Impacts of air pollution and noise on risk of preterm birth and stillbirth in London
journal contribution
posted on 2019-12-03, 17:07 authored by Rachel B. Smith, Sean D. Beevers, John Gulliver, David Dajnak, Daniela Fecht, Marta BlangiardoMarta Blangiardo, Margaret Douglass, Anna L. Hansell, H. Ross Anderson, Frank J. Kelly, Mireille B. ToledanoBackground: 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 nonexhaust), 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.
Funding
This work was funded by the UK Natural Environment Research Council, Medical Research Council, Economic and Social Research Council, Department of Environment, Food and Rural Affairs, and Department of Health (NE/I00789X/1, NE/I008039/1) through the cross-research council Environmental Exposures & Health Initiative. The research was part funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards at King’s College London in partnership with Public Health England (PHE). The work of the UK Small Area Health Statistics Unit (SAHSU) is funded by Public Health England as part of the MRC-PHE Centre for Environment and Health, funded also by the UK Medical Research Council (MR/L01341X/1).
History
Citation
Environment International Volume 134, January 2020, 105290Author affiliation
Centre for Environmental Health and Sustainability, University of LeicesterVersion
- VoR (Version of Record)
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Environment InternationalVolume
134Publisher
Elsevier Pergamonissn
0160-4120Acceptance date
2019-10-25Copyright date
2019Available date
2019-12-03Publisher DOI
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https://www.sciencedirect.com/science/article/pii/S0160412019314734Language
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