Air Pollution and the Risk of Cardiac Defects: A Population-Based Case-Control Study.
Air Pollution and the Risk of Cardiac Defects: A Population-Based Case-Control Study.
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DOI：
10.1097/md.0000000000001883
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发表时间：
2015-11
期刊：
影响因子：
1.6
通讯作者：
Jaakkola JJ
中科院分区：
文献类型：
--
作者：
Hwang BF;Lee YL;Jaakkola JJ
先前的流行病学研究评估了暴露于环境空气污染在心脏出生缺陷发展中的作用，但它们提供的结果有些不一致。为了评估暴露于环境空气污染物与心脏缺陷风险之间的关联，我们进行了一项以人群为基础的病例对照研究，使用了 2001 年至 2007 年间 1,533,748 名台湾新生儿中的 1087 例心脏缺陷病例和随机抽取的 10,870 名对照样本。采用逻辑回归来计算 O3 增加 10 ppb 和 O3 增加 10 μg/m3 的比值比。 PM10。此外，我们还比较了4类心脏缺陷的风险——高暴露（>75%）；中等暴露（第 75 至第 50 个百分位数）；低暴露（<50%–25%）；基于每种污染物分布的参考（<25%）。在足月儿和早产儿中，室间隔缺损 (VSD)、房间隔缺损 (ASD) 和动脉导管未闭 (PDA) 的风险与妊娠前 3 个月内 O3 暴露增加 10 ppb 相关。与高 PM10 暴露和参考类别相比，自闭症谱系障碍 (ASD) 对所有新生儿和足月新生儿的影响估计值在统计上显着升高。此外，SO2、NO2、CO 与心脏缺陷之间存在负相关或弱相关。研究证明，妊娠前三个月暴露于室外空气 O3 和 PM10 可能会增加 VSD、ASD 和 PDA 的风险。
Previous epidemiologic studies have assessed the role of the exposure to ambient air pollution in the development of cardiac birth defects, but they have provided somewhat inconsistent results. To assess the associations between exposure to ambient air pollutants and the risk of cardiac defects, a population-based case-control study was conducted using 1087 cases of cardiac defects and a random sample of 10,870 controls from 1,533,748 Taiwanese newborns in 2001 to 2007. Logistic regression was performed to calculate odds ratios for 10 ppb increases in O3 and 10 μg/m3 increases in PM10. In addition, we compared the risk of cardiac defects in 4 categories-high exposure (>75th percentile); medium exposure (75th to 50th percentile); low exposure (<50th–25th percentile); reference (<25th percentile) based on the distribution of each pollutant. The risks of ventricular septal defects (VSD), atrial septal defects (ASD), and patent ductus arteriosus (PDA) were associated with 10 ppb increases in O3 exposure during the first 3 gestational months among term and preterm babies. In comparison between high PM10 exposure and reference category, there were statistically significant elevations in the effect estimates of ASD for all and terms births. In addition, there was a negative or weak association between SO2, NO2, CO, and cardiac defects. The study proved that exposure to outdoor air O3 and PM10 during the first trimester of gestation may increase the risk of VSD, ASD, and PDA.