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PubMed1996

Short term respiratory health effects of ambient air pollution: results of the APHEA project in Paris.

STUDY OBJECTIVE: To quantify the short term respiratory health effects of ambient air pollution in the Paris area. DESIGN: Time series analysis of daily pollution levels using Poisson regression. SETTING: Paris, 1987-92. MEASUREMENTS AND MAIN RESULTS: Air pollution was monitored by measurement of black smoke (BS) (15 monitoring stations), sulphur dioxide (SO2), nitrogen dioxide (NO2), particulate matter less than 13 microns in diameter (PM13), and ozone (O3) (4 stations). Daily mortality and general admissions to public hospitals due to respiratory causes were considered. The statistical analysis was based on a time series procedure using linear regression modelling followed by a Poisson regression. Meterological variables, epidemics of influenza A and B, and strikes of medical staff were included in the models. The mean daily concentration of PM13 and daily 1 hour maximum of SO2 significantly affected daily mortality from respiratory causes. An increase in the concentration of PM13 of 100 micrograms/m3 above its 5th centile value increased the risk of respiratory death by 17%. PM13 and BS were also associated with hospital admissions due to all respiratory diseases (4.1% increased risk when the BS level exceeded its 5th centile value by 100 micrograms/m3). SO2 levels consistently influenced hospital admissions for all respiratory diseases, chronic obstructive pulmonary disease, and asthma. Asthma was also correlated with NO2 levels. CONCLUSIONS: These results indicate that even though the relative risk is weak in areas with low levels of pollution, ambient air pollution, and especially particulate matter and SO2, nonetheless require attention because of the number of people exposed and the existence of high risk groups.

Adolescent↗
PubMed2001

Comparing meta-analysis and ecological-longitudinal analysis in time-series studies. A case study of the effects of air pollution on mortality in three Spanish cities.

STUDY OBJECTIVE: The objective of this paper is to introduce a different approach, called the ecological-longitudinal, to carrying out pooled analysis in time series ecological studies. Because it gives a larger number of data points and, hence, increases the statistical power of the analysis, this approach, unlike conventional ones, allows the complementation of aspects such as accommodation of random effect models, of lags, of interaction between pollutants and between pollutants and meteorological variables, that are hardly implemented in conventional approaches. DESIGN: The approach is illustrated by providing quantitative estimates of the short-term effects of air pollution on mortality in three Spanish cities, Barcelona, Valencia and Vigo, for the period 1992-1994. Because the dependent variable was a count, a Poisson generalised linear model was first specified. Several modelling issues are worth mentioning. Firstly, because the relations between mortality and explanatory variables were non-linear, cubic splines were used for covariate control, leading to a generalised additive model, GAM. Secondly, the effects of the predictors on the response were allowed to occur with some lag. Thirdly, the residual autocorrelation, because of imperfect control, was controlled for by means of an autoregressive Poisson GAM. Finally, the longitudinal design demanded the consideration of the existence of individual heterogeneity, requiring the consideration of mixed models. MAIN RESULTS: The estimates of the relative risks obtained from the individual analyses varied across cities, particularly those associated with sulphur dioxide. The highest relative risks corresponded to black smoke in Valencia. These estimates were higher than those obtained from the ecological-longitudinal analysis. Relative risks estimated from this latter analysis were practically identical across cities, 1.00638 (95% confidence intervals 1.0002, 1.0011) for a black smoke increase of 10 microg/m(3) and 1.00415 (95% CI 1.0001, 1.0007) for a increase of 10 microg/m(3) of sulphur dioxide. Because the statistical power is higher than in the individual analysis more interactions were statistically significant, especially those among air pollutants and meteorological variables. CONCLUSIONS: Air pollutant levels were related to mortality in the three cities of the study, Barcelona, Valencia and Vigo. These results were consistent with similar studies in other cities, with other multicentric studies and coherent with both, previous individual, for each city, and multicentric studies for all three cities.

