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Costello JM, Steurer MA, Baer RJ, Witte JS, Jelliffe-Pawlowski LL. Residential particulate matter, proximity to major roads, traffic density and traffic volume as risk factors for preterm birth in California. Paediatr Perinat Epidemiol 2022; 36:70-79. [PMID: 34797570 DOI: 10.1111/ppe.12820] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND While pollution from vehicle sources is an established risk factor for preterm birth, it is unclear whether distance of residence to the nearest major road or related measures like major road density represent useful measures for characterising risk. OBJECTIVE To determine whether major road proximity measures (including distance to major road, major road density and traffic volume) are more useful risk factors for preterm birth than other established vehicle-related measures (including particulate matter <2.5 μm in diameter (PM2.5 ) and diesel particulate matter (diesel PM)). METHODS This retrospective cohort study included 2.7 million births across the state of California from 2011-2017; each address at delivery was geocoded. Geocoding was used to calculate distance to the nearest major road, major road density within a 500 m radius and major road density weighted by truck volume. We measured associations with preterm birth using risk ratios adjusted for target demographic, clinical, socioeconomic and environmental covariates (aRRs). We compared these to the associations between preterm birth and PM2.5 and diesel PM by census tract of residence. RESULTS Findings showed that whereas higher mean levels of PM2.5 and diesel PM by census tract were associated with a higher risk of preterm birth, living closer to roads or living in higher traffic density areas was not associated with higher risk. Residence in a census tract with a mean PM2.5 in the top quartile compared with the lowest quartile was associated with the highest observed risk of preterm birth (aRR 1.04, 95% CI 1.04, 1.05). CONCLUSIONS Over a large geographical region with a diverse population, PM2.5 and diesel PM were associated with preterm birth, while measures of distance to major road were not, suggesting that these distance measures do not serve as a proxy for measures of particulate matter in the context of preterm birth.
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Affiliation(s)
- Jean M Costello
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA.,Program in Biological and Medical Informatics, University of California San Francisco, San Francisco, CA, USA
| | - Martina A Steurer
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA.,Department of Paediatrics, University of California San Francisco, San Francisco, CA, USA.,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Rebecca J Baer
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA.,Department of Paediatrics, University of California San Diego, San Francisco, CA, USA
| | - John S Witte
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.,Department of Epidemiology & Population Health, Stanford University, Stanford, CA, USA.,Department of Biology, Stanford University, Stanford, CA, USA
| | - Laura L Jelliffe-Pawlowski
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA.,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
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Using a Clustering Approach to Investigate Socio-Environmental Inequality in Preterm Birth-A Study Conducted at Fine Spatial Scale in Paris (France). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091895. [PMID: 30200368 PMCID: PMC6163167 DOI: 10.3390/ijerph15091895] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/23/2018] [Accepted: 08/29/2018] [Indexed: 12/13/2022]
Abstract
Background & Objectives: Today, to support public policies aiming to tackle environmental and health inequality, identification and monitoring of the spatial pattern of adverse birth outcomes are crucial. Spatial identification of the more vulnerable population to air pollution may orient health interventions. In this context, the objective of this study is to investigate the geographical distribution of the risk of preterm birth (PTB, gestational age ≤36 weeks) at the census block level in in city of Paris, France. We also aimed to assess the implication of neighborhood characteristics including air pollution and socio-economic deprivation. Material & Methods: Newborn health data are available from the first birth certificate registered by the Maternal and Child Care department of Paris. All PTB from January 2008 to December 2011 were geocoded at the mother residential census block. Each census block was assigned a socioeconomic deprivation level and annual average ambient concentrations of NO2. A spatial clustering approach was used to investigate the spatial distribution of PTB. Results: Our results highlight that PTB is non-randomly spatially distributed, with a cluster of high risk in the northeastern area of Paris (RR = 1.15; p = 0.06). After adjustment for socio-economic deprivation and NO2 concentrations, this cluster becomes not statistically significant or shifts suggesting that these characteristics explain the spatial distribution of PTB; further, their combination shows an interaction in comparison with SES or NO2 levels alone. Conclusions: Our results may inform the decision makers about the areas where public health efforts should be strengthened to tackle the risk of PTB and to choose the most appropriate and specific community-oriented health interventions.
