Source apportionment of fine particulate matter and risk of term low birth weight in California: Exploring modification by region and maternal characteristics

Ambient air pollution and childhood obesity from infancy to late childhood: An individual participant data meta-analysis of 10 European birth cohorts

Ambient air pollution may contribute to childhood obesity through various mechanisms. However, few longitudinal studies examined the relationship between pre- and postnatal exposure to air pollution and obesity outcomes in childhood. We aimed to investigate the association between pre- and postnatal exposure to air pollution and body mass index (BMI) and the risk of overweight/obesity throughout childhood in European cohorts. This study included mother-child pairs from 10 European birth cohorts (n = 37111 (prenatal), 33860 (postnatal)). Exposure to nitrogen dioxide (NO2) and fine particulate matter with aerodynamic diameter < 2.5 µm (PM2.5) was estimated at the home addresses during pre- and postnatal periods (year prior outcome assessment). BMI z-scores (continuous) and overweight/obesity status (categorical: zBMI≥+2 (<5 years) or ≥+1 (≥5 years) standard deviations) were derived at 0-2, 2-5, 5-9, 9-12 years. Associations between air pollution exposure and zBMI were estimated separately for each pollutant and cohort using linear and logistic longitudinal mixed effects models, followed by a random-effects meta-analysis. The overweight/obesity prevalence ranged from 12.3-40.5 % between cohorts at 0-2 years, 16.7-35.3 % at 2-5 years, 12.5-40.7 % at 5-9 years, and 10.7-43.8 % at 9-12 years. Results showed no robust associations between NO2 exposure and zBMI or overweight/obesity risk. Exposure to PM2.5 during pregnancy was associated with 23 % (95%CI 1.05;1.37) higher overweight/obesity risk across childhood, and higher zBMI and overweight/obesity risk at 9-12 years. Heterogeneity between cohorts was considerable (I2:25-89 %), with some cohort-specific associations; e.g., pre- and postnatal exposure to PM2.5 was associated with lower zBMI across age periods in UK cohorts (ALSPAC and BiB), while postnatal exposure to PM2.5 and NO2 was associated with higher zBMI in one Dutch cohort (Generation R). Overall, this large-scale meta-analysis suggests that prenatal PM2.5 exposure may be associated with adverse childhood obesity outcomes, but provides no evidence to support an effect of postnatal air pollution exposure, although cohort-specific associations were observed.

Approaches in landscape fire smoke pregnancy research and the impact on offspring: A review of knowledge gaps and recommendations

The increase in wildfires and bushfires due to climate change means that more people, including pregnant women and their fetuses will be exposed to landscape fire smoke. Although there is evidence to suggest that pregnancy landscape fire exposure is associated with lower birth weight, preterm birth and pregnancy loss, there is a lack of information on many other perinatal outcomes, as well as information on subsequent respiratory outcomes in children. Furthermore, due to the generally short term (hours/days) and intermittent nature of landscape fire smoke exposure, the knowledge to date has largely relied on natural experiments and ecological studies which can be subject to misclassification of exposure and a lack of precision. On the other hand, general urban outdoor air pollution exposure during pregnancy and subsequent perinatal and respiratory effects has been well studied. In particular, as air exposure modelling has improved so have the adaptations of methods to analyze the effects of air pollution exposure during pregnancy enabling critical windows of exposure to be identified. In this narrative review we summarize the current state of knowledge about the perinatal and respiratory effects of pregnancy landscape fire and particulate matter <2.5 μm in diameter (PM2.5) air pollution exposure, including a comment on analysis methods to date, and an assessment of how methodologies used in general air pollution research in relation to pregnancy exposure can be further harnessed for landscape fire smoke exposure pregnancy research.

PM2.5 exposure disparities persist despite strict vehicle emissions controls in California

As policymakers increasingly focus on environmental justice, a key question is whether emissions reductions aimed at addressing air quality or climate change can also ameliorate persistent air pollution exposure disparities. We examine evidence from California's aggressive vehicle emissions control policy from 2000 to 2019. We find a 65% reduction in modeled statewide average exposure to PM2.5 from on-road vehicles, yet for people of color and overburdened community residents, relative exposure disparities increased. Light-duty vehicle emissions are the main driver of the exposure and exposure disparity, although smaller contributions from heavy-duty vehicles especially affect some overburdened groups. Our findings suggest that a continued trend of emissions reductions will likely reduce concentrations and absolute disparity but may not reduce relative disparities without greater attention to the systemic factors leading to this disparity.

Meta-analysis of fine particulate matter exposure during pregnancy and birth weight: Exploring sources of heterogeneity

BACKGROUND

Several meta-analyses assessed the relationship between exposure to PM with aerodynamic diameter ≤ 2.5 μm (PM2.5) during pregnancy and birth weight (BW), but results were inconsistent and substantial unexplained heterogeneity was reported. We aimed to investigate the above association and to explore sources of heterogeneity across studies.

METHODS

We systematically reviewed the current worldwide evidence examining the association between PM2.5 and BW. The review protocol was registered on the PROSPERO website (CRD42020188996) and followed PRISMA guidelines. We extracted association measures for BW and low birth weight (LBW, BW < 2500 g) from each study to evaluate pooled summary measures and to explore sources of between-study heterogeneity.

FINDINGS

Of the 2677 articles identified, 84 met the inclusion criteria (~42 M births). Our random effects meta-analyses revealed substantial heterogeneity among included studies (I2 = 98.4 % and I2 = 77.7 %, for BW and LBW respectively). For LBW, the heterogeneity decreased (I2 = 59.7 %) after excluding four outlying studies, with a pooled odds ratio 1.07 (95 % confidence interval, CI: 1.05, 1.09) per a 10-μg/m3 increase in mean PM2.5 exposure over the entire pregnancy. Further subgroup analysis revealed geographic heterogeneity with higher association in Europe (1.34, (1.16, 1.55)) compared to Asia (1.06, (1.03, 1.10)) and US (1.07, (1.04, 1.10)).

CONCLUSION

The association between PM2.5 and birth weight varied depending on several factors. The sources of heterogeneity between studies included modifiers such as study region and period. Hence, it is advisable not to pool summary measures of PM2.5-BW associations and that policy would be informed by local evidence.

Effects of in-utero personal exposure to PM2.5 sources and components on birthweight

In-utero exposure to fine particulate matter (PM2.5) and specific sources and components of PM2.5 have been linked with lower birthweight. However, previous results have been mixed, likely due to heterogeneity in sources impacting PM2.5 and due to measurement error from using ambient data. Therefore, we investigated the effect of PM2.5 sources and their high-loading components on birthweight using data from 198 women in the 3rd trimester from the MADRES cohort 48-h personal PM2.5 exposure monitoring sub-study. The mass contributions of six major sources of personal PM2.5 exposure were estimated for 198 pregnant women in the 3rd trimester using the EPA Positive Matrix Factorization v5.0 model, along with their 17 high-loading chemical components using optical carbon and X-ray fluorescence approaches. Single- and multi-pollutant linear regressions evaluated the association between personal PM2.5 sources/components and birthweight, adjusting for gestational age, maternal age, race, infant sex, parity, diabetes status, temperature, maternal education, and smoking history. Participants were predominately Hispanic (81%), with a mean (SD) gestational age of 39.1 (1.5) weeks and age of 28.2 (6.0) years. Mean birthweight was 3295.8 g (484.1) and mean PM2.5 exposure was 21.3 (14.4) µg/m3. A 1 SD increase in the mass contribution of the fresh sea salt source was associated with a 99.2 g decrease in birthweight (95% CI - 197.7, - 0.6), and aged sea salt was associated with a 70.1 g decrease in birthweight (95% CI - 141.7, 1.4). Magnesium, sodium, and chlorine were associated with lower birthweight, which remained after adjusting for PM2.5 mass. This study found evidence that major sources of personal PM2.5 including fresh and aged sea salt were negatively associated with birthweight, with the strongest effect on birthweight from Na and Mg. The effect of crustal and fuel oil sources differed by infant sex with negative associations seen in boys compared to positive associations in girls.

