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American Journal of Epidemiology Advance Access originally published online on March 3, 2009
American Journal of Epidemiology 2009 169(8):1004-1014; doi:10.1093/aje/kwp011
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American Journal of Epidemiology Published by the Johns Hopkins Bloomberg School of Public Health 2009.

ORIGINAL CONTRIBUTIONS

Ambient Air Pollution and Cardiovascular Malformations in Atlanta, Georgia, 1986–2003

Matthew J. Strickland, Mitchel Klein, Adolfo Correa, Mark D. Reller, William T. Mahle, Tiffany J. Riehle-Colarusso, Lorenzo D. Botto, W. Dana Flanders, James A. Mulholland, Csaba Siffel, Michele Marcus and Paige E. Tolbert

Correspondence to Dr. Matthew Strickland, Department of Environmental and Occupational Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322 (e-mail: mjstric{at}sph.emory.edu).

Received for publication February 22, 2008. Accepted for publication January 8, 2009.

Associations between ambient air pollution levels during weeks 3–7 of pregnancy and risks of cardiovascular malformations were investigated among the cohort of pregnancies reaching at least 20 weeks’ gestation that were conceived during January 1, 1986–March 12, 2003, in Atlanta, Georgia. Surveillance records obtained from the Metropolitan Atlanta Congenital Defects Program, which conducts active, population-based surveillance on this cohort, were reviewed to classify cardiovascular malformations. Ambient 8-hour maximum ozone and 24-hour average carbon monoxide, nitrogen dioxide, particulate matter with an average aerodynamic diameter of <10 µm (PM10), and sulfur dioxide measurements were obtained from centrally located stationary monitors. Temporal associations between these pollutants and daily risks of secundum atrial septal defect, aortic coarctation, hypoplastic left heart syndrome, patent ductus arteriosus, valvar pulmonary stenosis, tetralogy of Fallot, transposition of the great arteries, muscular ventricular septal defect, perimembranous ventricular septal defect, conotruncal defects, left ventricular outflow tract defect, and right ventricular outflow defect were modeled by using Poisson generalized linear models. A statistically significant association was observed between PM10 and patent ductus arteriosus (for an interquartile range increase in PM10 levels, risk ratio = 1.60, 95% confidence interval: 1.11, 2.31). Of the 60 associations examined in the primary analysis, no other significant associations were observed.

air pollution; heart defects, congenital

Abbreviations: CI, confidence interval; MACDP, Metropolitan Atlanta Congenital Defects Program; PM10,, particulate matter with an average aerodynamic diameter of <10 µm; RR, risk ratio


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