文章基本信息

标题：Child Survival and Early Lifetime Exposures to Ambient Fine Particulate Matter in India: A Retrospective Cohort Study
本地全文：下载
作者：Jiawen Liao ; Yang Liu ; Kyle Steenland 等
期刊名称：Environmental Health Perspectives
印刷版ISSN：0091-6765
电子版ISSN：1552-9924
出版年度：2022
卷号：130
期号：1
DOI：10.1289/EHP8910
语种：English
出版社：OCR Subscription Services Inc
摘要：Background: Ambient fine particulate matter [PM ≤ 2.5 μ m in aerodynamic diameter ( PM 2.5 )] is a major health risk for children, particularly in South Asia, which currently experiences the highest PM 2.5 levels globally. Nevertheless, there is comparatively little epidemiological evidence from this region to quantify the effects of PM 2.5 on child survival. Objectives: We estimated the association between PM 2.5 exposure and child survival in India. Methods: We constructed a large, retrospective, and nationally representative cohort of children < 5 years of age , born between 2009–2016, from the publicly available, cross-sectional 2015–2016 Demographic Health Surveys in India. In utero and post-delivery lifetime average ambient PM 2.5 exposures were estimated with data from satellite remote sensing, meteorology, and land use information (model R 2 = 0.82). We used Cox proportional hazards regression to estimate the association between both average in utero and post-delivery lifetime PM 2.5 and all-cause child mortality, controlling for individual- and household-level covariates, seasonality, location, and meteorology. Results: Over 7,447,724 child-months of follow-up, there were 11,559 deaths at < 5 years of age reported by the children’s mothers. The mean concentrations of 9-month in utero and post-delivery lifetime average ambient PM 2.5 exposure were 71.1 μ g / m 3 (range: 20.9 – 153.5 μ g / m 3 ) and 73.7 μ g / m 3 (range: 14.0 – 247.3 μ g / m 3 ), respectively. Estimated child mortality adjusted hazard ratios were 1.023 [95% confidence interval (CI): 1.008, 1.038] and 1.013 (95% CI: 1.001, 1.026) per 10 - μ g / m 3 increase of in utero and post-delivery lifetime PM 2.5 , with both exposures in the model. Discussion: This study adds to the growing body of evidence about the adverse health effects of PM 2.5 by demonstrating the association between exposure, both in utero and post-delivery, on child survival at the national level in India. Strategies to reduce ambient air pollution levels, including steps to minimize in utero and early life exposures, are urgently needed in India and other countries where exposures are above recommended guideline values. https://doi.org/10.1289/EHP8910