Air Pollutants↗
PubMed1997

Methods for assessing the extent of exposure and effects of air pollution.

BACKGROUND AND OBJECTIVES: In many places in Europe, the ambient air pollution exceeds the levels considered to be safe for health. The objective of the paper is to review and summarise the methods of assessment of its impact on health, and to indicate the contributions of various research disciplines, particularly environmental epidemiology. METHODS: The framework for assessment of impact is based on a four stage model: assessment of release of pollutant; assessment of exposure; assessment of the consequence; and risk estimation. RESULTS: Epidemiology is crucial in providing the data for the assessment of consequence. The criteria that determine the use of epidemiological studies for this task include lack of bias, correct control of confounding, and measured estimates of exposure. At present, those criteria are easier to satisfy for studies of short term effects on health than for the delayed consequences of exposure, or exposure accumulated over a prolonged period. Combinations of results from various populations through meta-analysis of existing studies or conducting multicentre studies is often necessary to increase the reliability of the consequence assessment stage. CONCLUSION: To assess the impact on health systematically helps to focus on actions to limit air pollutants with the greatest impacts on human health and on the most affected populations. This method allows identification of the most pertinent questions which have to be answered by studies on relations between pollution and health and on exposure of populations to air pollutants. Epidemiology has considerable potential to contribute to this research.

Air Pollutants↗
PubMed2000

Daily concentrations of air pollution and plasma fibrinogen in London.

OBJECTIVES: The reason for the association between air pollution and risk of cardiovascular diseases is unknown. The hypothesis was examined that daily concentrations of air pollution are associated with daily concentrations of fibrinogen, a risk factor for cardiovascular disease. METHODS: Data on concentrations of plasma fibrinogen for 4982 male and 2223 female office workers, collected in a cross sectional survey in London between September 1991 and May 1993, were combined with data on concentrations of air pollution during the day of blood sampling and during the 3 preceding days. RESULTS: After adjustment for weather and other confounding factors, an increase in the 24 hour mean NO(2) during the previous day from the 10th to the 90th percentile (61.7 microg/m(3)) was associated with a 1.5% (95% confidence interval (95% CI) 0.4% to 2.5%) higher fibrinogen concentration. The respective increase for CO (1.6 mg/m(3)) was 1.5% (95% CI 0.5%, 2.5%). These associations tended to be stronger in the warm season (April to September). Significant associations were found for black smoke and particulate matter of diameter 10 microm (PM(10)) only in the warm season. No association with fibrinogen was found for SO(2) or ozone. CONCLUSIONS: The short term association between air pollution, possibly from traffic, and risk of cardiovascular events may be at least partly mediated through increased concentrations of plasma fibrinogen, possibly due to an inflammatory reaction caused by air pollution.

Adult↗
PubMed2000

Respiratory diseases in children and outdoor air pollution in São Paulo, Brazil: a time series analysis.

OBJECTIVES: To investigate the short term effects of air pollution on the respiratory morbidity of children living in São Paulo, Brazil, one of the largest cities in the developing world. METHODS: Daily counts of hospital admissions due to respiratory diseases along with daily levels of meteorological variables and air pollutants (PM(10), SO(2), NO(2), O(3), and CO) were analysed with Poisson regression. Final models were adjusted for the effects of time trends, seasonal patterns, weekdays, holidays, meteorological factors, and serial correlation. RESULTS: Daily admissions of children to hospital for total respiratory disease and pneumonia showed significant increases associated with O(3) (5-8%), NO(2) (9%), and with PM(10) (9%) (results are for an increase from the 10th to the 90th percentile of pollution measurements). Consistently, effects for pneumonia were greater than for all respiratory diseases combined. Also, effects on infants (children <1 year old) presented higher estimates. Similar associations were found for asthma admissions. Point estimates for most pollutants were higher for asthma than for other diagnosed admissions. However, these associations were not significant. CONCLUSIONS: These results agree with the limited publications on this subject but indicate a rather smaller magnitude of effects. Nevertheless, given the present concentrations of air pollution in São Paulo and the large population potentially exposed attention should be directed to minimise such effects.