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Nansook P, Naidoo RN, Ramkaran P, Phulukdaree A, Muttoo S, Asharam K, Chuturgoon AA. IL-1β haplotype influences the effect of NO x exposure on gestational age in the South African MACE birth cohort. Hum Exp Toxicol 2017; 37:679-689. [PMID: 28875725 DOI: 10.1177/0960327117728386] [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: 11/16/2022]
Abstract
OBJECTIVE Cytokines, molecules within the immune system that affect either a pro- or anti-inflammatory response, have previously been shown to influence birth outcomes. The maternal cytokine gene-environment interactions are thought to alter their expression, potentially influencing susceptibility to adverse birth outcomes. The aim of this study was to determine the association between the maternal interleukin-1β (IL-1β) haplotype and expression variation with oxides of nitrogen (NOx) levels, and thereafter investigate the IL-1β haplotype-specific effects of NOx exposure levels, IL-1β mRNA expression and other variables on gestational age. MATERIAL AND METHODS Using the prospective Mother and Child in the Environment (MACE) birth cohort in Durban, South Africa, 335 participants were genotyped for the IL-1β haplotype. Previous studies showed that three single nucleotide polymorphisms (SNPs), IL-1β-1464G/C, -511C/T and -31C/T, constitute the IL-1β functional haplotype. These SNPs were genotyped using a restriction fragment length polymorphism assay, while IL-1β mRNA expression was measured using a quantitative real-time polymerase chain reaction assay. Individual estimates of NOx exposure were obtained by land use regression modelling. A multivariate linear regression analysis was employed to test for significant effects on gestational age. RESULTS IL-1β mRNA expression was found to possess a haplotype-dependent effect ( p = 0.0001) and its expression levels positively correlated with NOx levels ( r = 0.34; p = 0.006). In the high haplotype model, a unit increase in NOx exposure level was associated with a decrease in gestational age by 1 week ( p = 0.02). Furthermore, gestational age decreased by 0.9 weeks for every unit increase of IL-1β mRNA expression level ( p = 0.025). HIV-1 positivity was associated with a 0.2-week decrease in gestational age ( p = 0.035) in the intermediate haplotype model and a 0.4-week decrease in the high haplotype model ( p = 0.044). CONCLUSION These data have implications for better understanding the effect of prenatal NOx exposure on gestational age and demonstrate the role of the IL-1β haplotype in modulating the effects of NOx exposure.
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Affiliation(s)
- P Nansook
- 1 Discipline of Medical Biochemistry, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - R N Naidoo
- 2 Department of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - P Ramkaran
- 1 Discipline of Medical Biochemistry, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - A Phulukdaree
- 1 Discipline of Medical Biochemistry, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - S Muttoo
- 2 Department of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - K Asharam
- 2 Department of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - A A Chuturgoon
- 1 Discipline of Medical Biochemistry, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
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Padula AM, Mortimer KM, Tager IB, Hammond SK, Lurmann FW, Yang W, Stevenson DK, Shaw GM. Traffic-related air pollution and risk of preterm birth in the San Joaquin Valley of California. Ann Epidemiol 2015; 24:888-95e4. [PMID: 25453347 DOI: 10.1016/j.annepidem.2014.10.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 09/22/2014] [Accepted: 10/10/2014] [Indexed: 01/27/2023]
Abstract
PURPOSE To evaluate associations between traffic-related air pollution during pregnancy and preterm birth in births in four counties in California during years 2000 to 2006. METHODS We used logistic regression to examine the association between the highest quartile of ambient air pollutants (carbon monoxide, nitrogen dioxide, particulate matter <10 and 2.5 μm) and traffic density during pregnancy and each of five levels of prematurity based on gestational age at birth (20-23, 24-27, 28-31, 32-33, and 34-36 weeks) versus term (37-42 weeks). We examined trimester averages and the last month and the last 6 weeks of pregnancy. Models were adjusted for birthweight, maternal age, race/ethnicity, education, prenatal care, and birth costs payment. Neighborhood socioeconomic status (SES) was evaluated as a potential effect modifier. RESULTS There were increased odds ratios (ORs) for early preterm birth for those exposed to the highest quartile of each pollutant during the second trimester and the end of pregnancy (adjusted OR, 1.4-2.8). Associations were stronger among mothers living in low SES neighborhoods (adjusted OR, 2.1-4.3). We observed exposure-response associations for multiple pollutant exposures and early preterm birth. Inverse associations during the first trimester were observed. CONCLUSIONS The results confirm associations between traffic-related air pollution and prematurity, particularly among very early preterm births and low SES neighborhoods.
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Bijnens E, Zeegers MP, Gielen M, Kicinski M, Hageman GJ, Pachen D, Derom C, Vlietinck R, Nawrot TS. Lower placental telomere length may be attributed to maternal residential traffic exposure; a twin study. ENVIRONMENT INTERNATIONAL 2015; 79:1-7. [PMID: 25756235 DOI: 10.1016/j.envint.2015.02.008] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 01/09/2015] [Accepted: 02/13/2015] [Indexed: 05/03/2023]
Abstract
BACKGROUND High variation in telomere length between individuals is already present before birth and is as wide among newborns as in adults. Environmental exposures likely have an impact on this observation, but remain largely unidentified. We hypothesize that placental telomere length in twins is associated with residential traffic exposure, an important environmental source of free radicals that might accelerate aging. Next, we intend to unravel the nature-nurture contribution to placental telomere length by estimating the heritability of placental telomere length. METHODS We measured the telomere length in placental tissues of 211 twins in the East Flanders Prospective Twin Survey. Maternal traffic exposure was determined using a geographic information system. Additionally, we estimated the relative importance of genetic and environmental sources of variance. RESULTS In this twin study, a variation in telomere length in the placental tissue was mainly determined by the common environment. Maternal residential proximity to a major road was associated with placental telomere length: a doubling in the distance to the nearest major road was associated with a 5.32% (95% CI: 1.90 to 8.86%; p=0.003) longer placental telomere length at birth. In addition, an interquartile increase (22%) in maternal residential surrounding greenness (5 km buffer) was associated with an increase of 3.62% (95% CI: 0.20 to 7.15%; p=0.04) in placental telomere length. CONCLUSIONS In conclusion, we showed that maternal residential proximity to traffic and lower residential surrounding greenness is associated with shorter placental telomere length at birth. This may explain a significant proportion of air pollution-related adverse health outcomes starting from early life, since shortened telomeres accelerate the progression of many diseases.