Effects of Air Pollution Exposure during Preconception and Pregnancy on Gestational Diabetes Mellitus

This study aimed to investigate the association between air pollution and gestational diabetes mellitus (GDM) in small- and medium-sized cities, identify sensitive periods and major pollutants, and explore the effects of air pollution on different populations. A total of 9820 women who delivered in Handan Maternal and Child Health Hospital in the Hebei Province from February 2018 to July 2020 were included in the study. Logistic regression and principal component logistic regression models were used to assess the effects of air pollution exposure during preconception and pregnancy on GDM risk and the differences in the effects across populations. The results suggested that each 20 μg/m3 increase in PM2.5 and PM10 exposure during preconception and pregnancy significantly increased the risk of GDM, and a 10 μg/m3 increase in NO2 exposure during pregnancy was also associated with the risk of GDM. In a subgroup analysis, pregnant women aged 30-35 years, nulliparous women, and those with less than a bachelor's education were the most sensitive groups. This study provides evidence for an association between air pollution and the prevalence of GDM, with PM2.5, PM10, and NO2 as risk factors for GDM.

Effects of In-Utero Personal Exposure to PM2.5 Sources and Components on Birthweight

Background

In-utero exposure to fine particulate matter (PM2.5) and specific sources and components of PM2.5 have been linked with lower birthweight. However, previous results have been mixed, likely due to heterogeneity in sources impacting PM2.5 and due to measurement error from using ambient data. Therefore, we investigated the effect of PM2.5 sources and their high-loading components on birthweight using data from 198 women in the 3rd trimester from the MADRES cohort 48-hour personal PM2.5 exposure monitoring sub-study.

Methods

The mass contributions of six major sources of personal PM2.5 exposure were estimated for 198 pregnant women in the 3rd trimester using the EPA Positive Matrix Factorization v5.0 model, along with their 17 high-loading chemical components using optical carbon and X-ray fluorescence approaches. Single- and multi-pollutant linear regressions were used to evaluate the association between personal PM2.5 sources and birthweight. Additionally, high-loading components were evaluated with birthweight individually and in models further adjusted for PM2.5 mass.

Results

Participants were predominately Hispanic (81%), with a mean (SD) gestational age of 39.1 (1.5) weeks and age of 28.2 (6.0) years. Mean birthweight was 3,295.8g (484.1) and mean PM2.5 exposure was 21.3 (14.4) μg/m3. A 1 SD increase in the mass contribution of the fresh sea salt source was associated with a 99.2g decrease in birthweight (95% CI: -197.7, -0.6), while aged sea salt was associated with lower birthweight (β =-70.1; 95% CI: -141.7, 1.4). Magnesium sodium, and chlorine were associated with lower birthweight, which remained after adjusting for PM2.5 mass.

Conclusions

This study found evidence that major sources of personal PM2.5 including fresh and aged sea salt were negatively associated with birthweight, with the strongest effect on birthweight from Na and Mg. The effect of crustal and fuel oil sources differed by infant sex with negative associations seen in boys compared to positive associations in girls.

The association of birthweight with fine particle exposure is modifiable by source sector: Findings from a cross-sectional study of 17 low- and middle-income countries

BACKGROUND

Low birthweight attributable to fine particulate matter (PM_2.5) exposure is a global issue affecting infant health, especially in low- and middle-income countries (LMICs). However, large-population studies of multiple LMICs are lacking, and little is known about whether the source of PM_2.5 is a determinant of the toxic effect on birthweight.

OBJECTIVE

We examined the effect on birthweight of long-term exposure to PM_2.5 from different sources in LMICs.

METHODS

The birthweights of 53,449 infants born between September 16, 2017 and September 15, 2018 in 17 LMICs were collected from demographic and health surveys. Long-term exposure to PM_2.5 in 2017 produced by 20 different sources was estimated by combining chemical transport model simulations with satellite-based concentrations of total mass. Generalized linear regression models were used to investigate the associations between birthweight and each source-specific PM_2.5 exposure. A multiple-pollutant model with a ridge penalty on the coefficients of all 20-source-specific components was employed to develop a joint exposure-response function (JERF) of the PM_2.5 mixtures. The estimated JERF was then used to quantify the global burden of birthweight reduction attributable to PM_2.5 mixtures and to PM_2.5 from specific sources.

RESULTS

The fully adjusted single-pollutant model indicated that exposure to a 10 μg/m³ increase in total PM_2.5 was significantly associated with a -6.6 g (95% CI -11.0 to -2.3) reduction in birthweight. In single- and multiple-pollutant models, significant birthweight changes were associated with exposure to PM_2.5 produced by international shipping (SHP), solvents (SLV), agricultural waste burning (GFEDagburn), road transportation (ROAD), waste handling and disposal (WST), and windblown dust (WDUST). Based on the global average exposure to PM_2.5 mixtures, the JERF showed that the overall change in birthweight could mostly be attributed to PM_2.5 produced by ROAD (-37.7 g [95% CI -49.2 to -24.4] for a global average exposure of 2.2 μg/m³), followed by WST (-27.5 g [95% CI -42.6 to -10.7] for a 1.6-μg/m³ exposure), WDUST (-19.5 g [95% CI -26.7 to -12.6] for a 8.6-μg/m³ exposure), and SHP (-19.0 g [95% CI -32.3 to -5.7] for a 0.2-μg/m³ exposure), which, with the exception of WDUST, are anthropogenic sources. The changes in birthweight varied geographically and were co-determined by the concentration as well as the source profile of the PM_2.5 mixture.

CONCLUSION

PM_2.5 exposure is associated with a reduction in birthweight, but our study shows that the magnitude of the association differs depending on the PM_2.5 source. A source-targeted emission-control strategy that considers local features is therefore critical to maximize the health benefits of air quality improvement, especially with respect to promoting maternal and child health.

Exposure to local, source-specific ambient air pollution during pregnancy and autism in children: a cohort study from southern Sweden

Evidence of air pollution exposure, namely, ambient particulate matter (PM), during pregnancy and an increased risk of autism in children is growing; however, the unique PM sources that contribute to this association are currently unknown. The aim of the present study was to investigate local, source-specific ambient PM exposure during pregnancy and its associations with childhood autism, specifically, and autism spectrum disorders (ASD) as a group. A cohort of 40,245 singleton births from 2000 to 2009 in Scania, Sweden, was combined with data on locally emitted PM with an aerodynamic diameter < 2.5 µm (PM2.5). A flat, two-dimensional dispersion model was used to assess local PM2.5 concentrations (all-source PM2.5, small-scale residential heating- mainly wood burning, tailpipe exhaust, and vehicle wear-and-tear) at the mother's residential address during pregnancy. Associations were analyzed using binary logistic regression. Exposure to local PM2.5 during pregnancy from each of the investigated sources was associated with childhood autism in the fully adjusted models. For ASD, similar, but less pronounced, associations were found. The results add to existing evidence that exposure to air pollution during pregnancy may be associated with an increased risk of childhood autism. Further, these findings suggest that locally produced emissions from both residential wood burning and road traffic-related sources (tailpipe exhaust and vehicle wear-and-tear) contribute to this association.

