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Author Notes:

Dean Spears: Phone: (512) 471-3211, dean@riceinstitute.org.

DS and SD developed the idea; DS carried out the main analysis; SC carried out the satellite data analysis to generate the exposure data; DS and SD wrote the paper with inputs from all the authors; NS and SV revised the article, with inputs from all authors.

All authors have read and approved the final version.

All the authors acknowledge Dr. Aaron van Donkelaar, Dalhousie University for sharing the conversion factors from GEOS-Chem CTM which are used to estimate PM2.5.

The authors declare that they have no competing interests.


Research Funding:

This study received no specific funding; however, some of the authors are supported by research center funding.

SD acknowledges DST-FIST grant (SR/FST/ESII-016/2014) for upgradation of computing facility at IIT Delhi.

DS and SV acknowledge support for research time and computing resources from Bill and Melinda Gates Foundation grant OPP1125318.

Research by DS and SV was supported by grant, P2CHD042849, Population Research Center, awarded to the Population Research Center at The University of Texas at Austin by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

SV acknowledges that this material is based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. DGE-1610403.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Environmental Sciences
  • Public, Environmental & Occupational Health
  • Environmental Sciences & Ecology
  • Child height
  • Ambient air pollution
  • PM2.5
  • India
  • RISK

The association of early-life exposure to ambient PM2.5 and later-childhood height-for-age in India: an observational study


Journal Title:

Environmental Health and Preventive Medicine


Volume 18, Number 1


, Pages 62-62

Type of Work:

Article | Final Publisher PDF


Background: Children in India are exposed to high levels of ambient fine particulate matter (PM2.5). However, population-level evidence of associations with adverse health outcomes from within the country is limited. The aim of our study is to estimate the association of early-life exposure to ambient PM2.5 with child health outcomes (height-for-age) in India. Methods: We linked nationally-representative anthropometric data from India's 2015-2016 Demographic and Health Survey (n = 218,152 children under five across 640 districts of India) with satellite-based PM2.5 exposure (concentration) data. We then applied fixed effects regression to assess the association between early-life ambient PM2.5 and subsequent height-for-age, analyzing whether deviations in air pollution from the seasonal average for a particular place are associated with deviations in child height from the average for that season in that place, controlling for trends over time, temperature, and birth, mother, and household characteristics. We also explored the timing of exposure and potential non-linearities in the concentration-response relationship. Results: Children in the sample were exposed to an average of 55 μ g/m3 of PM2.5 in their birth month. After controlling for potential confounders, a 100 μg/m3 increase in PM2.5 in the month of birth was associated with a 0.05 [0.01-0.09] standard deviation reduction in child height. For an average 5 year old girl, this represents a height deficit of 0.24 [0.05-0.43] cm. We also found that exposure to PM2.5 in the last trimester in utero and in the first few months of life are significantly (p < 0.05) associated with child height deficits. We did not observe a decreasing marginal risk at high levels of exposure. Conclusions: India experiences some of the worst air pollution in the world. To our knowledge, this is the first study to estimate the association of early-life exposure to ambient PM2.5 on child height-for-age at the range of ambient pollution exposures observed in India. Because average exposure to ambient PM2.5 is high in India, where child height-for-age is a critical challenge in human development, our results highlight ambient air pollution as a public health policy priority.

Copyright information:

© 2019 The Author(s).

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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