1
|
Pedersen M, Nobile F, Stayner LT, de Hoogh K, Brandt J, Stafoggia M. Ambient air pollution and hypertensive disorders of pregnancy in Rome. ENVIRONMENTAL RESEARCH 2024; 251:118630. [PMID: 38452913 DOI: 10.1016/j.envres.2024.118630] [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: 12/07/2023] [Revised: 02/25/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Ambient air pollution has been associated with hypertensive disorders of pregnancy (HDP), but few studies rely on assessment of fine-scale variation in air quality, specific subtypes and multi-pollutant exposures. AIM To study the impact of long-term exposure to individual and mixture of air pollutants on all and specific subtypes of HDP. METHODS We obtained data from 130,470 liveborn singleton pregnacies in Rome during 2014-2019. Spatiotemporal land-use random-forest models at 1 km spatial resolution assigned to the maternal residential addresses were used to estimate the exposure to particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), and ozone (O3). RESULTS For PM2.5, PM10 and NO2, there was suggestive evidence of increased risk of preeclampsia (PE, n = 442), but no evidence of increased risk for all subtypes of HDP (n = 2297) and gestational hypertension (GH, n = 1901). For instance, an interquartile range of 7.0 μg/m3 increase in PM2.5 exposure during the first trimester of pregnancy was associated with an odds ratio (OR) of 1.06 (95% confidence interval: 0.81, 1.39) and 1.04 (0.92, 1.17) after adjustment for NO2 and the corresponding results for a 15.7 μg/m3 increase in NO2 after adjustment for PM2.5 were 1.11 (0.92, 1.34) for PE and 0.83 (0.76, 0.90) for HDP. Increased risks for HDP and GH were suggested for O3 in single-pollutant models and for PM after adjustment for NO2, but all other associations were stable or attenuated in two-pollutant models. CONCLUSIONS The results of our study suggest that PM2.5, PM10 and NO2 increases the risk of PE and that these effects are robust to adjustment for O3 while the increased risks for GH and HDP suggested for O3 attenuated after adjustment for PM or NO2. Additional studies are needed to evaluate the effects of source-specific component of PM on subtypes as well as all types of HDP which would help to target preventive actions.
Collapse
Affiliation(s)
- Marie Pedersen
- Department of Epidemiology, Lazio Region Health Service/ASL Roma, Rome, Italy.
| | - Federica Nobile
- Department of Epidemiology, Lazio Region Health Service/ASL Roma, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Kees de Hoogh
- The Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service/ASL Roma, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
2
|
Saleem A, Awan T, Akhtar MF. A comprehensive review on endocrine toxicity of gaseous components and particulate matter in smog. Front Endocrinol (Lausanne) 2024; 15:1294205. [PMID: 38352708 PMCID: PMC10863453 DOI: 10.3389/fendo.2024.1294205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024] Open
Abstract
Smog is a form of extreme air pollution which comprises of gases such as ozone, sulfur dioxide, nitrogen and carbon oxides, and solid particles including particulate matter (PM2.5 and PM10). Different types of smog include acidic, photochemical, and Polish. Smog and its constituents are hazardaous to human, animals, and plants. Smog leads to plethora of morbidities such as cancer, endocrine disruption, and respiratory and cardiovascular disorders. Smog components alter the activity of various hormones including thyroid, pituitary, gonads and adrenal hormones by altering regulatory genes, oxidation status and the hypothalamus-pituitary axis. Furthermore, these toxicants are responsible for the development of metabolic disorders, teratogenicity, insulin resistance, infertility, and carcinogenicity of endocrine glands. Avoiding fossil fuel, using renewable sources of energy, and limiting gaseous discharge from industries can be helpful to avoid endocrine disruption and other toxicities of smog. This review focuses on the toxic implications of smog and its constituents on endocrine system, their toxicodynamics and preventive measures to avoid hazardous health effects.
Collapse
Affiliation(s)
- Ammara Saleem
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan
| | - Tanzeela Awan
- Department of Pharmacy, The Women University Multan, Multan, Pakistan
| | - Muhammad Furqan Akhtar
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Pakistan
| |
Collapse
|
3
|
Zheng Y, McElrath T, Cantonwine D, Hu H. Longitudinal Associations between Ambient Air Pollution and Angiogenic Biomarkers among Pregnant Women in the LIFECODES Study, 2006-2008. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:87005. [PMID: 37556304 PMCID: PMC10411633 DOI: 10.1289/ehp11909] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 06/21/2023] [Accepted: 07/12/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Exposures to ambient air pollution during pregnancy have been linked to adverse pregnancy outcomes such as preeclampsia and fetal growth restriction. Although evidence has shown that women with preeclampsia have higher ratio of soluble fms-like tyrosine kinase 1 to placental growth factor (sFlt-1/PlGF ratio), the potential impact of air pollution on markers of placental growth and function has not been well studied. OBJECTIVES We aimed to examine longitudinal associations between ambient air pollution exposure and angiogenic factors among pregnant women in LIFECODES, a prospective birth cohort and biorepository in Massachusetts in the United States. METHODS PlGF and sFlt-1 were measured among pregnant women using plasma samples collected around 10, 18, 26, and 35 wk' gestation. Women's exposures to ozone (O 3 ), fine particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ), and nitrogen dioxide (NO 2 ) within 1, 2, 4, and 8 wk prior to each plasma sample collection were estimated based on geocoded residential addresses, and mixed effect linear regression models were fitted to assess their associations with sFlt-1/PlGF ratio, sFlt-1 (ng/mL), and PlGF (pg/mL). Percent changes in outcomes associated with each interquartile range increase in exposures were reported, along with their 95% confidence intervals. RESULTS A total of 1,066 pregnant women were included. In the multipollutant models, significant associations were observed for increased sFlt-1/PlGF ratio (PM 2.5 3-8 wk' gestation, NO 2 : 35-39 wk' gestation), elevated sFlt-1 (O 3 : 26-34 wk' gestation, PM 2.5 : 3-8 wk' gestation), decreased sFlt-1 (NO 2 : 4-8 wk' gestation), and decreased PlGF (NO 2 : 34-39 wk' gestation) after adjusting for sociodemographic status, smoking, drinking, body mass index, parity, history of chronic hypertension, and conception time. DISCUSSION Exposures to PM 2.5 during early pregnancy and exposures to O 3 and NO 2 during late pregnancy were associated with increased sFlt-1/PlGF ratio, elevated sFlt-1 and with decreased PlGF, which may be a potential mechanism underlying ambient air pollution's impacts on adverse pregnancy and birth outcomes. https://doi.org/10.1289/EHP11909.
Collapse
Affiliation(s)
- Yi Zheng
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas McElrath
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - David Cantonwine
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Hui Hu
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
4
|
Soesanti F, Uiterwaal CSPM, Meliefste K, Chen J, Brunekreef B, Idris NS, Grobbee DE, Klipstein-Grobusch K, Hoek G. The effect of exposure to traffic related air pollutants in pregnancy on birth anthropometry: a cohort study in a heavily polluted low-middle income country. Environ Health 2023; 22:22. [PMID: 36843017 PMCID: PMC9969650 DOI: 10.1186/s12940-023-00973-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Ambient air pollution has been recognized as one of the most important environmental health threats. Exposure in early life may affect pregnancy outcomes and the health of the offspring. The main objective of our study was to assess the association between prenatal exposure to traffic related air pollutants during pregnancy on birth weight and length. Second, to evaluate the association between prenatal exposure to traffic related air pollutants and the risk of low birth weight (LBW). METHODS Three hundred forty mother-infant pairs were included in this prospective cohort study performed in Jakarta, March 2016-September 2020. Exposure to outdoor PM2.5, soot, NOx, and NO2 was assessed by land use regression (LUR) models at individual level. Multiple linear regression models were built to evaluate the association between air pollutants with birth weight (BW) and birth length (BL). Logistic regression was used to assess the risk of low birth weight (LBW) associated with all air pollutants. RESULTS The average PM2.5 concentration was almost eight times higher than the current WHO guideline and the NO2 level was three times higher. Soot and NOx were significantly associated with reduced birth length. Birth length was reduced by - 3.83 mm (95% CI -6.91; - 0.75) for every IQR (0.74 × 10- 5 per m) increase of soot, and reduced by - 2.82 mm (95% CI -5.33;-0.30) for every IQR (4.68 μg/m3) increase of NOx. Outdoor air pollutants were not significantly associated with reduced birth weight nor the risk of LBW. CONCLUSION Exposure to soot and NOx during pregnancy was associated with reduced birth length. Associations between exposure to all air pollutants with birth weight and the risk of LBW were less convincing.
Collapse
Affiliation(s)
- Frida Soesanti
- Department of Child Health, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Cuno S P M Uiterwaal
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kees Meliefste
- Environmental and Occupational Health Group Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Jie Chen
- Environmental and Occupational Health Group Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Bert Brunekreef
- Environmental and Occupational Health Group Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Nikmah S Idris
- Department of Child Health, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Diederick E Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Gerard Hoek
- Environmental and Occupational Health Group Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| |
Collapse
|
5
|
Ferrari L, Iodice S, Cantone L, Solazzo G, Dioni L, Hoxha M, Vicenzi M, Mozzoni P, Bergamaschi E, Persico N, Bollati V. Extracellular vesicles and their miRNA contents counterbalance the pro-inflammatory effect of air pollution during physiological pregnancy: A focus on Syncytin-1 positive vesicles. ENVIRONMENT INTERNATIONAL 2022; 169:107502. [PMID: 36095930 DOI: 10.1016/j.envint.2022.107502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 06/15/2023]
Abstract
The impact of exposure to respirable particulate matter (PM) during pregnancy is a growing concern, as several studies have associated increased risks of adverse pregnancy and birth outcomes, and impaired intrauterine growth with air pollution. The molecular mechanisms responsible for such effects are still under debate. Extracellular vesicles (EVs), which travel in body fluids and transfer microRNAs (miRNAs) between tissues (e.g., pulmonary environment and placenta), might play an important role in PM-induced risk. We sought to determine whether the levels of PM with aerodynamic diameters of ≤10 µm (PM10) and ≤2.5 µm (PM2.5) are associated with changes in plasmatic EV release and EV-miRNA content by investigating 518 women enrolled in the INSIDE study during the first trimester of pregnancy. In all models, we included both the 90-day averages of PM (long-term effects) and the differences between the daily estimate of PM and the 90-day average (short-term effects). Short-term PM10 and PM2.5 were associated with increased concentrations of all seven EV types that we assayed (positive for human antigen leukocyte G (HLA-G), Syncytin-1 (Sync-1), CD14, CD105, CD62e, CD61, or CD25 determinants), while long-term PM10 showed a trend towards decreased EV concentrations. Increased Sync-1 + EV levels were associated with the plasmatic decrease of sVCAM-1, but not of sICAM-1, which are circulating biomarkers of endothelial dysfunction. Thirteen EV-miRNAs were downregulated in response to long-term PM10 and PM2.5 variations, while seven were upregulated (p-value < 0.05, false discovery rate p-value (qFDR) < 0.1). Only one EV-miRNA (hsa-miR-221-3p) was downregulated after short-term variations. The identified PM-modulated EV-miRNAs exhibited putative roles in inflammation, gestational hypertension, and pre-eclampsia, as highlighted by miRNA target analysis. Our findings strongly support the hypothesis that EVs have an important role in modulating PM exposure effects during pregnancy, possibly through their miRNA cargo.
Collapse
Affiliation(s)
- Luca Ferrari
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Simona Iodice
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Laura Cantone
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Giulia Solazzo
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Laura Dioni
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Mirjam Hoxha
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Marco Vicenzi
- Cardiovascular Disease Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Paola Mozzoni
- Department of Medicine and Surgery, Università degli Studi di Parma, Parma, Italy
| | - Enrico Bergamaschi
- Department of Public Health Sciences and Paediatrics, Università degli Studi di Torino, Torino, Italy
| | - Nicola Persico
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; Department of Obstetrics and Gynecology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Bollati
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| |
Collapse
|
6
|
Chen Z, Liu N, Tang H, Gao X, Zhang Y, Kan H, Deng F, Zhao B, Zeng X, Sun Y, Qian H, Liu W, Mo J, Zheng X, Huang C, Sun C, Zhao Z. Health effects of exposure to sulfur dioxide, nitrogen dioxide, ozone, and carbon monoxide between 1980 and 2019: A systematic review and meta-analysis. INDOOR AIR 2022; 32:e13170. [PMID: 36437665 DOI: 10.1111/ina.13170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
The burden of disease attributed to the indoor exposure to sulfur dioxide (SO2 ), nitrogen dioxide (NO2 ), ozone (O3 ), and carbon monoxide (CO) is not clear, and the quantitative concentration-response relationship is a prerequisite. This is a systematic review to summarize the quantitative concentration-response relationships by screening and analyzing the polled effects of population-based epidemiological studies. After collecting literature published between 1980 and 2019, a total of 19 health outcomes in 101 studies with 182 health risk estimates were recruited. By meta-analysis, the leave-one-out sensitivity analysis and Egger's test for publication bias, the robust and reliable effects were found for SO2 (per 10 μg/m3 ) with chronic obstructive pulmonary diseases (COPD) (pooled relative risks [RRs] 1.016, 95% CI: 1.012-1.021) and cardiovascular diseases (CVD) (RR 1.012, 95%CI: 007-1.018), respectively. NO2 (per 10 μg/m3 ) had the pooled RRs for childhood asthma, preterm birth, lung cancer, diabetes, and COPD by 1.134 (1.084-1.186), 1.079 (1.007-1.157), 1.055 (1.010-1.101), 1.019 (1.009-1.029), and 1.016 (1.012-1.120), respectively. CO (per 1 mg/m3 ) was significantly associated with Parkinson's disease (RR 1.574, 95% CI: 1.069-2.317) and CVD (RR 1.024, 95% CI: 1.011-1.038). No robust effects were observed for O3 . This study provided evidence and basis for further estimation of the health burden attributable to the four gaseous pollutants.