Maternal atmospheric particulate matter exposure and risk of adverse pregnancy outcomes: A meta-analysis of cohort studies

Ambient air particulate exposure not only capable of elevating the risks of adverse pregnancy outcomes, but also has profound implications for human health, but the results are discrepant. This meta-analysis aimed to provide higher grade evidence on the impacts of air particulate on specific pregnancy outcomes. A total of 81 eligible cohort studies were included in this meta-analysis, of which the outcomes included preterm birth (PTB), moderate PTB, very PTB, extreme PTB, term low birth weight (TLBW), term birth weight (TBW), stillbirth (SB) and small for gestational age (SGA). The results showed that every 10 μg/m³ increase of PM_2.5 exposure associated with 2.7%-9.3% increase of PTB risk in entire pregnancy, 2nd and 3rd trimesters; 10.5%-19.3% increase of very PTB risk in entire pregnancy, 1st and 2nd trimesters; 8.3% and 10.1% increase of TLBW and SGA risk in entire pregnancy; 25.6% and 10.1% increase of SB in entire pregnancy and 3rd trimester; and -13.274 g and -4.916 g reduce of TBW during entire pregnancy and 2nd trimester, respectively. Every 10 μg/m³ increase of PM₁₀ exposure associated with 12.1% and 2.6% increase of PTB risk in entire pregnancy and 3rd trimester; 48.9% and 5.0% increase of moderate PTB risk in entire pregnancy and 2nd trimester; 14.4% and 10.3% increase of very PTB risk in 1st and 3rd trimesters; 2.9% increase of extremely PTB risk in 2nd trimester; 1.5%-3.8% and 2.9%-3.7% increase of TLBW and SGA risk in entire pregnancy, 1st and 2nd trimesters; 7.0% increase of SB risk in 3rd trimesters; and -4.537 g and -5.263 g reduce of TBW in 1st and 2nd trimesters, respectively. High mean annual PM concentrations were associated with more extreme adverse pregnancy outcomes (PTBs, SGA and SB), while low mean annual PM concentrations were associated with decreased TBW and increased risk of TLBW.

PM2.5 exceedances and source appointment as inputs for an early warning system

Between June 2018 and April 2019, a sampling campaign was carried out to collect PM2.5, monitoring meteorological parameters and anthropogenic events in the Sartenejas Valley, Venezuela. We develop a logistic model for PM2.5 exceedances (≥ 12.5 µg m-3). Source appointment was done using elemental composition and morphology of PM by scanning electron microscopy coupled with energy dispersive spectroscopy (SEM-EDS). A proposal of an early warning system (EWS) for PM pollution episodes is presented. The logistic model has a holistic success rate of 94%, with forest fires and motor vehicle flows as significant variables. Source appointment analysis by occurrence of events showed that samples with higher concentrations of PM had carbon-rich particles and traces of K associated with biomass burning, as well as aluminosilicates and metallic elements associated with resuspension of soil dust by motor-vehicles. Quantitative source appointment analysis showed that soil dust, garbage burning/marine aerosols and wildfires are three majority sources of PM. An EWS for PM pollution episodes around the Sartenejas Valley is proposed considering the variables and elements mentioned.

Prenatal Exposure to Locally Emitted Air Pollutants Is Associated with Birth Weight: An Administrative Cohort Study from Southern Sweden

While prenatal exposure to ambient air pollution has been shown to be associated with reduced birth weight, there is substantial heterogeneity across studies, and few epidemiological studies have utilized source-specific exposure data. The aim of the present study was, therefore, to investigate the associations between local, source-specific exposure to fine particulate matter (PM2.5) during pregnancy and birth weight. An administrative cohort comprising 40,245 singleton births from 2000 to 2009 in Scania, Sweden, was combined with data on relevant covariates. Investigated sources of PM2.5 included all local sources together as well as tailpipe exhaust, vehicle wear-and-tear, and small-scale residential heating separately. The relationships between these exposures, represented as interquartile range (IQR) increases, and birth weight (continuous) and low birth weight (LBW; <2500 g) were analyzed in crude and adjusted models. Each local PM2.5 source investigated was associated with reduced birth weight; average decreases varied by source (12−34 g). Only small-scale residential heating was clearly associated with LBW (adjusted odds ratio: 1.14 (95% confidence interval: 1.04−1.26) per IQR increase). These results add to existing evidence that prenatal exposure to ambient air pollution disrupts fetal growth and suggest that PM2.5 from both vehicles and small-scale residential heating may reduce birth weight.

Both parents matter: a national-scale analysis of parental race/ethnicity, disparities in prenatal PM2.5 exposures and related impacts on birth outcomes

BACKGROUND

Most U.S. studies that report racial/ethnic disparities in increased risk of low birth weight associated with air pollution exposures have been conducted in California or northeastern states and/or urban areas, limiting generalizability of study results. Few of these studies have examined maternal racial/ethnic groups other than Non-Hispanic Black, non-Hispanic White and Hispanic, nor have they included paternal race. We aimed to examine the independent effects of PM2.5 on birth weight among a nationally representative sample of U.S. singleton infants and how both maternal and paternal race/ethnicity modify relationships between prenatal PM2.5 exposures and birth outcomes.

METHODS

We used data from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B), a longitudinal nationally representative cohort of 10,700 U.S. children born in 2001, which we linked to U.S.EPA's Community Multi-scale Air Quality (CMAQ)-derived predicted daily PM2.5 concentrations at the centroid of each Census Bureau Zip Code Tabulation Area (ZCTA) for maternal residences. We examined relationships between term birthweight (TBW), term low birthweight rate (TLBW) and gestational PM2.5 pollutant using multivariate regression models. Effect modification of air pollution exposures on birth outcomes by maternal and paternal race was evaluated using stratified models. All analyses were conducted with sample weights to provide national-scale estimates.

RESULTS

The majority of mothers were White (61%). Fourteen percent of mothers identified as Black, 21% as Hispanic, 3% Asian American and Pacific Islander (AAPI) and 1% American Indian and Alaskan Native (AIAN). Fathers were also racially/ethnically diverse with 55% identified as White Non-Hispanic, 10% as Black Non-Hispanic, 19% as Hispanic, 3% as AAPI and 1% as AIAN. Results from the chi-square and ANOVA tests of significance for racial/ethnic differences indicate disparities in prenatal exposures and birth outcomes by both maternal and paternal race/ethnicity. Prenatal PM2.5 was associated with reduced birthweights during second and third trimester and over the entire gestational period in adjusted regression models, although results did not reach statistical significance. In models stratified by maternal race and paternal race, one unit increase in PM2.5 was statistically significantly associated with lower birthweights among AAPI mothers, -5.6 g (95% CI:-10.3, -1.0 g) and AAPI fathers, -7.6 g (95% CI: -13.1, -2.1 g) during 3rd trimester and among births where father's race was not reported, -14.2 g (95% CI: -24.0, -4.4 g).

CONCLUSIONS

These data suggest that paternal characteristics should be used, in addition to maternal characteristics, to describe the risks of adverse birth outcomes. Additionally, our study suggests that serious consideration should be given to investigating environmental and social mechanisms, such as air pollution exposures, as potential contributors to disparities in birth outcomes among AAPI populations.

Maternal exposure to ambient PM2.5 and term birth weight: A systematic review and meta-analysis of effect estimates

Effect estimates of prenatal exposure to ambient PM_2.5 on change in grams (β) of birth weight among term births (≥37 weeks of gestation; term birth weight, TBW) vary widely across studies. We present the first systematic review and meta-analysis of evidence regarding these associations. Sixty-two studies met the eligibility criteria for this review, and 31 studies were included in the meta-analysis. Random-effects meta-analysis was used to assess the quantitative relationships. Subgroup analyses were performed to gain insight into heterogeneity derived from exposure assessment methods (grouped by land use regression [LUR]-models, aerosol optical depth [AOD]-based models, interpolation/dispersion/Bayesian models, and data from monitoring stations), study regions, and concentrations of PM_2.5 exposure. The overall pooled estimate involving 23,925,941 newborns showed that TBW was negatively associated with PM_2.5 exposure (per 10 μg/m³ increment) during the entire pregnancy (β = -16.54 g), but with high heterogeneity (I² = 95.6%). The effect estimate in the LUR-models subgroup (β = -16.77 g) was the closest to the overall estimate and with less heterogeneity (I² = 18.3%) than in the other subgroups of AOD-based models (β = -41.58 g; I² = 95.6%), interpolation/dispersion models (β = -10.78 g; I² = 86.6%), and data from monitoring stations (β = -11.53 g; I² = 97.3%). Even PM_2.5 exposure levels of lower than 10 μg/m³ (the WHO air quality guideline value) had adverse effects on TBW. The LUR-models subgroup was the only subgroup that obtained similar significant of negative associations during the three trimesters as the overall trimester-specific analyses. In conclusion, TBW was negatively associated with maternal PM_2.5 exposures during the entire pregnancy and each trimester. More studies based on relatively standardized exposure assessment methods need to be conducted to further understand the precise susceptible exposure time windows and potential mechanisms.

