexed: 11/20/2022] Open
Abstract
Background Female firefighters are exposed to hazardous environmental (chemical and physical) and working (shift work, psychological, and ergonomic factors) conditions that have reported or are suspected of adverse effects on reproductive health. However, no previous studies have reported on pregnancy, childbirth, and puerperium outcomes (PCPOs) in female firefighters. Methods The present study compared hospital admissions for PCPOs, based on 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes, among Korean female firefighters with those of the general Korean population. Standardized admission ratios (SARs) and their 95% confidence intervals (CIs) were calculated. Results The study population included 1,766 female firefighters. Total follow-up duration was 9,659 person-years. Compared to the general female population, the female firefighters' SARs were higher in all admissions for PCPOs (SAR, 1.92; 95% CI: 1.79–2.05); pregnancy and abortive outcomes (SAR, 1.56; 95% CI: 1.12–2.12); other maternal disorders predominantly related to pregnancy (SAR, 2.65; 95% CI: 1.99–3.46); maternal care related to the fetus, amniotic cavity, and possible delivery problems (SAR, 2.13; 95% CI: 1.74–2.57); labor and delivery complications (SAR, 1.55; 95% CI: 1.15–2.06); delivery (SAR, 1.94; 95% CI: 1.80–2.08); and complications predominantly related to puerperium (SAR, 4.68; 95% CI: 2.02–9.23). Conclusion The results of this study showed high SARs in all and specific subcategories of PCPOs in female firefighters.
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Sun Z, Yang L, Bai X, Du W, Shen G, Fei J, Wang Y, Chen A, Chen Y, Zhao M. Maternal ambient air pollution exposure with spatial-temporal variations and preterm birth risk assessment during 2013-2017 in Zhejiang Province, China. ENVIRONMENT INTERNATIONAL 2019; 133:105242. [PMID: 31665677 DOI: 10.1016/j.envint.2019.105242] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 09/25/2019] [Accepted: 10/02/2019] [Indexed: 06/10/2023]
Abstract
Preterm birth (PTB) can give rise to significant neonatal morbidity and mortality, as well as children's long-term health defects. Many studies have illustrated the associations between ambient air pollution exposure during gestational periods and PTB risks, but most of them only focused on one single air pollutant, such as PM2.5. In this population-based environmental-epidemiology study, we recruited 6275 pregnant mothers in Zhejiang Province, China, and evaluated their gestational exposures to various air pollutants during 2013-2017. Time-to-event logistic regressions were performed to estimate risk associations after adjusting all confounders, and Quasi-AQI model and PCA-GLM analysis were applied to resolve the collinearity issues in multi-pollutant regression models. It was found that gestational exposure to ambient air pollutants was significantly associated with the occurrence of PTB, and SO2 was the largest contributor with a proportion of 29.4%. Three new variables, prime factor (a combination of PM2.5, PM10, SO2, and NO2), carbon factor (CO), and ozone factor (O3), were generated by PCA integration, contributing 63.4%, 17.1%, and 19.5% to PTB risks, respectively. The first and third trimester was the most crucial exposure window, suggesting the pregnant mothers better to avoid severe air pollution exposures during these sensitive periods.
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Affiliation(s)
- Zhe Sun
- Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, College of Environment, Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China; Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Liyang Yang
- Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, College of Environment, Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
| | - Xiaoxia Bai
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China.
| | - Wei Du
- Ministry of Education Laboratory of Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China; School of Geographical Sciences, East China Normal University, Shanghai 200241, China
| | - Guofeng Shen
- Ministry of Education Laboratory of Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Jie Fei
- Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, College of Environment, Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
| | - Yonghui Wang
- Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, College of Environment, Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
| | - An Chen
- College of Information Engineering, China Jiliang University, Hangzhou, Zhejiang 310018, China
| | - Yuanchen Chen
- Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, College of Environment, Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China.
| | - Meirong Zhao
- Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, College of Environment, Zhejiang University of Technology, Hangzhou, Zhejiang 310014, China
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Alman BL, Stingone JA, Yazdy M, Botto LD, Desrosiers TA, Pruitt S, Herring AH, Langlois PH, Nembhard WN, Shaw GM, Olshan AF, Luben TJ. Associations between PM 2.5 and risk of preterm birth among liveborn infants. Ann Epidemiol 2019; 39:46-53.e2. [PMID: 31678056 PMCID: PMC7315599 DOI: 10.1016/j.annepidem.2019.09.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 09/19/2019] [Accepted: 09/28/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Studies suggest exposure to ambient particulate matter less than 2.5 μg/m3 in aerodynamic diameter (PM2.5) may be associated with preterm birth (PTB), but few have evaluated how this is modified by ambient temperature. We investigated the relationship between PM2.5 exposure during pregnancy and PTB in infants without birth defects (1999-2006) and enrolled in the National Birth Defects Prevention Study and how it is modified by concurrent temperature. METHODS PTB was defined as spontaneous or iatrogenic delivery before 37 weeks. Exposure was assigned using inverse distance weighting with up to four monitors within 50 kilometers of maternal residence. To account for state-level variations, a Bayesian two-level hierarchal model was developed. RESULTS PTB was associated with PM2.5 during the third and fourth months of pregnancy (range: (odds ratio (95% confidence interval) = 1.00 (0.35, 2.15) to 1.49 (0.82, 2.68) and 1.31 (0.56, 2.91) to 1.62 (0.7, 3.32), respectively); no week of exposure conveyed greater risk. Temperature may modify this relationship; higher local average temperatures during pregnancy yielded stronger positive relationships between PM2.5 and PTB compared to nonstratified results. CONCLUSIONS Results add to literature on associations between PM2.5 and PTB, underscoring the importance of considering co-exposures when estimating effects of PM2.5 exposure during pregnancy.
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Affiliation(s)
- Breanna L Alman
- Office of Air and Radiation, U.S. Environmental Protection Agency, Research Triangle Park, NC
| | - Jeanette A Stingone
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, NY, NY
| | - Mahsa Yazdy
- Massachusetts Department of Public Health, Boston, MA
| | - Lorenzo D Botto
- Department of Pediatrics, University of Utah, Salt Lake City
| | - Tania A Desrosiers
- Department of Epidemiology, Gillings School of Global Public Health, UNC Chapel Hill, NC
| | - Shannon Pruitt
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta, GA; Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Amy H Herring
- Global Health Institute, Duke University, Durham, NC
| | - Peter H Langlois
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX
| | - Wendy N Nembhard
- Departments of Pediatrics and Epidemiology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Gary M Shaw
- Department of Pediatrics, Stanford University, Stanford, CA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, UNC Chapel Hill, NC
| | - Thomas J Luben
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC.