Collapse
Affiliation(s)
- Zhuoru Chen
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Ningrui Liu
- Department of Building Science, Tsinghua University, Beijing, China
| | - Hao Tang
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xuehuan Gao
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Yinping Zhang
- Department of Building Science, Tsinghua University, Beijing, China
| | - Haidong Kan
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Furong Deng
- School of Public Health, Peking University, Beijing, China
| | - Bin Zhao
- Department of Building Science, Tsinghua University, Beijing, China
| | - Xiangang Zeng
- School of Environment and Natural Resources, Renmin University of China, Beijing, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Hua Qian
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Wei Liu
- Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China
| | - Jinhan Mo
- Department of Building Science, Tsinghua University, Beijing, China
| | - Xiaohong Zheng
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Chanjuan Sun
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Zhuohui Zhao
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
- Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, WMO/IGAC MAP-AQ Asian Office Shanghai, Fudan University, Shanghai, China
| |
Collapse
|
7
|
Palma A, Petrunyk I, Vuri D. Prenatal air pollution exposure and neonatal health. HEALTH ECONOMICS 2022; 31:729-759. [PMID: 35001469 DOI: 10.1002/hec.4474] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 11/19/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
Air pollution has been shown to have adverse effects on many health outcomes including respiratory effects, cardiovascular effects, and mortality. However, evidence on the effects of prenatal exposure is still limited. We investigate the causal impact of prenatal exposure to air pollution on neonatal health in Italy in the 2000s. We exploit variation in rainfall shocks to instrument for non-random air pollution exposure. Our empirical setting combines detailed information on mother's residential location from birth certificates with PM10 concentrations from air pollution monitors. Ten additional units in the average PM10 level (approximately one standard deviation) would decrease birth weight by about 0.5% and gestational age by 0.16%; it would increase the prevalence of low birth weight by 22% and of preterm birth by 16%. The effects are stronger in magnitude for third trimester exposure and for less educated mothers. These findings suggest that the health impacts of air pollution on newborns are unequally distributed in the population.
Collapse
Affiliation(s)
- Alessandro Palma
- Gran Sasso Science Institute (GSSI), Social Sciences Area, L'Aquila, Italy
- The Centre of Economic and International Studies (CEIS), University of Rome Tor Vergata, Rome, Italy
| | | | - Daniela Vuri
- The Centre of Economic and International Studies (CEIS), University of Rome Tor Vergata, Rome, Italy
- Department of Economics and Finance - DEF, University of Rome Tor Vergata, Rome, Italy
- Institute for the Study of Labor (IZA), University of Rome Tor Vergata, Rome, Italy
| |
Collapse
|
8
|
Olsson D, Forsberg B, Bråbäck L, Geels C, Brandt J, Christensen JH, Frohn LM, Oudin A. Early childhood exposure to ambient air pollution is associated with increased risk of paediatric asthma: An administrative cohort study from Stockholm, Sweden. ENVIRONMENT INTERNATIONAL 2021; 155:106667. [PMID: 34077855 DOI: 10.1016/j.envint.2021.106667] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/06/2021] [Accepted: 05/24/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Asthma is a complex, heterogeneous disease and one of the most common chronic diseases among children. Exposure to ambient air pollution in early life and childhood may influence asthma aetiology, but it is uncertain which specific components of air pollution and exposure windows are of importance. The role of socio-economic status (SES) is also unclear. The aims of the present study are, therefore, to investigate how various exposure windows of different pollutants affect risk-induced asthma in early life and to explore the possible effect SES has on that relationship. METHODS The study population was constructed using register data on all singleton births in the greater Stockholm area between 2006 and 2013. Exposure to ambient black carbon (BC), fine particulate matter (PM2.5), primary organic carbon (pOC) secondary organic aerosols (SOA), secondary inorganic aerosols, and oxidative potential at the residential address was modelled as mean values for the entire pregnancy period, the first year of life and the first three years of life. Swedish national registers were used to define the outcome: asthma diagnosis assessed at hospital during the first six years of life. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were modelled with Cox proportional hazards model with age as the underlying time-scale, adjusting for relevant potential confounding variables. RESULTS An increased risk for developing childhood asthma was observed in association with exposure to PM2.5, pOC and SOA during the first three years of life. With an interquartile range increase in exposure, the HRs were 1.06 (95% CI: 1.01-1.10), 1.05 (95% CI: 1.02-1.09) and 1.02 (95% CI: 1.00-1.04), for PM2.5, pOC and SOA, respectively, in the fully adjusted models. Exposure during foetal life or the first year of life was not associated with asthma risk, and the other pollutants were not statistically significantly associated with increased risk. Furthermore, the increase in risk associated with PM2.5 and the components BC, pOC and SOA were stronger in areas with lower SES. CONCLUSION Our results suggest that exposure to air pollution during the first three years of life may increase the risk for asthma in early childhood. The findings further imply a possible increased vulnerability to air pollution-attributed asthma among low SES children.
Collapse
Affiliation(s)
- David Olsson
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Sweden
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Sweden
| | - Lennart Bråbäck
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Sweden
| | - Camilla Geels
- Department of Environmental Science - Atmospheric Modelling, Aarhus University, Denmark
| | - Jørgen Brandt
- Department of Environmental Science - Atmospheric Modelling, Aarhus University, Denmark
| | - Jesper H Christensen
- Department of Environmental Science - Atmospheric Modelling, Aarhus University, Denmark
| | - Lise M Frohn
- Department of Environmental Science - Atmospheric Modelling, Aarhus University, Denmark
| | - Anna Oudin
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Sweden.
| |
Collapse
|
9
|
Stanhope KK, Adeyemi DI, Li T, Johnson T, Boulet SL. The relationship between the neighborhood built and social environment and hypertensive disorders of pregnancy: A scoping review. Ann Epidemiol 2021; 64:67-75. [PMID: 34547447 DOI: 10.1016/j.annepidem.2021.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/03/2021] [Accepted: 09/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Theory and limited empirical research suggest that the neighborhood environment influences maternal health outcomes. The goal of this scoping review is to summarize extant research considering the impact of the built and social environment of resident neighborhood on hypertensive disorders of pregnancy (HDP) globally. METHODS We performed a systematic search of the literature using four databases, PubMed, Web of Science, CINAHL, and Embase on July 15, 2020. We excluded articles not in English, that did not consider one or more HDP as a primary or secondary outcome, and that did not include an element of the neighborhood built or social environment as an exposure. We applied a modified version of the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies to evaluate quality of included studies. RESULTS Our search identified 11,385 unique abstracts for screening. Following exclusions, we included 64 articles in the final review. The majority of articles measured an element of the built environment (70.3% (44)), most commonly traffic-related air pollution (42.2% (27)). A third of articles (31.3% (20)) considered an element of the neighborhood social environment, most commonly neighborhood deprivation (10.9% (7)). Global quality ratings were mostly moderate (29.7% (19)) or weak (68.8% (44)), primarily due to inattention to neighborhood-level confounding. CONCLUSION Critical gaps remain in understanding how the resident neighborhood may impact HDP. Future research should focus on designing high-quality studies incorporating elements of both the built and social environment to holistically understand how context may impact maternal health.
Collapse
Affiliation(s)
- Kaitlyn K Stanhope
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA,.
| | - Deborah I Adeyemi
- Department of Epidemiology, Rollin School of Public Health, Emory University, Atlanta, GA
| | - Tanya Li
- Emory College of Arts and Sciences, Emory University, Atlanta, GA
| | | | - Sheree L Boulet
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| |
Collapse
|
10
|
Garcia M, Salazar R, Wilson T, Lucas S, Herbert G, Young T, Begay J, Denson JL, Zychowski K, Ashley R, Byrum S, Mackintosh S, Bleske BE, Ottens AK, Campen MJ. Early Gestational Exposure to Inhaled Ozone Impairs Maternal Uterine Artery and Cardiac Function. Toxicol Sci 2021; 179:121-134. [PMID: 33146391 DOI: 10.1093/toxsci/kfaa164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Exposure to air pollutants such as ozone (O3) is associated with adverse pregnancy outcomes, including higher incidence of gestational hypertension, preeclampsia, and peripartum cardiomyopathy; however, the underlying mechanisms of this association remain unclear. We hypothesized that O3 exposures during early placental formation would lead to more adverse cardiovascular effects at term for exposed dams, as compared with late-term exposures. Pregnant Sprague Dawley rats were exposed (4 h) to either filtered air (FA) or O3 (0.3 or 1.0 ppm) at either gestational day (GD)10 or GD20, with longitudinal functional assessments and molecular endpoints conducted at term. Exposure at GD10 led to placental transcriptional changes at term that were consistent with markers in human preeclampsia, including reduced mmp10 and increased cd36, fzd1, and col1a1. O3 exposure, at both early and late gestation, induced a significant increase in maternal circulating soluble FMS-like tyrosine kinase-1 (sFlt-1), a known driver of preeclampsia. Otherwise, exposure to 0.3 ppm O3 at GD10 led to several late-stage cardiovascular outcomes in dams that were not evident in GD20-exposed dams, including elevated uterine artery resistance index and reduced cardiac output and stroke volume. GD10 O3 exposure proteomic profile in maternal hearts characterized by a reduction in proteins with essential roles in metabolism and mitochondrial function, whereas phosphoproteomic changes were consistent with pathways involved in cardiomyopathic responses. Thus, the developing placenta is an indirect target of inhaled O3 and systemic maternal cardiovascular abnormalities may be induced by O3 exposure at a specific window of gestation.
Collapse
Affiliation(s)
- Marcus Garcia
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Raul Salazar
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Thomas Wilson
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Selita Lucas
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Guy Herbert
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Tamara Young
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Jessica Begay
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Jesse L Denson
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Katherine Zychowski
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Ryan Ashley
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, New Mexico 88003
| | - Stephanie Byrum
- Arkansas Children's Research Institute, Little Rock, Arkansas 72202
| | - Samuel Mackintosh
- Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Barry E Bleske
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Andrew K Ottens
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, Virginia 23298-0709
| | - Matthew J Campen
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| |
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
Hettfleisch K, Carvalho MA, Hoshida MS, Pastro LDM, Saldiva SRDM, Vieira SE, Francisco RPV, Saldiva PHN, Bernardes LS. Individual exposure to urban air pollution and its correlation with placental angiogenic markers in the first trimester of pregnancy, in São Paulo, Brazil. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:28658-28665. [PMID: 33544347 DOI: 10.1007/s11356-021-12353-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 01/02/2021] [Indexed: 06/12/2023]
Abstract
Pollution of the atmosphere is known that may lead to adverse obstetric outcomes, including fetal growth restriction, gestational hypertension, and preeclampsia. Such disorders are correlated with imbalances in angiogenic factors, which may also be involved in the pathological mechanism as the pollutants impact placental and maternal physiology. In the first trimester of gestation, this study assessed the outcomes of personal maternal short period exposure to air pollution on soluble fms-like tyrosine kinase 1 (sFlt1) and placental growth factor (PLGF) of pregnant women blood concentrations. This was a cross-sectional study, held in the city of São Paulo, Brazil, and conducted with low-risk pregnant women, who carried personal passive nitrogen dioxide (NO2) and ozone (O3) monitors for about a few days preceding the ultrasound evaluation, and on this day, the venous blood sample was collected to measure the angiogenic factors sFlt1 and PLGF and their ratio (sFlt1/PLGF) by enzyme-linked immunosorbent assay (ELISA). By means of multiple regression models, the effect of the studied pollutants on the log-transformed concentrations of the angiogenic factors was evaluated. One hundred thirty-one patients were included. The log of the sFlt1/PLGF ratio increased with rising NO2 levels (p = 0.021 and beta = 0.206), and the log of the PLGF concentration showed a negative correlation with NO2 (p = 0.008 and beta = - 0.234). NO2, an indicator of the levels of primary air pollutants, presented significant positive correlation with an increased sFlt1/PLGF ratio and diminished PLGF levels, which may reflect an antiangiogenic state generated by air pollution exposure.
Collapse
Affiliation(s)
- Karen Hettfleisch
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Mariana Azevedo Carvalho
- Divisao de Clinica Obstetrica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Mara Sandra Hoshida
- LIM 57 Laboratorio de Fisiologia Obstetrica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil
| | - Luciana Duzolina Manfré Pastro
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Sandra Elisabete Vieira
- Departamento de Pediatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil
| | - Rossana Pulcineli Vieira Francisco
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Lisandra Stein Bernardes
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.
| |
Collapse
|
13
|
Hassan Bhat T, Jiawen G, Farzaneh H. Air Pollution Health Risk Assessment (AP-HRA), Principles and Applications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1935. [PMID: 33671274 PMCID: PMC7922529 DOI: 10.3390/ijerph18041935] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/20/2022]
Abstract
Air pollution is a major public health problem. A significant number of epidemiological studies have found a correlation between air quality and a wide variety of adverse health impacts emphasizing a considerable role of air pollution in the disease burden in the general population ranging from subclinical effects to premature death. Health risk assessment of air quality can play a key role at individual and global health promotion and disease prevention levels. The Air Pollution Health Risk Assessment (AP-HRA) forecasts the expected health effect of policies impacting air quality under the various policy, environmental and socio-economic circumstances, making it a key tool for guiding public policy decisions. This paper presents the concept of AP-HRA and offers an outline for the proper conducting of AP-HRA for different scenarios, explaining in broad terms how the health hazards of air emissions and their origins are measured and how air pollution-related impacts are quantified. In this paper, seven widely used AP-HRA tools will be deeply explored, taking into account their spatial resolution, technological factors, pollutants addressed, geographical scale, quantified health effects, method of classification, and operational characteristics. Finally, a comparative analysis of the proposed tools will be conducted, using the SWOT (strengths, weaknesses, opportunities, and threats) method.
Collapse
Affiliation(s)
- Tavoos Hassan Bhat
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Fukuoka 816-8580, Japan; (T.H.B.); (G.J.)
| | - Guo Jiawen
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Fukuoka 816-8580, Japan; (T.H.B.); (G.J.)
- China-UK Low Carbon College, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Hooman Farzaneh
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Fukuoka 816-8580, Japan; (T.H.B.); (G.J.)
| |
Collapse
|
14
|
Chambers M, Rees A, Cronin JG, Nair M, Jones N, Thornton CA. Macrophage Plasticity in Reproduction and Environmental Influences on Their Function. Front Immunol 2021; 11:607328. [PMID: 33519817 PMCID: PMC7840613 DOI: 10.3389/fimmu.2020.607328] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/30/2020] [Indexed: 12/12/2022] Open
Abstract
Macrophages are key components of the innate immune system and exhibit extensive plasticity and heterogeneity. They play a significant role in the non-pregnant cycling uterus and throughout gestation they contribute to various processes underpinning reproductive success including implantation, placentation and parturition. Macrophages are also present in breast milk and impart immunomodulatory benefits to the infant. For a healthy pregnancy, the maternal immune system must adapt to prevent fetal rejection and support development of the semi-allogenic fetus without compromising host defense. These functions are dependent on macrophage polarization which is governed by the local tissue microenvironmental milieu. Disruption of this microenvironment, possibly by environmental factors of infectious and non-infectious origin, can affect macrophage phenotype and function and is linked to adverse obstetric outcomes, e.g. spontaneous miscarriage and preterm birth. Determining environmental influences on cellular and molecular mechanisms that control macrophage polarization at the maternal-fetal interface and the role of this in pregnancy complications could support approaches to alleviating adverse pregnancy outcomes.