Prenatal air pollution exposure and neurodevelopment: A review and blueprint for a harmonized approach within ECHO

BACKGROUND

Air pollution exposure is ubiquitous with demonstrated effects on morbidity and mortality. A growing literature suggests that prenatal air pollution exposure impacts neurodevelopment. We posit that the Environmental influences on Child Health Outcomes (ECHO) program will provide unique opportunities to fill critical knowledge gaps given the wide spatial and temporal variability of ECHO participants.

OBJECTIVES

We briefly describe current methods for air pollution exposure assessment, summarize existing studies of air pollution and neurodevelopment, and synthesize this information as a basis for recommendations, or a blueprint, for evaluating air pollution effects on neurodevelopmental outcomes in ECHO.

METHODS

We review peer-reviewed literature on prenatal air pollution exposure and neurodevelopmental outcomes, including autism spectrum disorder, attention deficit hyperactivity disorder, intelligence, general cognition, mood, and imaging measures. ECHO meta-data were compiled and evaluated to assess frequency of neurodevelopmental assessments and prenatal and infancy residential address locations. Cohort recruitment locations and enrollment years were summarized to examine potential spatial and temporal variation present in ECHO.

DISCUSSION

While the literature provides compelling evidence that prenatal air pollution affects neurodevelopment, limitations in spatial and temporal exposure variation exist for current published studies. As >90% of the ECHO cohorts have collected a prenatal or infancy address, application of advanced geographic information systems-based models for common air pollutant exposures may be ideal to address limitations of published research.

CONCLUSIONS

In ECHO we have the opportunity to pioneer unifying exposure assessment and evaluate effects across multiple periods of development and neurodevelopmental outcomes, setting the standard for evaluation of prenatal air pollution exposures with the goal of improving children's health.

Association of systemic inflammation and coagulation biomarkers with source-specific PM2.5 mass concentrations among young and elderly subjects in central Tehran

In this study, we investigated the association between short-term exposure to different sources of fine particulate matter (PM_2.5) and biomarkers of coagulation and inflammation in two different panels of elderly and healthy young individuals in central Tehran. Five biomarkers, including white blood cells (WBC), high sensitive C-reactive protein (hsCRP), tumor necrosis factor-soluble receptor-II (sTNF-RII), interleukin-6 (IL-6), and von Willebrand factor (vWF) were analyzed in the blood samples drawn every 8 weeks from the subjects between May 2012 and May 2013. The studied populations consisted of 44 elderly individuals at a retirement home as well as 40 young adults residing at a school dormitory. Positive Matrix Factorization (PMF)-resolved source-specific PM_2.5 mass concentrations and biomarker levels were used as the input to the linear mixed-effects regression model to evaluate the impact of exposure to previously identified PM sources at retirement home and school dormitory in two time lag configurations: lag 1-3 (1-3 days before the blood sampling), and lag 4-6 (4-6 days before the blood sampling). Our analysis of the elderly revealed positive associations of all biomarkers (except hsCRP) with particles of secondary origin in both time lags, further corroborating the toxicity of secondary aerosols formed by photochemical processing in central Tehran. Moreover, industrial emissions, and road dust particles were positively associated with WBC, sTNF-RII, and IL-6 among seniors, while vehicular emissions exhibited positive associations with all biomarkers in either first- or second-time lag. In contrast, most of the PM_2.5 sources showed insignificant associations with biomarkers of inflammation in the panel of healthy young subjects. Therefore, findings from this study indicated that various PM_2.5 sources increase the levels of inflammation and coagulation biomarkers, although the strength and significance of these associations vary depending on the type of PM sources, demographic characteristics, and differ across the different time lags. Implications: Tehran, the capital of Iran with a population of more than 9 million people, has been facing serious air pollution challenges as a result of extensive vehicular, and industrial activities in the previous years. Among various air pollutants in Tehran, fine particulate matters (PM_2.5, particles with aerodynamic diameters < 2.5 µm) are known as one of the most important critical pollutants, causing several adverse health impacts including lung cancer, respiratory, cardiovascular, and cardiopulmonary diseases. Therefore, a number of studies in the area have tried to investigate the adverse health impacts of exposure to PM_2.5. However, no studies have ever been conducted in Tehran to examine the association between specific PM_2.5 sources and biomarkers of coagulation and systemic inflammation as indicators of cardiovascular disorders. Indeed, this is the first study in the area investigating the association of source-specific PM_2.5 with biomarkers of inflammation including white blood cells (WBC), high sensitive C-reactive protein (hsCRP), tumor necrosis factor-soluble receptor-II (sTNF-RII), interleukin-6 (IL-6), and von Willebrand factor (vWF). Our results have important implications for policy makers in identifying the most toxic sources of PM_2.5, and in turn designing schemes for mitigating adverse health impacts of air pollution in Tehran.

Inferential challenges when assessing racial/ethnic health disparities in environmental research

Numerous epidemiologic studies have documented environmental health disparities according to race/ethnicity (R/E) to inform targeted interventions aimed at reducing these disparities. Yet, the use of R/E under the potential outcomes framework implies numerous underlying assumptions for epidemiologic studies that are often not carefully considered in environmental health research. In this commentary, we describe the current state of thinking about the interpretation of R/E variables in etiologic studies. We then discuss how such variables are commonly used in environmental epidemiology. We observed three main uses for R/E: i) as a confounder, ii) as an effect measure modifier and iii) as the main exposure of interest either through descriptive analysis or under a causal framework. We identified some common methodological concerns in each case and provided some practical solutions. The use of R/E in observational studies requires particular cautions in terms of formal interpretation and this commentary aims at providing a practical resource for future studies assessing racial/ethnic health disparities in environmental research.

Maternal immune response and air pollution exposure during pregnancy: insights from the Early Markers for Autism (EMA) study

BACKGROUND

Perinatal exposure to air pollution and immune system dysregulation are two factors consistently associated with autism spectrum disorders (ASD) and other neurodevelopmental outcomes. However, little is known about how air pollution may influence maternal immune function during pregnancy.

OBJECTIVES

To assess the relationship between mid-gestational circulating levels of maternal cytokines/chemokines and previous month air pollution exposure across neurodevelopmental groups, and to assess whether cytokines/chemokines mediate the relationship between air pollution exposures and risk of ASD and/or intellectual disability (ID) in the Early Markers for Autism (EMA) study.

METHODS

EMA is a population-based, nested case-control study which linked archived maternal serum samples collected during weeks 15-19 of gestation for routine prenatal screening, birth records, and Department of Developmental Services (DDS) records. Children receiving DDS services for ASD without intellectual disability (ASD without ID; n = 199), ASD with ID (ASD with ID; n = 180), ID without ASD (ID; n = 164), and children from the general population (GP; n = 414) with no DDS services were included in this analysis. Serum samples were quantified for 22 cytokines/chemokines using Luminex multiplex analysis technology. Air pollution exposure for the month prior to maternal serum collection was assigned based on the Environmental Protection Agency's Air Quality System data using the maternal residential address reported during the prenatal screening visit.