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26
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Guo LQ, Chen Y, Mi BB, Dang SN, Zhao DD, Liu R, Wang HL, Yan H. Ambient air pollution and adverse birth outcomes: a systematic review and meta-analysis. J Zhejiang Univ Sci B 2019; 20:238-252. [PMID: 30829011 DOI: 10.1631/jzus.b1800122] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Several reviews have assessed the relationship between exposure to ambient air pollution and adverse birth outcomes during pregnancy, but the results remain controversial. The objective of this study was to assess this correlation quantitatively and to explore sources of heterogeneity. We included all published case-control or cohort studies that evaluated the correlation between ambient air pollution and low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). Analytical methods and inclusion criteria were provided on the PROSPERO website (CRD42018085816). We evaluated pooled effects and heterogeneity. Subgroup analyses (grouped by exposure period, study settings, study design, exposure types, data source, Newcastle-Ottawa quality score (NOS), and adjustment for smoking or meteorological factors) were also conducted and publication bias was examined. The risk of bias in systematic reviews (ROBIS) tool was used to evaluate the overall risk of bias in this review. Forty studies met the inclusion criteria. We observed pooled odds ratios (ORs) of 1.03-1.21 for LBW and 0.97-1.06 for PTB when mothers were exposed to CO, NO2, NOx, O3, PM2.5, PM10, or SO2 throughout their pregnancy. For SGA, the pooled estimate was 1.02 in relation to NO2 concentrations. Subgroup analysis and sensitivity analysis decreased the heterogeneity to some extent, such as the subgroups of continuous measures (OR=0.98 (0.97-0.99), I2=0.0%) and NOS>7 (OR=0.98 (0.97-0.99), I2=0.0%) in evaluating the association between PTB and NO2. This review was completed with a low risk of bias. High concentrations of air pollution were significantly related to the higher risk of adverse birth outcomes. However, the sources of heterogeneity among studies should be further explored.
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Affiliation(s)
- Le-Qian Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Yu Chen
- Medical Records Department, the First Hospital of Yulin, Yulin 718000, China
| | - Bai-Bing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Shao-Nong Dang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Dou-Dou Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Rong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Hong-Li Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
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27
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Schwarz L, Bruckner T, Ilango SD, Sheridan P, Basu R, Benmarhnia T. A quantile regression approach to examine fine particles, term low birth weight, and racial/ethnic disparities. ACTA ACUST UNITED AC 2019; 3:e060. [PMID: 33778340 PMCID: PMC7939411 DOI: 10.1097/ee9.0000000000000060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 06/25/2019] [Indexed: 11/25/2022]
Abstract
Background Exposure to fine particulate matter (PM2.5) during pregnancy has been shown to be associated with reduced birth weight and racial/ethnic minorities have been found to be more vulnerable. Previous studies have focused on the mean value of birth weight associated with PM2.5, which may mask meaningful differences. We applied a quantile regression approach to investigate the variation by percentile of birth weight and compared non-Hispanic (NH) Black, NH White, and Hispanic mothers. Methods Data for singleton births in California from October 24, 2005 to February 27, 2010 were collected from the birth records accessed from the California Department of Public Health. Air pollution monitoring data collected by the California Air Resources Board and interpolated for each zip code using an inverse-distance weighting approach, and linked to maternal zip code of residence reported on the birth certificate. Multilevel linear regression models were conducted with mother's residential zip code tabulation area as a random effect. Multilevel quantile regression models were used to analyze the association at different percentiles of birth weight (5th, 10th, 25th, 50th, 75th, 90th, 95th), as well as examine the heterogeneity in this association between racial/ethnic groups. Results Linear regression revealed that a 10 μg/m3 increase in PM2.5 exposure during pregnancy is associated with a mean birth weight decrease of 7.31 g [95% confidence interval (CI): 8.10, 6.51] and NH Black mothers are the most vulnerable. Results of the quantile regression are not constant across quantiles. For NH Black mothers whose infants had the lowest birthweight of less than 2673 g (5th percentile), a 10 μg/m3 increase in PM2.5 exposure is associated with a decrease of 18.57 g [95% CI: 22.23, 14.91], while it is associated with a decrease of 7.77 g [95% CI: 8.73, 6.79] for NH White mothers and 7.76 [8.52, 7.00] decrease for Hispanic mothers at the same quantile. Conclusion Results of the quantile regression revealed greater disparities, particularly for infants with the lowest birth weight. By identifying vulnerable populations, we can promote and implement policies to confront these health disparities.
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Affiliation(s)
- Lara Schwarz
- School of Public Health, San Diego State University, San Diego, California.,Department of Family Medicine and Public Health University of California, San Diego, California
| | - Tim Bruckner
- Public Health, University of California, Irvine, California
| | - Sindana D Ilango
- School of Public Health, San Diego State University, San Diego, California.,Department of Family Medicine and Public Health University of California, San Diego, California
| | - Paige Sheridan
- School of Public Health, San Diego State University, San Diego, California.,Department of Family Medicine and Public Health University of California, San Diego, California
| | - Rupa Basu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, California
| | - Tarik Benmarhnia
- School of Public Health, San Diego State University, San Diego, California.,Scripps Institution of Oceanography University of California, San Diego, California
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28
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Abstract
Our genetic makeup and environment interact. Evidence has emerged demonstrating preconception and prenatal exposure to toxic agents have a profound effect on reproductive health. We cannot change our genetics, but we can change our environment. Health providers can protect pregnancies from harmful exposures. Pregnancy is the most critical time-window for human development, when any toxic exposure can cause lasting damage to brain development. Reproductive care professionals can provide useful information to patients and refer patients to appropriate specialists when hazardous exposure is identified. Clinical experience and expertise in communicating risks of treatment are transferable to environmental health.
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Affiliation(s)
- Kelly McCue
- Obstetrics and Gynecology, The Permanente Medical Group, North Valley, 3rd Floor, 501 J Street, Sacramento, CA 95814, USA
| | - Nathaniel DeNicola
- The George Washington University, 2511 I Street Northwest, Washington, DC 20037, USA.
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Environmental Interventions for Physical and Mental Health: Challenges and Opportunities for Greater Los Angeles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122180. [PMID: 31226746 PMCID: PMC6617017 DOI: 10.3390/ijerph16122180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/16/2019] [Accepted: 06/18/2019] [Indexed: 11/26/2022]
Abstract
The fields of urban planning and public health were conceived under the same pressures and goals at their inception in the 17th and 18th centuries and continue to address the health concerns of an ever-increasing urban population. While the mutual need that both philosophies have for each other becomes more tangible through research and practice, the application of their interrelatedness continues to benefit residents and visitors of mindfully-built environments. In health-conscious Los Angeles, there lacks a comprehensive assessment of health-centered considerations being implemented by those entrusted with the responsibility of shaping our cities. As a greater majority of the world’s population moves into urban settings, built environment interventions play a progressively vital role in addressing physical and mental health concerns. This piece hopes to bring to attention the need for focused and dynamic approaches in addressing health concerns by means of design, planning, and policy, by focusing on the challenges and opportunities faced by the geographic and human resources of the Greater Los Angeles area.
