Prenatal exposure to traffic-related air pollution and risk of congenital diseases in South Korea
Prenatal exposure to traffic-related air pollution and risk of congenital diseases in South Korea
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DOI：
10.1016/j.envres.2020.110060
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发表时间：
2020-12-01
影响因子：
8.3
通讯作者：
Hong, Yun-Chul
中科院分区：
文献类型：
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作者：
Lee, Kyung-Shin;Lim, Youn-Hee;Hong, Yun-Chul
背景：以前的研究表明，暴露在环境空气污染物中与先天性心脏病风险增加之间存在联系。然而，很少有研究调查其他先天性疾病与与交通相关的空气污染之间的联系。在本研究中，我们评估了出生前接触细颗粒物(PM2.5)和二氧化氮(NO2)与韩国先天性疾病的关系。方法：病例：对照比为1：3的非感染性胃肠炎和结肠炎患者组，取自韩国国家医疗保险服务中心2008-2013年的数据。结果：孕妇妊娠早期和中期的PM2.5暴露与先天性疾病的发生呈正相关，每增加11.1µg/m(3)和10.2µg/m(3)的PM2.5四分位差(IQR)分别变化14.7%(95%可信区间，9.3%，20.3%)和16.2%(95%CI，11.0%，21.7%)。同样，妊娠早期和中期接触NO2与整体先天畸形的增加有关，每增加10.6ppb的NO2分别增加8.2%(95%可信区间，4.2%，12.3%)和15.6%(95%可信区间，9.3%，22.2%)的病例。我们发现，孕妇在怀孕前和中期暴露于PM2.5与特定先天性疾病的风险增加显著相关，包括影响循环系统、泌尿生殖系统和肌肉骨骼系统的亚型。然而，在第三个三个月期间没有观察到明显的相关性。孕妇在整个妊娠期间接触NO2与肌肉骨骼系统畸形有关。结论：我们的研究确定了宫内PM2.5和NO2暴露与某些先天性疾病之间的显著联系，并建议需要对PM2.5和NO2浓度进行更严格的控制。
Background: Previous studies have suggested links between exposure to ambient air pollutants and increased risk of congenital heart defects. However, few studies have investigated the association between other congenital diseases and traffic-related air pollution. In this study, we assessed the relationship between prenatal exposure to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) with congenital diseases in South Korea.Methods: Patients with one or more congenital diseases and a control group of patients with non-infective gastroenteritis and colitis with a case:control ratio of 1:3 were obtained from the National Health Insurance Service data for 2008-2013 in South Korea. We estimated the associations of PM2.5 and NO2 exposures with congenital diseases using generalized estimation equations after controlling for covariates.Results: Maternal PM2.5 exposure during the first and second trimester showed positive associations with overall congenital diseases, with changes of 14.7% (95% confidence intervals (CI), 9.3%, 20.3%) and 16.2% (95% CI, 11.0%, 21.7%), respectively, per 11.1 mu g/m(3) and 10.2 mu g/m(3) increase of PM2.5 interquartile range (IQR). Similarly, NO2 exposure during the first and second trimester was associated with increased numbers of overall congenital anomalies, with 8.2% (95% CI, 4.2%, 12.3%) and 15.6% (95% CI, 9.3%, 22.2%) more cases, respectively, per 10.6 ppb increase of NO2. We found that maternal PM2.5 exposure during the first and second trimesters of pregnancy was significantly associated with increased risk of specific congenital diseases, including subtypes affecting the circulatory, genitourinary, and musculoskeletal system. However, no significant associations were observed during the third trimester. Maternal NO2 exposure across the entire pregnancy was associated with malformations of the musculoskeletal system.Conclusions: Our study identified significant links between in utero exposure to PM2.5 and NO2 and certain congenital diseases, and suggests that stricter controls on PM2.5 and NO2 concentrations are required.