RESULTS

Previous month air pollution exposure and mid-gestational maternal cytokine and chemokine levels were significantly correlated, though weak in magnitude (ranging from - 0.16 to 0.13). Ten pairs of mid-pregnancy immune markers and previous month air pollutants were significantly associated within one of the child neurodevelopmental groups, adjusted for covariates (p < 0.001). Mid-pregnancy air pollution was not associated with any neurodevelopmental outcome. IL-6 remained associated with ASD with ID even after adjusting for air pollution exposure.

CONCLUSION

This study suggests that maternal immune activation is associated with risk for neurodevelopmental disorders. Furthermore, that prenatal air pollution exposure is associated with small, but perhaps biologically relevant, effects on maternal immune system function during pregnancy. Additional studies are needed to better evaluate how prenatal exposure to air pollution affects the trajectory of maternal immune activation during pregnancy, if windows of heightened susceptibility can be identified, and how these factors influence neurodevelopment of the offspring.

Impact of Maternal Demographic and Socioeconomic Factors on the Association Between Particulate Matter and Adverse Birth Outcomes: a Systematic Review and Meta-analysis

BACKGROUND

Numerous studies conducted in the United States found associations between prenatal exposure to particulate matter (PM) and adverse birth outcomes, and some studies identified vulnerable populations, including certain racial/ethnic groups and people with low-socioeconomic status. However, their findings are not always consistent. In this review, we compared the risk of adverse birth outcomes due to PM exposures among subpopulations and investigated whether any particular population is more vulnerable.

METHODS

We selected U.S. studies examining associations between PM exposure during pregnancy and birth outcomes that included results for effect modification by race/ethnicity and/or maternal education. We summarized the findings for various sizes of PM and birth outcomes. Meta-analysis was conducted to quantify vulnerable race/ethnicity for the association between fine PM (PM_2.5) and birthweight.

RESULTS

In total, 19 studies were assessed, and PM-related risks of adverse birth outcomes, particularly those related to fetal growth, likely differ across subpopulations. A meta-analysis from five studies showed that a 10 μg/m³ increase of PM_2.5 during the full-gestation reduced birthweight by 21.9 g (95% confidence interval 11.7, 32.0), 15.7 g (10.1, 21.4), 9.3 g (2.7, 15.8), and 5.8 g (- 9.0, 20.7) for Black, White, Hispanic, and Asian mothers, respectively.

CONCLUSION

Our review indicated that Black mothers and mothers with low educational attainment are more vulnerable subpopulations. More investigation is needed for effect modification by other maternal factors, such as household income. Characterizing and quantifying vulnerable subpopulations are essential for addressing environmental justice since it can help regulatory agencies allocate resources and design policy interventions.

Quantile regression analysis of the socioeconomic inequalities in air pollution and birth weight

BACKGROUND

An association between maternal exposure to air pollution and the birth weight distribution has been reported, but the extent to which this relationship varies according to socioeconomic status (SES) is unknown. This study examined the relationship using the data from a Korean birth cohort.

METHODS

Data for singleton births in Seoul from 2007 to 2017 (n = 1739) were analyzed. Maternal exposures to particulate matter with an aerodynamic diameter <10 µm (PM₁₀) and <2.5 µm (PM_2.5), as well as to nitrogen dioxide (NO₂) and ozone (O₃) for each trimester and the entire pregnancy were estimated using residential address, gestational age, and the birth date. The associations between the interquartile range (IQR) increases in pollutant concentrations and the changes in birth weight were examined using linear regression and quantile regression models. The socioeconomic disparities in the associations were investigated using a derived SES variable based on the composite of parental education and occupation. This SES variable was then interacted with the air pollutant.

RESULTS

In the gestational age-adjusted models, particulate air pollutants (PM₁₀ and PM_2.5) and O₃ were associated with birth weight decreases for the lower birth weight percentiles. For example, the decrease in mean birthweight per IQR increase in PM_2.5 during second trimester was -21.1 g (95% confidence interval (CI) = -41.8, -0.4), whereas the quantile-specific associations were: 10th percentile -27.0 g (95% CI = -46.6, -7.3); 50th percentile -22.2 g (95% CI = -39.6, -4.8); and 90th percentile -22.9 g (95% CI = -45.5, -0.2). Particulate air pollutants and O₃ showed a pattern of socioeconomic inequalities; the reduced birth weight was of greater magnitude for children from a low SES group.

CONCLUSIONS

Negative associations between particulate air pollutants and O₃ and birth weight were consistently greater at the lower quantiles of the birth weight distribution, especially in lower SES group.

Testing the Multiple Pathways of Residential Greenness to Pregnancy Outcomes Model in a Sample of Pregnant Women in the Metropolitan Area of Donostia-San Sebastián

Residential greenness may positively impact diverse human health indicators through the reduction of air pollution, the improvement of psychological health, and the promotion of physical activity. Previous studies indicate a weak but positive association with pregnancy outcomes. Our aim was to test the multiple pathways from residential greenness to pregnancy outcomes model, using residential NO₂ concentrations, psychological health, and moderate-to-vigorous physical activity (MVPA) during the first trimester of pregnancy, in a sample of 440 pregnant women residing in Donostia, Spain. Three metrics of residential greenness were calculated around each participant’s home address: normalized difference vegetation index (NDVI) within 300 m, and green space (>5000 m²) availability within 300 and 500 m. Residential NO₂ concentrations, psychological health, and MVPA were explored as mediators of the associations between these metrics and the following pregnancy outcomes: birth weight (BW), low birth weight (LBW), prematurity, small for gestational age (SGA), and large for gestational age (LGA). Educational attainment, parity, and body mass index (BMI) were treated as covariates. Counterfactual mediation analyses showed very low to null statistical support for an association between any of the greenspace metrics and pregnancy outcomes in the full sample. Green space availability (300 m) was associated with lower BW and showed a marginal protective effect against LGA.

Maternal PM2.5 exposure triggers preterm birth: a cross-sectional study in Wuhan, China

Background

Most of the studies regarding air pollution and preterm birth (PTB) in highly polluted areas have estimated the exposure level based on fixed-site monitoring. However, exposure assessment methods relying on monitors have the potential to cause exposure misclassification due to a lack of spatial variation. In this study, we utilized a land use regression (LUR) model to assess individual exposure, and explored the association between PM_2.5 exposure during each time window and the risk of preterm birth in Wuhan city, China.

Methods

Information on 2101 singleton births, which were ≥ 20 weeks of gestation and born between November 1, 2013 and May 31, 2014; between January 1, 2015 and August 31, 2015, was obtained from the Obstetrics Department in one 3A hospital in Wuhan. Air quality index (AQI) data were accessed from the Wuhan Environmental Protection Bureau website. Individual exposure during pregnancy was assessed by LUR models and Kriging interpolation. Logistic regression analyses were conducted to determine the association between women exposure to PM_2.5 and the risk of different subtypes of PTB.

Results

During the study period, the average individual exposure concentration of PM_2.5 during the entire pregnancy was 84.54 μg/m³. A 10 μg/m³ increase of PM_2.5 exposure in the first trimester (OR: 1.169; 95% CI: 1.077, 1.262), the second trimester (OR: 1.056; 95% CI: 1.015, 1.097), the third trimester (OR: 1.052; 95% CI: 1.002, 1.101), and the entire pregnancy (OR: 1.263; 95% CI: 1.158, 1.368) was significantly associated with an increased risk of PTB. For the PTB subgroup, the hazard of PM_2.5 exposure during pregnancy was stronger for very preterm births (VPTB) than moderate preterm births (MPTB). The first trimester was the most susceptible exposure window. Moreover, women who had less than 9 years of education or who conceived during the cold season tended to be more susceptible to the PM_2.5 exposure during pregnancy.

Conclusions

Maternal exposure to PM_2.5 increased the risk of PTB, and this risk was stronger for VPTB than for MPTB, especially during the first trimester.

Prenatal exposure to traffic and ambient air pollution and infant weight and adiposity: The Healthy Start study

BACKGROUND

Prenatal exposures to ambient air pollution and traffic have been associated with adverse birth outcomes, and may also lead to an increased risk of obesity. Obesity risk may be reflected in changes in body composition in infancy.

