Wildfire Smoke and Severe Maternal Morbidity in California

项目摘要 早产是一个重要的危险因素，围产期死亡率和不利的健康后果， 童年和成年。在美国，大约10%的活产婴儿是早产儿（<37周 2012年，它继续攀升。弗雷斯诺县位于加州的圣华金河谷， 众所周知的高空气污染负担和高早产率（12%）。 野火是加州（CA）空气污染的重要且日益严重的来源， 过去几十年来，在减少空气污染及其对孕妇的影响方面取得了进展， 没有被很好地理解。此外，最近的火灾发生在野火城市界面， 结构燃烧。随着暴露于野火烟雾的增加，人们越来越关注 这些风险暴露为未来的监管提供信息。其他生物质燃烧源是农业废物燃烧， 规定的烧伤和住宅木材燃烧，这些都可以增加空气污染暴露，但在更多的 控制设置，并且通常在生长火灾季节以外的季节执行。它们的不同之处在于 范围、温度和化学成分，与野火相比，对健康的影响可能不那么严重。 我们和其他研究人员已经证明早产风险对产前暴露敏感， 环境空气污染，包括颗粒物和多环芳烃等标准污染物 碳氢化合物是不完全燃烧的产物。此外，我们还发现， 社会经济地位较低的社区。这种暴露于污染物和贫困的双重危险， 据推测，这是造成早产差异的原因之一，但往往缺乏足够的数据。 探讨野火和其他生物质燃烧烟雾暴露对早产的影响， 如何这些关系可能被修改邻里剥夺，我们建议编制一个独特的组 的火灾发生率、空气质量监测和建模数据集，以及CA的出生记录数据（2008-2016）， 评估野火和故意燃烧的影响（农业废物，住宅木材和规定的 烧伤）的影响，并评估是否有不同的浓度指数， 极端，一种衡量社区剥夺的指标，用于解释基于种族/民族的极端情况， 按人口普查区分列的收入。我们将比较不同的火灾暴露评估模型， 怀孕期间早产，同时控制季节。 这项研究将提供野火和其他生物质造成的空气污染影响的估计 早产时燃烧。这些发现有可能为消防和保护法规提供信息， 野火、农业废弃物燃烧、规定的燃烧和住宅木材燃烧。

Project Summary Preterm birth is an important risk factor for perinatal mortality and adverse health consequences in childhood and adulthood. In the United States, approximately 10% of all live births were preterm (<37 weeks gestation) in 2012 and it continues to climb. Fresno County, in the San Joaquin Valley of California, is an area of known high air pollution burden and a high prevalence of preterm birth (12%). Wildfires are a significant and increasing source of air pollution in California (CA) that threaten to reverse the progress made over the past decades in air pollution reduction and their effects on pregnant women are not well understood. Furthermore, recent fires are occurring at the wildfire urban interface leading to biomass and structure burning. With increased exposure to wildfire smoke comes increasing concern of health effects of these exposures to inform future regulation. Other biomass burning sources are agricultural waste burning, prescribed burns, and residential wood burning which all can increase air pollution exposure but in more controlled settings and are generally performed during seasons outside the growing fire season. They differ in scope, temperature and chemical composition and may have less severe health effects compared to wildfires. We and other investigators have demonstrated preterm birth risk is sensitive to prenatal exposures to ambient air pollution, including criteria pollutants such as particulate matter and polycyclic aromatic hydrocarbons, a product of incomplete combustion. Moreover, we have found stronger associations in neighborhoods with lower socioeconomic status. This double jeopardy of exposure to pollutants and poverty is hypothesized to contribute to disparities in preterm birth, but sufficient data are often lacking. To address the contribution of wildfire and other biomass burning smoke exposures on preterm birth, and how these relationships may be modified by neighborhood deprivation, we propose to compile a unique group of datasets of fire occurrence, air quality monitoring and modelling, and birth record data for CA (2008-2016) to evaluate the effects of wildfires and intentional burning (agricultural waste, residential wood, and prescribed burns) exposure on preterm birth and to evaluate if the effects differ by the Index of Concentration at the Extreme, a measure of neighborhood deprivation that accounts for extremes based on race/ethnicity and income by census tract. We will compare different models of fire exposure assessment and examine critical periods of pregnancy with regard to preterm birth, while controlling for season. This study will provide estimates of the impact of air pollution exposures from wildfires and other biomass burning on preterm birth. The findings have the potential to inform fire prevention and protection regulation for wildfires, agricultural waste burning, prescribed burns, and residential wood burning.