Ouidir Marion, Lepeule Johanna, Siroux Valérie, Malherbe Laure, Meleux Frederik, Rivière Emmanuel, Launay Ludivine, Zaros Cécile, Cheminat Marie, Charles Marie-Aline, Slama Rémy
IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Inserm, CNRS, Université Grenoble Alpes joint research center, Grenoble, France.
Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA.
J Epidemiol Community Health. 2017 Oct;71(10):1026-1036. doi: 10.1136/jech-2016-208674. Epub 2017 Aug 22.
Exposure to atmospheric pollutants is a danger for the health of pregnant mother and children. Our objective was to identify individual (socioeconomic and behavioural) and contextual factors associated with atmospheric pollution pregnancy exposure at the nationwide level.
Among 14 921 women from the French nationwide ELFE (French Longitudinal Study of Children) mother-child cohort recruited in 2011, outdoor exposure levels of PM, PM (particulate matter <2.5 µm and <10 µm in diameter) and NO (nitrogen dioxide) were estimated at the pregnancy home address from a dispersion model with 1 km resolution. We used classification and regression trees (CART) and linear regression to characterise the association of atmospheric pollutants with individual (maternal age, body mass index, parity, education level, relationship status, smoking status) and contextual (European Deprivation Index, urbanisation level) factors.
Patterns of associations were globally similar across pollutants. For the CART approach, the highest tertile of exposure included mainly women not in a relationship living in urban and socially deprived areas, with lower education level. Linear regression models identified different determinants of atmospheric pollutants exposure according to the residential urbanisation level. In urban areas, atmospheric pollutants exposure increased with social deprivation, while in rural areas a U-shaped relationship was observed.
We highlighted social inequalities in atmospheric pollutants exposure according to contextual characteristics such as urbanisation level and social deprivation and also according to individual characteristics such as education, being in a relationship and smoking status. In French urban areas, pregnant women from the most deprived neighbourhoods were those most exposed to health-threatening atmospheric pollutants.
暴露于大气污染物中对孕妇和儿童的健康构成威胁。我们的目标是在全国范围内确定与孕期大气污染暴露相关的个体（社会经济和行为）因素及环境因素。
在2011年招募的来自法国全国性ELFE（法国儿童纵向研究）母婴队列的14921名女性中，利用分辨率为1千米的扩散模型，估算其孕期家庭住址的室外PM、PM（直径<2.5微米和<10微米的颗粒物）和NO（二氧化氮）暴露水平。我们使用分类与回归树（CART）和线性回归来描述大气污染物与个体（母亲年龄、体重指数、胎次、教育水平、恋爱状况、吸烟状况）及环境（欧洲贫困指数、城市化水平）因素之间的关联。
各类污染物的关联模式总体相似。对于CART方法，暴露水平最高的三分位数主要包括生活在城市且社会贫困地区、教育水平较低的单身女性。线性回归模型根据居住的城市化水平确定了大气污染物暴露的不同决定因素。在城市地区，大气污染物暴露随社会贫困程度增加而上升，而在农村地区则观察到呈U形关系。
我们强调了根据城市化水平和社会贫困等环境特征以及教育、恋爱状况和吸烟状况等个体特征，在大气污染物暴露方面存在的社会不平等现象。在法国城市地区，来自最贫困社区的孕妇是暴露于威胁健康的大气污染物中最多的人群。