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Affiliation(s)
- Esmée Bijnens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; Department of Complex Genetics, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Maurice P Zeegers
- Department of Complex Genetics, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Marij Gielen
- Department of Complex Genetics, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Michal Kicinski
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Geja J Hageman
- Department of Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Daniëlle Pachen
- Department of Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Catherine Derom
- Centre of Human Genetics, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Robert Vlietinck
- Centre of Human Genetics, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; Department of Public Health, Leuven University (KU Leuven), Kapucijnenvoer 35, 3000 Leuven, Belgium.
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Edwards S, Maxson P, Sandberg N, Miranda ML. Air Pollution and Pregnancy Outcomes. MOLECULAR AND INTEGRATIVE TOXICOLOGY 2015. [DOI: 10.1007/978-1-4471-6669-6_3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Maternal residential proximity to major roads in north west England and adverse pregnancy outcomes. J Occup Environ Med 2014; 55:1329-36. [PMID: 24164770 DOI: 10.1097/jom.0b013e3182a3bb41] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To investigate the effects of maternal residential proximity to major roads on adverse pregnancy outcomes. METHODS Major road networks in North West England were linked to the maternal residence of 190,909 births (2004 to 2008). Distance between the residence and the nearest major road was calculated and dichotomized at 200 m. Logistic regression analyses were performed to investigate the association between distance to the major road with small for gestational age, low birth weight, and preterm birth. Analyses were adjusted for maternal age, ethnicity, socioeconomic status, parity, birth season, smoking, and body mass index. RESULTS No significant associations were observed between preterm birth (odds ratio [OR] = 1.04; 95% confidence interval [CI] = 0.98 to 1.11), low birth weight (OR = 0.99; 95% CI = 0.93 to 1.05) and small for gestational age (OR = 1.00; 95% CI = 0.95 to 1.06) and living less than 200 m from a major road. CONCLUSIONS These results, from a study with high statistical power, suggest that living less than 200 m from a major road per se does not pose any great risk of an adverse perinatal outcome. Nevertheless, it may be limited to this geographic location. Further work is needed to quantify individual pollutant effects in pregnancy.
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Amegah AK, Jaakkola JJ. Work as a street vendor, associated traffic-related air pollution exposures and risk of adverse pregnancy outcomes in Accra, Ghana. Int J Hyg Environ Health 2014; 217:354-62. [DOI: 10.1016/j.ijheh.2013.07.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 06/30/2013] [Accepted: 07/20/2013] [Indexed: 10/26/2022]
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Wu J, Jiang C, Jaimes G, Bartell S, Dang A, Baker D, Delfino RJ. Travel patterns during pregnancy: comparison between Global Positioning System (GPS) tracking and questionnaire data. Environ Health 2013; 12:86. [PMID: 24107241 PMCID: PMC3907015 DOI: 10.1186/1476-069x-12-86] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Accepted: 09/30/2013] [Indexed: 05/06/2023]
Abstract
BACKGROUND Maternal exposures to traffic-related air pollution have been associated with adverse pregnancy outcomes. Exposures to traffic-related air pollutants are strongly influenced by time spent near traffic. However, little is known about women's travel activities during pregnancy and whether questionnaire-based data can provide reliable information on travel patterns during pregnancy. OBJECTIVES Examine women's in-vehicle travel behavior during pregnancy and examine the difference in travel data collected by questionnaire and global positioning system (GPS) and their potential for exposure error. METHODS We measured work-related travel patterns in 56 pregnant women using a questionnaire and one-week GPS tracking three times during pregnancy (<20 weeks, 20-30 weeks, and >30 weeks of gestation). We compared self-reported activities with GPS-derived trip distance and duration, and examined potentially influential factors that may contribute to differences. We also described in-vehicle travel behavior by pregnancy periods and influences of demographic and personal factors on daily travel times. Finally, we estimated personal exposure to particle-bound polycyclic aromatic hydrocarbon (PB-PAH) and examined the magnitude of exposure misclassification using self-reported vs. GPS travel data. RESULTS Subjects overestimated both trip duration and trip distance compared to the GPS data. We observed moderately high correlations between self-reported and GPS-recorded travel distance (home to work trips: r = 0.88; work to home trips: r = 0.80). Better agreement was observed between the GPS and the self-reported travel time for home to work trips (r = 0.77) than work to home trips (r = 0.64). The subjects on average spent 69 and 93 minutes traveling in vehicles daily based on the GPS and self-reported data, respectively. Longer daily travel time was observed among participants in early pregnancy, and during certain pregnancy periods in women with higher education attainment, higher income, and no children. When comparing self-reported vs. GPS data, we found that estimated personal exposure to PB-PAH did not differ remarkably at the population level, but the difference was large at an individual level. CONCLUSION Self-reported home-to-work data overestimated both trip duration and trip distance compared to GPS data. Significant differences in PAH exposure estimates were observed at individual level using self-reported vs. GPS data, which has important implications in air pollution epidemiological studies.