Collapse
Affiliation(s)
- Megan Chambers
- Institute of Life Science, Swansea University Medical School, Swansea, United Kingdom
| | - April Rees
- Institute of Life Science, Swansea University Medical School, Swansea, United Kingdom
| | - James G Cronin
- Institute of Life Science, Swansea University Medical School, Swansea, United Kingdom
| | - Manju Nair
- Maternity and Child Health, Singleton Hospital, Swansea Bay University Health Board, Swansea, United Kingdom
| | - Nicholas Jones
- Institute of Life Science, Swansea University Medical School, Swansea, United Kingdom
| | - Catherine A Thornton
- Institute of Life Science, Swansea University Medical School, Swansea, United Kingdom
| |
Collapse
|
15
|
Jia L, Liu Q, Hou H, Guo G, Zhang T, Fan S, Wang L. Association of Ambient air Pollution with risk of preeclampsia during pregnancy: a retrospective cohort study. BMC Public Health 2020; 20:1663. [PMID: 33153479 PMCID: PMC7643463 DOI: 10.1186/s12889-020-09719-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/15/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Ambient air pollution is becoming a serious environmental problem in China. The results were inconsistent on that air pollution was a risk factor of preeclampsia in pregnancy. METHODS Total 116,042 pregnant women were enrolled from 22 hospitals in 10 cities of Hebei Province, China from January 1, 2015 to December 31, 2017. The parturients were divided into preeclampsia group (PE group) and non-preeclampsia group (non-PE group). The data of air pollutants, namely, particulate matter (PM)2.5, PM10, NO2, SO2, CO, O3 were collected from China Environmental Inspection Station. RESULTS Among the 116,042 pregnant women, 2988 (2.57%) pregnant women were diagnosed with preeclampsia. The concentrations of exposed PM2.5, PM10, NO2 and O3 in the PE group were significantly higher than those in the non-PE group, and they were risk factors of the PE group in the first and second trimester of pregnancy respectively. The concentrations of exposed SO2 and CO in PE patients and non-PE women were not different, but high concentration of these air pollutants were risk factors to PE in the second trimester. CONCLUSION The exposure to PM2.5, PM10, NO2, O3 were risk factors for preeclampsia in the first and second trimester of pregnancy, while only at high level, SO2 and CO were risk factors for preeclampsia in the second trimester of pregnancy.
Collapse
Affiliation(s)
- Lu Jia
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, No. 348 Heping Road, Shijiazhuang, 050051, Hebei, China
| | - Qing Liu
- Zibo Maternal and Child Health Hospital, No. 66, North Tianjin Road, Zibo, 255000, Shandong, China
| | - Huiqing Hou
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, No. 348 Heping Road, Shijiazhuang, 050051, Hebei, China
| | - Guangli Guo
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, No. 348 Heping Road, Shijiazhuang, 050051, Hebei, China
| | - Ting Zhang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, No. 348 Heping Road, Shijiazhuang, 050051, Hebei, China
| | - Songli Fan
- Hebei Women and Children's Health Center, No. 147, Jianhua Street, Shijiazhuang, 050000, China
| | - Li Wang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, No. 348 Heping Road, Shijiazhuang, 050051, Hebei, China.
| |
Collapse
|
16
|
Sun Y, Ilango SD, Schwarz L, Wang Q, Chen JC, Lawrence JM, Wu J, Benmarhnia T. Examining the joint effects of heatwaves, air pollution, and green space on the risk of preterm birth in California. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2020; 15:104099. [PMID: 34659452 PMCID: PMC8516119 DOI: 10.1088/1748-9326/abb8a3] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Exposure to high air temperature in late pregnancy is increasingly recognized as a risk factor for preterm birth (PTB). However, the combined effects of heatwaves with air pollution and green space are still unexplored. In the context of climate change, investigating the interaction between environmental factors and identifying communities at higher risk is important to better understand the etiological mechanisms and design targeted interventions towards certain women during pregnancy. OBJECTIVES To examine the combined effects of heatwaves, air pollution and green space exposure on the risk of PTB. METHODS California birth certificate records for singleton births (2005-2013) were obtained. Residential zip code-specific daily temperature during the last week of gestation was used to create 12 definitions of heatwave with varying temperature thresholds and durations. We fit multi-level Cox proportional hazard models with time to PTB as the outcome and gestational week as the temporal unit. Relative risk due to interaction (RERI) was applied to estimate the additive interactive effect of air pollution and green space on the effect of heatwaves on PTB. RESULTS In total, 1,967,300 births were included in this study. For PM2.5, PM10 and O3, we found positive additive interactions (RERIs >0) between heatwaves and higher air pollution levels. Combined effects of heatwaves and green space indicated negative interactions (RERIs <0) for less intense heatwaves (i.e., shorter duration or relatively low temperature), whereas there were potential positive interactions (RERIs >0) for more intense heatwaves. CONCLUSION This study found synergistic harmful effects for heatwaves with air pollution, and potential positive interactions with lack of green space on PTB. Implementing interventions, such as heat warning systems and behavioral changes, targeted toward pregnant women at risk for high air pollution and low green space exposures may optimize the benefits of reducing acute exposure to extreme heat before delivery.
Collapse
Affiliation(s)
- Yi Sun
- Department of Environmental and Occupational Health, University of California, Irvine, CA 92697-3957, USA
| | - Sindana D. Ilango
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA 92093, USA
- School of Public Health, San Diego State University, San Diego, CA, 92182, USA
| | - Lara Schwarz
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA 92093, USA
- School of Public Health, San Diego State University, San Diego, CA, 92182, USA
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiu-Chiuan Chen
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Jean M. Lawrence
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Jun Wu
- Department of Environmental and Occupational Health, University of California, Irvine, CA 92697-3957, USA
- Program in Public Health, 653 East Peltason Drive, University of California, Irvine CA 92697-3957, USA
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA 92093, USA
- Scripps Institution of Oceanography, UC San Diego, La Jolla, CA, 92037, USA
| |
Collapse
|
17
|
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.
Collapse
|
18
|
Urban-Related Environmental Exposures during Pregnancy and Placental Development and Preeclampsia: a Review. Curr Hypertens Rep 2020; 22:81. [PMID: 32880755 DOI: 10.1007/s11906-020-01088-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW To summarize the current knowledge of the pathophysiological implications and the clinical role of urban-related environmental exposures in pregnancy. RECENT FINDINGS The ongoing urbanization worldwide is leading to an increasing number of pregnant women being exposed to higher levels of urban-related environmental hazards such as air pollution and noise and, at the same time, having less contact with natural environments. Pregnancy represents a particular and vulnerable life period both for women and their children. Extensive physiological and metabolic changes, as well as changes to the cardiovascular and respiratory systems during pregnancy, could result in increased sensitivity to damage by environmental factors. Exposure to air pollution and noise is associated with placental dysfunction and damage, which, in turn, could lead to maternal complications such as preeclampsia. In contrast, more contact with greenspace during pregnancy seems to mitigate these adverse impacts. These findings open up new challenges for our understanding of the potential effect of urban living on placental function and preeclampsia, and offer new clinical and research opportunities.
Collapse
|
19
|
Sun Y, Sheridan P, Laurent O, Li J, Sacks DA, Fischer H, Qiu Y, Jiang Y, Yim IS, Jiang LH, Molitor J, Chen JC, Benmarhnia T, Lawrence JM, Wu J. Associations between green space and preterm birth: Windows of susceptibility and interaction with air pollution. ENVIRONMENT INTERNATIONAL 2020; 142:105804. [PMID: 32505016 PMCID: PMC7340571 DOI: 10.1016/j.envint.2020.105804] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/06/2020] [Accepted: 05/12/2020] [Indexed: 05/24/2023]
Abstract
BACKGROUND Recent studies have reported inconsistent associations between maternal residential green space and preterm birth (PTB, born < 37 completed gestational weeks). In addition, windows of susceptibility during pregnancy have not been explored and potential interactions of green space with air pollution exposures during pregnancy are still unclear. OBJECTIVES To evaluate the relationships between green space and PTB, identify windows of susceptibility, and explore potential interactions between green space and air pollution. METHODS Birth certificate records for all births in California (2001-2008) were obtained. The Normalized Difference Vegetation Index (NDVI) was used to characterized green space exposure. Gestational age was treated as a time-to-event outcome; Cox proportional hazard models were applied to estimate the association between green space exposure and PTB, moderately PTB (MPTB, gestational age < 35 weeks), and very PTB (VPTB, gestational age < 30 weeks), after controlling for maternal age, race/ethnicity, education, and median household income. Month-specific green space exposure was used to identify potential windows of susceptibility. Potential interactions between green space and air pollution [fine particulate matter < 2.5 µm (PM2.5), nitrogen dioxide (NO2), and ozone (O3)] were examined on both additive and multiplicative scales. RESULTS In total, 3,753,799 eligible births were identified, including 341,123 (9.09%) PTBs, 124,631 (3.32%) MPTBs, and 22,313 (0.59%) VPTBs. A reduced risk of PTB was associated with increases in residential NDVI exposure in 250 m, 500 m, 1000 m, and 2000 m buffers. In the 2000 m buffer, the association was strongest for VPTB [adjusted hazard ratio (HR) per interquartile range increase in NDVI: 0.959, 95% confidence interval (CI): 0.942-0.976)], followed by MPTB (HR = 0.970, 95% CI: 0.962-0.978) and overall PTB (HR = 0.972, 95% CI: 0.966-0.978). For PTB, green space during the 3rd - 5th gestational months had stronger associations than those in the other time periods, especially during the 4th gestational month (NDVI 2000 m: HR = 0.970, 95% CI: 0.965-0.975). We identified consistent positive additive and multiplicative interactions between decreasing green space and higher air pollution. CONCLUSION This large study found that maternal exposure to residential green space was associated with decreased risk of PTB, MPTB, and VPTB, especially in the second trimester. There is a synergistic effect between low green space and high air pollution levels on PTB, indicating that increasing exposure to green space may be more beneficial for women with higher air pollution exposures during pregnancy.
Collapse
Affiliation(s)
- Yi Sun
- Program in Environmental Health Sciences, University of California, Irvine, CA 92697-3957, USA
| | - Paige Sheridan
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography, University of California, San Diego, 9500 Gilman Drive #0725, CA La Jolla 92093, USA
| | - Olivier Laurent
- Program in Public Health, 653 East Peltason Drive, University of California, Irvine CA 92697-3957, USA
| | - Jia Li
- Program in Public Health, 653 East Peltason Drive, University of California, Irvine CA 92697-3957, USA
| | - David A Sacks
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Heidi Fischer
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Yang Qiu
- Department of Environmental Science and Engineering, College of Architecture and Environment, Sichuan University, #24 First Ring Road South Section One, Chengdu, Sichuan, China
| | - Yu Jiang
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ilona S Yim
- Department of Psychological Science, University of California, Irvine, CA 92697-7085, USA
| | - Luo-Hua Jiang
- Department of Epidemiology, University of California, Irvine, CA, USA
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA
| | - Jiu-Chiuan Chen
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography, University of California, San Diego, 9500 Gilman Drive #0725, CA La Jolla 92093, USA
| | - Jean M Lawrence
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Jun Wu
- Program in Environmental Health Sciences, University of California, Irvine, CA 92697-3957, USA; Program in Public Health, 653 East Peltason Drive, University of California, Irvine CA 92697-3957, USA.
| |
Collapse
|
20
|
Bai W, Li Y, Niu Y, Ding Y, Yu X, Zhu B, Duan R, Duan H, Kou C, Li Y, Sun Z. Association between ambient air pollution and pregnancy complications: A systematic review and meta-analysis of cohort studies. ENVIRONMENTAL RESEARCH 2020; 185:109471. [PMID: 32276169 DOI: 10.1016/j.envres.2020.109471] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/08/2020] [Accepted: 03/30/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND Pregnancy complications, such as gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), have a great impact on public health. Exposure to ambient air pollution during pregnancy may cause pregnancy complications. The aim of our study is to explore the risk of trimester-specific maternal exposure to air pollutants on complications of pregnancy. METHODS PubMed, EMBASE, Web of Science, and Cochrane were systematically searched for cohort studies published before October 27, 2019 which reported the association between ambient air pollutants (PM2.5, PM10, CO, NO, NO2, NOx, O3, and SO2) and pregnancy complications (GDM, HDP, preeclampsia, and gestational hypertension) during different exposure windows. A meta-analysis was applied to combine relative risks (RRs) and their confidence intervals (CIs) from eligible studies. Quality assessment was conducted and Egger test was used to evaluate the publication bias. All statistical analyses were performed by STATA software (Version 15, StataCorp, College Station, Texas, USA). RESULTS This meta-analysis consisted of 33 cohort studies conducted on 22,253,277 pregnant women. Meta-analyses showed during the first trimester, there were significant associations of PM10 with gestational hypertension (RR = 1.07, 95% CI: 1.02-1.12 per 10 μg/m3, I2 = 0.0%), of SO2 with GDM (RR = 1.04, 95% CI: 1.00-1.08 per 1 ppb increment, I2 = 54.1%), of PM2.5 with preeclampsia (RR = 0.97, 95% CI: 0.95-1.00 per 5 μg/m3, I2 = 4.1%). During the entire pregnancy, PM2.5 significantly increased the risk of hypertensive disorders of pregnancy (RR = 1.18, 95% CI: 1.02-1.34 per 5 μg/m3, I2 = 85.1%). Egger test indicated that wide-scale publication bias was unlikely. CONCLUSION Maternal exposure to ambient air pollutants is associated with pregnancy complications especially during the first trimester. Further large multicenter cohort studies considering different constituents of pollutants, levels of disease severity, sensitive populations, and various exposure windows are warranted in the future research.
