Department of Preventive Medicine, Hospital Central de la Cruz Roja, 28003 Madrid, Spain.
Doctoral Program in Biomedical Sciences and Public Health, International Doctorate Program, National University of Distance Education (UNED), 28015 Madrid, Spain.
Int J Environ Res Public Health. 2023 Jan 27;20(3):2290. doi: 10.3390/ijerph20032290.
Air pollution is considered an ongoing major public health and environmental issue around the globe, affecting the most vulnerable, such as pregnant women and fetuses. The aim of this study is to estimate the health impact and economic value on birth outcomes, such as low birthweight (LBW), preterm birth (PTB), small for gestational age (SGA), attributable to a reduction of PM levels in Spain. Reduction based on four scenarios was implemented: fulfillment of WHO guidelines and EU limits, and an attributable reduction of 15% and 50% in annual PM levels. Retrospective study on 288,229 live-born singleton children born between 2009-2010, using data from Spain Birth Registry Statistics database, as well as mean PM mass concentrations. Our finding showed that a decrease in annual exposure to PM appears to be associated with a decrease in the annual cases of LBW, SGA and PTB, as well as a reduction in hospital cost attributed to been born with LBW. Improving pregnancy outcomes by reducing the number of LBW up to 5% per year, will result in an estimate associated monetary saving of 50,000 to 7,000,000 euros annually. This study agrees with previous literature and highlights the need to implement, and ensure compliance with, stricter policies that regulate the maximum exposure to outdoor PM permitted in Spain, contributing to decreased environmental health risk, especially negative birth outcomes.
空气污染被认为是全球范围内持续存在的主要公共卫生和环境问题，影响到最脆弱的人群，如孕妇和胎儿。本研究旨在评估降低西班牙大气颗粒物（PM）水平对出生结局（如低出生体重（LBW）、早产（PTB）和小于胎龄儿（SGA））的健康影响和经济价值。基于以下四种情景实施了减排措施：达到世卫组织指南和欧盟限值，以及每年 PM 水平降低 15%和 50%。这是一项对 2009-2010 年间出生的 288229 名活产单胎儿童的回顾性研究，使用了西班牙出生登记统计数据库以及平均 PM 质量浓度的数据。我们的研究结果表明，每年接触 PM 的减少似乎与 LBW、SGA 和 PTB 的年病例数减少以及与 LBW 相关的住院费用减少有关。通过每年减少 5%的 LBW 数量来改善妊娠结局，每年将节省 5 万至 700 万欧元。这项研究与之前的文献一致，强调需要实施并确保遵守更严格的政策，以规范西班牙允许的室外 PM 最大暴露量，从而降低环境健康风险，特别是对负面出生结局的影响。