Air Pollutants↗
PubMed2002

Effect of air pollution and environmental tobacco smoke on serum hyaluronate concentrations in school children.

OBJECTIVES: To evaluate serum hyaluronate concentrations relative to air pollution, environmental tobacco smoke (ETS), and respiratory health in Japanese school children. METHODS: Respiratory symptoms and serum IgE concentrations were examined in 1037 school children living in four communities in Japan with differing levels of air pollution. Serum hyaluronate concentrations were assayed in 230 children, consisting of all the children who had symptoms of either asthma or wheeze (65 and 50 subjects, respectively) and normal controls adjusted for sex, school grade, and school without these symptoms (115 subjects). RESULTS: Although serum hyaluronate concentrations did not differ for either asthma or wheeze, the concentrations were significantly higher in children living in communities with higher levels of air pollution. Children with asthma or wheeze and those with serum IgE concentrations of 250 IU/ml or above showed differences in hyaluronate concentrations that related to the degree of air pollution in the communities. In children with higher serum IgE concentrations, the hyaluronate concentrations among subjects exposed to ETS were significantly higher than among those without exposure to ETS. CONCLUSIONS: The present results suggest that serum hyaluronate concentration is related to the degree of air pollution and exposure to ETS. Children with asthma or wheeze and children with higher IgE concentrations are considered to be more susceptible to environmental factors.

Air Pollution↗
PubMed2002

Effects of air pollution on general practitioner consultations for upper respiratory diseases in London.

OBJECTIVES: Few published studies have examined the effect of air pollution on upper respiratory conditions. Furthermore, most epidemiological studies on air pollution focus on mortality or hospital admissions as the main health outcomes, but very rarely consider the effect in primary care. If pollution effects do exist then the public health impact could be considerable because of the many patient contacts involved. We investigated the relation between air pollution and upper respiratory disease as reflected in number of consultations made at family practices in London. METHODS: The study used non-parametric methods of analysis of time series data, adjusting for seasonal factors, day of the week, holiday effects, influenza, weather, pollen concentrations, and serial correlation. RESULTS: It was estimated that a 10-90th percentile change (13-31 microg/m(3)) in sulphur dioxide (SO(2)) measures resulted in a small increase in numbers of childhood consultation: 3.5% (95% confidence interval (95% CI 1.4% to 5.8%). Stronger associations were found in the case of a 10-90th percentile change (16-47 microg/m(3)) in fine particles (PM(10)) in adults aged 15-64 5.7% (2.9% to 8.6%), and in adults aged 65 and over: 10.2% (5.3% to 15.3%). In general, associations were strongest in elderly people, weakest in the children, and were largely found in the winter months for these two age groups, and in the summer months for adults aged 15-64. An apparent decrease in consultations was associated with ozone concentrations but this was most pronounced in colder months when ozone concentrations were at their lowest. CONCLUSIONS: The results suggest an adverse effect of air pollution on consultations for upper respiratory symptoms, in particular in the case of PM(10) and SO(2). The effects are relatively small; however, due to the many consultations made in primary care, the impact on demand for services could be considerable.

Adolescent↗
PubMed1995

Health effects of an air pollution episode in London, December 1991.

