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患病率，特别是自闭症谱系 近几十年来，疾病（ASD）和注意力缺陷多动症（ADHD）急剧增加。 最近的研究表明，神经发育延迟（NDD）具有现代的遗传力，这表明 非核成分有助于其病因。估计的环境中介NDD的年成本 在美国，儿童为183亿美元。流行病学研究检查了产前和早期暴露于空气 污染物和NDD，有关于不同污染物，相互作用，敏感的影响的非确定证据 PM2.5的暴露窗口和化学成分。此外，社会经济地位（SES）在 这些关联很复杂。我们的总体目标是全面研究独立和联合 产前和幼儿期暴露于PM2.5，NO2和O3，PM2.5化学成分以及与 NDD上的温度以及SES的效果修饰。本应用程序的具体目的是：1）量化 协会产前和幼儿暴露于PM2.5，NO2，O3，温度和NDDS，2）检查 产前与儿童早期暴露于PM2.5化学规范和NDD之间的关联，3） 在环境暴露和SES对NDDS的途径和协同效应中检查途径和协同作用。我们有 从两个基于人群的数据库中建立了超过400万妊娠的出生队列 - 医疗补助分析提取物和IBM MarketScan-包括有关位置和个人级别的丰富信息 特征。到8岁，有23.9％的公共保险儿童和11.0％的私人保险儿童 接受了1个或更多NDD的诊断。对于所有污染物，PM2.5化学成分和温度，我们 已经验证了整个美国大陆的高度解决的日常预测。这些独特的组成 两个队列使我们能够确定SES修改这些关联的程度。对于我们的分析，我们 将调整各种个人级别特征和时空协变量。我们将估计 使用COX回归，分布式线性/非线性滞后模型的危险比及其95％的置信区间， 我们将检查婴儿性别的效果修饰。我们将使用高级统计方法来估计 混合物的影响。我们先前的工作和数据支持提议的假设和可行性 学习。拟议的研究具有创新性，因为它将是：1）研究关联的第一个研究 在全国范围内的空气污染物，温度和NDD之间； 2）使用最先进的时空模型 评估对PM2.5，NO2，O3和温度的个人暴露； 3）员工的临床数据创新资源 通过利用两个大型怀孕队列。拟议的研究具有重要意义，因为它将指导 决定保护孕妇和儿童健康的决策和污染物法规，告知热浪 警告系统，可能会降低NDD的速度以及随后的社会，财务和公共卫生伯恩。