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英国市立垃圾焚烧厂附近的胎儿生长、死产、婴儿死亡率和其他出生结局;回顾性基于人群的队列和病例对照研究。

Fetal growth, stillbirth, infant mortality and other birth outcomes near UK municipal waste incinerators; retrospective population based cohort and case-control study.

机构信息

UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK.

UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK; Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, SW3 6LR, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards, Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK.

出版信息

Environ Int. 2019 Jan;122:151-158. doi: 10.1016/j.envint.2018.10.060. Epub 2018 Nov 22.

Abstract

BACKGROUND

Some studies have reported associations between municipal waste incinerator (MWI) exposures and adverse birth outcomes but there are few studies of modern MWIs operating to current European Union (EU) Industrial Emissions Directive standards.

METHODS

Associations between modelled ground-level particulate matter ≤10 μm in diameter (PM) from MWI emissions (as a proxy for MWI emissions) within 10 km of each MWI, and selected birth and infant mortality outcomes were examined for all 22 MWIs operating in Great Britain 2003-10. We also investigated associations with proximity of residence to a MWI. Outcomes used were term birth weight, small for gestational age (SGA) at term, stillbirth, neonatal, post-neonatal and infant mortality, multiple births, sex ratio and preterm delivery sourced from national registration data from the Office for National Statistics. Analyses were adjusted for relevant confounders including year of birth, sex, season of birth, maternal age, deprivation, ethnicity and area characteristics and random effect terms were included in the models to allow for differences in baseline rates between areas and in incinerator feedstock.

RESULTS

Analyses included 1,025,064 births and 18,694 infant deaths. There was no excess risk in relation to any of the outcomes investigated during pregnancy or early life of either mean modelled MWI PM or proximity to an MWI.

CONCLUSIONS

We found no evidence that exposure to PM from, or living near to, an MWI operating to current EU standards was associated with harm for any of the outcomes investigated. Results should be generalisable to other MWIs operating to similar standards.

摘要

背景

一些研究报告称,城市垃圾焚烧厂(MWI)的暴露与不良出生结果之间存在关联,但很少有研究涉及符合当前欧盟(EU)工业排放指令标准的现代 MWI。

方法

在英国 2003-10 年间运营的 22 个 MWI 中,每个 MWI 周围 10 公里范围内模拟的地面水平直径≤10μm 的颗粒物(PM)作为 MWI 排放的替代物,与选定的出生和婴儿死亡率结果之间的关联进行了研究。我们还调查了居住地点与 MWI 接近度的关联。使用的结果是足月出生体重、足月时的胎儿生长受限(SGA)、死产、新生儿、后期新生儿和婴儿死亡率、多胎、性别比和早产,这些数据来自国家统计局的国家注册数据。分析调整了相关混杂因素,包括出生年份、性别、出生季节、母亲年龄、贫困程度、种族和地区特征,并在模型中纳入了随机效应项,以允许地区之间的基线率和焚烧炉进料的差异。

结果

分析包括 1,025,064 次分娩和 18,694 例婴儿死亡。在怀孕期间或生命早期,无论是平均模拟 MWI PM 还是接近 MWI,与任何调查结果的任何结果都没有超额风险。

结论

我们没有发现证据表明,接触当前欧盟标准下运行的 MWI 产生的 PM 或居住在 MWI 附近与任何研究结果的伤害有关。结果应该可以推广到其他符合类似标准的 MWI。

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