BACKGROUND: In December 1991 London experienced a unique air pollution episode during which concentrations of nitrogen dioxide rose to record levels, associated with moderate increases in black smoke. The aim of this study was to investigate whether this episode was associated with adverse health effects and whether any such effects could be attributed to air pollution. METHODS: The numbers of deaths and hospital admissions occurring in Greater London during the week of the episode were compared with those predicted using data from the week before the episode and from equivalent periods from the previous four years. Relative risks (RR) (episode week versus predicted) for adverse health events were estimated using log linear modelling and these were compared with estimates from control areas which had similar cold weather but without increased air pollution. RESULTS: In all age groups mortality was increased for all causes (excluding accidents) (relative risk = 1.10) and cardiovascular diseases (1.14); non-significant increases were observed for all respiratory diseases (1.22), obstructive lung diseases (1.23), and respiratory infections (1.23). In the elderly (65 + years) the relative risk of hospital admission was increased for all respiratory diseases (1.19) and for obstructive lung diseases (1.43), and a non-significant increase was observed for ischaemic heart disease (1.04). In children (0-14 years) there was no increase in admissions for all respiratory diseases and only a small non-significant increase for asthma. When compared with control areas the relative risks became non-significant but remained increased. CONCLUSIONS: The air pollution episode was associated with an increase in mortality and morbidity which was unlikely to be explained by the prevailing weather, a coincidental respiratory epidemic, or psychological factors due to publicity. Air pollution is a plausible explanation but the relative roles of nitrogen dioxide and particulates cannot be distinguished.

Adolescent↗
PubMed1994

Air pollution and hospital admissions for the elderly in Detroit, Michigan.

Several studies in recent years have suggested that exposure to airborne particles and to ozone are associated with increases in respiratory hospital admissions. Few of those studies have used inhalable particles as their measure of exposure, and the studies did not always examine both particle and ozone exposure. This study examined the association between both PM10 and ozone and respiratory hospital admissions for persons 65 yr of age and older in the Detroit, Michigan, metropolitan area during the years 1986 to 1989. After controlling for seasonal and other long-term temporal trends, temperature, and dew point temperature, both PM10 (RR = 1.012, 95% CI = 1.019-1.004) and 24-h ozone concentrations (RR = 1.026, 95% CI = 1.040-1.013) were associated with daily admissions for pneumonia. The relative risks are for a 10-microgram/m3 increase in PM10 and a 5-ppb increase in 24-h ozone concentration and from models including both pollutants. Admissions for COPD other than asthma were associated with PM10 (RR = 1.020, 95% CI = 1.032-1.009) and ozone (RR = 1.028, 95% CI = 1.049-1.007) as well. Asthma admissions were not associated with either pollutant. Controlling for one pollutant did not effect the magnitude of the association with the other pollutant. The magnitude of these relative risks are very similar to those recently reported in Birmingham, Alabama, Ontario, and New York State. This suggests that the associations with both pollutants are likely to be causal.

Aged↗
PubMed2004

Air pollution attributable postneonatal infant mortality in U.S. metropolitan areas: a risk assessment study.

BACKGROUND: The impact of outdoor air pollution on infant mortality has not been quantified. METHODS: Based on exposure-response functions from a U.S. cohort study, we assessed the attributable risk of postneonatal infant mortality in 23 U.S. metropolitan areas related to particulate matter <10 microm in diameter (PM10) as a surrogate of total air pollution. RESULTS: The estimated proportion of all cause mortality, sudden infant death syndrome (normal birth weight infants only) and respiratory disease mortality (normal birth weight) attributable to PM10 above a chosen reference value of 12.0 microg/m3 PM10 was 6% (95% confidence interval 3-11%), 16% (95% confidence interval 9-23%) and 24% (95% confidence interval 7-44%), respectively. The expected number of infant deaths per year in the selected areas was 106 (95% confidence interval 53-185), 79 (95% confidence interval 46-111) and 15 (95% confidence interval 5-27), respectively. Approximately 75% of cases were from areas where the current levels are at or below the new U.S. PM2.5 standard of 15 microg/m3 (equivalent to 25 microg/m3 PM10). In a country where infant mortality rates and air pollution levels are relatively low, ambient air pollution as measured by particulate matter contributes to a substantial fraction of infant death, especially for those due to sudden infant death syndrome and respiratory disease. Even if all counties would comply to the new PM2.5 standard, the majority of the estimated burden would remain. CONCLUSION: Given the inherent limitations of risk assessments, further studies are needed to support and quantify the relationship between infant mortality and air pollution.

