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Synergistic effects of prenatal exposure to fine particulate matter (PM2.5) and ozone (O3) on the risk of preterm birth: A population-based cohort study.
Environ Res. 2019 09; 176:108549.ER

Abstract

BACKGROUND

There is some evidence that prenatal exposure to low-level air pollution increases the risk of preterm birth (PTB), but little is known about synergistic effects of different pollutants.

OBJECTIVES

We assessed the independent and joint effects of prenatal exposure to air pollution during the entire duration of pregnancy.

METHODS

The study population consisted of the 2568 members of the Espoo Cohort Study, born between 1984 and 1990, and living in the City of Espoo, Finland. We assessed individual-level prenatal exposure to ambient air pollutants of interest at all the residential addresses from conception to birth. The pollutant concentrations were estimated both by using regional-to-city-scale dispersion modelling and land-use regression-based method. We applied Poisson regression analysis to estimate the adjusted risk ratios (RRs) with their 95% confidence intervals (CI) by comparing the risk of PTB among babies with the highest quartile (Q4) of exposure during the entire duration of pregnancy with those with the lower exposure quartiles (Q1-Q3). We adjusted for season of birth, maternal age, sex of the baby, family's socioeconomic status, maternal smoking during pregnancy, maternal exposure to environmental tobacco smoke during pregnancy, single parenthood, and exposure to other air pollutants (only in multi-pollutant models) in the analysis.

RESULTS

In a multi-pollutant model estimating the effects of exposure during entire pregnancy, the adjusted RR was 1.37 (95% CI: 0.85, 2.23) for PM2.5 and 1.64 (95% CI: 1.15, 2.35) for O3. The joint effect of PM2.5 and O3 was substantially higher, an adjusted RR of 3.63 (95% CI: 2.16, 6.10), than what would have been expected from their independent effects (0.99 for PM2.5 and 1.34 for O3). The relative risk due to interaction (RERI) was 2.30 (95% CI: 0.95, 4.57).

DISCUSSION

Our results strengthen the evidence that exposure to fairly low-level air pollution during pregnancy increases the risk of PTB. We provide novel observations indicating that individual air pollutants such as PM2.5 and O3 may act synergistically potentiating each other's adverse effects.

Authors+Show Affiliations

Center for Environmental and Respiratory Health Research, Faculty of Medicine, P.O. Box 5000, FI-90014, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, P.O. Box 8000, FI-90014, University of Oulu, Oulu, Finland.Center for Environmental and Respiratory Health Research, Faculty of Medicine, P.O. Box 5000, FI-90014, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, P.O. Box 8000, FI-90014, University of Oulu, Oulu, Finland.Geography Research Unit, P.O. Box 3000, 90014, University of Oulu, Oulu, Finland.Center for Environmental and Respiratory Health Research, Faculty of Medicine, P.O. Box 5000, FI-90014, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, P.O. Box 8000, FI-90014, University of Oulu, Oulu, Finland.Public Health Research Group, Department of Biomedical Sciences, University Post Office, University of Cape Coast, Cape Coast, Ghana.Center for Environmental and Respiratory Health Research, Faculty of Medicine, P.O. Box 5000, FI-90014, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, P.O. Box 8000, FI-90014, University of Oulu, Oulu, Finland.Finnish Meteorological Institute, P.O. Box 503, FI-00101, Helsinki, Finland.Finnish Meteorological Institute, P.O. Box 503, FI-00101, Helsinki, Finland.Center for Environmental and Respiratory Health Research, Faculty of Medicine, P.O. Box 5000, FI-90014, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, P.O. Box 8000, FI-90014, University of Oulu, Oulu, Finland.Center for Environmental and Respiratory Health Research, Faculty of Medicine, P.O. Box 5000, FI-90014, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, P.O. Box 8000, FI-90014, University of Oulu, Oulu, Finland. Electronic address: jouni.jaakkola@oulu.fi.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31252204