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Chastko K, Adams M. Assessing the accuracy of long-term air pollution estimates produced with temporally adjusted short-term observations from unstructured sampling. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2019; 240:249-258. [PMID: 30952045 DOI: 10.1016/j.jenvman.2019.03.108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 03/12/2019] [Accepted: 03/24/2019] [Indexed: 06/09/2023]
Abstract
More commonly air pollution observations are obtained with unstructured monitoring, where either a research grade monitor or low-cost sensor is irregularly relocated throughout the study area. This unstructured data is commonly observed in community science programs. Often the objective is to apply these data to estimate a long-term concentration, which is achieved using a temporal adjustment to correct for the irregular sampling. Temporal adjustments leverage information from a stationary continuous reference monitor, in combination with short-term monitoring data, to estimate long-term pollutant concentrations. We assess the performance of temporal adjustment approaches to predict long-term pollutant concentrations using data representing unstructured sampling. A series of monitoring campaigns are simulated from air pollution data obtained from regulatory monitoring networks in four different cities (Paris, France; Taipei, Taiwan; Toronto, Canada; and Vancouver, Canada) for eight different pollutants (CO, NO, NOx, NO2, O3, PM10, PM2.5, and SO2). These simulated campaigns have randomized monitoring locations and sampling times to simulate the irregular nature of crowd sourced or mobile monitoring data. The number of consecutive samples reported, and selection of the reference monitor used to adjust observations, are varied in this study. The accuracy of estimates is assessed by comparing the estimated long-term concentration to the observed long-term concentration from the complete regulatory monitoring dataset. This study found that a common temporal adjustment applied in research performed significantly worse than other adjustments including a Naïve Temporal Approach where no data adjustment occurred. Increasing the sample size improved the accuracy of estimates, which showed decreasing benefit with increased sample lengths. Lastly, controlling for land use conditions of the reference monitor did not consistently improve the long-term estimates, which suggests that land use pairing of mobile and reference monitors does not significantly influence the predictive power of temporal adjustment approaches. Temporal adjustments can reduce the error in long-term concentration estimates of air pollution using incomplete data, but this benefit cannot be assumed across all approaches, pollutants or sampling programs.
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Affiliation(s)
- Karl Chastko
- Department of Geography, University of Toronto Mississauga, Ontario, Canada
| | - Matthew Adams
- Department of Geography, University of Toronto Mississauga, Ontario, Canada.
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31
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Zhang Y, Wang J, Chen L, Yang H, Zhang B, Wang Q, Hu L, Zhang N, Vedal S, Xue F, Bai Z. Ambient PM 2.5 and clinically recognized early pregnancy loss: A case-control study with spatiotemporal exposure predictions. ENVIRONMENT INTERNATIONAL 2019; 126:422-429. [PMID: 30836309 DOI: 10.1016/j.envint.2019.02.062] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/29/2019] [Accepted: 02/25/2019] [Indexed: 05/28/2023]
Abstract
BACKGROUND Experimental research suggests that fine particulate matter (PM2.5) exposure might affect embryonic development. However, only few population-based studies have investigated the impact of maternal exposure to PM2.5 on the early pregnancy loss. OBJECTIVES To estimate associations between clinically recognized early pregnancy loss (CREPL) and exposure to ambient PM2.5 at individual residences during peri-conception periods, with the aim to identify susceptible exposure time windows. METHODS CREPL cases and normal early pregnancy controls (of similar age and gravidity presenting within one week, a total of 364 pairs) were recruited between July 2017 and July 2018 among women residing in Tianjin, China. Average ambient PM2.5 concentrations of ten exposure windows (4 weeks, 2 weeks and 1 week before conception; the first, second, third and fourth single week, the first and second 2-week periods, and the entire 4-week period after conception) at the women's residential addresses were estimated using temporally-adjusted land use regression models. Associations between PM2.5 exposures at specific peri-conception time windows and CREPL were examined using conditional logistic regression models, adjusted for covariates. RESULTS Based on adjusted models, CREPL was significantly associated with a 10 μg/m3 increase in PM2.5 exposure during the second week after conception (OR = 1.15; 95% CI: 1.04, 1.27; p = 0.005), independent of effects at other time windows. There was also an association of CREPL with PM2.5 during the entire 4-week period after conception (OR = 1.22; 95% CI: 1.02, 1.46; p = 0.027). There was little evidence for associations with exposure during pre-conception exposure windows. CONCLUSIONS Maternal exposures to ambient PM2.5 during a critical time window following conception are associated with CREPL, with the second week after conception possibly being the exposure window of most vulnerability. Future studies should focus on replicating these findings and on pathogenic mechanisms.
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Affiliation(s)
- Yujuan Zhang
- Department of Family Planning, The Second Hospital of Tianjin Medical University, Tianjin, China; Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China; State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Jianmei Wang
- Department of Family Planning, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Li Chen
- School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin, China
| | - Hua Yang
- Department of Family Planning, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, China
| | - Bumei Zhang
- Department of Family Planning, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qina Wang
- Department of Family Planning, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Liyuan Hu
- School of Geographic and Environmental Sciences, Tianjin Normal University, Tianjin, China
| | - Nan Zhang
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Sverre Vedal
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China; Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Fengxia Xue
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China.
| | - Zhipeng Bai
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China.
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Perera F, Ashrafi A, Kinney P, Mills D. Towards a fuller assessment of benefits to children's health of reducing air pollution and mitigating climate change due to fossil fuel combustion. ENVIRONMENTAL RESEARCH 2019; 172:55-72. [PMID: 30771627 DOI: 10.1016/j.envres.2018.12.016] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/20/2018] [Accepted: 12/08/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Fossil fuel combustion by-products, including particulate matter (PM2.5), polycyclic aromatic hydrocarbons (PAH), nitrogen dioxide (NO2) and carbon dioxide (CO2), are a significant threat to children's health and equality. Various policies to reduce emissions have been implemented to reduce air pollution and mitigate climate change, with sizeable estimated health and economic benefits. However, only a few adverse outcomes in children have been considered, resulting in an undercounting of the benefits to this vulnerable population. OBJECTIVES Our goal was to expand the suite of child health outcomes addressed by programs to assess health and economic benefits, such as the Environmental Protection Agency (EPA) Benefits Mapping and Analysis Program (BenMAP), by identifying concentration-response (C-R) functions for six outcomes related to PM2.5, NO2, PAH, and/or PM10: preterm birth (PTB), low birthweight (LBW), autism, attention deficit hyperactivity disorder, IQ reduction, and the development of childhood asthma. METHODS We conducted a systematic review of the literature published between January 1, 2000 and April 30, 2018 to identify relevant peer-reviewed case-control and cohort studies and meta-analyses. In some cases meta-analyses were available that provided reliable C-R functions and we assessed their consistency with subsequent studies. Otherwise, we reviewed all eligible studies published between our search dates. RESULTS For each pollutant and health outcome, we present the characteristics of each selected study. We distinguish between C-R functions for endpoints having a causal or likely relationship (PTB, LBW, autism, asthma development) with the pollutants for incorporation into primary analyses and endpoints having a suggestive causal relationship with the pollutants (IQ reduction, ADHD) for secondary analyses. CONCLUSION We have identified C-R functions for a number of adverse health outcomes in children associated with air pollutants largely from fossil fuel combustion. Their incorporation into expanded assessments of health benefits of clean air and climate mitigation policies will provide an important incentive for preventive action.
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Affiliation(s)
- F Perera
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 W. 168th Street, New York, NY 10032, USA.
| | - A Ashrafi
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 722 W. 168th Street, New York, NY 10032, USA.
| | - P Kinney
- Boston University School of Public Health, Boston, MA, USA.
| | - D Mills
- Abt Associates, Boulder, CO, USA.
