Woodruff T J, Grillo J, Schoendorf K C
U.S. Environmental Protection Agency, Washington, D.C. 20460, USA.
Environ Health Perspect. 1997 Jun;105(6):608-12. doi: 10.1289/ehp.97105608.
Recent studies have found associations between particulate air pollution and total and adult mortality. The relationship between particulate air pollution and mortality among infants has not been examined in the United States. This study evaluates the relationship between postneonatal infant mortality and particulate matter in the United States. Our study involved analysis of cohorts consisting of approximately 4 million infants born between 1989 and 1991 in states that report relevant covariates; this included 86 metropolitan statistical areas (MSAs) in the United States. Data from the National Center for Health Statistics-linked birth/infant death records were combined at the MSA level with measurements of particulate matter 10 microns or less (PM10) from the EPA's Aerometric Database. Infants were categorized as having high, medium, or low exposures based on tertiles of PM10. Total and cause-specific postneonatal mortality rates were examined using logistic regression to control for demographic and environmental factors. Overall postneonatal mortality rates were 3.1 among infants with low PM10 exposures, 3.5 among infants with medium PM10 exposures, and 3.7 among highly exposed infants. After adjustment for other covariates, the odds ratio (OR) and 95% confidence intervals (CI) for total postneonatal mortality for the high exposure versus the low exposure group was 1.10 (1.04, 1.16). In normal birth weight infants, high PM10 exposure was associated with respiratory causes [OR = 1.40, (1.05, 1.85)] and sudden infant death syndrome [OR = 1.26, (1.14, 1.39)]. For low birth weight babies, high PM10 exposure was associated, but not significantly, with mortality from respiratory causes [OR = 1.18, (0.86, 1.61)]. This study suggests that particulate matter is associated with risk of postneonatal mortality. Continued attention should be paid to air quality to ensure optimal health of infants in the United States.
近期研究发现，空气中的颗粒物污染与全因死亡率及成人死亡率之间存在关联。在美国，尚未对空气中的颗粒物污染与婴儿死亡率之间的关系进行过研究。本研究评估了美国新生儿期后婴儿死亡率与颗粒物之间的关系。我们的研究涉及对队列进行分析，这些队列由1989年至1991年间在报告了相关协变量的州出生的约400万婴儿组成；这包括美国的86个大都市统计区（MSA）。来自国家卫生统计中心链接的出生/婴儿死亡记录的数据，在MSA层面与美国环境保护局空气测量数据库中10微米及以下颗粒物（PM10）的测量数据相结合。根据PM10的三分位数，将婴儿分为高暴露、中暴露或低暴露组。使用逻辑回归来控制人口统计学和环境因素，对全因和特定原因的新生儿期后死亡率进行了检查。PM10低暴露组婴儿的总体新生儿期后死亡率为3.1，PM10中暴露组婴儿为3.5，高暴露组婴儿为3.7。在对其他协变量进行调整后，高暴露组与低暴露组相比，全因新生儿期后死亡率的优势比（OR）和95%置信区间（CI）为1.10（1.04，1.16）。在正常出生体重的婴儿中，高PM10暴露与呼吸道疾病原因相关[OR = 1.40，（1.05，1.85）]以及婴儿猝死综合征[OR = 1.26，（1.14，1.39）]。对于低出生体重婴儿，高PM10暴露与呼吸道疾病导致的死亡率相关，但不显著[OR = 1.18，（0.86，1.61）]。本研究表明，颗粒物与新生儿期后死亡风险相关。应持续关注空气质量，以确保美国婴儿的最佳健康状况。