Collapse
Affiliation(s)
- Wei Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Yuanyuan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Yaling Niu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Ye Ding
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Xiao Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Bo Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Ruixin Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Huawei Duan
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China.
| | - Yanbo Li
- School of Public Health, Capital Medical University, Beijing, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China.
| | - Zhiwei Sun
- School of Public Health, Capital Medical University, Beijing, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| |
Collapse
|
21
|
Olsson D, Johansson C, Forsberg B. Associations between Vehicle Exhaust Particles and Ozone at Home Address and Birth Weight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113836. [PMID: 32481677 PMCID: PMC7312427 DOI: 10.3390/ijerph17113836] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/22/2020] [Accepted: 05/27/2020] [Indexed: 12/17/2022]
Abstract
We have studied the associations between exhaust particles and birth weight. Adjustments were made for ozone and potential confounding factors at the individual level. The study included all singletons conceived between August 2003 and February 2013 with mothers living in Greater Stockholm. We obtained record-based register data from the Swedish Medical Birth Register. Data concerning the parents were provided by Statistics Sweden. Exposure levels for nearly 187,000 pregnancies were calculated using a validated air quality dispersion model with input from a detailed emission database. A higher socioeconomic status was associated with higher levels of exhaust particles at the home address. In this region, with rather low air pollution levels, the associations between levels of exhaust particles and birth weight were negative for all three of the studied exposure windows (i.e., first and second trimester and full pregnancy). For the entire pregnancy, the linear decrease in birth weight was 7.5 grams (95% CI−12.0; −2.9) for an increase in exposure, corresponding to the inter quartile range (IQR = 209 ng/m3). We also found that the risk of being born small for gestational age increased with the level of exhaust particles in all three exposure windows, but these associations were not statistically significant.
Collapse
Affiliation(s)
- David Olsson
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, 901 87 Umeå, Sweden;
- Correspondence:
| | - Christer Johansson
- Department of Environmental Science, Stockholm University, 106 91 Stockholm, Sweden;
- Environment and Health Administration, SLB-analys, 104 20 Stockholm, Sweden
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, 901 87 Umeå, Sweden;
| |
Collapse
|
22
|
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.
Collapse
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
| |
Collapse
|
23
|
Cao W, Dong M, Sun X, Liu X, Xiao J, Feng B, Zeng W, Hu J, Li X, Guo L, Wan D, Sun J, Ning D, Wang J, Chen D, Zhang Y, Du Q, Ma W, Liu T. Associations of maternal ozone exposures during pregnancy with maternal blood pressure and risk of hypertensive disorders of pregnancy: A birth cohort study in Guangzhou, China. ENVIRONMENTAL RESEARCH 2020; 183:109207. [PMID: 32050130 DOI: 10.1016/j.envres.2020.109207] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/14/2020] [Accepted: 01/30/2020] [Indexed: 06/10/2023]
Abstract
Although studies have assessed the associations of maternal exposure to ozone (O3) during pregnancy with blood pressure and the risk of hypertensive disorders of pregnancy (HDP), the results were inconsistent. Furthermore, no studies have been conducted in China where the ambient O3 concentration continuedly increased. The present study aimed to estimate the effects of maternal exposure to O3 during pregnancy on the HDP risk, systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP). All participants of pregnant women were selected from the prospective birth cohort study on Prenatal Environments and Offspring Health conducted in Guangzhou, China. A spatiotemporal land-use-regression model was used to estimate individual monthly air pollution exposure from three months before pregnancy to childbirth date. Information on HDP, SBP, DBP and PP was obtained from maternal medical records. A Logistic regression model and a mixed linear model were used to estimate the associations of maternal exposure to O3 with the risk of HDP and blood pressure (SBP, DBP and PP), respectively. We found significant associations of maternal exposure to O3 during the third (OR = 1.31, 95%CI: 1.07, 1.60) and the second month (OR = 1.25, 95%CI: 1.02, 1.51) before pregnancy with the risk of HDP. Observed significantly positive associations of O3 exposures with SBP, DBP and PP during the two months before pregnancy and during the early pregnancy. The peak effects of O3 exposure on SBP, DBP and PP were respectively observed during the second month of pregnancy (β = 1.07 mmHg, 95%CI: 0.84, 1.31 mmHg), the first month before pregnancy (β = 0.40 mmHg, 95%CI: 0.21, 0.50 mmHg) and the second month of pregnancy (β = 0.78 mmHg, 95%CI: 0.59, 0.97 mmHg). Our results suggest that maternal exposure to O3 were positively associated with blood pressure and the risk of HDP, and the period from three months before pregnancy to the first trimester might be the critical exposure window.
Collapse
Affiliation(s)
- Wenjun Cao
- General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, 528200, China
| | - Moran Dong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Xiaoli Sun
- Gynecology Department, Guangdong Women and Children Hospital, Guangzhou, 511442, China
| | - Xin Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Baixiang Feng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Donghua Wan
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China; General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, 528200, China
| | - Jiufeng Sun
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Dan Ning
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Jiaqi Wang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Dengzhou Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Qingfeng Du
- General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, 528200, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China; General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, 528200, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
| |
Collapse
|
24
|
Maternal Exposure to Ambient Air Pollution and Risk of Preeclampsia: A Population-Based Cohort Study in Scania, Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051744. [PMID: 32155988 PMCID: PMC7084298 DOI: 10.3390/ijerph17051744] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/28/2020] [Accepted: 03/04/2020] [Indexed: 12/16/2022]
Abstract
The aim of this study was to investigate the risk of developing preeclampsia (PE) associated with gestational exposure to ambient air pollutants in southern Sweden, a low-exposure area. We used a cohort of 43,688 singleton pregnancies and monthly mean exposure levels of black carbon (BC), local and total particulate matter (PM2.5 and PM10), and NOX at the maternal residential address estimated by Gaussian dispersion modeling from 2000 to 2009. Analyses were conducted using binary logistic regression. A subtype analysis for small-for-gestational age (SGA) was performed. All analyses were adjusted for obstetrical risk factors and socioeconomic predictors. There were 1286 (2.9%) PE cases in the analysis. An adjusted odds ratio (AOR) of 1.35 with a 95% confidence interval (CI) of 1.11–1.63 was found when comparing the lowest quartile of BC exposure to the highest quartile in the third trimester The AOR for PE associated with each 5 µg/m3 increase in locally emitted PM2.5 was 2.74 (95% CI: 1.68, 4.47) in the entire pregnancy. Similar patterns were observed for each 5 µg/m3 increment in locally emitted PM10. In pregnancies complicated by PE with SGA, the corresponding AOR for linear increases in BC was 3.48 (95% CI: 1.67, 7.27). In this low-level setting, maternal exposure to ambient air pollution during gestation was associated with the risk of developing PE. The associations seemed more pronounced in pregnancies with SGA complications, a finding that should be investigated further.
Collapse
|
25
|
Smith RB, Beevers SD, Gulliver J, Dajnak D, Fecht D, Blangiardo M, Douglass M, Hansell AL, Anderson HR, Kelly FJ, Toledano MB. Impacts of air pollution and noise on risk of preterm birth and stillbirth in London. ENVIRONMENT INTERNATIONAL 2020; 134:105290. [PMID: 31783238 DOI: 10.1016/j.envint.2019.105290] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 10/14/2019] [Accepted: 10/25/2019] [Indexed: 05/17/2023]
Abstract
BACKGROUND Evidence for associations between ambient air pollution and preterm birth and stillbirth is inconsistent. Road traffic produces both air pollutants and noise, but few studies have examined these co-exposures together and none to date with all-cause or cause-specific stillbirths. OBJECTIVES To analyse the relationship between long-term exposure to air pollution and noise at address level during pregnancy and risk of preterm birth and stillbirth. METHODS The study population comprised 581,774 live and still births in the Greater London area, 2006-2010. Outcomes were preterm birth (<37 completed weeks gestation), all-cause stillbirth and cause-specific stillbirth. Exposures during pregnancy to particulate matter with diameter <2.5 μm (PM2.5) and <10 μm (PM10), ozone (O3), primary traffic air pollutants (nitrogen dioxide, nitrogen oxides, PM2.5 from traffic exhaust and traffic non-exhaust), and road traffic noise were estimated based on maternal address at birth. RESULTS An interquartile range increase in O3 exposure was associated with elevated risk of preterm birth (OR 1.15 95% CI: 1.11, 1.18, for both Trimester 1 and 2), all-cause stillbirth (Trimester 1 OR 1.17 95% CI: 1.07, 1.27; Trimester 2 OR 1.20 95% CI: 1.09, 1.32) and asphyxia-related stillbirth (Trimester 1 OR 1.22 95% CI: 1.01, 1.49). Odds ratios with the other air pollutant exposures examined were null or <1, except for primary traffic non-exhaust related PM2.5, which was associated with 3% increased odds of preterm birth (Trimester 1) and 7% increased odds stillbirth (Trimester 1 and 2) when adjusted for O3. Elevated risk of preterm birth was associated with increasing road traffic noise, but only after adjustment for certain air pollutant exposures. DISCUSSION Our findings suggest that exposure to higher levels of O3 and primary traffic non-exhaust related PM2.5 during pregnancy may increase risk of preterm birth and stillbirth; and a possible relationship between long-term traffic-related noise and risk of preterm birth. These findings extend and strengthen the evidence base for important public health impacts of ambient ozone, particulate matter and noise in early life.
Collapse
Affiliation(s)
- Rachel B Smith
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK; NIHR HPRU in Health Impact of Environmental Hazards, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
| | - Sean D Beevers
- MRC-PHE Centre for Environment and Health, Environmental Research Group, Faculty of Life Sciences & Medicine, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
| | - John Gulliver
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK; Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK
| | - David Dajnak
- MRC-PHE Centre for Environment and Health, Environmental Research Group, Faculty of Life Sciences & Medicine, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
| | - Daniela Fecht
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK
| | - Marta Blangiardo
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK
| | - Margaret Douglass
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK
| | - Anna L Hansell
- NIHR HPRU in Health Impact of Environmental Hazards, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK; Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK; UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK
| | - H Ross Anderson
- MRC-PHE Centre for Environment and Health, Environmental Research Group, Faculty of Life Sciences & Medicine, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK; Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Frank J Kelly
- NIHR HPRU in Health Impact of Environmental Hazards, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK; MRC-PHE Centre for Environment and Health, Environmental Research Group, Faculty of Life Sciences & Medicine, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
| | - Mireille B Toledano
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK; NIHR HPRU in Health Impact of Environmental Hazards, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK.
| |
Collapse
|
26
|
Lu C, Cao L, Norbäck D, Li Y, Chen J, Deng Q. Combined effects of traffic air pollution and home environmental factors on preterm birth in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 184:109639. [PMID: 31525560 DOI: 10.1016/j.ecoenv.2019.109639] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Although mounting evidence have linked traffic-related air pollution (TRAP) with increased risk of preterm birth (PTB), whether it can interact with indoor environmental factors remains unknown, and its window(s) susceptibility at the stage of gestation is unclear. OBJECTIVE To explore PTB risk for prenatal exposure to traffic-related air pollution and home environmental factors during pregnancy, so as to identify critical window(s) in the combined effect of traffic air pollution and main home environmental factor(s) on PTB development. METHODS A retrospective cohort study of 3,509 preschool children was performed in Changsha, China during 2011-2012. The PTB prevalence was reported by the parents based on a questionnaire. We estimated each mother's exposure to traffic-related air pollutant NO2 in different windows of gestation, including conception month, three trimesters, birth month, and whole gestation. Maternal exposure to home environmental factors was considered by renovation (new furniture/redecoration) in pregnancy, and mold/damp stains and window condensation during perinatal period. Associations of PTB with both ambient NO2 and home environmental factors, and their interactions on PTB were evaluated by logistic regression models using odds ratio (OR) with 95% confidence interval (CI). RESULTS Traffic air pollutant NO2 exposure in utero was significantly associated with PTB, with adjusted odds ratio (OR) (95% CI) of 1.41 (1.00-1.98) for an IQR increase in NO2 exposure during whole pregnancy, particularly in the conception month and 1st trimester. We further found a positive relationship between perinatal exposure to mold/damp stains in the homes and PTB, OR (95% CI) = 1.73 (1.04-2.90). Especially, we detected a significant interaction between outdoor NO2 and indoor mold/damp stains on PTB risk. Male and female foetus were respectively more susceptible to perinatal mold/dampness at home and outdoor NO2 exposure in early gestation. CONCLUSION Our finding indicates that both outdoor traffic air pollutant and indoor mold/dampness play key roles in PTB development, and their interaction effect in early pregnancy significantly increases PTB risk.
Collapse
Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, China; Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University, Changsha, China
| | - Lanqin Cao
- Department of Gynecology, XiangYa Hospital, Central South University, Changsha, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Jing Chen
- School of Architecture and Art, Central South University, Changsha, China
| | - Qihong Deng
- XiangYa School of Public Health, Central South University, Changsha, China; Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University, Changsha, China; School of Architecture and Art, Central South University, Changsha, China.
| |
Collapse
|
27
|
Percy Z, DeFranco E, Xu F, Hall ES, Haynes EN, Jones D, Muglia LJ, Chen A. Trimester specific PM 2.5 exposure and fetal growth in Ohio, 2007-2010. ENVIRONMENTAL RESEARCH 2019; 171:111-118. [PMID: 30660917 PMCID: PMC6382528 DOI: 10.1016/j.envres.2019.01.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 01/10/2019] [Accepted: 01/14/2019] [Indexed: 05/04/2023]
Abstract
BACKGROUND Exposure to particulate matter, particularly with aerodynamic diameter < 2.5 µm (PM2.5), may increase inflammation and oxidative stress in pregnant women and affect fetal growth. We examined trimester specific PM2.5 exposure levels and small for gestational age (SGA) using the statewide birth registry of Ohio from 2007 to 2010. METHODS Exposure to PM2.5 in each trimester and for each gestational week was determined using data from 57 Environmental Protection Agency network monitoring stations across the state of Ohio. We restricted the data to 224,921 singleton live births, with a gestational age of 20-42 weeks, no genetic disorders or congenital abnormalities, and who had home addresses within a 10 km radius of any PM2.5 monitoring station. We estimated odds ratios of SGA using Generalized Linear Models (GLMs) and Distributed Lag Models (DLMs), and adjustment for maternal age, race, education, parity, body mass index, insurance type, tobacco use, prenatal care initiation, birth year, season of birth, and sex of the baby. RESULTS Mean PM2.5 levels during the entire pregnancy were 13.03 µg/m3 with a standard deviation of 1.57 µg/m3. Covariates adjusted odds ratios and 95% confidence intervals of a 10 µg/m3 increase in PM2.5 levels with a 10 km buffer radius for SGA and trimesters modeled separately were 0.94 (0.88, 1.00) for the first trimester, 0.93 (0.86, 1.00) for the second trimester, 1.07 (1.00, 1.15) for the third trimester, and 0.92 (0.81, 1.06) for the entire pregnancy. When a 5 km buffer radius was used, adjusted odds ratios and 95% confidence intervals for SGA were 0.97 (0.89, 1.05) for the first trimester, 0.96 (0.88, 1.05) for the second trimester, 1.09 (1.02, 1.17) for the third trimester, and 0.99 (0.85, 1.14) for the overall pregnancy, indicating sensitivity to buffer choice. DLMs showed gestational weeks 30-35 to be a particular window of vulnerability. CONCLUSION Increasing exposure to PM2.5 during the third trimester of pregnancy was associated with a small increase in risk of SGA in this population-based study. Selection of a buffer radius significantly impacted our results in the first trimester, but not in the third trimester.