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Affiliation(s)
- Jun Wu
- Program in Public Health, College of Health Sciences, University of California, Irvine, CA, USA
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Guillermo Jaimes
- Department of Environmental Science, Policy, & Management, University of California, Berkeley, CA, USA
| | - Scott Bartell
- Program in Public Health, College of Health Sciences, University of California, Irvine, CA, USA
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - Andy Dang
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - Dean Baker
- Center for Occupational & Environmental Health, University of California, Irvine, CA, USA
| | - Ralph J Delfino
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
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Miranda ML, Edwards SE, Chang HH, Auten RL. Proximity to roadways and pregnancy outcomes. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2013; 23:32-8. [PMID: 22805991 DOI: 10.1038/jes.2012.78] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 05/11/2012] [Indexed: 05/21/2023]
Abstract
Adverse birth outcomes are associated with exposure to air pollution during pregnancy. Road proximity is a simple, widely available metric for capturing local variation in exposure to traffic-related air pollution. We characterized maternal exposure to traffic-related air pollution during pregnancy using residential proximity to major roadways among 2004-2008 singleton births in NC. Controlling for maternal race, age, education, nativity, marital status, and tobacco use, and season of birth, parity, infant sex, and Census tract-level urbanization and income, we evaluated the association between road proximity and pregnancy outcomes using generalized linear mixed models with a random intercept for each Census tract. Birth weight, birth weight percentile for gestational age, gestational hypertension, and small-for-gestational age were not associated with road proximity; however, women residing within 250 m of a major roadway were at 3-5% increased odds of low birth weight, preterm birth, and late preterm birth compared with women residing beyond 250 m (P<0.05). Our analyses demonstrate an association between proximity to major roadways and pregnancy outcomes using a large sample. Road proximity may represent a relatively straightforward method for assessing maternal risk from exposure to traffic-related air pollution, with results offering guidance for studies that can more accurately characterize air pollution exposures.
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Affiliation(s)
- Marie Lynn Miranda
- Children's Environmental Health Initiative, School of Natural Resources and Environment, University of Michigan, Ann Arbor, Michigan 48109, USA.
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van den Hooven EH, Jaddoe VWV, de Kluizenaar Y, Hofman A, Mackenbach JP, Steegers EAP, Miedema HME, Pierik FH. Residential traffic exposure and pregnancy-related outcomes: a prospective birth cohort study. Environ Health 2009; 8:59. [PMID: 20028508 PMCID: PMC2811104 DOI: 10.1186/1476-069x-8-59] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Accepted: 12/22/2009] [Indexed: 05/16/2023]
Abstract
BACKGROUND The effects of ambient air pollution on pregnancy outcomes are under debate. Previous studies have used different air pollution exposure assessment methods. The considerable traffic-related intra-urban spatial variation needs to be considered in exposure assessment. Residential proximity to traffic is a proxy for traffic-related exposures that takes into account within-city contrasts. METHODS We investigated the association between residential proximity to traffic and various birth and pregnancy outcomes in 7,339 pregnant women and their children participating in a population-based cohort study. Residential proximity to traffic was defined as 1) distance-weighted traffic density in a 150 meter radius, and 2) proximity to a major road. We estimated associations of these exposures with birth weight, and with the risks of preterm birth and small size for gestational age at birth. Additionally, we examined associations with pregnancy-induced hypertension, (pre)eclampsia, and gestational diabetes. RESULTS There was considerable variation in distance-weighted traffic density. Almost fifteen percent of the participants lived within 50 m of a major road. Residential proximity to traffic was not associated with birth and pregnancy outcomes in the main analysis and in various sensitivity analyses. CONCLUSIONS Mothers exposed to residential traffic had no higher risk of adverse birth outcomes or pregnancy complications in this study. Future studies may be refined by taking both temporal and spatial variation in air pollution exposure into account.
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Affiliation(s)
- Edith H van den Hooven
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Environment and Health, Netherlands Organisation for Applied Scientific Research (TNO), Delft, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Vincent WV Jaddoe
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Paediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Yvonne de Kluizenaar
- Department of Environment and Health, Netherlands Organisation for Applied Scientific Research (TNO), Delft, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Johan P Mackenbach
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Eric AP Steegers
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Henk ME Miedema
- Department of Environment and Health, Netherlands Organisation for Applied Scientific Research (TNO), Delft, The Netherlands
| | - Frank H Pierik
- Department of Environment and Health, Netherlands Organisation for Applied Scientific Research (TNO), Delft, The Netherlands
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Wu J, Ren C, Delfino RJ, Chung J, Wilhelm M, Ritz B. Association between local traffic-generated air pollution and preeclampsia and preterm delivery in the south coast air basin of California. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:1773-9. [PMID: 20049131 PMCID: PMC2801174 DOI: 10.1289/ehp.0800334] [Citation(s) in RCA: 186] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2008] [Accepted: 06/23/2009] [Indexed: 04/14/2023]
Abstract
BACKGROUND Preeclampsia is a major complication of pregnancy that can lead to substantial maternal and perinatal morbidity, mortality, and preterm birth. Increasing evidence suggests that air pollution adversely affects pregnancy outcomes. Yet few studies have examined how local traffic-generated emissions affect preeclampsia in addition to preterm birth. OBJECTIVES We examined effects of residential exposure to local traffic-generated air pollution on preeclampsia and preterm delivery (PTD). METHODS We identified 81,186 singleton birth records from four hospitals (1997-2006) in Los Angeles and Orange Counties, California (USA). We used a line-source dispersion model (CALINE4) to estimate individual exposure to local traffic-generated nitrogen oxides (NO(x)) and particulate matter < 2.5 mum in aerodynamic diameter (PM(2.5)) across the entire pregnancy. We used logistic regression to estimate effects of air pollution exposures on preeclampsia, PTD (gestational age < 37 weeks), moderate PTD (MPTD; gestational age < 35 weeks), and very PTD (VPTD; gestational age < 30 weeks). RESULTS We observed elevated risks for preeclampsia and preterm birth from maternal exposure to local traffic-generated NO(x) and PM(2.5). The risk of preeclampsia increased 33% [odds ratio (OR) = 1.33; 95% confidence interval (CI), 1.18-1.49] and 42% (OR = 1.42; 95% CI, 1.26-1.59) for the highest NO(x) and PM(2.5) exposure quartiles, respectively. The risk of VPTD increased 128% (OR = 2.28; 95% CI, 2.15-2.42) and 81% (OR = 1.81; 95% CI, 1.71-1.92) for women in the highest NO(x) and PM(2.5) exposure quartiles, respectively. CONCLUSION Exposure to local traffic-generated air pollution during pregnancy increases the risk of preeclampsia and preterm birth in Southern California women. These results provide further evidence that air pollution is associated with adverse reproductive outcomes.
