PM2.5 暴露与出生结局：卫星和监测数据的应用。
PM2.5 exposure and birth outcomes: use of satellite- and monitor-based data.
机构信息
From the a School of Public Health, Yale University, New Haven, CT; bDepartment of Environmental Health, Harvard School of Public Health, Harvard University, Boston, MA; cand School of Forestry and Environmental Studies, Yale University, New Haven, CT.
出版信息
Epidemiology. 2014 Jan;25(1):58-67. doi: 10.1097/EDE.0000000000000027.
BACKGROUND
Air pollution may be related to adverse birth outcomes. Exposure information from land-based monitoring stations often suffers from limited spatial coverage. Satellite data offer an alternative data source for exposure assessment.
METHODS
We used birth certificate data for births in Connecticut and Massachusetts, United States (2000-2006). Gestational exposure to PM2.5 was estimated from US Environmental Protection Agency monitoring data and from satellite data. Satellite data were processed and modeled by using two methods-denoted satellite (1) and satellite (2)-before exposure assessment. Regression models related PM2.5 exposure to birth outcomes while controlling for several confounders. Birth outcomes were mean birth weight at term birth, low birth weight at term (<2500 g), small for gestational age (SGA, <10th percentile for gestational age and sex), and preterm birth (<37 weeks).
RESULTS
Overall, the exposure assessment method modified the magnitude of the effect estimates of PM2.5 on birth outcomes. Change in birth weight per interquartile range (2.41 μg/m) increase in PM2.5 was -6 g (95% confidence interval = -8 to -5), -16 g (-21 to -11), and -19 g (-23 to -15), using the monitor, satellite (1), and satellite (2) methods, respectively. Adjusted odds ratios, based on the same three exposure methods, for term low birth weight were 1.01 (0.98-1.04), 1.06 (0.97-1.16), and 1.08 (1.01-1.16); for SGA, 1.03 (1.01-1.04), 1.06 (1.03-1.10), and 1.08 (1.04-1.11); and for preterm birth, 1.00 (0.99-1.02), 0.98 (0.94-1.03), and 0.99 (0.95-1.03).
CONCLUSIONS
Under exposure assessment methods, we found associations between PM2.5 exposure and adverse birth outcomes particularly for birth weight among term births and for SGA. These results add to the growing concerns that air pollution adversely affects infant health and suggest that analysis of health consequences based on satellite-based exposure assessment can provide additional useful information.
背景
空气污染可能与不良生育结局有关。陆地监测站的暴露信息通常存在空间覆盖范围有限的问题。卫星数据为暴露评估提供了一种替代数据源。
方法
我们使用了美国康涅狄格州和马萨诸塞州的出生证明数据（2000-2006 年）。通过美国环境保护署的监测数据和卫星数据来估计妊娠期间 PM2.5 的暴露情况。在进行暴露评估之前，我们使用两种方法（分别表示为卫星 1 和卫星 2）对卫星数据进行了处理和建模。回归模型将 PM2.5 暴露与出生结局相关联，同时控制了多个混杂因素。出生结局为足月出生时的平均出生体重、足月出生时的低体重（<2500 克）、小于胎龄儿（SGA，胎龄和性别<10 百分位）和早产（<37 周）。
结果
总体而言，暴露评估方法改变了 PM2.5 对出生结局影响的估计值大小。PM2.5 每增加一个四分位距（2.41μg/m），体重就会减少 6 克（95%置信区间为-8 至-5）、16 克（-21 至-11）和 19 克（-23 至-15），分别使用监测仪、卫星 1 和卫星 2 方法。基于相同的三种暴露方法，足月低体重的校正比值比为 1.01（0.98-1.04）、1.06（0.97-1.16）和 1.08（1.01-1.16）；SGA 的比值比为 1.03（1.01-1.04）、1.06（1.03-1.10）和 1.08（1.04-1.11）；早产的比值比为 1.00（0.99-1.02）、0.98（0.94-1.03）和 0.99（0.95-1.03）。
结论
在暴露评估方法下，我们发现 PM2.5 暴露与不良出生结局之间存在关联，尤其是在足月出生时的体重和 SGA 方面。这些结果增加了人们对空气污染对婴儿健康产生不利影响的担忧，并表明基于卫星进行暴露评估的分析可以提供额外的有用信息。
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