Ritz Beate, Liew Zeyan, Yan Qi, Cui Xin, Virk Jasveer, Ketzel Matthias, Raaschou-Nielsen Ole
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, USA; Department of Neurology, School of Medicine, University of California at Los Angeles, CA, USA.
Department of Epidemiology, UCLA, Los Angeles, USA.
Environ Epidemiol. 2018 Dec;2(4):e028. doi: 10.1097/EE9.0000000000000028.
Previous autism spectrum disorder (ASD) and air pollution studies focused on pregnancy exposures, but another vulnerable period is immediate postnatally. Here, we examined early life exposures to air pollution from the pre- to the postnatal period and ASD/ASD subtypes in the Danish population.
With Danish registers, we conducted a nationwide case-control study of 15,387 children with ASD born 1989-2013 and 68,139 population controls matched by birth year and sex identified from the birth registry. We generated air dispersion model (AirGIS) estimates for NO2, SO2, PM2.5 and PM10 at mothers' home from 9 months before to 9 months after pregnancy and calculated odds ratios (OR) and 95% confidence intervals (CI), adjusting for parental age, neighborhood socio-economic indicators, and maternal smoking using conditional logistic regression.
In models that included all exposure periods, we estimated adjusted ORs for ASD per interquartile range (IQR) increase for 9 month after pregnancy with NO2 of 1.08 (95% CI: 1.01, 1.15) and with PM2.5 of 1.06 (95% CI: 1.01, 1.11); associations were smaller for PM10 (1.04; 95% CI: 1.00, 1.09) and strongest for SO2 (1.21; 95% CI: 1.13, 1.29). Also, associations for pollutants were stronger in more recent years (2000-2013) and in larger cities compared with provincial towns/rural counties. For particles and NO2, associations were only specific to autism and Asperger diagnoses.
Our data suggest that air pollutant exposure in early infancy but not during pregnancy increases the risk of being diagnosed with autism and Asperger among children born in Denmark.
以往关于自闭症谱系障碍（ASD）与空气污染的研究主要聚焦于孕期暴露，但另一个易受影响的时期是出生后不久。在此，我们研究了丹麦人群从产前到产后早期生活中的空气污染暴露情况以及ASD/ASD亚型。
利用丹麦的登记资料，我们开展了一项全国性病例对照研究，研究对象为1989年至2013年出生的15387名患有ASD的儿童以及从出生登记处确定的68139名按出生年份和性别匹配的人群对照。我们利用空气扩散模型（AirGIS）估算了母亲孕期前9个月至产后9个月在家中接触二氧化氮（NO2）、二氧化硫（SO2）、细颗粒物（PM2.5）和可吸入颗粒物（PM10）的情况，并通过条件逻辑回归计算比值比（OR）和95%置信区间（CI），同时对父母年龄、邻里社会经济指标和母亲吸烟情况进行了校正。
在纳入所有暴露时期的模型中，我们估计，产后9个月时，每增加一个四分位间距（IQR）的NO2，ASD的校正OR为1.08（95%CI：1.01，1.15），PM2.5为1.06（95%CI：1.01，1.11）；PM10的关联较小（1.04；95%CI：1.00，1.09），SO2的关联最强（1.21；95%CI：1.13，1.29）。此外，与省级城镇/农村县相比，近年来（2000 - 2013年）和大城市中污染物的关联更强。对于颗粒物和NO2，关联仅特定于自闭症和阿斯伯格综合征诊断。
我们的数据表明，丹麦出生儿童在婴儿早期而非孕期暴露于空气污染物会增加被诊断为自闭症和阿斯伯格综合征的风险。