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Affiliation(s)
- Jun Wu
- Program in Public Health, College of Health Sciences, University of California, Irvine, California 92697-7555, USA.
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Miranda ML, Maxson P, Edwards S. Environmental contributions to disparities in pregnancy outcomes. Epidemiol Rev 2009; 31:67-83. [PMID: 19846592 DOI: 10.1093/epirev/mxp011] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
One of the most persistent disparities in American health status is the pronounced difference in birth outcomes between non-Hispanic black and non-Hispanic white women. Poor pregnancy outcomes have a substantial impact on mortality, morbidity, and health care costs. Increasing evidence indicates that environmental exposures are associated with poor birth outcomes. This paper reviews the latest research on how environmental exposures affect pregnancy outcomes and then discusses how these exposures may be embedded within a context of significant social and host factor stress. The analysis suggests that environmental, social, and host factors are cumulatively stressing non-Hispanic black women and that this cumulative stress may be a cause of the persistent disparities in pregnancy outcomes.
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Affiliation(s)
- Marie Lynn Miranda
- Nicholas School of the Environment, Duke University, A134-LSRC, Box 90328, Durham, NC 27708, USA.
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Frizzelle BG, Evenson KR, Rodriguez DA, Laraia BA. The importance of accurate road data for spatial applications in public health: customizing a road network. Int J Health Geogr 2009; 8:24. [PMID: 19409088 PMCID: PMC2685779 DOI: 10.1186/1476-072x-8-24] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Accepted: 05/01/2009] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Health researchers have increasingly adopted the use of geographic information systems (GIS) for analyzing environments in which people live and how those environments affect health. One aspect of this research that is often overlooked is the quality and detail of the road data and whether or not it is appropriate for the scale of analysis. Many readily available road datasets, both public domain and commercial, contain positional errors or generalizations that may not be compatible with highly accurate geospatial locations. This study examined the accuracy, completeness, and currency of four readily available public and commercial sources for road data (North Carolina Department of Transportation, StreetMap Pro, TIGER/Line 2000, TIGER/Line 2007) relative to a custom road dataset which we developed and used for comparison. METHODS AND RESULTS A custom road network dataset was developed to examine associations between health behaviors and the environment among pregnant and postpartum women living in central North Carolina in the United States. Three analytical measures were developed to assess the comparative accuracy and utility of four publicly and commercially available road datasets and the custom dataset in relation to participants' residential locations over three time periods. The exclusion of road segments and positional errors in the four comparison road datasets resulted in between 5.9% and 64.4% of respondents lying farther than 15.24 meters from their nearest road, the distance of the threshold set by the project to facilitate spatial analysis. Agreement, using a Pearson's correlation coefficient, between the customized road dataset and the four comparison road datasets ranged from 0.01 to 0.82. CONCLUSION This study demonstrates the importance of examining available road datasets and assessing their completeness, accuracy, and currency for their particular study area. This paper serves as an example for assessing the feasibility of readily available commercial or public road datasets, and outlines the steps by which an improved custom dataset for a study area can be developed.