OBJECTIVE

To estimate associations between prenatal ambient air pollution and traffic exposure, and infant weight and adiposity in a Colorado-based prospective cohort study.

METHODS

Participants were 1125 mother-infant pairs with term births. Birth weight was recorded from medical records and body composition measures (fat mass, fat-free mass, and adiposity [percent fat mass]) were evaluated via air displacement plethysmography at birth (n = 951) and at ~5 months (n = 574). Maternal residential address was used to calculate distance to nearest roadway, traffic density, and ambient concentrations of fine particulate matter (PM2.5) and ozone (O3) via inverse-distance weighted interpolation of stationary monitoring data, averaged by trimester and throughout pregnancy. Adjusted linear regression models estimated associations between exposures and infant weight and body composition.

RESULTS

Participants were urban residents and diverse in race/ethnicity and socioeconomic status. Average ambient air pollutant concentrations were generally low; the median, interquartile range (IQR), and range of third trimester concentrations were 7.3 μg/m3 (IQR: 1.3, range: 3.3-12.7) for PM2.5 and 46.3 ppb (IQR: 18.4, range: 21.7-63.2) for 8-h maximum O3. Overall there were few associations between traffic and air pollution exposures and infant outcomes. Third trimester O3 was associated with greater adiposity at follow-up (2.2% per IQR, 95% CI 0.1, 4.3), and with greater rates of change in fat mass (1.8 g/day, 95% CI 0.5, 3.2) and adiposity (2.1%/100 days, 95% CI 0.4, 3.7) from birth to follow-up.

CONCLUSIONS

We found limited evidence of an association between prenatal traffic and ambient air pollution exposure and infant body composition. Suggestive associations between prenatal ozone exposure and early postnatal changes in body composition merit further investigation.

Ambient air pollution and markers of fetal growth: A retrospective population-based cohort study of 2.57 million term singleton births in China

BACKGROUNDS

Evidence is scarce on the relation between maternal exposure to ambient air pollution during pregnancy and fetal growth in developing countries. Moreover, the current evidence is inconsistent. We aimed to investigate the association of trimester-specific exposure to air pollution with risk of being born small for gestational age (SGA) and birth weight-markers of fetal growth-among Chinese term births.

METHODS

This retrospective population-based cohort study consisted of 2,567,457 singleton term live-births from January 1, 2014 to December 31, 2017 across 123 Chinese districts and counties. Personal exposure to ambient air pollutants including carbon monoxide (CO), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃), particulate matter with aerodynamic diameter < 2.5 μm (PM_2.5), and PM₁₀ was assigned using the inverse distance weighting spatial interpolation algorithm. Generalized estimating equations (GEE) logistic regression models were performed to estimate the associations between trimester-specific exposure to air pollution and risk of SGA or low birth weight (LBW), and GEE linear regression to examine the associations between the exposure and term birth weight, adjusting for maternal demographics, maternal cigarette smoking status during pregnancy, mode of delivery, gravidity, gestational age, year and month of conception, neonate's sex, and meteorological factors. Stratified and sensitivity analyses were also performed.

RESULTS

When mother exposed to ambient air pollutants over the entire pregnancy, per IQR increment (0.122 mg/m³) in ambient CO concentrations was associated with higher risk of SGA (odds ratio (OR) = 1.04, 95% confidence interval (CI): 1.02, 1.05) and reduced birth weight among term births (-5.95 g, 95% CI: -8.01, -3.89). This association was also pronounced in the second and third trimesters. Term birth weight was negatively associated with per IQR increase of O₃ (-3.52 g, 95% CI: -6.23, -0.81), PM_2.5 (-5.93 g, 95% CI: -8.36, -3.49) and PM₁₀ (-7.78 g, 95% CI: -10.41, -5.16) during the entire pregnancy, respectively. No significant association was detected between maternal exposure to air pollutants and term LBW. Effect estimates of heterogeneity suggested that maternal age and infant sex modified the impact of air pollution on birth weight.

CONCLUSIONS

The findings suggest that maternal exposure to air pollution during pregnancy is adversely affecting fetal growth. Further studies are warranted to integrate these findings and take clinical or public health interventions in pregnancy.

Risk of particulate matter on birth outcomes in relation to maternal socio-economic factors: a systematic review

A growing number of studies provide evidence of an association between exposure to maternal air pollution during pregnancy and adverse birth outcomes including low birth weight and preterm birth. Prevention of these health effects of air pollution is critical to reducing the adverse infant outcomes, which can have impacts throughout the life course. However, there is no consensus on whether the association between air pollution exposure and birth outcomes varies by maternal risk factors including demographic characteristics and socio-economic status. Such information is vital to understand potential environmental health disparities. Our search found 859 unique studies, of which 45 studies met our inclusion criteria (Jan. 2000- July. 2019). We systematically reviewed the 45 identified epidemiologic studies and summarized the results on effect modifications by maternal race/ethnicity, educational attainment, income, and area-level socio-economic status. We considered adverse birth outcomes of preterm birth, low birth weight, small for gestational age (SGA), and stillbirth. Suggestive evidence of higher risk of particulate matter in infants of African-American/black mothers than infants of other women was found for preterm birth and low birth weight. We found weak evidence that particulate matter risk was higher for infants of mothers with lower educational attainment for preterm birth and low birth weight. Due to the small study numbers, we were unable to conclude whether effect modification is present for income, occupation, and area-level socio-economic status, and additional research is needed. Furthermore, adverse birth outcomes such as SGA and stillbirth need more study to understand potential environmental justice issues regarding the impact of particulate matter exposure during pregnancy on birth outcomes.

Fine Particulate Air Pollution and Birthweight: Differences in Associations Along the Birthweight Distribution

BACKGROUND

Maternal exposure to fine particulate air pollution (PM2.5) during pregnancy is associated with lower newborn birthweight, which is a risk factor for chronic disease. Existing studies typically report the average association related with PM2.5 increase, which does not offer information about potentially varying associations at different points of the birthweight distribution.

METHODS

We retrieved all birth records in Massachusetts between 2001 and 2013 then restricted our analysis to full-term live singletons (n = 775,768). Using the birthdate, gestational age, and residential address reported at time of birth, we estimated the average maternal PM2.5 exposure during pregnancy of each birth. PM2.5 predictions came from a model that incorporates satellite, land use, and meteorologic data. We applied quantile regression to quantify the association between PM2.5 and birthweight at each decile of birthweight, adjusted for individual and neighborhood covariates. We considered effect modification by indicators of individual and neighborhood socioeconomic status (SES).

RESULTS

PM2.5 was negatively associated with birthweight. An interquartile range increase in PM2.5 was associated with a 16 g [95% confidence interval (CI) = 13, 19] lower birthweight on average, 19 g (95% CI = 15, 23) lower birthweight at the lowest decile of birthweight, and 14 g (95% CI = 9, 19) lower birthweight at the highest decile. In general, the magnitudes of negative associations were larger at lower deciles. We did not find evidence of effect modification by individual or neighborhood SES.

CONCLUSIONS

In full-term live births, PM2.5 and birthweight were negatively associated with more severe associations at lower quantiles of birthweight.

A quantile regression approach to examine fine particles, term low birth weight, and racial/ethnic disparities

Background

Exposure to fine particulate matter (PM_2.5) 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 PM_2.5, 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 PM_2.5 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 PM_2.5 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.

