Methodological issues in studies of air pollution and reproductive health

• Type of Material: Article
• Authors: Tracey J. Woodruff, University of California San Francisco; Jennifer D. Parker, Centers for Disease Control and Prevention; Lyndsey Darrow, Emory University; Remy Slama, INSERM; Michelle L. Bell, Yale University; Hyunok Choi, Harvard University; Svetlana Glinianaia, Newcastle University; Katherine J. Hoggatt, University of Michigan; Catherine J. Karr, University of Washington; Danelle T. Lobdell, US Environmental Protection Agency; Michelle Wilhelm, University of California Los Angeles
• Language: English
• Date: 2009-04-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2009 Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.envres.2008.12.012
• Title of Journal or Parent Work: Environmental Research
• ISSN: 0013-9351
• Volume: 109
• Issue: 3
• Start Page: 311
• End Page: 320
• Grant/Funding Information: This represents the findings from the Workshop on “Methodological Issues in Studies of Air Pollution and Perinatal Outcomes”. Funding for the workshop was provided by: Association of Occupational and Environmental Medicine Clinics, University of Washington, Seattle; Center for Occupational and Environmental Health and Fogarty Center, University of California at Los Angeles; Health Effects Institute; Institute of Health and Society, Newcastle University; Program on Reproductive Health and the Environment, National Center of Excellence in Women’s Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco; School of Forestry and Environmental Studies, Yale University.
• Keywords: Environmental Sciences & Ecology; SOUTHERN CALIFORNIA; Science & Technology; OF-THE-LITERATURE; LOW-BIRTH-WEIGHT; Environmental Sciences; PRETERM BIRTH; Public, Environmental & Occupational Health; Preterm delivery; LOS-ANGELES; CARBON-MONOXIDE; FETAL-GROWTH; CHILDREN BORN; Epidemiologic methods; PARTICULATE MATTER; Low birthweight; PREGNANCY OUTCOMES; Life Sciences & Biomedicine; Perinatal outcomes; Air pollution
• Research Categories: Health Sciences, Public Health; Health Sciences, Obstetrics and Gynecology; Biology, Ecology

Abstract

In the past decade there have been an increasing number of scientific studies describing possible effects of air pollution on perinatal health. These papers have mostly focused on commonly monitored air pollutants, primarily ozone (O3), particulate matter (PM), sulfur dioxide (SO2), carbon monoxide (CO), and nitrogen dioxide (NO2), and various indices of perinatal health, including fetal growth, pregnancy duration, and infant mortality. While most published studies have found some marker of air pollution related to some types of perinatal outcomes, variability exists in the nature of the pollutants and outcomes associated. Synthesis of the findings has been difficult for various reasons, including differences in study design and analysis. A workshop was held in September 2007 to discuss methodological differences in the published studies as a basis for understanding differences in study findings and to identify priorities for future research, including novel approaches for existing data. Four broad topic areas were considered: confounding and effect modification, spatial and temporal exposure variations, vulnerable windows of exposure, and multiple pollutants. Here we present a synopsis of the methodological issues and challenges in each area and make recommendations for future study. Two key recommendations include: (1) parallel analyses of existing data sets using a standardized methodological approach to disentangle true differences in associations from methodological differences among studies; and (2) identification of animal studies to inform important mechanistic research gaps. This work is of critical public health importance because of widespread exposure and because perinatal outcomes are important markers of future child and adult health.