Stingone Jeanette A, McVeigh Katharine H, Claudio Luz
Icahn School of Medicine at Mount Sinai, Department of Preventive Medicine, One Gustave Levy Pl, BOX 1057, New York, NY, 10029, USA.
New York City Department of Health and Mental Hygiene, Division of Family and Child Health, 42-09 28th Street, Queens, NY, 11101, USA.
Environ Health. 2017 Jan 18;16(1):2. doi: 10.1186/s12940-017-0210-z.
There is a growing literature showing associations between prenatal and early-life exposure to air pollution and children's neurodevelopment. However, it is unclear if decrements in neurodevelopment observed in epidemiologic research translate into observable functional outcomes in the broader pediatric population. The objective of this study was to examine the association between early-life exposures to common urban air toxics and the use of academic support services, such as early intervention and special education within a population-based cohort of urban children.
Data for 201,559 children born between 1994 and 1998 in New York City were obtained through administrative data linkages between birth, early intervention and educational records. Use of academic support services was ascertained from birth through attendance in 3 grade. Census tract at birth was used to assign estimates of annual average ambient concentrations of benzene, toluene, ethylbenzene and xylenes (BTEX) using the 1996 National Air Toxics Assessment. Discrete-time hazard models were fit to the data and adjusted for confounders including maternal, childhood and neighborhood factors.
Children with higher exposures to BTEX compounds were more likely to receive academic support services later in childhood. For example, the adjusted hazard ratio comparing children exposed to the highest decile of benzene to those with lower exposure was 1.09 (95% confidence interval 1.05, 1.13). Results were consistent across individual BTEX compounds, for exposure metrics which summarized exposure to all four BTEX pollutants and for multiple sensitivity analyses.
These findings suggest urban air pollution may affect children's neurodevelopment and educational trajectories. They also demonstrate the use of public health data systems to advance children's environmental health research.
越来越多的文献表明，产前及生命早期接触空气污染与儿童神经发育之间存在关联。然而，流行病学研究中观察到的神经发育减退是否会转化为更广泛儿科人群中可观察到的功能结果尚不清楚。本研究的目的是在一个以城市儿童为基础的队列中，研究生命早期接触常见城市空气毒物与使用学术支持服务（如早期干预和特殊教育）之间的关联。
通过出生、早期干预和教育记录之间的行政数据关联，获取了1994年至1998年在纽约市出生的201559名儿童的数据。从出生到三年级入学，确定学术支持服务的使用情况。利用1996年国家空气毒物评估，根据出生时的普查区来估算苯、甲苯、乙苯和二甲苯（BTEX）的年平均环境浓度。对数据拟合离散时间风险模型，并对包括母亲、儿童和邻里因素在内的混杂因素进行调整。
接触BTEX化合物水平较高的儿童在童年后期更有可能接受学术支持服务。例如，将接触苯最高十分位数的儿童与接触较低水平的儿童进行比较，调整后的风险比为1.09（95%置信区间1.05，1.13）。对于单个BTEX化合物、总结所有四种BTEX污染物接触情况的接触指标以及多项敏感性分析，结果都是一致的。
这些发现表明城市空气污染可能影响儿童的神经发育和教育轨迹。它们还证明了利用公共卫生数据系统推进儿童环境健康研究的作用。