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Kim JJ, Axelrad DA, Dockins C. Preterm birth and economic benefits of reduced maternal exposure to fine particulate matter. ENVIRONMENTAL RESEARCH 2019; 170:178-186. [PMID: 30583127 PMCID: PMC6423977 DOI: 10.1016/j.envres.2018.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 10/27/2018] [Accepted: 12/06/2018] [Indexed: 05/13/2023]
Abstract
Preterm birth (PTB) is a predictor of infant mortality and later-life morbidity. Despite recent declines, PTB rates remain high in the United States. Growing research suggests a possible relationship between a mother's exposure to common air pollutants, including fine particulate matter (PM2.5), and PTB of her baby. Many policy actions to reduce exposure to common air pollutants require benefit-cost analysis (BCA), and it's possible that PTB will need to be included in BCA in the future. However, an estimate of the willingness to pay (WTP) to avoid PTB risk is not available, and a comprehensive alternative valuation of the health benefits of reducing pollutant-related PTB currently does not exist. This paper demonstrates an approach to assess potential economic benefits of reducing PTB resulting from environmental exposures when an estimate of WTP to avoid PTB risk is unavailable. We utilized a recent meta-analysis, county-level air quality data and county-level PTB prevalence data to estimate the potential health and economic benefits of a reduction in air pollution-related PTB, with PM2.5 as our case study pollutant. Using this method, a simulated nationwide 10% decrease from 2008 PM2.5 levels resulted in an estimated reduction of 5016 PTBs and benefits of at least $339 million, potentially reaching over one billion dollars when considering later-life effects of PTB.
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Affiliation(s)
- Jina J Kim
- ASPPH/EPA Environmental Health Fellowship Program, Hosted by US Environmental Protection Agency, 1200 Pennsylvania Ave. NW, Washington, D.C. 20460, USA.
| | - Daniel A Axelrad
- National Center for Environmental Economics, Office of Policy, US Environmental Protection Agency, 1200 Pennsylvania Ave. NW, Washington, D.C. 20460, USA
| | - Chris Dockins
- National Center for Environmental Economics, Office of Policy, US Environmental Protection Agency, 1200 Pennsylvania Ave. NW, Washington, D.C. 20460, USA
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Xiong L, Xu Z, Tan J, Wang H, Liu Z, Wang A, Xie D, Kong F. Acute effects of air pollutants on adverse birth outcomes in Changsha, China: A population data with time-series analysis from 2015 to 2017. Medicine (Baltimore) 2019; 98:e14127. [PMID: 30653143 PMCID: PMC6370066 DOI: 10.1097/md.0000000000014127] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Evidence for the acute effects of air pollutants on adverse birth outcomes is not yet conclusive. Furthermore, there are no investigations relating to the association between air pollutants and macrosomia. The aim of this study was to determine the relationship between air pollutants and low birth weight, preterm birth, and macrosomia in Changsha. Time-series analysis, using a generalized additive model was applied. Data about the adverse birth outcomes was collected from 78 midwifery institutions. Air pollution data including SO2, NO2, particulate matter <10 μm in diameter (PM10), particulate matter <2.5 μm in diameter (PM2.5), O3, CO, and climate data were respectively collected from the Changsha Environmental Protection Agency and the Changsha Meteorological Bureau from January 2015 to December 2017. During the study period, there were 344,880 live births to be studied. In a single pollutant model, for every increase of 10 μg/m in PM10 and PM2.5, low birth weight increased by 0.12% (95% confidence interval [CI]: 0.01-0.23%) at a lag 06 and 0.44% (95% CI: 0.35-0.53%) at a lag 3, respectively. Preterm birth increased most by 1.60% (95% CI: 1.41-1.80%) at a lag 2 for every increase of 10 μg/m in SO2. The highest increases in macrosomia associated with a 10 μg/m increase in air pollutant were 3.53% (95% CI: 3.41-3.64%) for NO2 at lag 0, 3.33% (95% CI: 3.05-3.60%) for SO2 at lag03. Multi-pollutant models showed that only PM10 increased the low birth weight and preterm birth risk effect by 3.91% (95% CI: 3.67-4.12%) and 0.25% (95% CI: 0.14-0.37%). NO2 increased macrosomia risk by 4.14% (95% CI: 3.97-4.31%) with a 10 μg/m increase. There was no association observed between the air pollutants O3 and CO and adverse birth outcomes. Pregnant women should also take steps to limit their exposure to high levels of air pollutants during the final weeks of pregnancy.
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Affiliation(s)
- Lili Xiong
- Hunan Province Maternal and Children Care Hospital
| | | | - Jie Tan
- Hunan Province Environmental Monitoring Centre, Changsha, China
| | - Hua Wang
- Hunan Province Maternal and Children Care Hospital
| | - Zhiyu Liu
- Hunan Province Maternal and Children Care Hospital
| | - Aihua Wang
- Hunan Province Maternal and Children Care Hospital
| | - Donghua Xie
- Hunan Province Maternal and Children Care Hospital
| | - Fanjuan Kong
- Hunan Province Maternal and Children Care Hospital
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Zhu J, Lee RW, Twum C, Wei Y. Exposure to ambient PM 2.5 during pregnancy and preterm birth in metropolitan areas of the state of Georgia. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:2492-2500. [PMID: 30471062 DOI: 10.1007/s11356-018-3746-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/12/2018] [Indexed: 05/21/2023]
Abstract
A number of studies has pointed to air pollution as an additional factor that could be associated with preterm birth. We assessed in this study the association between exposure to PM2.5 in ambient air during pregnancy and preterm birth in metropolitan areas of the state of Georgia, where the rate of preterm birth has been among the highest in the nation over the years. Birth data were obtained from the National Center for Health Statistics natality dataset. The study population consisted of 53,094 singleton live births between January 1 and December 31, 2004 in nine metropolitan counties of Georgia. Preterm birth was defined as birth, which occurs before 37 weeks of gestation. County-level daily air quality index (AQI) data obtained from the US Environmental Protection Agency (EPA) was used to estimate individual exposure levels of PM2.5 for each study participant based on the county of residence for the duration of the pregnancy. A multivariate logistic regression analysis was conducted to assess the association, adjusting for potential confounders. Of the infants whose mothers resided in the nine metropolitan counties of Georgia, 4543 (8.6%) were born preterm. A higher rate of preterm birth (9.8%) was observed in infants whose mothers were exposed to ambient PM2.5 with AQI values > 50 than the ones with AQI ≤ 50 (EPA standard for good air quality conditions). Mothers with exposure to PM2.5 at average AQI values greater than 50 during the entire pregnancy were at increased risk of preterm birth (odds ratio 1.15; 95% CI 1.07, 1.25), after adjusting for sex of infant, mother's age, race/ethnicity, education, marital status, prenatal care, cigarette smoking, alcohol consumption, and season of conception. The study provides more evidence on the role of PM2.5 in preterm birth. Reducing exposure to ambient particulate matter, especially in urban areas, for pregnant women would be necessary to improve the health of infants.
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Affiliation(s)
- Jianmin Zhu
- Department of Mathematics and Computer Science, Fort Valley State University, Fort Valley, GA, 31030, USA
| | - Rina Won Lee
- Mercer University School of Medicine, Macon, GA, 31207, USA
| | - Claudia Twum
- Mercer University School of Medicine, Macon, GA, 31207, USA
| | - Yudan Wei
- Department of Community Medicine, Mercer University School of Medicine, 1550 College St, Macon, GA, 31207, USA.