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Affiliation(s)
- Brian G Frizzelle
- Carolina Population Center, CB# 8120, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Daniel A Rodriguez
- Department of City and Regional Planning, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Barbara A Laraia
- Department of Medicine, Division of Prevention Sciences, Center for Health and Community, University of California, San Francisco, California, USA
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Setton EM, Keller CP, Cloutier-Fisher D, Hystad PW. Spatial variations in estimated chronic exposure to traffic-related air pollution in working populations: a simulation. Int J Health Geogr 2008; 7:39. [PMID: 18638398 PMCID: PMC2515287 DOI: 10.1186/1476-072x-7-39] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Accepted: 07/18/2008] [Indexed: 11/10/2022] Open
Abstract
Background Chronic exposure to traffic-related air pollution is associated with a variety of health impacts in adults and recent studies show that exposure varies spatially, with some residents in a community more exposed than others. A spatial exposure simulation model (SESM) which incorporates six microenvironments (home indoor, work indoor, other indoor, outdoor, in-vehicle to work and in-vehicle other) is described and used to explore spatial variability in estimates of exposure to traffic-related nitrogen dioxide (not including indoor sources) for working people. The study models spatial variability in estimated exposure aggregated at the census tracts level for 382 census tracts in the Greater Vancouver Regional District of British Columbia, Canada. Summary statistics relating to the distributions of the estimated exposures are compared visually through mapping. Observed variations are explored through analyses of model inputs. Results Two sources of spatial variability in exposure to traffic-related nitrogen dioxide were identified. Median estimates of total exposure ranged from 8 μg/m3 to 35 μg/m3 of annual average hourly NO2 for workers in different census tracts in the study area. Exposure estimates are highest where ambient pollution levels are highest. This reflects the regional gradient of pollution in the study area and the relatively high percentage of time spent at home locations. However, for workers within the same census tract, variations were observed in the partial exposure estimates associated with time spent outside the residential census tract. Simulation modeling shows that some workers may have exposures 1.3 times higher than other workers residing in the same census tract because of time spent away from the residential census tract, and that time spent in work census tracts contributes most to the differences in exposure. Exposure estimates associated with the activity of commuting by vehicle to work were negligible, based on the relatively short amount of time spent in this microenvironment compared to other locations. We recognize that this may not be the case for pollutants other than NO2. These results represent the first time spatially disaggregated variations in exposure to traffic-related air pollution within a community have been estimated and reported. Conclusion The results suggest that while time spent in the home indoor microenvironment contributes most to between-census tract variation in estimates of annual average exposures to traffic-related NO2, time spent in the work indoor microenvironment contributes most to within-census tract variation, and time spent in transit by vehicle makes a negligible contribution. The SESM has potential as a policy evaluation tool, given input data that reflect changes in pollution levels or work flow patterns due to traffic demand management and land use development policy.
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Affiliation(s)
- Eleanor M Setton
- Geography Department, University of Victoria, PO Box 3050, STN CSC, Victoria, B,C,, V8P 3W5, Canada.
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Wigle DT, Arbuckle TE, Turner MC, Bérubé A, Yang Q, Liu S, Krewski D. Epidemiologic evidence of relationships between reproductive and child health outcomes and environmental chemical contaminants. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2008; 11:373-517. [PMID: 18074303 DOI: 10.1080/10937400801921320] [Citation(s) in RCA: 281] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
This review summarizes the level of epidemiologic evidence for relationships between prenatal and/or early life exposure to environmental chemical contaminants and fetal, child, and adult health. Discussion focuses on fetal loss, intrauterine growth restriction, preterm birth, birth defects, respiratory and other childhood diseases, neuropsychological deficits, premature or delayed sexual maturation, and certain adult cancers linked to fetal or childhood exposures. Environmental exposures considered here include chemical toxicants in air, water, soil/house dust and foods (including human breast milk), and consumer products. Reports reviewed here included original epidemiologic studies (with at least basic descriptions of methods and results), literature reviews, expert group reports, meta-analyses, and pooled analyses. Levels of evidence for causal relationships were categorized as sufficient, limited, or inadequate according to predefined criteria. There was sufficient epidemiological evidence for causal relationships between several adverse pregnancy or child health outcomes and prenatal or childhood exposure to environmental chemical contaminants. These included prenatal high-level methylmercury (CH(3)Hg) exposure (delayed developmental milestones and cognitive, motor, auditory, and visual deficits), high-level prenatal exposure to polychlorinated biphenyls (PCBs), polychlorinated dibenzofurans (PCDFs), and related toxicants (neonatal tooth abnormalities, cognitive and motor deficits), maternal active smoking (delayed conception, preterm birth, fetal growth deficit [FGD] and sudden infant death syndrome [SIDS]) and prenatal environmental tobacco smoke (ETS) exposure (preterm birth), low-level childhood lead exposure (cognitive deficits and renal tubular damage), high-level childhood CH(3)Hg exposure (visual deficits), high-level childhood exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) (chloracne), childhood ETS exposure (SIDS, new-onset asthma, increased asthma severity, lung and middle ear infections, and adult breast and lung cancer), childhood exposure to biomass smoke (lung infections), and childhood exposure to outdoor air pollutants (increased asthma severity). Evidence for some proven relationships came from investigation of relatively small numbers of children with high-dose prenatal or early childhood exposures, e.g., CH(3)Hg poisoning episodes in Japan and Iraq. In contrast, consensus on a causal relationship between incident asthma and ETS exposure came only recently after many studies and prolonged debate. There were many relationships supported by limited epidemiologic evidence, ranging from several studies with fairly consistent findings and evidence of dose-response relationships to those where 20 or more studies provided inconsistent or otherwise less than convincing evidence of an association. The latter included childhood cancer and parental or childhood exposures to pesticides. In most cases, relationships supported by inadequate epidemiologic evidence reflect scarcity of evidence as opposed to strong evidence of no effect. This summary points to three main needs: (1) Where relationships between child health and environmental exposures are supported by sufficient evidence of causal relationships, there is a need for (a) policies and programs to minimize population exposures and (b) population-based biomonitoring to track exposure levels, i.e., through ongoing or periodic surveys with measurements of contaminant levels in blood, urine and other samples. (2) For relationships supported by limited evidence, there is a need for targeted research and policy options ranging from ongoing evaluation of evidence to proactive actions. (3) There is a great need for population-based, multidisciplinary and collaborative research on the many relationships supported by inadequate evidence, as these represent major knowledge gaps. Expert groups faced with evaluating epidemiologic evidence of potential causal relationships repeatedly encounter problems in summarizing the available data. A major driver for undertaking such summaries is the need to compensate for the limited sample sizes of individual epidemiologic studies. Sample size limitations are major obstacles to exploration of prenatal, paternal, and childhood exposures during specific time windows, exposure intensity, exposure-exposure or exposure-gene interactions, and relatively rare health outcomes such as childhood cancer. Such research needs call for investments in research infrastructure, including human resources and methods development (standardized protocols, biomarker research, validated exposure metrics, reference analytic laboratories). These are needed to generate research findings that can be compared and subjected to pooled analyses aimed at knowledge synthesis.