Air Pollutants↗
PubMed2001

The potential impacts of climate variability and change on air pollution-related health effects in the United States.

Climate change may affect exposures to air pollutants by affecting weather, anthropogenic emissions, and biogenic emissions and by changing the distribution and types of airborne allergens. Local temperature, precipitation, clouds, atmospheric water vapor, wind speed, and wind direction influence atmospheric chemical processes, and interactions occur between local and global-scale environments. If the climate becomes warmer and more variable, air quality is likely to be affected. However, the specific types of change (i.e., local, regional, or global), the direction of change in a particular location (i.e., positive or negative), and the magnitude of change in air quality that may be attributable to climate change are a matter of speculation, based on extrapolating present understanding to future scenarios. There is already extensive evidence on the health effects of air pollution. Ground-level ozone can exacerbate chronic respiratory diseases and cause short-term reductions in lung function. Exposure to particulate matter can aggravate chronic respiratory and cardiovascular diseases, alter host defenses, damage lung tissue, lead to premature death, and possibly contribute to cancer. Health effects of exposures to carbon monoxide, sulfur dioxide, and nitrogen dioxide can include reduced work capacity, aggravation of existing cardiovascular diseases, effects on pulmonary function, respiratory illnesses, lung irritation, and alterations in the lung's defense systems. Adaptations to climate change should include ensuring responsiveness of air quality protection programs to changing pollution levels. Research needs include basic atmospheric science work on the association between weather and air pollutants; improving air pollution models and their linkage with climate change scenarios; and closing gaps in the understanding of exposure patterns and health effects.

Aerosols↗
PubMed2006

Increased risk of paroxysmal atrial fibrillation episodes associated with acute increases in ambient air pollution.

OBJECTIVES: We reported previously that 24-hr moving average ambient air pollution concentrations were positively associated with ventricular arrhythmias detected by implantable cardioverter defibrillators (ICDs). ICDs also detect paroxysmal atrial fibrillation episodes (PAF) that result in rapid ventricular rates. In this same cohort of ICD patients, we assessed the association between ambient air pollution and episodes of PAF. DESIGN: We performed a case-crossover study. PARTICIPANTS: Patients who lived in the Boston, Massachusetts, metropolitan area and who had ICDs implanted between June 1995 and December 1999 (n=203) were followed until July 2002. EVALUATIONS/MEASUREMENTS: We used conditional logistic regression to explore the association between community air pollution and 91 electrophysiologist-confirmed episodes of PAF among 29 subjects. RESULTS: We found a statistically significant positive association between episodes of PAF and increased ozone concentration (22 ppb) in the hour before the arrhythmia (odds ratio=2.08; 95% confidence interval=1.22, 3.54; p=0.001). The risk estimate for a longer (24-hr) moving average was smaller, thus suggesting an immediate effect. Positive but not statistically significant risks were associated with fine particles, nitrogen dioxide, and black carbon. CONCLUSIONS: Increased ambient O3 pollution was associated with increased risk of episodes of rapid ventricular response due to PAF, thereby suggesting that community air pollution may be a precipitant of these events.

Aged↗
PubMed2006

Use of the land snail Helix aspersa as sentinel organism for monitoring ecotoxicologic effects of urban pollution: an integrated approach.