Time-Varying Exposure to Ozone and Risk of Stillbirth in a Nonattainment Urban Region

In a racially and ethnically diverse urban area (Harris County, Texas) with historic nonattainment O3 levels, we obtained birth and fetal death records from 2008-2013 and estimated maternal residential O3 concentrations from conception until delivery using inverse-distance interpolation from the local air monitoring network. We examined multipollutant models (with fine particulate matter and nitrogen dioxide) and effect measure modification by race/ethnicity and length of gestation. We found a 9% (95% confidence interval (CI): 1, 18) increased stillbirth risk associated with a 3.6-parts-per-billion increase in O3 exposure. The risk was higher among women with pregnancies of <37 gestational weeks (hazard ratio (HR) = 1.13, 95% CI: 1.04, 1.23) compared with women with pregnancies of longer gestation (HR = 1.05, 95% CI: 0.87, 1.27) and among Hispanic women (HR = 1.14, 95% CI: 1.02, 1.27). We also conducted a case-crossover analysis and detected no associations with short-term exposure. To our knowledge, this study is the first to use time-to-event analyses to examine stillbirth risk associated with time-varying prenatal ozone (O3) exposure over pregnancy. Our findings indicate that maternal O3 exposure over pregnancy is associated with stillbirth risk and that Hispanic women and women with shorter pregnancies might be at particular risk.

Relative toxicities of major particulate matter constituents on birthweight in Massachusetts

BACKGROUND

Maternal exposure to fine particulate air pollution (PM2.5) during pregnancy has been linked to lower newborn birthweight, making it a toxic exposure because lower birthweight is a risk factor for chronic disease and mortality. However, the toxicity of major constituents of PM2.5 and how they compare to each other remain uncertain.

METHODS

We assigned address-specific exposure to PM2.5, elemental carbon (EC), organic carbon (OC), nitrate, and sulfate averaged over the entire period of pregnancy for each birth in Massachusetts from 2001 to 2012 using a high-resolution exposure model. Using multivariate regression adjusted for total PM2.5, we estimated the relative toxicity of each constituent on continuous birthweight.

RESULTS

EC was more toxic per interquartile range increase compared with remaining PM2.5 in single constituent models that estimated the effect of a constituent with adjustment for PM2.5. OC, nitrate, and sulfate were each less toxic than their respective remaining PM2.5 per interquartile range increase. When all constituents and total PM2.5 were included in the same model, EC was most toxic, followed by nitrate, then OC and sulfate with similar toxicities. Sensitivity analyses using term low birth weight and small for gestational age also showed that EC was most detrimental as did averaging exposures over the third trimester of pregnancy. Scaling to unit mass increases also showed EC to be most toxic.

CONCLUSION

Four major constituents of PM2.5 had different relative toxicities on continuous birthweight. Our findings suggest that EC was most toxic, followed by nitrate, OC, and sulfate.

Maternal fine particulate matter (PM2.5) exposure and adverse birth outcomes: an updated systematic review based on cohort studies

Exposure to ambient air pollutants during pregnancy may be associated with numerous side health effects and adverse birth outcomes. Growing numbers of studies have explored a possible linkage between prenatal exposure to PM_2.5 (particulate matter with aerodynamic diameter ≤ 2.5 μm) and impacts on fetal development. We aimed to conduct a systematic review based on published cohort studies to summarize evidence regarding the association between maternal PM_2.5 exposure and birth outcomes, including birth weight, low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). Eligible studies meeting the following criterion were selected: PM_2.5 exposure during pregnancy and live birth singletons, certain presentation of sample sizes, and quantitative evaluation of the associations between exposure and outcomes. Among the 42 selected studies, 23 evaluated the impact of prenatal PM_2.5 exposure on birth weight of infants while 12 of them provided a significantly negative association for exposure and birth weight. Twenty-one studies aimed to identify the possible relationship between maternal exposure and LBW and 8 studies proved significant associations. Among 18 studies that explored the correlation between prenatal exposure and PTB, 9 reached a consistent conclusion that gestational exposure would add to the risk of PTB. Nine studies assessed the impact of PM_2.5 on SGA and 5 of them demonstrated a significant effect. So far, linkages between maternal PM_2.5 exposure during varied gestational stages and multiple adverse birth outcomes have been observed in many studies. A summary of them will be meaningful for further research on maternal exposure and adverse birth outcomes.

Epigenetic marks of prenatal air pollution exposure found in multiple tissues relevant for child health

BACKGROUND

Prenatal air pollution exposure has been linked to many adverse health conditions in the offspring. However, little is known about the mechanisms underlying these associations. Epigenetics may be one plausible biologic link. Here, we sought to identify site-specific and global DNA methylation (DNAm) changes, in developmentally relevant tissues, associated with prenatal exposure to nitrogen dioxide (NO₂) and ozone (O₃). Additionally, we assessed whether sex-specific changes in methylation exist and whether DNAm changes are consistently observed across tissues.

METHODS

Genome-scale DNAm measurements were obtained using the Infinium HumanMethylation450k platform for 133 placenta and 175 cord blood specimens from Early Autism Risk Longitudinal Investigation (EARLI) neonates. Ambient NO₂ and O₃ exposure levels were based on prenatal address locations of EARLI mothers and the Environmental Protection Agency's AirNOW monitoring network using inverse distance weighting. We computed sample-level aggregate methylation measures for each of 5 types of genomic regions including genome-wide, open sea, shelf, shore, and island regions. Linear regression was performed for each genomic region; per-sample aggregate methylation measures were modeled as a function of quantitative exposure level with covariate adjustment. In addition, bumphunting was performed to identify differentially methylated regions (DMRs) associated with prenatal O₃ and NO₂ exposures in each tissue and by sex, with adjustment for technical and biological sources of variation.

RESULTS

We identified global and locus-specific changes in DNA methylation related to prenatal exposure to NO₂ and O₃ in 2 developmentally relevant tissues. Neonates with increased prenatal O₃ exposure had lower aggregate levels of DNAm at CpGs located in open sea and shelf regions of the genome. We identified 6 DMRs associated with prenatal NO₂ exposure, including 3 sex-specific. An additional 3 sex-specific DMRs were associated with prenatal O₃ exposure levels. DMRs initially detected in cord blood samples (n = 4) showed consistent exposure-related changes in DNAm in placenta. However, the DMRs initially detected in placenta (n = 5) did not show DNAm differences in cord blood and, thus, they appear to be tissue-specific.

CONCLUSIONS

We observed global, locus, and sex-specific methylation changes associated with prenatal NO₂ and O₃ exposures. Our findings support DNAm is a biologic target of prenatal air pollutant exposures and highlight epigenetic involvement in sex-specific differential susceptibility to environmental exposure effects in 2 developmentally relevant tissues.

Cytotoxicity comparison between fine particles emitted from the combustion of municipal solid waste and biomass

Fine particles (PM_2.5) emitted from municipal solid waste incineration (MSWI) contain high amounts of toxic compounds and pose a serious threat to environment and human health. In this study, entire particles as well as extracted water-soluble and -insoluble fractions of PM_2.5 collected from MSWI and biomass incineration (BMI) were subjected to physiochemical characterization and cytotoxic tests in A549 and BEAS-2B cells. MSWI PM_2.5 had higher contents of heavy metals (including Pb, Zn, and Cu) and dioxins (PCDD/Fs) than did BMI PM_2.5. The metals were enriched in the water-insoluble fraction, as measured by inductively coupled plasma-atomic emission spectrometry. BMI PM_2.5 had a higher content of endotoxin, which was also enriched in the water-insoluble fraction. MSWI PM_2.5 caused more serious cell injuries, as indicated by the lower viability, higher ROS generation, and DNA damage, whereas BMI PM_2.5 presented higher pro-inflammatory potential, as indicated by increased mRNA levels of interleukin 6. Normal human BEAS-2B cells were more sensitive than A549 cells in all these tests. Toxic effects caused by MSWI and BMI PM_2.5 were mostly attributable to their water-insoluble fractions. Our results indicate different chemical and biological compositions in MSWI and BMI PM_2.5 probably dominate in different toxic endpoints in vitro.

