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

• Authors: Dean Spears, University of Texas Austin; Sagnik Dey, Indian Institute of Technology; Sourangsu Chowdhury, Indian Institute of Technology; Noah Scovronick, Emory University; Sangita Vyas, University of Texas Austin; Joshua Apte, University of Texas Austin
• Journal Title: Environmental Health and Preventive Medicine
• Volume: Volume 18, Number 1
• Publisher: BMC (part of Springer Nature) | 2019-07-09, Pages 62-62
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1186/s12940-019-0501-7
• Subjects: Environmental Sciences; Health Sciences, Public Health
• Keywords: Science & Technology; Life Sciences & Biomedicine; Environmental Sciences; Public, Environmental & Occupational Health; Environmental Sciences & Ecology; Child height; Ambient air pollution; PM2.5; India; FINE PARTICULATE MATTER; LONG-TERM EXPOSURE; AIR-POLLUTION; BIRTH-WEIGHT; GLOBAL BURDEN; MORTALITY; RISK; HEALTH; COHORT; URBAN

Abstract

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.