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Klepac P, Locatelli I, Korošec S, Künzli N, Kukec A. Ambient air pollution and pregnancy outcomes: A comprehensive review and identification of environmental public health challenges. ENVIRONMENTAL RESEARCH 2018; 167:144-159. [PMID: 30014896 DOI: 10.1016/j.envres.2018.07.008] [Citation(s) in RCA: 211] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 05/19/2023]
Abstract
There is a growing number of studies on the association between ambient air pollution and adverse pregnancy outcomes, but their results have been inconsistent. Consequently, a comprehensive review of this research area is needed. There was a wide variability in studied pregnancy outcomes, observed gestational windows of exposure, observed ambient air pollutants, applied exposure assessment methods and statistical analysis methods Gestational duration, preterm birth, (low) birth weight, and small for gestational age/intrauterine growth restriction were most commonly investigated pregnancy outcomes. Gestational windows of exposure typically included were whole pregnancy period, 1st, 2nd, 3rd trimester, first and last gestational months. Preterm birth was the outcome most extensively studied across various gestational windows, especially at the beginning and at the end of pregnancy. Particulate matter, nitrogen dioxide, ozone, and carbon monoxide were the most commonly used markers of ambient air pollution. Continuous monitoring data were frequently combined with spatially more precisely modelled estimates of exposure. Exposure to particulate matter and ozone over the entire pregnancy was significantly associated with higher risk for preterm birth: the pooled effect estimates were 1.09 (1.03-1.16) per 10 μg/m3 increase in particulate matter with an aerodynamic diameter of 10 µm or less (PM10),1.24 (1.08-1.41) per 10 μg/m3 increase in particulate matter with an aerodynamic diameter of 2.5 µm or less (PM2.5), and 1.03 (1.01-1.04) per 10 ppb increase in ozone. For pregnancy outcomes other than PTB, ranges of observed effect estimates were reported due to smaller number of studies included in each gestational window of exposure. Further research is needed to link the routine pregnancy outcome data with spatially and temporally resolved ambient air pollution data, while adjusting for commonly defined confounders. Methods for assessing exposure to mixtures of pollutants, indoor air pollution exposure, and various other environmental exposures, need to be developed.
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Affiliation(s)
- Petra Klepac
- National institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia.
| | - Igor Locatelli
- University of Ljubljana, Faculty of Pharmacy, Aškerčeva 7, 1000 Ljubljana, Slovenia.
| | - Sara Korošec
- Department of Obstetrics and Gynecology, Reproductive Unit, University Medical Centre Ljubljana, Zaloška 3, 1525 Ljubljana, Slovenia.
| | - Nino Künzli
- Swiss Tropical and Public Health Institute (SwissTPH), Socinstrasse 57, 4002 Basel, Switzerland; University of Basel, Petersplatz 1, 4001 Basel, Switzerland.
| | - Andreja Kukec
- National institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia; University of Ljubljana, Faculty of Medicine, Vrazov trg 2, 1000 Ljubljana, Slovenia.
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Kim D, Chen Z, Zhou LF, Huang SX. Air pollutants and early origins of respiratory diseases. Chronic Dis Transl Med 2018; 4:75-94. [PMID: 29988883 PMCID: PMC6033955 DOI: 10.1016/j.cdtm.2018.03.003] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Indexed: 12/13/2022] Open
Abstract
Air pollution is a global health threat and causes millions of human deaths annually. The late onset of respiratory diseases in children and adults due to prenatal or perinatal exposure to air pollutants is emerging as a critical concern in human health. Pregnancy and fetal development stages are highly susceptible to environmental exposure and tend to develop a long-term impact in later life. In this review, we briefly glance at the direct impact of outdoor and indoor air pollutants on lung diseases and pregnancy disorders. We further focus on lung complications in later life with early exposure to air pollutants. Epidemiological evidence is provided to show the association of prenatal or perinatal exposure to air pollutants with various adverse birth outcomes, such as preterm birth, lower birth weight, and lung developmental defects, which further associate with respiratory diseases and reduced lung function in children and adults. Mechanistic evidence is also discussed to support that air pollutants impact various cellular and molecular targets at early life, which link to the pathogenesis and altered immune responses related to abnormal respiratory functions and lung diseases in later life.
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Affiliation(s)
- Dasom Kim
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45249, USA
| | - Zi Chen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Lin-Fu Zhou
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Shou-Xiong Huang
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45249, USA
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Zhang TN, Li D, Wu QJ, Xia J, Wen R, Chen XC, Yang N, Chen YL, Huang YH, Liu CF. Exposure to Nitrogen Oxide in the First Trimester and Risk of Cardiovascular-Related Malformations: A Dose-Response Meta-Analysis of Observational Studies. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1948407. [PMID: 29850486 PMCID: PMC5914127 DOI: 10.1155/2018/1948407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 02/23/2018] [Accepted: 03/05/2018] [Indexed: 11/24/2022]
Abstract
Nitrogen oxide (NO x ) is produced during combustion at high temperature, which is a major constituent of air pollutants. Recent studies suggested inconsistent results on the association between NO x exposure and cardiovascular-related malformations. We aimed to assess aforementioned association in pregnant women in the first trimester and cardiovascular-related malformations of infants. A systematic literature review identified studies for observational studies about NO x exposure and cardiovascular-related malformation in PubMed. Random-effect models were used to estimate summary odds ratio (SOR) and 95% confidence intervals (CIs) for aforementioned association. Finally, nine studies met the inclusion criteria. Overall, the SOR of cardiovascular-related malformation per 10 ppb increment in NO x and NO2 concentration was 1.01 (95% CI: 0.98-1.04; I2 = 38.6%, P = 0.09) and 0.99 (95% CI: 0.95-1.04; I2 = 37.8%, P = 0.13), respectively. Stratifying by study design, geographic locations, and confounded adjustments, the majority of strata showed negative results, which were consistent with the main findings. However, we found that exposure to NO x and NO2 in the first trimester increased the risk of coarctation of the aorta (COA) malformation by 13% and 19%, respectively. Our study provided limited evidence regarding the association between NO x exposure in the first trimester and cardiovascular-related malformations in infants.
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Affiliation(s)
- Tie-Ning Zhang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Da Li
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jing Xia
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ri Wen
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xing-Chen Chen
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ni Yang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yan-Ling Chen
- Liaoning Women and Children's Health Hospital, Shenyang, China
| | - Yan-Hong Huang
- Department of Science and Education, Shenyang Women and Children Health Care Centre, Shenyang, China
| | - Chun-Feng Liu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
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Dastoorpoor M, Idani E, Goudarzi G, Khanjani N. Acute effects of air pollution on spontaneous abortion, premature delivery, and stillbirth in Ahvaz, Iran: a time-series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:5447-5458. [PMID: 29214476 DOI: 10.1007/s11356-017-0692-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 11/06/2017] [Indexed: 05/22/2023]
Abstract
Living in areas with high air pollution may have adverse effects on human health. There are few studies about the association between breathing polluted air and adverse pregnancy outcomes in the Middle East. The aim of this study was to determine the relationship between air pollution and spontaneous abortion, premature birth, and stillbirth in Ahvaz. A time-series study was conducted. Data about spontaneous abortion, premature deliveries, and stillbirth was collected from Ahvaz Imam Khomeini Hospital. Air pollution data including NO, CO, NO2, PM10, SO2, O3, and climate data were, respectively, collected from the Environmental Protection Agency and the Khuzestan Province Meteorology Office from March 2008 until March 2015. The relationship between air pollutants with the number of abortions, premature births, and stillbirths was found using a quasi-Poisson distributed lag model, adjusted by trend, seasonality, temperature, relative humidity, weekdays, and holidays. The average daily dust in Ahvaz on 7.2% days of the year was higher than 500 μg/m3 (very dangerous). Findings from this study indicate a significant association between each 10-unit increase in SO2 and spontaneous abortion in lag 0 and 9 days. There was a significant relation between each 10-unit increase in NO2 and CO, and premature birth in lag 0. Also, we found a significant association between each 10-unit increase in CO and premature delivery in lag 1; PM10 and premature delivery in lags 10, 11, and 12; and NO and premature delivery in lags 3, 4, 10, 11, 12, and 13 (p value < 0.05). Contact with polluted air during pregnancy may increase adverse pregnancy outcomes and stillbirth. Pregnant women should avoid polluted air.
