Department of Civil and Environmental Engineering, University of Alabama in Huntsville, 301 Sparkman Drive, Huntsville, AL, 35899, USA.
Department of Mathematics, Alabama Agricultural and Mechanical University, Normal, AL, 35762, USA.
Environ Sci Pollut Res Int. 2018 Mar;25(8):7924-7936. doi: 10.1007/s11356-017-1114-8. Epub 2018 Jan 3.
This study aimed to assess the association between exposures to outdoor environmental factors and autism spectrum disorder (ASD) prevalence in a diverse and spatially distributed population of 8-year-old children from the USA (n = 2,097,188) using the air quality index (AQI) of the US Environmental Protection Agency as well as satellite-derived data of PM concentrations, sunlight, and maximum heat index. Multivariable logistic regression analyses were performed to determine whether the unhealthy AQI, PM, sunlight, and maximum heat index were related to the odds of ASD prevalence based on gender and race and taking into consideration the confounding factors of smoking and socioeconomic status. The logistic regression odds ratios for ASD per 10% increase in the unhealthy AQI were greater than 1 for all categories, indicating that unhealthy AQI is related to the odds of ASD prevalence. The odds ratio of ASD due to the exposure to the unhealthy AQI was higher for Asians (OR = 2.96, 95% CI = 1.11-7.88) than that for Hispanics (OR = 1.308, 95% CI = 0.607-2.820), and it was higher for Blacks (OR = 1.398, 95% CI = 0.827-2.364) than that for Whites (OR = 1.219, 95% CI = 0.760-1.954). The odds ratio of ASD due to the unhealthy AQI was slightly higher for males (OR = 1.123, 95% CI = 0.771-1.635) than that for females (OR = 1.117, 95% CI = 0.789-1.581). The effects of the unhealthy environmental exposures on the odds ratios of ASD of this study were inconclusive (i.e., statically insignificant; p value > 0.05) for all categories except for Asians. The odds ratios of ASD for Asians were increased by 5, 12, and 14% with increased levels of the environmental exposures of 10 μg/m of PM, 1000 kJ/m of sunlight, and 1 °F of maximum heat index, respectively. The odds ratios of ASD prevalence for all categories, except for Asians, were increased with the inclusion of the smoking covariate, reflecting the effect of smoking on ASD prevalence besides the unhealthy environmental factors.
本研究旨在评估美国 8 岁儿童（n=2097188 人）中，户外环境因素暴露与自闭症谱系障碍（ASD）患病率之间的关联。使用美国环保署（US Environmental Protection Agency）的空气质量指数（AQI）以及 PM 浓度、阳光和最高热指数的卫星衍生数据来评估。多变量逻辑回归分析用于确定不健康的 AQI、PM、阳光和最高热指数是否与 ASD 患病率有关，考虑到吸烟和社会经济地位等混杂因素。对于所有类别，不健康 AQI 每增加 10%，ASD 的逻辑回归比值比都大于 1，这表明不健康 AQI 与 ASD 患病率有关。与西班牙裔（OR=1.308，95%CI=0.607-2.820）相比，亚洲人（OR=2.96，95%CI=1.11-7.88）因接触不健康 AQI 而导致 ASD 的比值比更高，与白人（OR=1.219，95%CI=0.760-1.954）相比，黑人（OR=1.398，95%CI=0.827-2.364）因接触不健康 AQI 而导致 ASD 的比值比更高。对于男性（OR=1.123，95%CI=0.771-1.635），与女性（OR=1.117，95%CI=0.789-1.581）相比，因接触不健康 AQI 而导致 ASD 的比值比略高。除了亚洲人，本研究中所有类别的不健康环境暴露对 ASD 比值比的影响均不确定（即统计学上无显著性；p 值>0.05）。随着 PM 水平增加 10μg/m、阳光增加 1000kJ/m 和最高热指数增加 1°F，亚洲人患 ASD 的比值比分别增加了 5%、12%和 14%。除了亚洲人，所有类别的 ASD 患病率比值比都随着吸烟协变量的纳入而增加，这反映了吸烟对 ASD 患病率的影响，除了不健康的环境因素之外。