Atmospheric pollution from vehicular traffic is a matter of growing interest, often leading to temporary restrictions in urban areas. Although guidelines indicate limits for several parameters, the real toxicologic impacts remain largely unexplored in field conditions. In this study our aim was to validate an ecotoxicologic approach to evaluate both bioaccumulation and toxicologic effects caused by airborne pollutants. Specimens of the land snail Helix aspersa were caged in five sites in the urban area of Ancona, Italy. After 4 weeks, trace metals (cadmium, chromium, copper, iron, manganese, nickel, lead, and zinc) and polycyclic aromatic hydrocarbons (PAHs) were measured and these data integrated with the analyses of molecular and biochemical responses. Such biomarkers reflected the induction of detoxification pathways or the onset of cellular toxicity caused by pollutants. Biomarkers that correlated with contaminant accumulation included levels of metallothioneins, activity of biotransformation enzymes (ethoxyresorufin O-deethylase, ethoxycoumarin O-deethylase), and peroxisomal proliferation. More general responses were investigated as oxidative stress variations, including efficiency of antioxidant defenses (catalase, glutathione reductase, glutathione S-transferases, glutathione peroxidases, and total glutathione) and total oxyradical scavenging capacity toward peroxyl and hydroxyl radicals, onset of cellular damages (i.e., lysosomal destabilization), and loss of DNA integrity. Results revealed a marked accumulation of metals and PAHs in digestive tissues of organisms maintained in more traffic-congested sites. The contemporary appearance of several alterations confirmed the cellular reactivity of these chemicals with toxicologic effects of potential concern for human health. The overall results of this exploratory study suggest the utility of H. aspersa as a sentinel organism for biomonitoring the biologic impact of atmospheric pollution in urban areas. Key words: atmospheric pollutants, bioindicators, biomarkers, DNA integrity, lysosomes, metallothioneins, oxidative stress, peroxisomes, polycyclic aromatic hydrocarbons, trace metals.

Air Pollutants↗
PubMed1987

Conjugation of organic pollutants in aquatic species.

Aquatic organisms can take up organic pollutants from their environment and subsequently excrete the pollutant or its biotransformation products (metabolites). Phase II (conjugation) biotransformation products are almost always less toxic than the unmetabolized organic pollutant. For many organic pollutants, the extent to which conjugates are formed is extremely important in determining the rate of excretion of the pollutant. This is because most conjugates (glycosides, sulfates, amino acid conjugates, mercapturic acids) are organic anions which are readily water-soluble and are rapidly excreted by fish (and probably higher invertebrates) by a combination of glomerular filtration and tubular transport. In this paper, each major conjugation pathway is discussed with respect to what is known about its occurrence in fish and aquatic invertebrates, both from in vivo and in vitro data. Although limited data are available, this paper also considers what is known about how each conjugation reaction affects the toxicity and potential for renal and biliary excretion of organic xenobiotic substrates.

Animals↗
PubMed1993

Assessment of health effects in epidemiologic studies of air pollution.

As we increasingly recognize the complexity of the pollutants in indoor and outdoor microenvironments, a broad array of inhaled mixtures has assumed scientific, public health, and regulatory importance. Few adverse effects of environmental pollutants are specific, that is, uniquely associated with a single agent; the adverse effects that might be considered in an investigation of the consequences of exposure to an inhaled complex mixture are generally nonspecific. In the context of this paper, we will refer to binary mixtures as complex, though we realize that a more precise definition of complexity would restrict the term to mixtures of three or more constituents. Their causes potentially include not only pollutant exposures through the medium of inhaled air but other environmental agents, such as infectious organisms and radiation, and inherent characteristics of the exposed persons, such as atopy. We review the outcome measures that have been used in epidemiologic studies of the health effects of single pollutants and complex mixtures. Some of these outcome measures have been carefully standardized, whereas others need similar standardization and modification to improve sensitivity and specificity for investigating the health effects of air pollution.

Air Pollutants↗
PubMed1994

Effect of air pollution on lung cancer: a Poisson regression model based on vital statistics.

