Childhood Autism and Air Pollution - A Statewide Study

 描述（由申请人提供）：专家们一致认为，基因和环境因素都有助于自闭症的发展，最近的研究表明环境因素的作用令人惊讶地强大。然而，即使公众非常关注环境影响，哪些因素可能起重要作用仍然难以捉摸。最近，环境空气污染对自闭症的产前和早期生活发展的关注越来越多，很少有研究报告表明，这种积极的联系令人震惊，而且主要是小型研究。我们最近对洛杉矶约7，000名自闭症儿童进行的试点研究表明，与产前接触交通有关的风险增加，尽管风险的大小比以前的研究报告要小得多（5）。综上所述，以前大多数小规模研究的结果提出了一个重要的公共卫生问题，以及在脆弱发育期进行大规模基于人口的调查和科学水平的空气污染暴露评估的必要性，以解决空气污染是否以及什么类型的空气污染对自闭症构成风险的问题。如果这些结果在精心设计的大规模研究中得到证实，这将对胎儿保护和空气污染法规产生重要影响。这一建议及时有效地解决了这一问题。 在这里，我们建议彻底检查假设，即在怀孕期间，子宫内和生命的第一年暴露于空气污染会增加儿童自闭症的风险。我们建议使用高度复杂的建模和分析技术，对我们小组开发、验证和建立的空气污染进行详细的空间和时间评估。我们建议首次使用全州范围内基于自闭症病例（> 35，000）和对照组（比例为1：10）的出生队列来检查脆弱时期的这些暴露。加州（CA）是研究环境对自闭症的潜在影响的绝佳地点。CA部门发展服务部运作着一个全州范围的系统，协调自闭症儿童的服务，并维护电子记录。此外，加州是全国空气污染最严重的州之一，拥有密集的空气污染监测网络。 因此，该提案的目标是探索-第一次-可靠和可理解的可能影响空气污染在易感发育期和自闭症的风险基于加州全州人口，使用高度复杂的国家的科学空气污染暴露评估和尖端的分析方法。这将有助于阐明这种无处不在的环境暴露是否会导致儿童患自闭症的风险。如果这种关联在这项大规模高质量的研究中被证明存在，它将为预防性环境政策提供必要的证据，以保护发育中的儿童，从而为基于人口的自闭症预防提供独特的机会。

 DESCRIPTION (provided by applicant): Experts agree that both genes and environmental factors contribute to development of autism with recent research suggesting a surprisingly strong role for environmental factors. However, which factors may play important roles remains elusive even though the public is very concerned about environmental influences. Ambient air pollution has recently been of growing concern for the prenatal and early life development of autism with alarming reports of positive associations from very few and mainly small studies. Our own recent pilot study of ~7,000 autistic children in LA, suggested increases in risk related to prenatal exposure to traffic albeit risks were much smaller in size than reported in previous studies (5). Taken together, findings from previous mostly small-scale studies raise an important public health issue and the necessity to conduct a large- scale population based investigation with state-of-the-science air pollution exposure assessment during vulnerable developmental periods to address the question whether and what type of air pollution poses a risk for autism. Should these results be confirmed in well-designed and large-scale studies, this would have critical implications for the protection of the fetus and for air pollution regulations. This propoal addresses this question in a timely and efficient manner. Here, we propose to thoroughly examine hypotheses that exposure to air pollution during vulnerable periods around conception, in utero, and in the first year of life increases risks of autism in children. We propose to use highly sophisticated modeling and analytical techniques for the detailed spatial and temporal assessment of air pollution, developed, validated, and established by our group. We propose to examine these exposures during vulnerable periods using for the first time, a statewide population based birth cohort of autistic disorder cases (>35,000) and controls (ratio 1:10). California (CA) is an excellent location for studying potential environmental contributions to autism. The CA Dept. of Developmental Services operates a statewide system that coordinates services for children with autism and maintains electronic records. Further, the state of CA has among the highest levels of air pollution in the nation and a dense air pollution monitoring network. The goal of this proposal is thus to explore - for the first time - reliably and comprehensibly possible effects of air pollution during susceptible developmental periods and the risk of autism based on a statewide population in CA, using highly sophisticated state-of-the-science air pollution exposure assessment and cutting edge analytical approaches. This will help to elucidate whether or not, this ubiquitous environmental exposure contributes to the risk of autism in children. Should this association be shown to exist in this large-scale high quality study, it would provide the necessary evidence for preventive environmental policies to protect the developing child and thus provide a unique opportunity for population based prevention of autism.