Collapse
Affiliation(s)
- Zana Percy
- Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Emily DeFranco
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Fan Xu
- Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Eric S Hall
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Erin N Haynes
- Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - David Jones
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Louis J Muglia
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Aimin Chen
- Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
| |
Collapse
|
28
|
Nyári TA, McNally R. Seasonal variation in childhood mortality. J Matern Fetal Neonatal Med 2019; 33:4055-4061. [PMID: 30880511 DOI: 10.1080/14767058.2019.1594765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Aim: This ecological study was carried out to determine the cyclic trends in the rate of perinatal and infant mortality and among children aged under 15 years who died in traffic accidents or from drowning, respiratory disease or cancer.Methods: Monthly data on the numbers of live births, perinatal and infant deaths, and deaths from respiratory disease, cancer, traffic accidents, accidental drowning, and submersion in children aged under 15 years were obtained from the Hungarian nationwide population register. The data were aggregated over the study period and cyclic trends were investigated using the Walter-Elwood and negative binomial regression methods.Results: Significant double-peak (May and November) trends were found in mortality rates for perinatal and infant deaths, respectively. Additionally, significant (p-value < .001) seasonal variation in monthly mortality rates for deaths from respiratory diseases was observed with a peak in February, and a significant single peak was observed in mortality rates in July in both deaths from traffic accidents and drowning among children aged 0-14 years. However, there was no seasonal variation in monthly mortality rates for deaths from childhood cancer.Conclusions: Since cyclic trends in mortality suggest some effect of environmental factors in etiology, we might speculate that perinatal mortality may have been related to respiratory infections. A significant single peak was observed in mortality rates in July in both deaths from traffic accidents and drowning among children aged 0-14 years which could be related to environmental factors, such as temperature, air masses, and fronts. However, there was no seasonal variation in monthly mortality rates for deaths from childhood cancer. All of these novel findings could prove useful in preventive strategies, but further cohort studies are needed to investigate this hypothesis.What is knownSeasonality in infant mortality is known.What is newA significant cyclic trend was found in infants' mortality, with a peak in deaths in winter during the post-perinatal period and double peaks in May and November during the perinatal period, which might be associated with respiratory syncytial virus infections.Winter-peak cyclic trends were observed in both preterm and low birthweight mortality.A significant cyclic trend was observed in mortality, with a peak in deaths from traffic accidents and drowning in July for children aged 0-14 years, but seasonal variation was not found in monthly deaths from childhood cancer.
Collapse
Affiliation(s)
- Tibor András Nyári
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
| | - Richard McNally
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
29
|
Madsen C, Håberg SE, Aamodt G, Stigum H, Magnus P, London SJ, Nystad W, Nafstad P. Preeclampsia and Hypertension During Pregnancy in Areas with Relatively Low Levels of Traffic Air Pollution. Matern Child Health J 2019; 22:512-519. [PMID: 29285630 DOI: 10.1007/s10995-017-2417-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives Air pollution exposure may contribute to the development of preeclampsia and hypertension during pregnancy. However, the evidence for such a relation is still limited. We investigated the associations between exposure for moderate to low levels of air pollution during pregnancy and preeclampsia and gestational hypertension in selected urban and county areas of Norway. Methods This study used a sub-group of 17,533 women in the Norwegian Mother and Child Cohort Study. Air pollution levels at residential addresses were estimated using land use regression models and back-extrapolated to the period of each pregnancy. Information on preeclampsia and gestational hypertension were obtained from the Medical Birth Registry of Norway and information on lifestyle factors was collected from questionnaires completed by the women during pregnancy. Results Moderate mean levels of NO2 (13.6 ± 6.9 µg/m3) at residential address during pregnancy were not associated with preeclampsia and pregnancy hypertension. We found no statistically significant associations per 10 µg/m3 change in NO2 exposure and preeclampsia (adjusted OR 0.89, 95% CI 0.74, 1.08) or hypertension during pregnancy (adjusted OR 0.91, 95% CI 0.78, 1.06). Conclusions for Practice In this large Norwegian pregnancy cohort, we found no statistically significant associations for moderate to low levels of pregnancy NO2 exposure and preeclampsia or hypertension during pregnancy.
Collapse
Affiliation(s)
- Christian Madsen
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway. .,Department of Community Medicine and Global Health, Medical Faculty, University of Oslo, Oslo, Norway. .,Department of Health and Inequality, Domain for Mental and Physical Health, Norwegian Institute of Public Health, Nydalen, P.O. Box 4404, 0403, Oslo, Norway.
| | - Siri Eldevik Håberg
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Aamodt
- Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Ås, Norway
| | - Hein Stigum
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Community Medicine and Global Health, Medical Faculty, University of Oslo, Oslo, Norway
| | - Per Magnus
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Stephanie J London
- Department of Health and Human Services, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Wenche Nystad
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Per Nafstad
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Community Medicine and Global Health, Medical Faculty, University of Oslo, Oslo, Norway
| |
Collapse
|
30
|
Liu Y, Xu J, Chen D, Sun P, Ma X. The association between air pollution and preterm birth and low birth weight in Guangdong, China. BMC Public Health 2019; 19:3. [PMID: 30606145 PMCID: PMC6318948 DOI: 10.1186/s12889-018-6307-7] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 12/05/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND A mountain of evidence has shown that people's physical and mental health can be affected by various air pollutions. Poor pregnancy outcomes are associated with exposure to air pollution. Therefore, this study aims to investigate the association between air pollutions (PM2.5, PM10, SO2, NO2, CO, and O3) and preterm birth/low birth weight in Guangdong province, China. METHOD All maternal data and birth data from January 1, 2014 to December 31, 2015 were selected from a National Free Pre-pregnancy Check-ups system, and the daily air quality data of Guangdong Province was collected from China National Environmental Monitoring Center. 1784 women with either preterm birth information (n = 687) or low birth weight information (n = 1097) were used as experimental group. Control group included 1766 women with healthy birth information. Logistic regression models were employed to evaluate the effects of air pollutants on the risk of preterm birth and low birth weight. RESULTS The pollution levels of PM2.5, PM10, SO2, NO2, CO, and O3 in Guangdong province were all lower than the national air pollution concentrations. The concentrations of PM2.5, PM10, SO2, NO2 and CO had obvious seasonal trends with the highest in winter and the lowest in summer. O3 concentrations in September (65.72 μg/m3) and October (84.18 μg/m3) were relatively higher. After controlling for the impact of confounding factors, the increases in the risk of preterm birth were associated with each 10 μg/m3 increase in PM2.5 (OR 1.043, 95% CI 1.01-1.09) and PM10 (OR 1.039, 95% CI 1.01~1.14) during the first trimester and in PM2.5 (OR 1.038, 95% CI 1.01~1.12), PM10 (OR 1.024, 95% CI 1.02~1.09), SO2 (OR 1.081, 95% CI 1.01~1.29), and O3 (OR 1.016, 95% CI 1.004~1.35) during the third trimester. The increase in the risk of low birth weight was associated with PM2.5, PM10, NO2, and O3 in the first month and the last month. CONCLUSION This study provides further evidence for the relationships between air pollutions and preterm birth/low birth weight. Pregnant women are recommended to reduce or avoid exposure to air pollutions during pregnancy, especially in the early and late stages of pregnancy.
Collapse
Affiliation(s)
- Ying Liu
- Institute of Psychology Continuing Education College, University of the Chinese Academy of Sciences, National Research Institute for Family Planning, No.12, Dahuisi Road, Hai Dian District, Beijing, 100081 China
| | - Jihong Xu
- Research Center for Mental Health and Behavior Big Data, National Research Institute for Family Planning, Beijing, China
| | - Dian Chen
- Department of Psychology, Tsinghua University, Beijing, China
| | - Pei Sun
- Department of Psychology, Tsinghua University, Beijing, China
| | - Xu Ma
- Research Center for Mental Health and Behavior Big Data, National Research Institute for Family Planning, Beijing, China
| |
Collapse
|
31
|
Leiser CL, Hanson HA, Sawyer K, Steenblik J, Al-Dulaimi R, Madsen T, Gibbins K, Hotaling JM, Ibrahim YO, VanDerslice JA, Fuller M. Acute effects of air pollutants on spontaneous pregnancy loss: a case-crossover study. Fertil Steril 2018; 111:341-347. [PMID: 30528056 DOI: 10.1016/j.fertnstert.2018.10.028] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/25/2018] [Accepted: 10/26/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate the relationship between acute exposure to air pollutants and spontaneous pregnancy loss. DESIGN Case-crossover study from 2007 to 2015. SETTING An academic emergency department in the Wasatch Front area of Utah. PATIENT(S) A total of 1,398 women who experienced spontaneous pregnancy loss events. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Odds of spontaneous pregnancy loss. RESULT(S) We found that a 10-ppb increase in 7-day average levels of nitrogen dioxide was associated with a 16% increase in the odds of spontaneous pregnancy loss (odds ratio [OR] = 1.16; 95% confidence interval [CI] 1.01-1.33; P=.04). A 10-μg/m3 increase in 3-day and 7-day averages of fine particulate matter were associated with increased risk of spontaneous pregnancy loss, but the associations did not reach statistical significance (OR3-day average = 1.09; 95% CI 0.99-1.20; P=.05) (OR7-day average = 1.11; 95% CI 0.99-1.24; P=.06). We found no evidence of increased risk for any other metrics of nitrogen dioxide or fine particulate matter or any metric for ozone. CONCLUSIONS We found that short-term exposure to elevated levels of air pollutants was associated with higher risk for spontaneous pregnancy loss.
Collapse
Affiliation(s)
- Claire L Leiser
- Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah.
| | - Heidi A Hanson
- Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah; Department of Surgery, University of Utah, Salt Lake City, Utah
| | - Kara Sawyer
- Division of Emergency Medicine, University of Utah, Salt Lake City, Utah
| | - Jacob Steenblik
- Division of Emergency Medicine, University of Utah, Salt Lake City, Utah
| | - Ragheed Al-Dulaimi
- Department of Internal Medicine, Hurley Medical Center, Flint, Michigan; College of Human Medicine, Michigan State University, Lansing, Michigan
| | - Troy Madsen
- Division of Emergency Medicine, University of Utah, Salt Lake City, Utah
| | - Karen Gibbins
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | | | | | - James A VanDerslice
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
| | - Matthew Fuller
- Division of Emergency Medicine, University of Utah, Salt Lake City, Utah
| |
Collapse
|
32
|
Naidoo P, Naidoo RN, Ramkaran P, Muttoo S, Asharam K, Chuturgoon AA. Maternal miRNA-146a G/C rs2910164 variation, HIV/AIDS and nitrogen oxide pollution exposure collectively affects foetal growth. Hum Exp Toxicol 2018; 38:82-94. [PMID: 29896975 DOI: 10.1177/0960327118781902] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE: Nitrogen oxide (NOx) pollution and human immunodeficiency virus (HIV)/AIDS intensify inflammation during pregnancy and linked with adverse birth outcomes (ABOs). MicroRNA (miRNA)-146a plays a crucial role in regulating inflammation in the NF-κB pathway. The G/C rs2910164 dampens miRNA-146a activity and linked with inflammatory diseases. The present study investigated whether HIV/AIDS and NOx exposure throughout pregnancy further intensifies ABO in Black South African women genotyped for the rs2910164. METHODS: Pregnant women ( n = 300) were subdivided into low, medium and high NOx exposure groups, genotyped for the miRNA-146a G/C rs2910164 using polymerase chain reaction-restriction fragment length polymorphism, and further stratified based on HIV status. RESULTS: Unstratified data (HIV+ and HIV- mothers combined): Mothers from the high NOx group with the variant C-allele had low blood iron levels ( p = 0.0238), and had babies with reduced birthweights ( p = 0.0283). As NOx increased, the prevalence of preterm birth and low birth weight also increased in mothers with the variant C-allele versus wildtype G-allele. HIV-infected mothers: In all NOx exposure groups, mothers with the variant C-allele had higher systolic blood pressure (low: p = 0.0386, medium: p = 0.0367 and high: p = 0.0109) and had babies with lower Appearance, Pulse, Grimace, Activity and Respiration scores at 1 min (low: p = 0.0190, medium: p = 0.0301 and high: p = 0.0361). CONCLUSION: Maternal rs2910164 variant C-allele, NOx pollution and HIV/AIDS might collectively play a role in intensifying gestational hypertension and ABO.
Collapse
Affiliation(s)
- P Naidoo
- 1 Discipline of Medical Biochemistry and Chemical Pathology, University of KwaZulu-Natal, Durban, South Africa
| | - R N Naidoo
- 2 Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, Durban, South Africa
| | - P Ramkaran
- 1 Discipline of Medical Biochemistry and Chemical Pathology, University of KwaZulu-Natal, Durban, South Africa
| | - S Muttoo
- 2 Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, Durban, South Africa
| | - K Asharam
- 2 Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, Durban, South Africa
| | - A A Chuturgoon
- 1 Discipline of Medical Biochemistry and Chemical Pathology, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
33
|
Nieuwenhuijsen MJ. Influence of urban and transport planning and the city environment on cardiovascular disease. Nat Rev Cardiol 2018; 15:432-438. [DOI: 10.1038/s41569-018-0003-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
34
|
Koman PD, Hogan KA, Sampson N, Mandell R, Coombe CM, Tetteh MM, Hill-Ashford YR, Wilkins D, Zlatnik MG, Loch-Caruso R, Schulz AJ, Woodruff TJ. Examining Joint Effects of Air Pollution Exposure and Social Determinants of Health in Defining "At-Risk" Populations Under the Clean Air Act: Susceptibility of Pregnant Women to Hypertensive Disorders of Pregnancy. WORLD MEDICAL & HEALTH POLICY 2018; 10:7-54. [PMID: 30197817 PMCID: PMC6126379 DOI: 10.1002/wmh3.257] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Pregnant women are uniquely susceptible to adverse effects of air pollution exposure due to vulnerabilities and health consequences during pregnancy (e.g., hypertensive disorders of pregnancy [HDP]) compared to the general population. Because the Clean Air Act (CAA) creates a duty to protect at-risk groups, the regulatory assessment of at-risk populations has both policy and scientific foundations. Previously, pregnant women have not been specially protected in establishing the margin of safety for the ozone and particulate matter (PM) standards. Due to physiological changes, pregnant women can be at greater risk of adverse effects of air pollution and should be considered an at-risk population. Women with preexisting conditions, women experiencing poverty, and groups that suffer systematic discrimination may be particularly susceptible to cardiac effects of air pollutants during pregnancy. We rigorously reviewed 11 studies of over 1.3 million pregnant women in the United States to characterize the relationship between ozone or PM exposure and HDP. Findings were generally mixed, with a few studies reporting a joint association between ozone or PM and social determinants or pre-existing chronic health conditions related to HDP. Adequate evidence associates exposure to PM with an adverse effect of HDP among pregnant women not evident among non-gravid populations.
