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American Journal of Epidemiology Vol. 155, No. 1 : 17-25
Copyright © 2002 by The Johns Hopkins University School of Hygiene and Public Health


ORIGINAL CONTRIBUTIONS

Ambient Air Pollution and Risk of Birth Defects in Southern California

Beate Ritz1,2, Fei Yu3, Scott Fruin4,5, Guadalupe Chapa4, Gary M. Shaw6 and John A. Harris6

1 Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA.
2 Center for Occupational and Environmental Health, School of Public Health, University of California, Los Angeles, Los Angeles, CA.
3 Department of Biostatistics, School of Public Health, University of California, Los Angeles, Los Angeles, CA.
4 Department of Environmental Health Sciences, School of Public Health, University of California, Los Angeles, Los Angeles, CA.
5 California Air Resources Board, Sacramento, CA.
6 California Birth Defects Monitoring Program, Oakland, CA.

The authors evaluated the effect of air pollution on the occurrence of birth defects ascertained by the California Birth Defects Monitoring Program in neonates and fetuses delivered in southern California in 1987–1993. By using measurements from ambient monitoring stations of carbon monoxide (CO), nitrogen dioxide, ozone, and particulate matter <10 µm in aerodynamic diameter, they calculated average monthly exposure estimates for each pregnancy. Conventional, polytomous, and hierarchical logistic regression was used to estimate odds ratios for subgroups of cardiac and orofacial defects. Odds ratios for cardiac ventricular septal defects increased in a dose-response fashion with increasing second-month CO exposure (odds ratio (OR)2nd quartile CO = 1.62, 95% confidence interval (CI): 1.05, 2.48; OR3rd quartile CO = 2.09, 95% CI: 1.19, 3.67; OR4th quartile CO = 2.95, 95% CI: 1.44, 6.05). Similarly, risks for aortic artery and valve defects, pulmonary artery and valve anomalies, and conotruncal defects increased with second-month ozone exposure. The study was inconclusive for other air pollutants. The authors' results are supported by the specificity of the timing of the effect and some evidence from animal data; however, this is the first known study to link ambient air pollution during a vulnerable window of development to human malformations. Confirmation by further studies is needed.

abnormalities; air pollution; carbon monoxide; cleft lip; cleft palate; environment and public health; heart defects, congenital; ozone

Abbreviations: CBDMP, California Birth Defects Monitoring Program; CI, confidence interval; OR, odds ratio; PM10, particulate matter <10 µm in aerodynamic diameter


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