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Affiliation(s)
- Donald T Wigle
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Ontario, Canada.
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Lee SJ, Hajat S, Steer PJ, Filippi V. A time-series analysis of any short-term effects of meteorological and air pollution factors on preterm births in London, UK. ENVIRONMENTAL RESEARCH 2008; 106:185-94. [PMID: 18021762 DOI: 10.1016/j.envres.2007.10.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2006] [Revised: 09/26/2007] [Accepted: 10/03/2007] [Indexed: 05/18/2023]
Abstract
Although much is known about the incidence and burden of preterm birth, its biological mechanisms are not well understood. While several studies have suggested that high levels of air pollution or exposure to particular climatic factors may be associated with an increased risk of preterm birth, other studies do not support such an association. To determine whether exposure to various environmental factors place a large London-based population at higher risk for preterm birth, we analyzed 482,568 births that occurred between 1988 and 2000 from the St. Mary's Maternity Information System database. Using an ecological study design, any short-term associations between preterm birth and various environmental factors were investigated using time-series regression techniques. Environmental exposures included air pollution (ambient ozone and PM(10)) and climatic factors (temperature, rainfall, sunshine, relative humidity, barometric pressure, and largest drop in barometric pressure). In addition to exposure on the day of birth, cumulative exposure up to 1 week before birth was investigated. The risk of preterm birth did not increase with exposure to the levels of ambient air pollution or meteorological factors experienced by this population. Cumulative exposure from 0 to 6 days before birth also did not show any significant effect on the risk of preterm birth. This large study, covering 13 years, suggests that there is no association between preterm births and recent exposure to ambient air pollution or recent changes in the weather.
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Affiliation(s)
- Sue J Lee
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
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18
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Ghosh R, Rankin J, Pless-Mulloli T, Glinianaia S. Does the effect of air pollution on pregnancy outcomes differ by gender? A systematic review. ENVIRONMENTAL RESEARCH 2007; 105:400-8. [PMID: 17493608 DOI: 10.1016/j.envres.2007.03.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2006] [Revised: 03/05/2007] [Accepted: 03/23/2007] [Indexed: 05/15/2023]
Abstract
Gender is known to influence pregnancy outcomes. Recent studies have reported an association between air pollution exposure and adverse pregnancy outcomes, but gender differences have not been considered. In order to assess the current evidence of the interactive effects between gender and air pollution on pregnancy outcomes we undertook a systematic literature review. Using a comprehensive list of keywords, English language articles published between 1966 and 2005 were retrieved from major databases. Additional information on gender was obtained from the study authors. Studies were included if they contained well-defined measurements of ambient air pollutants, investigated pregnancy outcomes and reported estimates by gender. In total 11 studies were included. The quality of the studies was assessed using the framework in Systematic Reviews in Health Care Meta-analysis in context and Bracken's Guidelines. Of the 11 studies, four evaluated low birth weight (LBW); one each evaluated very low birth weight and fetal growth and six examined preterm birth (PTB). Females were at higher risk of LBW: adjusted odds ratios (AOR) ranged from 1.07 to 1.62. Males were at higher risk for PTB: AORs ranged from 1.11 to 1.20. In addition, there was some evidence to suggest that the effect of air pollution on LBW is differential by gender; however, the evidence was available only from four studies. This is the first systematic review to consider gender effect. Further high quality studies are needed to establish whether these findings prevail.
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Affiliation(s)
- Rakesh Ghosh
- Institute of Health and Society, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
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Abstract
An epidemiological and environmental approach is the appropriate starting point to understanding preterm labour. Although there are multiple aetiologies it seems likely that anthropometric and environmental risk factors in combination with inherent genetic susceptibilities contribute to an increased risk of preterm labour for certain women. Poct 2pulation-based studies identifying risk factors and quantifying outcomes facilitate informed counselling and provide a framework for developing prediction tools. Carefully conducted case-control and cohort studies identify associations that may contribute to an understanding of causation. A combined approach encompassing epidemiology, pathophysiology and clinical research is required to understand the aetiologies, prevention and optimal management of preterm labour. This review focuses on the epidemiology of preterm labour and the role of environmental factors.
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Affiliation(s)
- Deirdre J Murphy
- Department of Obstetrics and Gynaecology, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland.