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Affiliation(s)
- Maryam Dastoorpoor
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Esmaeil Idani
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholamreza Goudarzi
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Environmental Technologies Research Center (ETRC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran.
- Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Kerman Medical University, Kerman, Iran.
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Liang F, Tian L, Guo Q, Westerdahl D, Liu Y, Jin X, Li G, Pan X. Associations of PM 2.5 and Black Carbon with Hospital Emergency Room Visits during Heavy Haze Events: A Case Study in Beijing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070725. [PMID: 28678202 PMCID: PMC5551163 DOI: 10.3390/ijerph14070725] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 11/18/2022]
Abstract
In January 2013, severe haze events over northeastern China sparked substantial health concerns. This study explores the associations of fine particulate matter less than 2.5 μm (PM2.5) and black carbon (BC) with hospital emergency room visits (ERVs) during a haze season in Beijing. During that period, daily counts of ERVs for respiratory, cardiovascular and ocular diseases were obtained from a Level-3A hospital in Beijing from 1 December 2012 to 28 February 2013, and associations of which with PM2.5 and BC were estimated by time-stratified case-crossover analysis in single- and two-pollutant models. We found a 27.5% (95% confidence interval (CI): 13.0, 43.9%) increase in respiratory ERV (lag02), a 19.4% (95% CI: 2.5, 39.0%) increase in cardiovascular ERV (lag0), and a 12.6% (95% CI: 0.0, 26.7%) increase in ocular ERV (lag0) along with an interquartile range (IQR) increase in the PM2.5. An IQR increase of BC was associated with 27.6% (95% CI: 9.6, 48.6%) (lag02), 18.8% (95% CI: 1.4, 39.2%) (lag0) and 11.8% (95% CI: −1.4, 26.8%) (lag0) increases for changes in these same health outcomes respectively. Estimated associations were consistent after adjusting SO2 or NO2 in two-pollutant models. This study provides evidence that improving air quality and reducing haze days would greatly benefit the population health.
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Affiliation(s)
- Fengchao Liang
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Lin Tian
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Qun Guo
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Dane Westerdahl
- School of Energy and Environment, City University of Hong Kong, Hong Kong, China.
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
| | - Xiaobin Jin
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Guoxing Li
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
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Michikawa T, Morokuma S, Nitta H, Kato K, Yamazaki S. Comparison between air pollution concentrations measured at the nearest monitoring station to the delivery hospital and those measured at stations nearest the residential postal code regions of pregnant women in Fukuoka. Environ Health Prev Med 2017; 22:55. [PMID: 29165140 PMCID: PMC5664789 DOI: 10.1186/s12199-017-0663-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 06/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Numerous earlier studies examining the association of air pollution with maternal and foetal health estimated maternal exposure to air pollutants based on the women's residential addresses. However, residential addresses, which are personally identifiable information, are not always obtainable. Since a majority of pregnant women reside near their delivery hospitals, the concentrations of air pollutants at the respective delivery hospitals may be surrogate markers of pollutant exposure at home. We compared air pollutant concentrations measured at the nearest monitoring station to Kyushu University Hospital with those measured at the closest monitoring stations to the respective residential postal code regions of pregnant women in Fukuoka. METHODS Aggregated postal code data for the home addresses of pregnant women who delivered at Kyushu University Hospital in 2014 was obtained from Kyushu University Hospital. For each of the study's 695 women who resided in Fukuoka Prefecture, we assigned pollutant concentrations measured at the nearest monitoring station to Kyushu University Hospital and pollutant concentrations measured at the nearest monitoring station to their respective residential postal code regions. RESULTS Among the 695 women, 584 (84.0%) resided in the proximity of the nearest monitoring station to hospital or one of the four other stations (as the nearest stations to their respective residential postal code region) in Fukuoka city. Pearson's correlation for daily mean concentrations among the monitoring stations in Fukuoka city was strong for fine particulate matter (PM2.5), suspended particulate matter (SPM), and photochemical oxidants (Ox) (coefficients ≥0.9), but moderate for coarse particulate matter (the result of subtracting the PM2.5 from the SPM concentrations), nitrogen dioxide, and sulphur dioxide. Hospital-based and residence-based concentrations of PM2.5, SPM, and Ox were comparable. CONCLUSIONS For PM2.5, SPM, and Ox, exposure estimation based on the delivery hospital is likely to approximate that based on the home of pregnant women.
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Affiliation(s)
- Takehiro Michikawa
- Environmental Epidemiology Section, Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, 305-8506, Japan.
| | - Seiichi Morokuma
- Department of Obstetrics and Gynaecology, Kyushu University Hospital, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hiroshi Nitta
- Environmental Epidemiology Section, Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, 305-8506, Japan
| | - Kiyoko Kato
- Department of Obstetrics and Gynaecology, Kyushu University Hospital, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shin Yamazaki
- Environmental Epidemiology Section, Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, 305-8506, Japan
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Giovannini N, Schwartz L, Cipriani S, Parazzini F, Baini I, Signorelli V, Cetin I. Particulate matter (PM10) exposure, birth and fetal-placental weight and umbilical arterial pH: results from a prospective study. J Matern Fetal Neonatal Med 2017; 31:651-655. [PMID: 28277922 DOI: 10.1080/14767058.2017.1293032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This prospective study aims to analyze the relation between particulate matter (PM10) exposure during pregnancy and birth weight (BW), placental weight (PW) and umbilical artery PH (UAPH). STUDY DESIGN Population included 3614 women born in Italy, living in Lombardia Region, consecutively admitted to the Clinica Mangiagalli for an elective cesarean section from January 2004 through December 2006. Outdoor air quality data were provided by the Department of the Regional Environmental Protection Agency and obtained by a network of fixed monitoring stations representatively distributed in eight geographical areas. RESULTS AND CONCLUSION Birth weight was negatively associated with exposure to PM10 concentration during the first trimester of pregnancy (mean change -22.2 g, 95%CI -8.7 to -35.7, p = 0.0013). Placental weight and umbilical artery PH were not associated with exposure to PM10 concentration. Fetal weight was negatively associated with exposure to PM10 concentration during the first trimester of pregnancy.
