University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Environmental and Public Health Sciences, University of Cincinnati, College of Medicine, Cincinnati, OH, USA.
Int J Hyg Environ Health. 2023 Jun;251:114172. doi: 10.1016/j.ijheh.2023.114172. Epub 2023 Apr 27.
Autism Spectrum Disorder (ASD) affects about 1 in 44 children and environmental exposures may contribute to disease onset. Air pollution has been associated with adverse neurobehavioral outcomes, yet little research has examined its association with autistic-like behaviors. Therefore, our objective was to examine the association between exposure to air pollution, including NO and PM, during pregnancy and the first year of life to ASD-like behaviors during childhood. Participants (n = 435) enrolled in the Cincinnati Childhood Allergy and Air Pollution Study and the Health Outcomes and Measures of the Environment Study were included in the analysis. Daily exposures to NO and PM at the residential addresses of participants were estimated using validated spatiotemporal models and averaged to obtain prenatal and first year exposure estimates. ASD-like behaviors were assessed via the Social Responsiveness Scale (SRS) questionnaire at age 12. Linear regression models adjusting for confounders were applied to estimate the association between pollutants and SRS scores. After adjusting for covariates, the association between NO and PM and SRS scores remained positive but were no longer statistically significant. Prenatal and first year exposure to NO were associated with total SRS T-scores with an estimated 0.4 point increase (95% CI: -0.7, 1.6) per 5.2 ppb increase in NO exposure and 0.7 point (95% CI: -0.3, 1.6) per 4.2 ppb increase in NO exposure, respectively. For PM, a 2.6 μg/m increase in prenatal exposure was associated with a 0.1 point increase (95% CI: -1.1, 1.4) in SRS Total T-scores and a 1.3 μg/m increase first year of life was associated with a 1 point increase (95% CI: -0.2, 2.3). In summary, exposure to NO and PM during pregnancy and the first year of life were not significantly associated with higher autistic-like behaviors measured with SRS scores after adjustment of covariates. Additional research is warranted given prior studies suggesting air pollution contributes to ASD.
自闭症谱系障碍 (ASD) 影响大约每 44 名儿童中有 1 名,环境暴露可能导致疾病发作。空气污染与不良神经行为结果有关,但很少有研究检查其与类自闭症行为的关联。因此,我们的目的是研究怀孕期间和生命的第一年暴露于空气污染(包括 NO 和 PM)与儿童时期类自闭症行为之间的关联。参与者(n=435)参加了辛辛那提儿童过敏和空气污染研究以及健康结果和环境测量研究,被纳入分析。使用经过验证的时空模型估计参与者居住地址的每日 NO 和 PM 暴露量,并对其进行平均以获得产前和第一年的暴露估计值。通过社会反应量表(SRS)问卷在 12 岁时评估类自闭症行为。应用线性回归模型调整混杂因素,以估计污染物与 SRS 评分之间的关联。在调整协变量后,NO 和 PM 与 SRS 评分之间的关联仍然呈正相关,但不再具有统计学意义。NO 和 PM 的产前和第一年暴露与总 SRS T 评分相关,NO 暴露每增加 5.2 ppb,估计总 SRS T 评分增加 0.4 点(95%CI:-0.7,1.6),NO 暴露每增加 4.2 ppb,总 SRS T 评分增加 0.7 点(95%CI:-0.3,1.6)。对于 PM,产前暴露增加 2.6 μg/m,SRS 总 T 评分增加 0.1 点(95%CI:-1.1,1.4),生命第一年的暴露增加 1.3 μg/m,SRS 总 T 评分增加 1 点(95%CI:-0.2,2.3)。总之,在调整了混杂因素后,怀孕期间和生命的第一年暴露于 NO 和 PM 与 SRS 评分测量的较高类自闭症行为没有显著关联。鉴于先前的研究表明空气污染会导致 ASD,因此需要进一步研究。