High level of source-specific particulate matter air pollution associated with cardiac arrhythmias

Epidemiological evidence linking source-specific ambient particulate matter with aerodynamic diameter <2.5 μm (PM_2.5) and cardiac arrhythmias is limited. In this study, we investigated the impact of source-specific PM_2.5 on cardiac arrhythmias in a panel of forty-five healthy adults living in Beijing, China, between 2015 and 2016. Repeated measures of 24-hour electrocardiograms were conducted during clinical visits, and daily counts of four arrhythmia events including supraventricular premature beat (SVPB), atrial tachycardia (AT), premature ventricular contraction (PVC) and ventricular tachycardia (VT) were recorded. One hundred forty-seven constituents in PM_2.5 were analyzed for collected particulate samples, in which fifty-six of them above laboratory detection limits were selected for source apportionment analysis using positive matrix factorization. The average contributions of identified five major sources to PM_2.5 were 45.9% from secondary nitrate/sulfate, 18.0% from coal combustion, 16.9% from crustal soil, 13.8% from biomass burning, and 5.4% from cooking. Generalized estimating equation models were used to estimate relative risks (RR) of arrhythmias in association with interquartile-range (IQR) increases in PM_2.5 constituents and specific sources. Total PM_2.5 mass as well as several combustion related constituents were found of significant impacts on increased risks of arrhythmia events. Among the identified sources of PM_2.5, coal burning has been found the major source that associated with increased risks of SVPB, PVC and VT with RR of 1.19 [95% confidence intervals (CI): 1.04, 1.36] to 1.64 (95% CI: 1.35, 2.00). PM_2.5 from combustion related secondary nitrate/sulfate was also found of significant impact on SVPB and AT, followed by PM_2.5 from biomass burning and crustal soil. Our results indicated that PM_2.5 from anthropogenic activity related sources were most responsible for increased risks of arrhythmia events. Our findings enhance the understanding of increased risks of arrhythmias from exposure to PM_2.5, and provide evidence on source-specific PM control priorities.

Exposure to coarse particulate matter during gestation and term low birthweight in California: Variation in exposure and risk across region and socioeconomic subgroup

Despite evidence that particulate matter with an aerodynamic diameter ≤10 μm (PM₁₀) or ≤2.5 μm (PM_2.5) are associated with several adverse birth outcomes, research on the association between coarse particulate matter (PM_10-2.5) and birth outcomes is scarce, and results have been inconsistent. Furthermore, the literature is unclear whether associations between PM₁₀ and adverse birth outcomes were driven by PM_2.5 alone or also by PM_10-2.5 exposure. Research on the variation in exposure to and risk from PM_10-2.5 across populations is also needed to identify potentially vulnerable subgroups. We used birth certificate and ambient air monitoring data in California from 2002 to 2013 to develop a retrospective cohort study of pregnant women and their infants. Averaged gestational and trimester-specific exposures of PM_10-2.5 and PM_2.5 were calculated for mothers whose residential zip code tabulation areas were within a 20 km radius of monitors. We assessed the relationship between prenatal exposure to PM_10-2.5 and term low birthweight (TLBW) using logistic and linear regression, adjusting for maternal and paternal demographic, environmental, temporal, and health-related covariates. We also conducted analyses stratified by socioeconomic characteristics and regions. We found a relationship between PM_10-2.5 exposure during pregnancy and TLBW after controlling for PM_2.5 exposure: odds ratio for second quartile of exposure: 1.00 (95% confidence interval: 0.98, 1.03), third quartile: 1.03 (1.00, 1.06), fourth quartile: 1.04 (1.01, 1.07), compared to the first quartile. Associations were strong among Non-Hispanic Black mothers, mothers living in the Central Valley, and fathers without a college degree. Exposure to and risk from PM_10-2.5 were heterogeneous across California indicating environmental justice implications. We also found that paternal characteristics were associated with the risk of TLBW even after controlling for maternal characteristics. In addition to PM_10-2.5 total mass, further research is needed on the components of PM_10-2.5 which may be driving these associations.

Temperature and Term Low Birth Weight in California

Few investigations have explored temperature and birth outcomes. In a retrospective cohort study, we examined apparent temperature, a combination of temperature and relative humidity, and term low birth weight (LBW) among 43,629 full-term LBW infants and 2,032,601 normal-weight infants in California (1999-2013). The California Department of Public Health provided birth certificate data, while meteorological data came from the California Irrigation Management Information System, US Environmental Protection Agency, and National Centers for Environmental Information. After considering several temperature metrics, we observed the best model fit for term LBW over the full gestation (per 10-degrees-Fahrenheit (°F) increase in apparent temperature, 13.0% change, 95% confidence interval: 4.1, 22.7) above 55°F, and the greatest association was for third-trimester exposure above 60°F (15.8%, 95% confidence interval: 5.0, 27.6). Apparent temperature during the first month of pregnancy exhibited no significant risk, while the first trimester had a significantly negative association, and second trimester, last month, and last 2 weeks had slightly increased risks. Mothers who were black or older, delivered male infants, or gave birth during the warm season had infants at the highest risks. This study provides further evidence for adverse birth outcomes from heat exposure for vulnerable subgroups of pregnant women.

Acute changes in a respiratory inflammation marker in guards following Beijing air pollution controls

The adverse respiratory health effects of PM_2.5 have been studied. However, the epidemiological evidence for the association of specific PM_2.5 sources with health outcomes is still limited. This study investigated the association between PM_2.5 components and sources with a biomarker of acute respiratory inflammation (FeNO) in guards. Personal exposure was estimated by microenvironment samplers and FeNO measurements were carried out before, during and after the Victory Day Military Parade in Beijing. Four sources were determined by factor analysis, including urban pollution, dust, alloy steel abrasion and toxic metals. A mixed-effect model was used to estimate the associations of FeNO with PM_2.5 sources and chemical constituents, controlling for age, BMI, smoke activity, physical activity, waist circumference, temperature and relative humidity. In summary, large concentration decreases in PM_2.5 concentration and PM_2.5 chemical constituents were observed in both roadside and indoor environments during the air control periods, immediately followed by statistically significant decreases in FeNO of roadside guards and patrol guards. Besides, statistically significant increases in FeNO were found to be associated with interquartile range (IQR) increases in some pollutants, with an increase of 1.45ppb (95% CI: 0.69, 2.20), 0.65ppb (95% CI: 0.13, 1.17), 1.48ppb (95% CI: 0.60, 2.35), 0.82ppb (95% CI: 0.44, 1.20), 0.77ppb (95% CI: 0.42, 1.11) in FeNO for mass, sulfate, BC, Ca²⁺ and Sm, respectively. In addition, compared to alloy steel abrasion and toxic metals, urban pollution and dust factors were more associated with acute airway inflammation for highly-exposed populations.

Cause-specific stillbirth and exposure to chemical constituents and sources of fine particulate matter

The stillbirth rate in the United States is relatively high, but limited evidence is available linking stillbirth with fine particulate matter (PM_2.5), its chemical constituents and sources. In this study, we explored associations between cause-specific stillbirth and prenatal exposures to those pollutants with using live birth and stillbirth records from eight California locations during 2002-2009. ICD-10 codes were used to identify cause of stillbirth from stillbirth records. PM_2.5 total mass and chemical constituents were collected from ambient monitors and PM_2.5 sources were quantified using Positive Matrix Factorization. Conditional logistic regression was applied using a nested case-control study design (N = 32,262). We found that different causes of stillbirth were associated with different PM_2.5 sources and/or chemical constituents. For stillbirths due to fetal growth, the odds ratio (OR) per interquartile range increase in gestational age-adjusted exposure to PM_2.5 total mass was 1.23 (95% confidence interval (CI): 1.06, 1.44). Similar associations were found with resuspended soil (OR=1.25, 95% CI: 1.10, 1.42), and secondary ammonium sulfate (OR=1.45, 95% CI: 1.18, 1.78). No associations were found between any pollutants and stillbirths caused by maternal complications. This study highlighted the importance of investigating cause-specific stillbirth and the differential toxicity levels of specific PM_2.5 sources and chemical constituents.