背景:燃煤发电厂是环境二氧化硫(SO2)空气污染的主要贡献者。流行病学文献表明,妊娠期SO2暴露与早产(PTB;妊娠<37周)之间存在不良关联。PTB与婴儿死亡率和以后生活发病率的风险增加密切相关。
目的:我们调查了北卡罗来纳州SO2和PTB之间的关联,并评估了这种关联是否因种族/民族而改变。
方法:我们进行了回顾性研究,2003-2015年北卡罗来纳州单胎出生的行政队列。我们使用美国EPAEQUATES数据将长期SO2妊娠暴露分配给整个妊娠和妊娠中期的合格分娩。我们使用多变量广义线性回归来估计SO2每增加1-ppb的风险差异(RD(95CI)),并根据妊娠父母的教育进行调整。医疗补助状况,婚姻状况,和受孕季节。针对其他标准空气共污染物(O3,PM2.5,NO2),还对多污染物模型进行了调整。
结果:暴露窗口的SO2中位数(24小时平均值)为〜1.5(IQR:1.8)ppb。PTB的总体基线风险为每100,000例活产8,756例。当按种族/民族分层时,在非西班牙裔黑人中,PTB的基线风险为每100,000活产12215、7824和7187,非西班牙裔白人,和西班牙裔出生,分别。对于单污染物和多污染物模型,整个怀孕期间SO2平均每增加1-ppb的RD分别为317.0(95CI:279.4,354.5)和568.2(95CI:500.3,636.1)/100,000活产,分别。对于PTB多污染物模型,我们观察到非西班牙裔黑人参与者(669.6[95CI:573.9,765.2])和非西班牙裔白人参与者(635.4[95CI:557.2,713.6])的RD相似,西班牙裔参与者的RD较小(336.8[95CI:241.3,432.2]).
结论:我们调整后的单污染物和多污染物模型的结果显示,SO2和PTB之间存在不利关联,有一些证据表明,在PTB的子类别中,通过种族/族裔对效果测量进行了修改。
BACKGROUND: Coal-fired power plants are major contributors of ambient sulfur dioxide (SO2) air pollution. Epidemiological literature suggests an adverse association between SO2 exposure during gestation and preterm birth (PTB; <37 weeks completed gestation). PTB is strongly associated with infant mortality and increased risk for later life morbidities.
OBJECTIVE: We investigated associations between SO2 and PTB in North Carolina and evaluated whether the associations were modified by race/ethnicity.
METHODS: We assembled a retrospective, administrative cohort of singleton births in North Carolina from 2003-2015. We used US EPA EQUATES data to assign long-term SO2 gestational exposures to eligible births for the entire pregnancy and by trimester. We used multivariable generalized linear regression to estimate risk differences (RD (95%CI)) per 1-ppb increase in SO2, adjusted for gestational parent education, Medicaid status, marital status, and season of conception. Multi-pollutant models were additionally adjusted for other criteria air co-pollutants (O3, PM2.5, NO2).
RESULTS: The median SO2 (24-hour average) across exposure windows was ~1.5 (IQR: 1.8) ppb. The overall baseline risk for PTB was 8,756 per 100,000 live births. When stratified by race/ethnicity, the baseline risk for PTB was 12215, 7824, and 7187 per 100,000 live births among non-Hispanic Black, non-Hispanic white, and Hispanic births, respectively. RDs per 1-ppb increase in SO2 averaged across the entire pregnancy were 317.0 (95%CI: 279.4, 354.5) and 568.2 (95%CI: 500.3, 636.1) per 100,000 live births for single- and multi-pollutant models, respectively. For the PTB multi-pollutant models, we observed similar RDs for non-Hispanic Black participants (669.6 [95%CI: 573.9, 765.2]) and non-Hispanic white participants (635.4 [95%CI: 557.2, 713.6]) with smaller RDs for Hispanic participants (336.8 [95%CI: 241.3, 432.2]).
CONCLUSIONS: The results for our adjusted single- and multi-pollutant models showed adverse associations between SO2 and PTB, with some evidence of effect measure modification by race/ethnicity within subcategories of PTB.