A national study on the effects of air pollution and temperature on children's neurodevelopmental outcomes

一项关于空气污染和温度对儿童神经发育结果影响的全国研究

• 批准号: 10585592
• 负责人: Stefania Papatheodorou
• 金额: $ 66.68万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-01 至 2027-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585592
• 关键词: 8 year old; Adverse effects; Age; Air; Air Pollutants; Air Pollution; Area; Attention deficit hyperactivity disorder; Behavior Disorders; Big Data; Birth; Body mass index; Brain; Caring; Characteristics; Chemicals; Child; Childhood; Clinical Data; Code; Complex; Confidence Intervals; Data; Data Sources; Databases; Developmental Coordination Disorders; Diagnosis; Economics; Education; Elements; Environment; Environmental Exposure; Environmental Risk Factor; Etiology; Exposure to; Fetus; Goals; Health; Health protection; Heat Waves; Heritability; Incidence; Income; Individual; Infant; Intellectual functioning disability; Intervention; Joints; Knowledge; Language Disorders; Learning Disabilities; Location; Marital Status; Mediating; Medicaid; Medical; Mental Health; Metals; Methods; Modeling; Modification; Neurodevelopmental Disorder; Nitrogen Dioxide; Outcome; Ozone; Pathway interactions; Pediatric cohort; Pollution; Predictive Value; Predisposition; Pregnancy; Pregnant Women; Prevalence; Privatization; Productivity; Public Health; Race; Regulation; Research; Resources; Risk; Risk Factors; Role; Sample Size; Scientific Evaluation; Smoking; Socioeconomic Status; Source; Speech Disorders; Statistical Methods; System; Temperature; Uncertainty; Work; adverse pregnancy outcome; autism spectrum disorder; climate change; cohort; cost; developmental disease; early childhood; epidemiology study; fine particles; follow-up; hazard; implementation barriers; innovation; modifiable risk; non-genetic; novel; pollutant; population based; postnatal; prenatal; sex; social; socioeconomic disadvantage; spatiotemporal

PROJECT SUMMARY/ABSTRACT Evidence suggests that the prevalence of certain developmental disorders, specifically autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD), has increased sharply in recent decades. Recent studies have shown a moderate heritability for neurodevelopmental delays (NDDs), suggesting a nongenetic component contributing to its etiology. The estimated annual cost of environmentally mediated NDDs in US children is $18.3 billion. Epidemiologic studies examined prenatal and early childhood exposure to air pollutants and NDDs, with non-conclusive evidence on the effects of different pollutants, interactions, sensitive windows of exposure and chemical components of PM2.5. In addition, the role of socioeconomic status (SES) in these associations is complex. Our overarching goal is to comprehensively investigate the independent and joint prenatal and early childhood exposure to PM2.5, NO2 and O3, PM2.5 chemical components and interactions with temperature on NDDs as well as effect modification by SES. The specific aims of this application are: 1) Quantify the association prenatal and early childhood exposure to PM2.5, NO2, O3, temperature and NDDs, 2) Examine the association between prenatal and early childhood exposure to PM2.5 chemical speciation and NDDs, and 3) Examine pathways and synergistic effects, among environmental exposures and SES on NDDs. We have established a birth cohort of more than 4 million pregnancies from two population-based databases—the Medicaid Analytic eXtract and IBM MarketScan—that include rich information on location and individual-level characteristics. By 8 years of age, 23.9% of publicly insured children and 11.0% of privately insured children received a diagnosis of 1 or more NDDs. For all pollutants, PM2.5 chemical components and temperature, we have validated highly resolved daily predictions for the entire continental US. The unique composition of these two cohorts, allows us to determine the extent to which SES modifies these associations. For our analyses, we will adjust for a wide range of individual-level characteristics and spatiotemporal covariates. We will estimate hazard ratios and their 95% confidence intervals using cox regression, distributed-linear/non-linear lag models, and we will examine effect modification by infant sex. We will use advanced statistical methods to estimate the effects of mixtures. Our prior work and data support both the hypothesis for and the feasibility of the proposed study. The proposed research is innovative because it will be the first study to: 1) investigate associations between air pollutants, temperature and NDDs on a national scale; 2) use state-of-the-art spatiotemporal models to assess individual exposures to PM2.5, NO2, O3 and temperature; 3) employ innovative resources of clinical data by leveraging two large pregnancy cohorts. The proposed research is of great significance because it will guide decisions and pollutant regulations to protect the health of pregnant women and children, inform heat wave warning systems, potentially reducing rates of NDDs and subsequent social, financial, and public health burden.

项目摘要/摘要 有证据表明，某些发育障碍的流行，特别是自闭症谱系 近几十年来，注意力缺陷多动障碍(ADHD)和自闭症(ASD)的发病率急剧上升。 最近的研究表明，神经发育迟缓(NDDS)的遗传性中等，这表明 导致其病因学的非遗传成分。环境介导型非排毒药物的估计年度成本 美国儿童的收入为183亿美元。流行病学研究检查了产前和儿童早期接触空气 污染物和NDDs，关于不同污染物的影响的非确凿证据，相互作用，敏感 PM2.5的暴露窗口和化学成分。此外，社会经济地位(SES)在 这些关联是复杂的。我们的总目标是全面调查独立和联合 产前和早期儿童暴露于PM2.5、NO2和O3、PM2.5化学成分及其相互作用 温度对NDDS的影响以及SES的修饰效果。本申请的具体目的是：1)量化 产前和儿童早期暴露于PM2.5、NO2、O3、温度和NDDs之间的关系，2)检查 产前和儿童早期接触PM2.5化学形态与NDDs之间的关系，以及3) 研究环境暴露和SES之间对NDDS的路径和协同效应。我们有 从两个基于人口的数据库中建立了400多万名孕妇的出生队列- Medicaid Analytic Extract和IBM MarketScan-包含丰富的位置和个人级别信息 特点。到8岁时，23.9%的公共保险儿童和11.0%的私人保险儿童 收到1个或多个NDD的诊断。对于所有污染物、PM2.5化学成分和温度，我们 已经证实了对整个美国大陆的高度分辨率的每日预测。这些独特的构成 两个队列，使我们能够确定SES修改这些关联的程度。在我们的分析中，我们 将根据广泛的个人水平特征和时空协变量进行调整。我们会估计 使用COX回归、分布线性/非线性滞后模型的风险比及其95%可信区间， 我们将研究婴儿性别对效果的影响。我们将使用先进的统计方法来估计 混合物的影响。我们之前的工作和数据支持了所提出的假设和可行性 学习。这项拟议的研究具有创新性，因为它将是第一项研究：1)调查关联 全国范围内的空气污染物、温度和NDDS之间的关系；2)使用最先进的时空模型 评估个人对PM2.5、NO2、臭氧和温度的暴露；3)利用创新的临床数据资源 通过利用两个大的怀孕队列。提出的研究具有重要的意义，因为它将指导 保护孕妇和儿童健康的决定和污染物法规，通报热浪 预警系统，有可能降低非传染性疾病的发病率以及随后的社会、财政和公共卫生负担。