Citation

Siddika, Nazeeba, et al. "Synergistic Effects of Prenatal Exposure to Fine Particulate Matter (PM2.5) and Ozone (O3) On the Risk of Preterm Birth: a Population-based Cohort Study." Environmental Research, vol. 176, 2019, p. 108549.
Siddika N, Rantala AK, Antikainen H, et al. Synergistic effects of prenatal exposure to fine particulate matter (PM2.5) and ozone (O3) on the risk of preterm birth: A population-based cohort study. Environ Res. 2019;176:108549.
Siddika, N., Rantala, A. K., Antikainen, H., Balogun, H., Amegah, A. K., Ryti, N. R. I., Kukkonen, J., Sofiev, M., Jaakkola, M. S., & Jaakkola, J. J. K. (2019). Synergistic effects of prenatal exposure to fine particulate matter (PM2.5) and ozone (O3) on the risk of preterm birth: A population-based cohort study. Environmental Research, 176, 108549. https://doi.org/10.1016/j.envres.2019.108549
Siddika N, et al. Synergistic Effects of Prenatal Exposure to Fine Particulate Matter (PM2.5) and Ozone (O3) On the Risk of Preterm Birth: a Population-based Cohort Study. Environ Res. 2019;176:108549. PubMed PMID: 31252204.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Synergistic effects of prenatal exposure to fine particulate matter (PM2.5) and ozone (O3) on the risk of preterm birth: A population-based cohort study. AU - Siddika,Nazeeba, AU - Rantala,Aino K, AU - Antikainen,Harri, AU - Balogun,Hamudat, AU - Amegah,A Kofi, AU - Ryti,Niilo R I, AU - Kukkonen,Jaakko, AU - Sofiev,Mikhail, AU - Jaakkola,Maritta S, AU - Jaakkola,Jouni J K, Y1 - 2019/06/19/ PY - 2019/03/06/received PY - 2019/06/14/revised PY - 2019/06/18/accepted PY - 2019/6/30/pubmed PY - 2020/4/16/medline PY - 2019/6/29/entrez KW - Air pollution KW - Fine particulates KW - Interaction KW - Ozone KW - Prenatal exposure KW - Preterm birth SP - 108549 EP - 108549 JF - Environmental research JO - Environ. Res. VL - 176 N2 - BACKGROUND: There is some evidence that prenatal exposure to low-level air pollution increases the risk of preterm birth (PTB), but little is known about synergistic effects of different pollutants. OBJECTIVES: We assessed the independent and joint effects of prenatal exposure to air pollution during the entire duration of pregnancy. METHODS: The study population consisted of the 2568 members of the Espoo Cohort Study, born between 1984 and 1990, and living in the City of Espoo, Finland. We assessed individual-level prenatal exposure to ambient air pollutants of interest at all the residential addresses from conception to birth. The pollutant concentrations were estimated both by using regional-to-city-scale dispersion modelling and land-use regression-based method. We applied Poisson regression analysis to estimate the adjusted risk ratios (RRs) with their 95% confidence intervals (CI) by comparing the risk of PTB among babies with the highest quartile (Q4) of exposure during the entire duration of pregnancy with those with the lower exposure quartiles (Q1-Q3). We adjusted for season of birth, maternal age, sex of the baby, family's socioeconomic status, maternal smoking during pregnancy, maternal exposure to environmental tobacco smoke during pregnancy, single parenthood, and exposure to other air pollutants (only in multi-pollutant models) in the analysis. RESULTS: In a multi-pollutant model estimating the effects of exposure during entire pregnancy, the adjusted RR was 1.37 (95% CI: 0.85, 2.23) for PM2.5 and 1.64 (95% CI: 1.15, 2.35) for O3. The joint effect of PM2.5 and O3 was substantially higher, an adjusted RR of 3.63 (95% CI: 2.16, 6.10), than what would have been expected from their independent effects (0.99 for PM2.5 and 1.34 for O3). The relative risk due to interaction (RERI) was 2.30 (95% CI: 0.95, 4.57). DISCUSSION: Our results strengthen the evidence that exposure to fairly low-level air pollution during pregnancy increases the risk of PTB. We provide novel observations indicating that individual air pollutants such as PM2.5 and O3 may act synergistically potentiating each other's adverse effects. SN - 1096-0953 UR - https://www.unboundmedicine.com/medline/citation/31252204/Synergistic_effects_of_prenatal_exposure_to_fine_particulate_matter__PM2_5__and_ozone__O3__on_the_risk_of_preterm_birth:_A_population_based_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0013-9351(19)30346-9 DB - PRIME DP - Unbound Medicine ER -