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Affiliation(s)
- Niccolò Giovannini
- a Dipartimento Materno infantile IRCCS Fondazione Policlinico Mangiagalli Regina Elena , Università degli Studi di Milano , Milano , Italy
| | - Lianne Schwartz
- b School of Nursing and Midwifery, Griffith University , Brisbane , Australia
| | - Sonia Cipriani
- a Dipartimento Materno infantile IRCCS Fondazione Policlinico Mangiagalli Regina Elena , Università degli Studi di Milano , Milano , Italy
| | - Fabio Parazzini
- a Dipartimento Materno infantile IRCCS Fondazione Policlinico Mangiagalli Regina Elena , Università degli Studi di Milano , Milano , Italy.,c Dipartimento Scienze Cliniche e di Comunità , Università di Milano , Milano , Italy
| | - Ilaria Baini
- a Dipartimento Materno infantile IRCCS Fondazione Policlinico Mangiagalli Regina Elena , Università degli Studi di Milano , Milano , Italy
| | - Valentina Signorelli
- d Dipartimento Materno Infantile , Istituti Clinici di Perfezionamento , Milano , Italy
| | - Irene Cetin
- e Dipartimento di Scienze Biologiche e Cliniche , University of Milan, Sacco Hospital , Milan , Italy
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Malley CS, Kuylenstierna JCI, Vallack HW, Henze DK, Blencowe H, Ashmore MR. Preterm birth associated with maternal fine particulate matter exposure: A global, regional and national assessment. ENVIRONMENT INTERNATIONAL 2017; 101:173-182. [PMID: 28196630 DOI: 10.1016/j.envint.2017.01.023] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 05/22/2023]
Abstract
Reduction of preterm births (<37 completed weeks of gestation) would substantially reduce neonatal and infant mortality, and deleterious health effects in survivors. Maternal fine particulate matter (PM2.5) exposure has been identified as a possible risk factor contributing to preterm birth. The aim of this study was to produce the first estimates of ambient PM2.5-associated preterm births for 183 individual countries and globally. To do this, national, population-weighted, annual average ambient PM2.5 concentration, preterm birth rate and number of livebirths were combined to calculate the number of PM2.5-associated preterm births in 2010 for 183 countries. Uncertainty was quantified using Monte-Carlo simulations, and analyses were undertaken to investigate the sensitivity of PM2.5-associated preterm birth estimates to assumptions about the shape of the concentration-response function at low and high PM2.5 exposures, inclusion of provider-initiated preterm births, and exposure to indoor air pollution. Globally, in 2010, the number of PM2.5-associated preterm births was estimated as 2.7 million (1.8-3.5 million, 18% (12-24%) of total preterm births globally) with a low concentration cut-off (LCC) set at 10μgm-3, and 3.4 million (2.4-4.2 million, 23% (16-28%)) with a LCC of 4.3μgm-3. South and East Asia, North Africa/Middle East and West sub-Saharan Africa had the largest contribution to the global total, and the largest percentage of preterm births associated with PM2.5. Sensitivity analyses showed that PM2.5-associated preterm birth estimates were 24% lower when provider-initiated preterm births were excluded, 38-51% lower when risk was confined to the PM2.5 exposure range in the studies used to derive the effect estimate, and 56% lower when mothers who live in households that cook with solid fuels (and whose personal PM2.5 exposure is likely dominated by indoor air pollution) were excluded. The concentration-response function applied here derives from a meta-analysis of studies, most of which were conducted in the US and Europe, and its application to the areas of the world where we estimate the greatest effects on preterm births remains uncertain. Nevertheless, the substantial percentage of preterm births estimated to be associated with anthropogenic PM2.5 (18% (13%-24%) of total preterm births globally) indicates that reduction of maternal PM2.5 exposure through emission reduction strategies should be considered alongside mitigation of other risk factors associated with preterm births.
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Affiliation(s)
- Christopher S Malley
- Stockholm Environment Institute, Environment Department, University of York, York, United Kingdom.
| | - Johan C I Kuylenstierna
- Stockholm Environment Institute, Environment Department, University of York, York, United Kingdom
| | - Harry W Vallack
- Stockholm Environment Institute, Environment Department, University of York, York, United Kingdom
| | - Daven K Henze
- Department of Mechanical Engineering, University of Colorado, Boulder, CO, United States
| | - Hannah Blencowe
- Maternal, Adolescent, Reproductive, and Child Health Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mike R Ashmore
- Stockholm Environment Institute, Environment Department, University of York, York, United Kingdom
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Abstract
OBJECTIVE This study aimed to explore evidence for the influence of air pollution on the risk of birth defects in China and contribute to establish prevention strategies. METHODS We conducted a retrospective cohort study in Anqing city, Eastern China, from 2010 to 2012. Binary logistic regression models were used to estimate odds ratios (ORs) per 10 μg/m3 change for SO2, NO2, and PM10. RESULTS For continuous exposure to SO2 (10 μg/m increase), the adjusted OR for birth defects is 1.20 [95% confidence interval (95% CI) 1.09 to 1.29] in the preconception. A 10 μg/m increase in SO2 (adjusted OR 1.26, 95% CI 1.15 to 1.36) during the second trimester is strongly associated with birth defects. No associations have been observed for NO2 and PM10. CONCLUSION The results suggested that exposure to ambient SO2 during pregnancy may increase the risk of birth defects.
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Jones SJ, Lewis H, McCarthy J, James K, McFarlane K, Brunt H. Carbon monoxide alarms: a community distribution project. J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0737-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
OBJECTIVE This retrospective observational study investigates the association between maternal exposure to air pollutants and pregnancy adverse outcomes in low urbanization areas. METHODS We used multivariate regression analysis to estimate, in the Como province (2005-2012), the effects of NO(x), NO2, SO2, O3, CO, and PM10 on low birth weight (LBW), babies small for gestational age (SGA), and preterm birth (PTB). RESULTS PTB was inversely associated with high (5.5 μg/m³) exposure to SO2 (adjusted odds ratio [aOR] = 0.74, 95% confidence interval [95% CI] = 0.58-0.95) and to CO (1.8 mg/m³, aOR = 0.84, CI = 0.72-0.99). PTB risk increased with second trimester exposure to NO(x) (118.3 μg/m³, aOR = 1.53, CI = 1.25-1.87), while LBW risk increased with third trimester PM10 (56.1 μg/m³, aOR = 1.44, CI = 1.03-2.02). SGA was inversely associated with third trimester NO(x) (115.8 μg/m³, aOR = 0.89, CI = 0.79-0.99). CONCLUSIONS Exposure to SO2 and CO seems to postpone delivery: a longer gestation could compensate for maternal hypoxemic-hypoxic damage.
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Johnson S, Bobb JF, Ito K, Savitz DA, Elston B, Shmool JL, Dominici F, Ross Z, Clougherty JE, Matte T. Ambient Fine Particulate Matter, Nitrogen Dioxide, and Preterm Birth in New York City. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:1283-90. [PMID: 26862865 PMCID: PMC4977049 DOI: 10.1289/ehp.1510266] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 09/09/2015] [Accepted: 01/21/2016] [Indexed: 05/20/2023]
Abstract
BACKGROUND Recent studies have suggested associations between air pollution and various birth outcomes, but the evidence for preterm birth is mixed. OBJECTIVE We aimed to assess the relationship between air pollution and preterm birth using 2008-2010 New York City (NYC) birth certificates linked to hospital records. METHODS We analyzed 258,294 singleton births with 22-42 completed weeks gestation to nonsmoking mothers. Exposures to ambient fine particles (PM2.5) and nitrogen dioxide (NO2) during the first, second, and cumulative third trimesters within 300 m of maternal address were estimated using data from the NYC Community Air Survey and regulatory monitors. We estimated the odds ratio (OR) of spontaneous preterm (gestation < 37 weeks) births for the first- and second-trimester exposures in a logistic mixed model, and the third-trimester cumulative exposures in a discrete time survival model, adjusting for maternal characteristics and delivery hospital. Spatial and temporal components of estimated exposures were also separately analyzed. RESULTS PM2.5 was not significantly associated with spontaneous preterm birth. NO2 in the second trimester was negatively associated with spontaneous preterm birth in the adjusted model (OR = 0.90; 95% CI: 0.83, 0.97 per 20 ppb). Neither pollutant was significantly associated with spontaneous preterm birth based on adjusted models of temporal exposures, whereas the spatial exposures showed significantly reduced odds ratios (OR = 0.80; 95% CI: 0.67, 0.96 per 10 μg/m3 PM2.5 and 0.88; 95% CI: 0.79, 0.98 per 20 ppb NO2). Without adjustment for hospital, these negative associations were stronger. CONCLUSION Neither PM2.5 nor NO2 was positively associated with spontaneous preterm delivery in NYC. Delivery hospital was an important spatial confounder. CITATION Johnson S, Bobb JF, Ito K, Savitz DA, Elston B, Shmool JL, Dominici F, Ross Z, Clougherty JE, Matte T. 2016. Ambient fine particulate matter, nitrogen dioxide, and preterm birth in New York City. Environ Health Perspect 124:1283-1290; http://dx.doi.org/10.1289/ehp.1510266.