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20
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Kajekar R. Environmental factors and developmental outcomes in the lung. Pharmacol Ther 2007; 114:129-45. [PMID: 17408750 DOI: 10.1016/j.pharmthera.2007.01.011] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2007] [Accepted: 01/12/2007] [Indexed: 11/26/2022]
Abstract
The developing lung is highly susceptible to damage from exposure to environmental toxicants particularly due to the protracted maturation of the respiratory system, extending from the embryonic phase of development in utero through to adolescence. The functional organization of the lungs requires a coordinated ontogeny of critical developmental processes that include branching morphogenesis, cellular differentiation and proliferation, alveolarization, and maturation of the pulmonary immune, vasculature, and neural systems. Therefore, exposure to environmental pollutants during crucial periods of prenatal and/or postnatal development may determine the course of lung morphogenesis and maturation. Depending on the timing of exposure and pathobiological response of the affected tissue, exposure to environmental pollutants can potentially result in long-term alterations that affect the structure and function of the respiratory system. Besides an immature respiratory system at birth, children possess unique differences in their physiology and behavioral characteristics compared to adults that are believed to augment the vulnerability of their developing lungs to perturbations by environmental toxins. Furthermore, an interaction between genetic predisposition and increased opportunity for exposure to chemical and infectious disease increase the hazards and risks for infants and children. In this article, the evidence for perturbations of lung developmental processes by key ambient pollutants (environmental tobacco smoke [ETS], ozone, and particulate matter [PM]) are discussed in terms of biological factors that are intrinsic to infants and children and that influence exposure-related lung development and respiratory outcomes.
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Affiliation(s)
- Radhika Kajekar
- Immunobiology, Centocor, 145 King of Prussia Road, Radnor, PA 19087, USA.
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21
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Hansen C, Neller A, Williams G, Simpson R. Maternal exposure to low levels of ambient air pollution and preterm birth in Brisbane, Australia. BJOG 2006; 113:935-41. [PMID: 16907939 DOI: 10.1111/j.1471-0528.2006.01010.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND [corrected] There is evidence that maternal exposure to ambient air pollution during pregnancy is associated with adverse birth outcomes. OBJECTIVE To assess preterm birth (PTB) in relation to maternal exposure to ambient air pollution. DESIGN Retrospective cohort. SETTING Brisbane, Australia. POPULATION A total of 28,200 singleton live births for the period of 1 July 2000 to 30 June 2003. METHODS Average maternal exposure estimates for ambient particulate matter (PM(10) and bsp), ozone (O(3)) and nitrogen dioxide were calculated over the first 3 months after last menstrual period (LMP) and the last 3 months prior to birth (individually and combined as trimesters). MAIN OUTCOME MEASURES PTB was defined as gestation <37 weeks and odds ratios (OR) were calculated for PTB per interquartile range increase in the maternal exposure estimate for each pollutant. Various covariates were controlled for, including season of birth. RESULTS Exposure to PM(10) and O(3) during trimester one was associated with an increased risk of PTB (OR = 1.15, 95% CI 1.06-1.25 and OR = 1.26, 95% CI 1.10-1.45, respectively). The PM(10) exposure effect associated with trimester one was strongly related to exposure during the first month post-LMP (PM(10), month one; OR = 1.19, 95% CI 1.13-1.26). CONCLUSION These results suggest that maternal exposure to low levels of ambient air pollution is associated with PTB.
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Affiliation(s)
- C Hansen
- Faculty of Science, Health and Education & Institute for Sustainability, Health and Regional Engagement, University of the Sunshine Coast, Maroochydore, Queensland, Australia.
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Abstract
OBJECTIVE The goal was to examine systematically the association between maternal exposure to particulate matter of <10 microm and very low birth weight (<1500 g) delivery for evidence of an effect on duration of gestation and/or intrauterine growth restriction. METHODS This case-control study took place between April 1, 1986, and March 30, 1988, in Georgia Health Care District 9 and included 128 mothers of very low birth weight infants, all of whom were preterm and were classified as either small for gestational age or appropriate for gestational age, and 197 mothers of term, appropriate-for-gestational-age infants weighing > or = 2500 g. Maternal exposure to particulate matter of <10 microm was estimated with 2 exposure measures, namely, a county-level measure based on residence in a county with an industrial point source and an environmental transport model based on the geographic location of the birth home. RESULTS Considering preterm/appropriate-for-gestational-age infants as cases and term/appropriate-for-gestational-age infants as controls, adjusted odds ratios for maternal exposure to particulate matter of <10 microm were statistically significant (adjusted odds ratio for county-level model: 4.31; adjusted odds ratio for environmental transport model: 3.68). Although elevated, no statistically significant association was found between maternal exposure and preterm/appropriate-for-gestational-age delivery when compared to preterm/small-for-gestational-age delivery. CONCLUSIONS There are increased odds of maternal exposure to ambient particulate matter of <10 microm for very low birth weight preterm/appropriate-for-gestational-age delivery, compared with term/appropriate-for-gestational-age delivery, which suggests that the observed association between maternal exposure to air pollution and low infant birth weight (particularly <1500 g) is at least partially attributable to an effect on duration of gestation.
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Affiliation(s)
- J Felix Rogers
- National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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