This article describes a Poisson regression model for time trends of mortality to detect the long-term effects of common levels of air pollution on lung cancer, in which the adjustment for cigarette smoking is not always necessary. The main hypothesis to be tested in the model is that if the long-term and common-level air pollution had an effect on lung cancer, the death rate from lung cancer could be expected to increase gradually at a higher rate in the region with relatively high levels of air pollution than in the region with low levels, and that this trend would not be expected for other control diseases in which cigarette smoking is a risk factor. Using this approach, we analyzed the trend of mortality in females aged 40 to 79, from lung cancer and two control diseases, ischemic heart disease and cerebrovascular disease, based on vital statistics in 23 wards of the Tokyo metropolitan area for 1972 to 1988. Ward-specific mean levels per day of SO2 and NO2 from 1974 through 1976 estimated by Makino (1978) were used as the ward-specific exposure measure of air pollution. No data on tobacco consumption in each ward is available. Our analysis supported the existence of long-term effects of air pollution on lung cancer.

Adult↗
PubMed1995

Health effects of high level exposure to traditional pollutants in East Germany--review and ongoing research.

In East Germany ambient air pollution is characterized by high concentrations of sulfur dioxide (SO2) and suspended particulates (SP). Since acidity and sulfate are surprisingly low, oxidation of SO2 seems to be incomplete and neutralization seems to play an important role. Few studies on health effects of air pollution in the former German Democratic Republic have been performed. They showed an increased prevalence in polluted areas of respiratory symptoms, lung function decrement, mild anemia, nonspecific stimulation of the immune system and, retardation of skeletal maturation of children. Since the German unification in 1990, several large-scale studies have been started. Short-term effects of air pollution on daily mortality have been investigated in Erfurt retrospectively for 1980 to 1989. Logarithmic exposure-effect curves have been found for both SO2 and SP. The number of deaths increased by about 10% with SO2 and by more than 20% with SP if the 95th percentile of the pollutant is compared to the 5th percentile. The logarithmic shape shows that the increase of ambient concentrations at the beginning of the heating season in fall is more important than further increases in concentrations later in winter. A second study on short-term effects was conducted using daily peak flow measurements and respiratory symptoms in 270 patients with asthma and other obstructive airway diseases in East Germany and the Czech Republic between 1990 and 1992. From regression analysis it follows that an increase by 500 micrograms/m3 of SO2 leads to a mean decrease of the average patient's peak flow below 2%.(ABSTRACT TRUNCATED AT 250 WORDS)

Air Pollutants↗
PubMed1997

Association between air pollution and low birth weight: a community-based study.

The relationship between maternal exposure to air pollution during periods of pregnancy (entire and specific periods) and birth weight was investigated in a well-defined cohort. Between 1988 and 1991, all pregnant women living in four residential areas of Beijing were registered and followed from early pregnancy until delivery. Information on individual mothers and infants was collected. Daily air pollution data were obtained independently. The sample for analysis included 74,671 first-parity live births were gestational age 37-44 weeks. Multiple linear regression and logistic regression were used to estimate the effects of air pollution on birth weight and low birth weight (< 2,500 g), adjusting for gestational age, residence, year of birth, maternal age, and infant gender. There was a significant exposure-response relationship between maternal exposures to sulfur dioxide (SO2) and total suspended particles (TSP) during the third trimester of pregnancy and infant birth weight. The adjusted odds ratio for low birth weight was 1.11 (95% CI, 1.06-1.16) for each 100 micrograms/m3 increase in SO2 and 1.10 (95% CI, 1.05-1.14) for each 100 micrograms/m3 increase in TSP. The estimated reduction in birth weight was 7.3 g and 6.9 g for each 100 micrograms/m3 increase in SO2 and in TSP, respectively. The birth weight distribution of the high-exposure group was more skewed toward the left tail (i.e., with higher proportion of births < 2,500 g) than that of the low-exposure group. Although the effects of other unmeasured risk factors cannot be excluded with certainty, our data suggests that TSP and SO2, or a more complex pollution mixture associated with these pollutants, contribute to an excess risk of low birth weight in the Beijing population.

Adult↗