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Affiliation(s)
- Sarah Johnson
- New York City Department of Health and Mental Hygiene, New York, New York, USA
- Address correspondence to S. Johnson, Bureau of Environmental Surveillance and Policy, New York City Department of Health and Mental Hygiene, CN 34E, 125 Worth St., New York, NY 10013 USA. Telephone: (646) 632-6543. E-mail:
| | - Jennifer F. Bobb
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Kazuhiko Ito
- New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - David A. Savitz
- Department of Epidemiology, and
- Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island, USA
| | - Beth Elston
- Department of Epidemiology, and
- Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island, USA
| | - Jessie L.C. Shmool
- Department of Occupational and Environmental Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Zev Ross
- ZevRoss Spatial Analysis, Ithaca, New York, USA
| | - Jane E. Clougherty
- Department of Occupational and Environmental Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Thomas Matte
- New York City Department of Health and Mental Hygiene, New York, New York, USA
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Baltrus P, Xu J, Immergluck L, Gaglioti A, Adesokan A, Rust G. Individual and county level predictors of asthma related emergency department visits among children on Medicaid: A multilevel approach. J Asthma 2016; 54:53-61. [PMID: 27285734 DOI: 10.1080/02770903.2016.1196367] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Disparities in asthma outcomes are well documented in the United States. Interventions to promote equity in asthma outcomes could target factors at the individual and community levels. The objective of this analysis was to understand the effect of individual (race, gender, age, and preventive inhaler use) and county-level factors (demographic, socioeconomic, health care, air-quality) on asthma emergency department (ED) visits among Medicaid-enrolled children. This was a retrospective cohort study of Medicaid-enrolled children with asthma in 29 states in 2009. Multilevel regression models of asthma ED visits were constructed utilizing individual-level variables (race, gender, age, and preventive inhaler use) from the Medicaid enrollment file and county-level variables reflecting population and health system characteristics from the Area Resource File (ARF). County-level measures of air quality were obtained from Environmental Protection Agency (EPA) data. RESULTS The primary modifiable risk factor at the individual level was found to be the ratio of long-term controller medications to total asthma medications. County-level factors accounted for roughly 6% of the variance in the asthma ED visit risk. Increasing county-level racial segregation (OR=1.04, 95% CI=1.01-1.08) was associated with increasing risk of asthma ED visits. Greater supply of pulmonary physicians at the county level (OR=0.81, 95% CI=0.68-0.97) was associated with a reduction in risk of asthma ED visits. CONCLUSIONS At the patient care level, proper use of controller medications is the factor most amenable to intervention. There is also a societal imperative to address negative social determinants, such as residential segregation.
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Affiliation(s)
- Peter Baltrus
- a National Center for Primary Care, Morehouse School of Medicine , Atlanta , GA , USA.,b Department of Community Health & Preventive Medicine , Morehouse School of Medicine , Atlanta , GA , USA
| | - Junjun Xu
- a National Center for Primary Care, Morehouse School of Medicine , Atlanta , GA , USA
| | - Lilly Immergluck
- a National Center for Primary Care, Morehouse School of Medicine , Atlanta , GA , USA.,c Departments of Microbiology , Biochemistry, & Immunology and Pediatrics, Morehouse School of Medicine , Atlanta , GA , USA
| | - Anne Gaglioti
- a National Center for Primary Care, Morehouse School of Medicine , Atlanta , GA , USA.,d Department of Family Medicine , Morehouse School of Medicine , Atlanta , GA , USA
| | - Adeola Adesokan
- e Master of Science in Clinical Research Program, Morehouse School of Medicine , Atlanta , GA , USA
| | - George Rust
- a National Center for Primary Care, Morehouse School of Medicine , Atlanta , GA , USA.,d Department of Family Medicine , Morehouse School of Medicine , Atlanta , GA , USA
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Coker E, Liverani S, Ghosh JK, Jerrett M, Beckerman B, Li A, Ritz B, Molitor J. Multi-pollutant exposure profiles associated with term low birth weight in Los Angeles County. ENVIRONMENT INTERNATIONAL 2016; 91:1-13. [PMID: 26891269 DOI: 10.1016/j.envint.2016.02.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 05/12/2023]
Abstract
Research indicates that multiple outdoor air pollutants and adverse neighborhood conditions are spatially correlated. Yet health risks associated with concurrent exposure to air pollution mixtures and clustered neighborhood factors remain underexplored. Statistical models to assess the health effects from pollutant mixtures remain limited, due to problems of collinearity between pollutants and area-level covariates, and increases in covariate dimensionality. Here we identify pollutant exposure profiles and neighborhood contextual profiles within Los Angeles (LA) County. We then relate these profiles with term low birth weight (TLBW). We used land use regression to estimate NO2, NO, and PM2.5 concentrations averaged over census block groups to generate pollutant exposure profile clusters and census block group-level contextual profile clusters, using a Bayesian profile regression method. Pollutant profile cluster risk estimation was implemented using a multilevel hierarchical model, adjusting for individual-level covariates, contextual profile cluster random effects, and modeling of spatially structured and unstructured residual error. Our analysis found 13 clusters of pollutant exposure profiles. Correlations between study pollutants varied widely across the 13 pollutant clusters. Pollutant clusters with elevated NO2, NO, and PM2.5 concentrations exhibited increased log odds of TLBW, and those with low PM2.5, NO2, and NO concentrations showed lower log odds of TLBW. The spatial patterning of pollutant cluster effects on TLBW, combined with between-pollutant correlations within pollutant clusters, imply that traffic-related primary pollutants influence pollutant cluster TLBW risks. Furthermore, contextual clusters with the greatest log odds of TLBW had more adverse neighborhood socioeconomic, demographic, and housing conditions. Our data indicate that, while the spatial patterning of high-risk multiple pollutant clusters largely overlaps with adverse contextual neighborhood cluster, both contribute to TLBW while controlling for the other.
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Affiliation(s)
- Eric Coker
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | | | - Jo Kay Ghosh
- School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Michael Jerrett
- School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Bernardo Beckerman
- School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Arthur Li
- Department of Information Science, City of Hope National Cancer Center, Duarte, CA, United States
| | - Beate Ritz
- School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
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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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