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American Journal of Epidemiology Advance Access originally published online on June 29, 2005
American Journal of Epidemiology 2005 162(3):238-252; doi:10.1093/aje/kwi189
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved

ORIGINAL CONTRIBUTIONS

Relation between Ambient Air Quality and Selected Birth Defects, Seven County Study, Texas, 1997–2000

S. M. Gilboa1, P. Mendola2, A. F. Olshan1, P. H. Langlois3, D. A. Savitz1, D. Loomis1, A. H. Herring4 and D. E. Fixler5

1 Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC
2 Human Studies Division, National Health and Environmental Effects Research Laboratory, Environmental Protection Agency, Research Triangle Park, NC
3 Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX
4 Department of Biostatistics, School of Public Health, University of North Carolina, Chapel Hill, NC
5 Department of Cardiology, Children's Medical Center, Dallas, TX

Reprint requests to Pauline Mendola, Human Studies Division, National Health and Environmental Effects Research Laboratory, Environmental Protection Agency, MD 58A, Research Triangle Park, NC 27711 (e-mail: mendola.pauline{at}epa.gov).

A population-based case-control study investigated the association between maternal exposure to air pollutants, carbon monoxide, nitrogen dioxide, ozone, sulfur dioxide, and particulate matter <10 µm in aerodynamic diameter during weeks 3–8 of pregnancy and the risk of selected cardiac birth defects and oral clefts in livebirths and fetal deaths between 1997 and 2000 in seven Texas counties. Controls were frequency matched to cases on year of birth, vital status, and maternal county of residence at delivery. Stationary monitoring data were used to estimate air pollution exposure. Logistic regression models adjusted for covariates available in the vital record. When the highest quartile of exposure was compared with the lowest, the authors observed positive associations between carbon monoxide and tetralogy of Fallot (odds ratio = 2.04, 95% confidence interval: 1.26, 3.29), particulate matter <10 µm in aerodynamic diameter and isolated atrial septal defects (odds ratio = 2.27, 95% confidence interval: 1.43, 3.60), and sulfur dioxide and isolated ventricular septal defects (odds ratio = 2.16, 95% confidence interval: 1.51, 3.09). There were inverse associations between carbon monoxide and isolated atrial septal defects and between ozone and isolated ventricular septal defects. Evidence that air pollution exposure influences the risk of oral clefts was limited. Suggestive results support a previously reported finding of an association between ozone exposure and pulmonary artery and valve defects.

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


Abbreviations: CI, confidence interval; OR, odds ratio; PM10, particulate matter <10 µm in aerodynamic diameter


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