Air pollution and preterm birth in the U.S. State of Georgia (2002–2006): Associations with concentrations of 11 ambient air pollutants estimated by combining community multiscale air quality model (CMAQ) simulations with stationary monitor measurements

• Type of Material: Article
• Authors: Hua Hao, Emory University; Howard Chang, Emory University; Heather A. Holmes, Emory University; James A Mulholland, Georgia Institute of Technology; Mitchel Klein, Emory University; Lyndsey Darrow, Emory University; Matthew Strickland, Emory University
• Language: English
• Date: 2016-06-01
• Publisher: National Institute of Environmental Health Sciences (NIEHS)
• Publication Version: Final Published Version
• Copyright Statement: © 2016, Public Health Services, US Dept of Health and Human Services. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1289/ehp.1409651
• Title of Journal or Parent Work: Environmental Health Perspectives
• ISSN: 0091-6765
• Volume: 124
• Issue: 6
• Start Page: 875
• End Page: 880
• Grant/Funding Information: Financial support was provided by the National Institutes of Health (grants R01ES019897 and K01ES019877), and by the U.S. Environmental Protection Agency (EPA STAR grant RD834799).
• Research Categories: Health Sciences, Public Health; Biology, Bioinformatics; Environmental Sciences

Abstract

Background: Previous epidemiologic studies suggest associations between preterm birth and ambient air pollution. Objective: We investigated associations between 11 ambient air pollutants, estimated by combining Community Multiscale Air Quality model (CMAQ) simulations with measurements from stationary monitors, and risk of preterm birth (< 37 weeks of gestation) in the U.S. state of Georgia. Methods: Birth records for singleton births ≥ 27 weeks of gestation with complete covariate information and estimated dates of conception between 1 January 2002 and 28 February 2006 were obtained from the Office of Health Indicators for Planning, Georgia Department of Public Health (n = 511,658 births). Daily pollutant concentrations at 12-km resolution were estimated for 11 ambient air pollutants. We used logistic regression with county-level fixed effects to estimate associations between preterm birth and average pollutant concentrations during the first and second trimester. Discrete-time survival models were used to estimate third-trimester and total pregnancy associations. Effect modification was investigated by maternal education, race, census tract poverty level, and county-level urbanicity. Results: Trimester-specific and total pregnancy associations (p < 0.05) were observed for several pollutants. All the traffic-related pollutants (carbon monoxide, nitrogen dioxide, PM2.5 elemental carbon) were associated with preterm birth [e.g., odds ratios for interquartile range increases in carbon monoxide during the first, second, and third trimesters and total pregnancy were 1.005 (95% CI: 1.001, 1.009), 1.007 (95% CI: 1.002, 1.011), 1.010 (95% CI: 1.006, 1.014), and 1.011 (95% CI: 1.006, 1.017)]. Associations tended to be higher for mothers with low educational attainment and African American mothers. Conclusion: Several ambient air pollutants were associated with preterm birth; associations were observed in all exposure windows.