Collapse
Affiliation(s)
- Patricia D Koman
- University of Michigan School of Public Health, Environmental Health Sciences Department in Ann Arbor, Michigan
| | - Kelly A Hogan
- University of Michigan School of Public Health, Environmental Health Sciences Department in Ann Arbor, Michigan, and presently a research fellow in the Department of Biochemistry and Molecular Biology and the Robert and Arlene Kogod Center on Aging at Mayo Clinic, Rochester, Minnesota
| | - Natalie Sampson
- University of Michigan-Dearborn, Department of Health & Human Services in Dearborn, Michigan
| | - Rebecca Mandell
- Arbor Research Collaborative for Health in Ann Arbor, Michigan
| | - Chris M Coombe
- University of Michigan School of Public Health, Department of Health Behavior & Health Education in Ann Arbor, Michigan
| | - Myra M Tetteh
- University of Michigan School of Public Health, Department of Health Behavior & Health Education in Ann Arbor, Michigan
| | | | | | - Marya G Zlatnik
- University of California San Francisco, Department of Obstetrics, Gynecology and Reproductive Sciences in San Francisco, California
| | - Rita Loch-Caruso
- University of Michigan School of Public Health, Environmental Health Sciences Department and director of the Michigan Center on Lifestage Environmental Exposures and Disease and director of the Environmental Toxicology and Epidemiology Program in Ann Arbor, Michigan
| | - Amy J Schulz
- Department of Health Behavior and Health Education, associate director for the Center for Research on Ethnicity, Culture and Health, and co-lead for the Community Engagement Core for the Michigan Center on Lifestage Environmental Exposures and Disease at the University of Michigan School of Public Health
| | - Tracey J Woodruff
- University of California, San Francisco in the Department of Obstetrics, Gynecology, and Reproductive Sciences and Philip R. Lee Institute for Health Policy Studies and the director of the Program on Reproductive Health and the Environment in San Francisco, California
| |
Collapse
|
35
|
Meta-Prediction of MTHFR Gene Polymorphisms and Air Pollution on the Risk of Hypertensive Disorders in Pregnancy Worldwide. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020326. [PMID: 29438331 PMCID: PMC5858395 DOI: 10.3390/ijerph15020326] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 01/24/2018] [Accepted: 02/05/2018] [Indexed: 11/16/2022]
Abstract
Hypertensive disorders in pregnancy (HDP) are devastating health hazards for both women and children. Both methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and air pollution can affect health status and result in increased risk of HDP for women. The major objective of this study was to investigate the effect of MTHFR polymorphisms, air pollution, and their interaction on the risk of HDP by using meta-predictive analytics. We searched various databases comprehensively to access all available studies conducted for various ethnic populations from countries worldwide, from 1997 to 2017. Seventy-one studies with 8064 cases and 13,232 controls for MTHFR C677T and 11 studies with 1425 cases and 1859 controls for MTHFR A1298C were included. MTHFR C677T homozygous TT (risk ratio (RR) = 1.28, p < 0.0001) and CT plus TT (RR = 1.07, p = 0.0002) were the risk genotypes, while wild-type CC played a protective role (RR = 0.94, p = 0.0017) for HDP. The meta-predictive analysis found that the percentage of MTHFR C677T TT plus CT (p = 0.044) and CT (p = 0.043) genotypes in the HDP case group were significantly increased with elevated levels of air pollution worldwide. Additionally, in countries with higher air pollution levels, the pregnant women with wild-type CC MTHFR 677 had a protection effect against HDP (p = 0.014), whereas, the homozygous TT of MTHFR C677T polymorphism was a risk genotype for developing HDP. Air pollution level is an environmental factor interacting with increased MTHFR C677T polymorphisms, impacting the susceptibility of HDP for women.
Collapse
|
36
|
Miller CN, Dye JA, Ledbetter AD, Schladweiler MC, Richards JH, Snow SJ, Wood CE, Henriquez AR, Thompson LC, Farraj AK, Hazari MS, Kodavanti UP. Uterine Artery Flow and Offspring Growth in Long-Evans Rats following Maternal Exposure to Ozone during Implantation. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:127005. [PMID: 29269335 PMCID: PMC5963593 DOI: 10.1289/ehp2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 11/07/2017] [Accepted: 11/13/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Epidemiological studies suggest that increased ozone exposure during gestation may compromise fetal growth. In particular, the implantation stage of pregnancy is considered a key window of susceptibility for this outcome. OBJECTIVES The main goals of this study were to investigate the effects of short-term ozone inhalation during implantation on fetal growth outcomes and to explore the potential for alterations in uterine arterial flow as a contributing mechanism. METHODS Pregnant Long-Evans rats were exposed to filtered air, 0.4 ppm ozone, or 0.8 ppm ozone for 4 h/d during implantation, on gestation days (GD) 5 and 6. Tail cuff blood pressure and uterine artery Doppler ultrasound were measured on GD 15, 19, and 21. To assess whether peri-implantation ozone exposure resulted in sustained pulmonary or systemic health effects, bronchoalveolar lavage fluid, serum metabolic and inflammatory end points, and kidney histopathology were evaluated in dams at GD 21. Growth parameters assessed in GD 21 offspring included fetal weight, length, and body composition. RESULTS Measures of maternal uterine arterial flow, including resistance index and mean velocity, indicated that resistance increased between GD 15 and GD 21 in 0.8 ppm dams but decreased in controls, although absolute values were similar in both groups on GD 21. Ozone-exposed dams also had lower serum glucose and higher free fatty acid concentrations than controls on GD 21. On GD 21, both male and female offspring had lower body weight than controls, and pooled subsets of 3 male and 3 female fetuses from litters exposed to 0.8 ppm ozone had lower lean mass and fat mass than pooled control offspring. CONCLUSIONS Findings from our experimental model suggest that the offspring of dams exposed to ozone during implantation had reduced growth compared with controls, possibly as a consequence of ozone-induced vascular dysfunction. https://doi.org/10.1289/EHP2019.
Collapse
Affiliation(s)
- Colette N Miller
- Environmental Public Health Division, National Health & Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency (EPA), Research Triangle Park, North Carolina, USA
| | - Janice A Dye
- Environmental Public Health Division, National Health & Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency (EPA), Research Triangle Park, North Carolina, USA
| | - Allen D Ledbetter
- Environmental Public Health Division, National Health & Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency (EPA), Research Triangle Park, North Carolina, USA
| | - Mette C Schladweiler
- Environmental Public Health Division, National Health & Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency (EPA), Research Triangle Park, North Carolina, USA
| | - Judy H Richards
- Environmental Public Health Division, National Health & Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency (EPA), Research Triangle Park, North Carolina, USA
| | - Samantha J Snow
- Environmental Public Health Division, National Health & Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency (EPA), Research Triangle Park, North Carolina, USA
| | - Charles E Wood
- Integrated Systems Toxicology Division, National Health & Environmental Effects Research Laboratory, Office of Research and Development, U.S. EPA, Research Triangle Park, North Carolina, USA
| | - Andres R Henriquez
- Curriculum in Toxicology, University of North Carolina School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Leslie C Thompson
- Environmental Public Health Division, National Health & Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency (EPA), Research Triangle Park, North Carolina, USA
| | - Aimen K Farraj
- Environmental Public Health Division, National Health & Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency (EPA), Research Triangle Park, North Carolina, USA
| | - Mehdi S Hazari
- Environmental Public Health Division, National Health & Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency (EPA), Research Triangle Park, North Carolina, USA
| | - Urmila P Kodavanti
- Environmental Public Health Division, National Health & Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency (EPA), Research Triangle Park, North Carolina, USA
| |
Collapse
|
37
|
Abstract
PURPOSE OF REVIEW Air pollution significantly affects health, causing up to 7 million premature deaths annually with an even larger number of hospitalizations and days of sick leave. Climate change could alter the dispersion of primary pollutants, particularly particulate matter, and intensify the formation of secondary pollutants, such as near-surface ozone. The purpose of the review is to evaluate the recent evidence on the impacts of climate change on air pollution and air pollution-related health impacts and identify knowledge gaps for future research. RECENT FINDINGS Several studies modelled future ozone and particulate matter concentrations and calculated the resulting health impacts under different climate scenarios. Due to climate change, ozone- and fine particle-related mortalities are expected to increase in most studies; however, results differ by region, assumed climate change scenario and other factors such as population and background emissions. This review explores the relationships between climate change, air pollution and air pollution-related health impacts. The results highly depend on the climate change scenario used and on projections of future air pollution emissions, with relatively high uncertainty. Studies primarily focused on mortality; projections on the effects on morbidity are needed.
Collapse
Affiliation(s)
- H Orru
- Department of Family Medicine and Public Health, University of Tartu, Ravila 19, 50411, Tartu, Estonia.
- Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden.
| | - K L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - B Forsberg
- Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| |
Collapse
|
38
|
Song J, Chen Y, Wei L, Ma Y, Tian N, Huang SY, Dai YM, Zhao LH, Kong YY. Early-life exposure to air pollutants and adverse pregnancy outcomes: protocol for a prospective cohort study in Beijing. BMJ Open 2017; 7:e015895. [PMID: 28871018 PMCID: PMC5588991 DOI: 10.1136/bmjopen-2017-015895] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION The association between early exposure to ambient air pollution and adverse pregnancy outcomes in China is unclear. This study will assess the risk of early-life exposure to air pollutants in Beijing and explore the viability of 8-hydroxydeoxyguanosine (8-OHdG) as a biological indicator to assess oxidative stress induced by early-life exposure to air pollution. METHODS AND ANALYSIS Here, 2500 women with singleton pregnancies and their infants will be recruited from the Beijing Obstetrics and Gynecology Hospital. We will collect nine types of biological samples, including maternal serum, urine, placental tissue, umbilical cord tissue and umbilical cord blood during all three trimesters. The air pollution data (particulate matter (PM)2.5, PM10 and similar factors) will be recorded at official fixed-site monitoring stations closest to where the pregnant women live. We plan to assess the effect of air pollutants on adverse pregnancy outcomes and infant respiratory and circulatory disease using Cox regression and competitive risk analysis and explore possible critical windows of exposure during pregnancy using daily pollutant concentrations averaged over various periods of pregnancy combined with individual activity and physiological parameters. Maternal and umbilical cord blood samples (1000 samples) will be randomly selected for 8-OHdG assays to assess the correlation between exposures to air pollutants and oxidative stress. We will determine whether air pollutant exposure or 8-OHdG levels are associated with adverse pregnancy outcomes. SPSS and SAS statistical software will be used for data analysis. Cox regression and competing risk analysis will be used to compute the HR and population attributable risk. ETHICS AND DISSEMINATION This research protocol has already been approved by the Medical Ethics Committee of Beijing Obstetrics and Gynecology Hospital. Written informed consent will be obtained from all study participants prior to enrolment. The results will be published in peer-reviewed journals or disseminated through conference presentations. TRIAL REGISTRATION NUMBER This study has been registered in WHO International Clinical Trial Register-Chinese Clinical Trial Registry under registrationnumber ChiCTR-ROC-16010181 (http :// www.chictr.org.cn / showproj.aspx ?proj=17328).
Collapse
Affiliation(s)
- Jing Song
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Yi Chen
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Ling Wei
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Ying Ma
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Ning Tian
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Shi Yun Huang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Yin Mei Dai
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Li Hong Zhao
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Yuan Yuan Kong
- Beijing Maternal and Child Health Care Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
39
|
Hettfleisch K, Bernardes LS, Carvalho MA, Pastro LDM, Vieira SE, Saldiva SRDM, Saldiva P, Francisco RPV. Short-Term Exposure to Urban Air Pollution and Influences on Placental Vascularization Indexes. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:753-759. [PMID: 27384326 PMCID: PMC5381983 DOI: 10.1289/ehp300] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 05/26/2016] [Accepted: 06/14/2016] [Indexed: 05/05/2023]
Abstract
BACKGROUND It has been widely demonstrated that air pollution can affect human health and that certain pollutant gases lead to adverse obstetric outcomes, such as preeclampsia and fetal growth restriction. OBJECTIVES We evaluated the influence of individual maternal exposure to air pollution on placental volume and vascularization evaluated in the first trimester of pregnancy. METHODS This was a cross-sectional study on low-risk pregnant women living in São Paulo, Brazil. The women carried passive personal NO2 and O3 monitors in the week preceding evaluation. We employed the virtual organ computer-aided analysis (VOCAL) technique using three-dimensional power Doppler ultrasound to evaluate placental volume and placental vascular indexes [vascularization index (VI), flow index (FI), and vascularization flow index (VFI)]. We analyzed the influence of pollutant levels on log-transformed placental vascularization and volume using multiple regression models. RESULTS We evaluated 229 patients. Increased NO2 levels had a significant negative association with log of VI (p = 0.020 and beta = -0.153) and VFI (p = 0.024 and beta = -0.151). NO2 and O3 had no influence on the log of placental volume or FI. CONCLUSIONS NO2, an estimator of primary air pollutants, was significantly associated with diminished VI and VFI in the first trimester of pregnancy.
Collapse
Affiliation(s)
| | - Lisandra Stein Bernardes
- Department of Obstetrics and Gynecology, and
- Address correspondence to L.S. Bernardes, The Procriar Study Group, Department of Obstetrics and Gynecology, School of Medicine at the University of São Paulo, São Paulo, Brazil; 255, Av. Dr. Enéas de Carvalho Aguiar, São Paulo, Brazil 05403-900. Telephone: 551126616209. E-mail:
| | - Mariana Azevedo Carvalho
- Department of Obstetrics and Gynecology, and
- Address correspondence to L.S. Bernardes, The Procriar Study Group, Department of Obstetrics and Gynecology, School of Medicine at the University of São Paulo, São Paulo, Brazil; 255, Av. Dr. Enéas de Carvalho Aguiar, São Paulo, Brazil 05403-900. Telephone: 551126616209. E-mail:
| | | | | | | | - Paulo Saldiva
- Institute of Advanced Studies of the University of São Paulo, São Paulo, Brazil
| | | |
Collapse
|
40
|
Ferguson KK, Chin HB. Environmental chemicals and preterm birth: Biological mechanisms and the state of the science. CURR EPIDEMIOL REP 2017; 4:56-71. [PMID: 28944158 PMCID: PMC5608103 DOI: 10.1007/s40471-017-0099-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE OF REVIEW Preterm birth is a significant worldwide health problem of uncertain origins. The extant body of literature examining environmental contaminant exposures in relation to preterm birth is extensive but results remain ambiguous for most organic pollutants, metals and metalloids, and air pollutants. In the present review we examine recent epidemiologic studies investigating these associations, and identify recent advances and the state of the science. Additionally, we highlight biological mechanisms of action in the pathway between chemical exposures and preterm birth, including inflammation, oxidative stress, and endocrine disruption, that deserve more attention in this context. RECENT FINDINGS Important advances have been made in the study of the environment and preterm birth, particularly in regard to exposure assessment methods, exploration of effect modification by co-morbidities and exposures, and in identification of windows of vulnerability during gestation. There is strong evidence for an association between maternal exposure to some persistent pesticides, lead, and fine particulate matter, but data on other contaminants is sparse and only suggestive trends can be noted with the current data. SUMMARY Beyond replicating current findings, further work must be done to improve understanding of mechanisms underlying the associations observed between environmental chemical exposures and preterm birth. By examining windows of vulnerability, disaggregating preterm birth by phenotypes, and measuring biomarkers of mechanistic pathways in these epidemiologic studies we can improve our ability to detect associations with exposure, provide additional evidence for causality in an observational setting, and identify opportunities for intervention.
Collapse
Affiliation(s)
- Kelly K. Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Helen B. Chin
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| |
Collapse
|
41
|
Hu H, Ha S, Xu X. Ozone and hypertensive disorders of pregnancy in Florida: Identifying critical windows of exposure. ENVIRONMENTAL RESEARCH 2017; 153:120-125. [PMID: 27940104 PMCID: PMC5222744 DOI: 10.1016/j.envres.2016.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 11/30/2016] [Accepted: 12/01/2016] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Ozone (O3) has been linked to hypertensive disorders of pregnancy (HDP). However, inconsistent results have been reported, and no study has examined the critical exposure windows during pregnancy. MATERIALS AND METHODS We used Florida birth vital statistics records to investigate the association between HDP and O3 exposure among 655,529 pregnancies with conception dates between 2005 and 2007. Individual O3 exposure was assessed at mothers' home address at the time of delivery using the Hierarchical Bayesian space-time statistical model. We examined the association during three predefined exposure windows including trimester 1, trimester 2, and trimesters 1&2, as well as in each week of the first two trimesters using distributed lag models. RESULTS Pregnancies with HDP had a higher mean exposure to O3 (39.07 in trimester 1, 39.02 in trimester 2, and 39.06 in trimesters 1&2, unit: ppb) than those without HDP (38.65 in trimester 1, 38.57 in trimester 2, and 38.61 in trimesters 1&2, unit: ppb). In the adjusted logistic regression model, increased odds of HDP were observed for each 5 ppb increase in O3 (ORTrimester1=1.04, 95% CI: 1.03, 1.06; ORTrimester2=1.03, 95% CI: 1.02, 1.04; ORTrimester1&2=1.07, 95% CI: 1.05, 1.08). In the distributed lag models, elevated odds of HDP were observed with increased O3 exposure during the 1st to 24th weeks of gestation, with higher odds during early pregnancy. CONCLUSIONS O3 exposure during pregnancy is related to increased odds of HDP, and early pregnancy appears to be a potentially critical window of exposure.
Collapse
Affiliation(s)
- Hui Hu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.
| | - Sandie Ha
- Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, 20892 USA
| | - Xiaohui Xu
- Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA.
| |
Collapse
|
42
|
Finlayson-Pitts BJ. Introductory lecture: atmospheric chemistry in the Anthropocene. Faraday Discuss 2017; 200:11-58. [DOI: 10.1039/c7fd00161d] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The term “Anthropocene” was coined by Professor Paul Crutzen in 2000 to describe an unprecedented era in which anthropogenic activities are impacting planet Earth on a global scale. Greatly increased emissions into the atmosphere, reflecting the advent of the Industrial Revolution, have caused significant changes in both the lower and upper atmosphere. Atmospheric reactions of the anthropogenic emissions and of those with biogenic compounds have significant impacts on human health, visibility, climate and weather. Two activities that have had particularly large impacts on the troposphere are fossil fuel combustion and agriculture, both associated with a burgeoning population. Emissions are also changing due to alterations in land use. This paper describes some of the tropospheric chemistry associated with the Anthropocene, with emphasis on areas having large uncertainties. These include heterogeneous chemistry such as those of oxides of nitrogen and the neonicotinoid pesticides, reactions at liquid interfaces, organic oxidations and particle formation, the role of sulfur compounds in the Anthropocene and biogenic–anthropogenic interactions. A clear and quantitative understanding of the connections between emissions, reactions, deposition and atmospheric composition is central to developing appropriate cost-effective strategies for minimizing the impacts of anthropogenic activities. The evolving nature of emissions in the Anthropocene places atmospheric chemistry at the fulcrum of determining human health and welfare in the future.
Collapse
|
43
|
Aylin P, Bennett P, Bottle A, Brett S, Sodhi V, Rivers A, Balinskaite V. Estimating the risk of adverse birth outcomes in pregnant women undergoing non-obstetric surgery using routinely collected NHS data: an observational study. HEALTH SERVICES AND DELIVERY RESEARCH 2016. [DOI: 10.3310/hsdr04290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundPrevious research suggests that non-obstetric surgery is carried out in 1–2% of all pregnancies. However, there is limited evidence quantifying the associated risks. Furthermore, of the evidence available, none relates directly to outcomes in the UK, and there are no current NHS guidelines regarding non-obstetric surgery in pregnant women.ObjectivesTo estimate the risk of adverse birth outcomes of pregnancies in which non-obstetric surgery was or was not carried out. To further analyse common procedure groups.Data SourceHospital Episode Statistics (HES) maternity data collected between 2002–3 and 2011–12.Main outcomesSpontaneous abortion, preterm delivery, maternal death, caesarean delivery, long inpatient stay, stillbirth and low birthweight.MethodsWe utilised HES, an administrative database that includes records of all patient admissions and day cases in all English NHS hospitals. We analysed HES maternity data collected between 2002–3 and 2011–12, and identified pregnancies in which non-obstetric surgery was carried out. We used logistic regression models to determine the adjusted relative risk and attributable risk of non-obstetric surgical procedures for adverse birth outcomes and the number needed to harm.ResultsWe identified 6,486,280 pregnancies, in 47,628 of which non-obstetric surgery was carried out. In comparison with pregnancies in which surgery was not carried out, we found that non-obstetric surgery was associated with a higher risk of adverse birth outcomes, although the attributable risk was generally low. We estimated that for every 287 pregnancies in which a surgical operation was carried out there was one additional stillbirth; for every 31 operations there was one additional preterm delivery; for every 25 operations there was one additional caesarean section; for every 50 operations there was one additional long inpatient stay; and for every 39 operations there was one additional low-birthweight baby.LimitationsWe have no means of disentangling the effect of the surgery from the effect of the underlying condition itself. Many spontaneous abortions will not be associated with a hospital admission and, therefore, will not be included in our analysis. A spontaneous abortion may be more likely to be reported if it occurs during the same hospital admission as the procedure, and this could account for the associated increased risk with surgery during pregnancy. There are missing values of key data items to determine parity, gestational age, birthweight and stillbirth.ConclusionsThis is the first study to report the risk of adverse birth outcomes following non-obstetric surgery during pregnancy across NHS hospitals in England. We have no means of disentangling the effect of the surgery from the effect of the underlying condition itself. Our observational study can never attribute a causal relationship between surgery and adverse birth outcomes, and we were unable to determine the risk of not undergoing surgery where surgery was clinically indicated. We have some reservations over associations of risk factors with spontaneous abortion because of potential ascertainment bias. However, we believe that our findings and, in particular, the numbers needed to harm improve on previous research, utilise a more recent and larger data set based on UK practices, and are useful reference points for any discussion of risk with prospective patients. The risk of adverse birth outcomes in pregnant women undergoing non-obstetric surgery is relatively low, confirming that surgical procedures during pregnancy are generally safe.Future workFurther evaluation of the association of non-obstetric surgery and spontaneous abortion. Evaluation of the impact of non-obstetric surgery on the newborn (e.g. neonatal intensive care unit admission, prolonged length of neonatal stay, neonatal death).FundingThe National Institute for Health Research Health Services and Delivery Research programme.
Collapse
Affiliation(s)
- Paul Aylin
- Dr Foster Unit at Imperial College London, Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Phillip Bennett
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Alex Bottle
- Dr Foster Unit at Imperial College London, Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Stephen Brett
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Vinnie Sodhi
- Imperial College Healthcare NHS Trust, London, UK
| | - Angus Rivers
- Imperial College Healthcare NHS Trust, London, UK
| | - Violeta Balinskaite
- Dr Foster Unit at Imperial College London, Department of Primary Care and Public Health, Imperial College London, London, UK
| |
Collapse
|
44
|
Laurent O, Hu J, Li L, Kleeman MJ, Bartell SM, Cockburn M, Escobedo L, Wu J. A Statewide Nested Case-Control Study of Preterm Birth and Air Pollution by Source and Composition: California, 2001-2008. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:1479-86. [PMID: 26895492 PMCID: PMC5010414 DOI: 10.1289/ehp.1510133] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 07/08/2015] [Accepted: 02/04/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND Preterm birth (PTB) has been associated with exposure to air pollution, but it is unclear whether effects might vary among air pollution sources and components. OBJECTIVES We studied the relationships between PTB and exposure to different components of air pollution, including gases and particulate matter (PM) by size fraction, chemical composition, and sources. METHODS Fine and ultrafine PM (respectively, PM2.5 and PM0.1) by source and composition were modeled across California over 2000-2008. Measured PM2.5, nitrogen dioxide, and ozone concentrations were spatially interpolated using empirical Bayesian kriging. Primary traffic emissions at fine scale were modeled using CALINE4 and traffic indices. Data on maternal characteristics, pregnancies, and birth outcomes were obtained from birth certificates. Associations between PTB (n = 442,314) and air pollution exposures defined according to the maternal residence at birth were examined using a nested matched case-control approach. Analyses were adjusted for maternal age, race/ethnicity, education and neighborhood income. RESULTS Adjusted odds ratios for PTB in association with interquartile range (IQR) increases in average exposure during pregnancy were 1.133 (95% CI: 1.118, 1.148) for total PM2.5, 1.096 (95% CI: 1.085, 1.108) for ozone, and 1.079 (95% CI: 1.065, 1.093) for nitrogen dioxide. For primary PM, the strongest associations per IQR by source were estimated for onroad gasoline (9-11% increase), followed by onroad diesel (6-8%) and commercial meat cooking (4-7%). For PM2.5 composition, the strongest positive associations per IQR were estimated for nitrate, ammonium, and secondary organic aerosols (11-14%), followed by elemental and organic carbon (2-4%). Associations with local traffic emissions were positive only when analyses were restricted to births with residences geocoded at the tax parcel level. CONCLUSIONS In our statewide nested case-control study population, exposures to both primary and secondary pollutants were associated with an increase in PTB. CITATION Laurent O, Hu J, Li L, Kleeman MJ, Bartell SM, Cockburn M, Escobedo L, Wu J. 2016. A statewide nested case-control study of preterm birth and air pollution by source and composition: California, 2001-2008. Environ Health Perspect 124:1479-1486; http://dx.doi.org/10.1289/ehp.1510133.
Collapse
Affiliation(s)
- Olivier Laurent
- Program in Public Health, University of California, Irvine, Irvine, California, USA
| | - Jianlin Hu
- Department of Civil and Environmental Engineering, University of California, Davis, Davis, California, USA
- School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, Nanjing, Jiangsu, China
| | - Lianfa Li
- Program in Public Health, University of California, Irvine, Irvine, California, USA
| | - Michael J. Kleeman
- Department of Civil and Environmental Engineering, University of California, Davis, Davis, California, USA
| | - Scott M. Bartell
- Program in Public Health, University of California, Irvine, Irvine, California, USA
- Department of Statistics, University of California, Irvine, Irvine, California, USA
| | - Myles Cockburn
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Loraine Escobedo
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Jun Wu
- Program in Public Health, University of California, Irvine, Irvine, California, USA
- Address correspondence to J. Wu, Anteater Instruction & Research Building, Room 2034, 653 East Peltason Dr., University of California, Irvine, Irvine, CA 92697-3957 USA. Telephone: (949) 824-0548. E-mail:
| |
Collapse
|
45
|
Mendola P, Wallace M, Hwang BS, Liu D, Robledo C, Männistö T, Sundaram R, Sherman S, Ying Q, Grantz KL. Preterm birth and air pollution: Critical windows of exposure for women with asthma. J Allergy Clin Immunol 2016; 138:432-440.e5. [PMID: 26944405 PMCID: PMC4975980 DOI: 10.1016/j.jaci.2015.12.1309] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 11/13/2015] [Accepted: 12/01/2015] [Indexed: 01/16/2023]
Abstract
BACKGROUND Ambient air pollutants may increase preterm birth (PTB) risk, but critical exposure windows are uncertain. The interaction of asthma and pollutant exposure is rarely studied. OBJECTIVE We sought to assess the interaction of maternal asthma and air pollutant exposures in relation to PTB risk. METHODS Electronic medical records for 223,502 US deliveries were linked with modified Community Multiscale Air Quality model outputs. Logistic regression with generalized estimating equations estimated the odds ratio and 95% CIs for PTB on the basis of the interaction of maternal asthma and particulate matter with aerodynamic diameter of less than 2.5 microns and particulate matter with aerodynamic diameter of less than 10 microns, ozone (O3), nitrogen oxides (NOx), sulfur dioxide (SO2), and carbon monoxide (CO) per interquartile range. For each gestational week 23 to 36, exposures among women who delivered were compared with those remaining pregnant. Three-month preconception, whole pregnancy, weeks 1 to 28, and the last 6 weeks of gestation averages were also evaluated. RESULTS On assessing PTB by gestational week, we found that significant asthma interactions were sporadic before 30 weeks but more common during weeks 34 to 36, with higher risk among mothers with asthma for NOx, CO, and SO2 exposure and an inverse association with O3 in week 34. Odds of PTB were significantly higher among women with asthma for CO and NOx exposure preconception and early in pregnancy. In the last 6 weeks of pregnancy, PTB risk associated with particulate matter with aerodynamic diameter of less than 10 microns was higher among women with asthma. CONCLUSIONS Mothers with asthma may experience a higher risk for PTB after exposure to traffic-related pollutants such as CO and NOx, particularly for exposures 3-months preconception and in the early weeks of pregnancy.
Collapse
Affiliation(s)
- Pauline Mendola
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Md.
| | - Maeve Wallace
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Md
| | - Beom Seuk Hwang
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Md
| | - Danping Liu
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Md
| | - Candace Robledo
- Department of Behavioral and Community Health, University of North Texas Health Science Center, Fort Worth, Tex
| | - Tuija Männistö
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu, Finland; Northern Finland Laboratory Centre Nordlab, Oulu, Finland; Department of Clinical Chemistry, University of Oulu, Oulu, Finland
| | - Rajeshwari Sundaram
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Md
| | | | - Qi Ying
- Zachary Department of Civil Engineering, Texas A&M University, College Station, Tex
| | - Katherine L Grantz
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Md
| |
Collapse
|
46
|
Mendola P, Wallace M, Liu D, Robledo C, Mӓnnistӧ T, Grantz KL. Air pollution exposure and preeclampsia among US women with and without asthma. ENVIRONMENTAL RESEARCH 2016; 148:248-255. [PMID: 27085496 PMCID: PMC4874861 DOI: 10.1016/j.envres.2016.04.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 04/01/2016] [Accepted: 04/02/2016] [Indexed: 05/05/2023]
Abstract
Maternal asthma and air pollutants have been independently associated with preeclampsia but rarely studied together. Our objective was to comprehensively evaluate preeclampsia risk based on the interaction of maternal asthma and air pollutants. Preeclampsia and asthma diagnoses, demographic and clinical data came from electronic medical records for 210,508 singleton deliveries. Modified Community Multiscale Air Quality models estimated preconception, first and second trimester and whole pregnancy exposure to: particulate matter (PM)<2.5 and <10µm, ozone, nitrogen oxides (NOx), sulfur dioxide (SO2) and carbon monoxide (CO); PM2.5 constituents; volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs). Asthma-pollutant interaction adjusted relative risks (RR) and 95% confidence intervals (CI) for preeclampsia were calculated by interquartile range for criteria pollutants and high exposure (≥75th percentile) for PAHs and VOCs. Asthmatics had higher risk associated with first trimester NOx and SO2 and whole pregnancy elemental carbon (EC) exposure than non-asthmatics, but only EC significantly increased risk (RR=1.11, CI:1.03-1.21). Asthmatics also had a 10% increased risk associated with second trimester CO. Significant interactions were observed for nearly all VOCs and asthmatics had higher risk during all time windows for benzene, ethylbenzene, m-xylene, o-xylene, p-xylene and toluene while most PAHs did not increase risk.
Collapse
Affiliation(s)
- Pauline Mendola
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20852, United States.
| | - Maeve Wallace
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20852, United States
| | - Danping Liu
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Biostatistics and Bioinformatics Branch, Rockville, MD 20852, United States
| | - Candace Robledo
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20852, United States
| | - Tuija Mӓnnistӧ
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20852, United States; Northern Finland Laboratory Centre NordLab, Oulu, Finland; Department of Clinical Chemistry, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 500, 90029 OYS, Finland; Department of Chronic Disease Prevention, National Institute for Health and Welfare, PO Box 310, 90101 Oulu, Finland
| | - Katherine L Grantz
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20852, United States
| |
Collapse
|
47
|
Savitz DA, Elston B, Bobb JF, Clougherty JE, Dominici F, Ito K, Johnson S, McAlexander T, Ross Z, Shmool JLC, Matte TD, Wellenius GA. Ambient Fine Particulate Matter, Nitrogen Dioxide, and Hypertensive Disorders of Pregnancy in New York City. Epidemiology 2016; 26:748-57. [PMID: 26237745 DOI: 10.1097/ede.0000000000000349] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Previous studies suggested a possible association between fine particulate matter air pollution (PM2.5) and nitrogen dioxide (NO2) and the development of hypertensive disorders of pregnancy, but effect sizes have been small and methodologic weaknesses preclude firm conclusions. METHODS We linked birth certificates in New York City in 2008-2010 to hospital discharge diagnoses and estimated air pollution exposure based on maternal address. The New York City Community Air Survey provided refined estimates of PM2.5 and NO2 at the maternal residence. We estimated the association between exposures to PM2.5 and NO2 in the first and second trimester and risk of gestational hypertension, mild preeclampsia, and severe preeclampsia among 268,601 births. RESULTS In unadjusted analyses, we found evidence of a positive association between both pollutants and gestational hypertension. However, after adjustment for individual covariates, socioeconomic deprivation, and delivery hospital, we did not find evidence of an association between PM2.5 or NO2 in the first or second trimester and any of the outcomes. CONCLUSIONS Our data did not provide clear evidence of an effect of ambient air pollution on hypertensive disorders of pregnancy. Results need to be interpreted with caution considering the quality of the available exposure and health outcome measures and the uncertain impact of adjusting for hospital. Relative to previous studies, which have tended to identify positive associations with PM2.5 and NO2, our large study size, refined air pollution exposure estimates, hospital-based disease ascertainment, and little risk of confounding by socioeconomic deprivation, does not provide evidence for an association.
Collapse
Affiliation(s)
- David A Savitz
- From the aDepartments of Epidemiology and Obstetrics and Gynecology, Brown University, Providence, RI; bDepartment of Epidemiology, Brown University, Providence, RI; cDepartment of Biostatistics, Harvard School of Public Health, Boston, MA; dDepartment of Occupational and Environmental Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; eNew York City Department of Health and Mental Hygiene, New York, NY; and f ZevRoss Spatial Analysis, Ithaca, NY
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Symanski E, McHugh MK, Zhang X, Craft ES, Lai D. Evaluating narrow windows of maternal exposure to ozone and preterm birth in a large urban area in Southeast Texas. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:167-172. [PMID: 25944700 DOI: 10.1038/jes.2015.32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 03/05/2015] [Indexed: 06/04/2023]
Abstract
The association between O3 exposure and preterm birth (PTB) remains unclear. We evaluated associations for three categories of PTB and O3 in Harris County, Texas, during narrow periods of gestation. We computed two sets of exposure metrics during every 4 weeks of pregnancy for 152,214 mothers who delivered singleton, live-born infants in 2005-2007, accounting first for temporal variability and then for temporal and spatial sources of variability in ambient O3 levels. Associations were assessed using multiple logistic regression. We also examined the potential for a fixed cohort bias. In the bias-corrected cohort where associations were somewhat stronger, elevated odds ratios (ORs) per 10 parts per billion increase in O3 exposure (county-level metric) were detected for the fifth (OR=1.08, 95% confidence interval (CI): 1.04-1.12), sixth (OR=1.05, 95% CI=1.01-1.09), and seventh (OR=1.07, 95% CI=1.03-1.10) 4-week periods of pregnancy for late PTB (33-36 completed weeks gestation), the fifth (OR=1.13, 95% CI=1.02-1.25) and seventh (OR=1.15, 95% CI=1.04-1.27) 4-week periods of pregnancy for moderate PTB (29-32 completed weeks gestation), and the fifth (OR=1.21, 95% CI=1.08-1.36) 4-week period of pregnancy for severe PTB (20-28 completed weeks gestation). Conversely, decreased odds were found in the first 4-week period of pregnancy for severe PTB (OR=0.83, 95% CI=0.74-0.94). Associations were slightly attenuated using the spatially interpolated (kriged) metrics, and for women who did not work outside of the home. Our analyses confirm reports in other parts of the United States and elsewhere with findings that suggest that maternal exposure to ambient levels of O3 is associated with PTB.
Collapse
Affiliation(s)
- Elaine Symanski
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Michelle K McHugh
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Xuan Zhang
- Department of Biostatistics, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Elena S Craft
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
- Environmental Defense Fund, Austin, TX, USA
| | - Dejian Lai
- Department of Biostatistics, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| |
Collapse
|
49
|
Kumarathasan P, Vincent R, Bielecki A, Blais E, Blank K, Das D, Karthikeyan S, Cakmak S, Fisher M, Arbuckle T, Fraser W. Infant birth weight and third trimester maternal plasma markers of vascular integrity: the MIREC study. Biomarkers 2016; 21:257-66. [PMID: 26900787 PMCID: PMC4841026 DOI: 10.3109/1354750x.2015.1134663] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: There is paucity of information on mechanisms constituting adverse birth outcomes. We assessed here the relationship between vascular integrity and adverse birth effects. Methods and results: Third trimester maternal plasma (n = 144) from the Maternal-Infant Research on Environmental Chemicals Study (MIREC) was analysed for vascular, inflammatory and oxidative stress markers by HPLC-fluorescence, protein array and EIA method. Analysis of the <25th and >75th percentile birth weight subgroups revealed markers associated with birth weight (ETs, MMP-9, VEGF, and 8-isoPGF-2α) and gestational age (ET-1, MMP-2, and VEGF). Conclusions: Mechanistic insights into adverse birth outcome pathways can be achieved by integrating information on multiple biomarkers, physiology using systems biology approach.
Collapse
Affiliation(s)
- Premkumari Kumarathasan
- a Analytical Biochemistry and Proteomics Laboratory, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada , Ottawa , ON , Canada
| | - Renaud Vincent
- b Inhalation Toxicology Laboratory, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada , Ottawa , ON , Canada
| | - Agnieszka Bielecki
- a Analytical Biochemistry and Proteomics Laboratory, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada , Ottawa , ON , Canada
| | - Erica Blais
- a Analytical Biochemistry and Proteomics Laboratory, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada , Ottawa , ON , Canada
| | - Katrin Blank
- a Analytical Biochemistry and Proteomics Laboratory, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada , Ottawa , ON , Canada
| | - Dharani Das
- a Analytical Biochemistry and Proteomics Laboratory, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada , Ottawa , ON , Canada
| | - Subramanian Karthikeyan
- b Inhalation Toxicology Laboratory, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada , Ottawa , ON , Canada
| | - Sabit Cakmak
- c Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada , Ottawa , ON , Canada , and
| | - Mandy Fisher
- c Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada , Ottawa , ON , Canada , and
| | - Tye Arbuckle
- c Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada , Ottawa , ON , Canada , and
| | - William Fraser
- d Department of Obstetrics and Gynecology , University of Sherbrooke , Sherbrooke , QC , Canada
| |
Collapse
|
50
|
Wu J, Laurent O, Li L, Hu J, Kleeman M. Adverse Reproductive Health Outcomes and Exposure to Gaseous and Particulate-Matter Air Pollution in Pregnant Women. Res Rep Health Eff Inst 2016; 2016:1-58. [PMID: 29659239 PMCID: PMC7266373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Introduction There is growing epidemiologic evidence of associations between maternal exposure to ambient air pollution and adverse birth outcomes, such as preterm birth (PTB). Recently, a few studies have also reported that exposure to ambient air pollution may also increase the risk of some common pregnancy complications, such as preeclampsia and gestational diabetes mellitus (GDM). Research findings, however, have been mixed. These inconsistent results could reflect genuine differences in the study populations, the study locations, the specific pollutants considered, the designs of the study, its methods of analysis, or random variation. Dr. Jun Wu of the University of California– Irvine, a recipient of HEI’s Walter A. Rosenblith New Investigator Award, and colleagues have examined the association between air pollution and adverse birth and pregnancy outcomes in California women. In addition, they examined the effect modification by socioeconomic status (SES) and other factors. Approach A retrospective nested case–control study was conducted using birth certificate data from about 4.4 million birth records in California from 2001 to 2008. Wu and colleagues analyzed data on low birth weight (LBW) at term (infants born between 37 and 43 weeks of gestation and weighing less than 2500 g), PTB (infants born before 37 weeks of gestation), and preeclampsia (including eclampsia) of the mother during the pregnancy. In addition, they obtained data on GDM for the years 2006– 2008. In the analyses, all outcomes were included as binary variables. Maternal residential addresses at the time of delivery were geocoded, and a large suite of air pollution exposure metrics was considered, such as (1) regulatory monitoring data on concentrations of criteria pollutants NO2, PM2.5 (particulate matter ≤ 2.5 μm in aerodynamic diameter), and ozone (O3) estimated by empirical Bayesian kriging; (2) concentrations of primary and secondary PM2.5 and PM0.1 components and sources estimated by the University of California–Davis Chemical Transport Model; (3) traffic-related ultrafine particles and concentrations of carbon monoxide (CO) and nitrogen oxides (NOx) estimated by a modified CALINE4 air pollution dispersion model; and (4) proximity to busy roads, road length, and traffic density calculated for different buffer sizes using geographic information system tools. In total, 50 different exposure metrics were available for the analyses. The exposure of primary interest was the mean of the entire pregnancy period for each mother. For the health analyses, controls were randomly selected from the source population. PTB controls were matched on conception year. Term LBW, preeclampsia, and GDM were analyzed using generalized additive mixed models with inclusion of a random effect per hospital. PTB analyses were conducted using conditional logistic regression, with no adjustment for hospital. The main results— adjusted for race and education as categorical variables and adjusted for maternal age and median household income at the census-block level—were derived from single-pollutant models. Main results and interpretation In its independent review of the study, the HEI Health Review Committee concluded that Wu and colleagues had conducted a comprehensive nested case–control study of air pollution and adverse birth and pregnancy outcomes. The very large data set and the extensive exposure assessment were strengths of the study. The study documented associations between increases in various air pollution metrics and increased risks of PTB, whereas the evidence was weaker overall for term LBW; in addition, decreases in many air pollution metrics were associated with an increased risk of preeclampsia and GDM, an unexpected result. The investigators suggested that underreporting in the registry data, especially in lower-SES groups, might have caused the many negative associations found for preeclampsia and GDM. In addition, poor geocoding was listed as a potential explanation, affecting in particular the results that were based on measures of proximity to busy roads and traffic density in the smallest buffer size (50 m). However, those issues were not fully explored. In general, the Committee thought that the analysis of road traffic indicators in the 50 m buffer was hampered by the lack of contrast and that the results are therefore difficult to interpret. Some other issues with the analytical approaches should be considered when interpreting the results. Only a subset of controls was used, to reduce computational demands. Hence, some models did not converge, especially in the subgroup analyses. Most of the results in the report were based on analyses using single-pollutant models, which is a reasonable approach but ignores that people are exposed to complex mixtures of pollutants. The Committee believed that the few two-pollutant models that were run provided important insights: these models showed the strongest association for PM2.5 mass, whereas components and source-specific positive associations largely disappeared after adjusting for PM2.5 mass. This study adds to the ongoing debate about whether some particle components and sources are of greater public health concern than others.
Collapse
|