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Air Pollution and Adverse Birth Outcomes in Lanzhou, China.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Air Pollution and Adverse Birth Outcomes in Lanzhou, China./
Author:	Jin, Lan.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2018,
Description:	198 p.
Notes:	Source: Dissertations Abstracts International, Volume: 80-09, Section: B.
Contained By:	Dissertations Abstracts International80-09B.
Subject:	Environmental Health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=13841673
ISBN:	9780438907362

Air Pollution and Adverse Birth Outcomes in Lanzhou, China.
Jin, Lan.

Air Pollution and Adverse Birth Outcomes in Lanzhou, China. - Ann Arbor : ProQuest Dissertations & Theses, 2018 - 198 p.

Source: Dissertations Abstracts International, Volume: 80-09, Section: B.

Thesis (Ph.D.)--Yale University, 2018.

This item must not be added to any third party search indexes.

A growing body of literature showed associations between maternal exposures to air pollution during pregnancy and adverse birth outcomes. However, these associations are not conclusive, and limited evidence was reported in developing countries with high air pollution levels. The inconsistencies of previous studies might be due to different exposure assessment methods or different pollution and population characteristics. Recent studies estimated exposures using models with high spatiotemporal resolution, such as land use regression (LUR) models with temporal adjustment, in efforts to improve exposure and risk assessment. However, previous findings were conflicted on whether spatiotemporal exposure estimates lead to higher risk estimates, compared to exposures with mainly temporal variations, which were common in earlier studies with government monitoring data. This dissertation comprehensively investigated maternal exposures to air pollution with various temporal and spatial variations, and related risks of adverse birth outcomes, aiming to shed light on which air pollutants or pollution sources could be most responsible, and what the local government or citizens could do to reduce newborn's risks in Lanzhou, China. This dissertation's research framework could be an example for future work in other similar cities with high pollution levels and health burdens. In Project 1, I investigated 8,969 singleton live births in Gansu Provincial Maternity and Child Care Hospital in Lanzhou, China from 2010-2012. Maternal exposures to PM10, NO2, and SO2 were estimated using government monitoring data. An interquartile range (IQR) increase in PMK() exposures tripled the congenital heart defects (CHD) risks of the newborns during the first trimester (OR: 3.10; 95% CI: 1.28, 7.51), and more than doubled the CHD risks during the entire pregnancy (OR: 2.28; 95% CI: 1.45, 3.60). For the entire pregnancy, NO2 exposures showed similar effect estimates with PM10 exposures. To my best knowledge, this was the first study (published in 2015) investigating the relationships between air pollution and heart defects in China, and showed larger effect sizes than previous studies in other countries. To improve exposure assessment based on limited government monitors in Project 1, I conducted 2-stage air pollution sampling campaigns and developed LUR models to characterize air pollution exposures at high spatial resolution in Lanzhou urban area (Project 2 and 3). In Project 2, I demonstrated a cost-effective framework of monitoring network design, and obtained preliminary understanding of air pollution distributions. The first-stage monitoring network was developed using stratified-random sampling, and consisted 47 sampling sites representing wide ranges of spatial characteristics. At these sampling sites, NO2 was measured, which was used to develop a preliminary LUR model (R2: 71%). The regression mapping showed high spatial variability of NO2 that was not captured by limited government monitors. Based on the pilot measurements, a statistical simulation procedure was developed and allocated additional 28 sampling sites to the existing network, forming the second-stage monitoring network with a total of 75 sampling sites. In Project 3, based on the second-stage network, NO2 and PM 2.5 were measured in 4 seasons of 2016-2017 both at the ground level and higher floors. Well-validated LUR models were developed and explained 71% and 77% variances of NO2 and PM2.5 measurements, respectively. The prediction maps showed that NO2 distributions closely followed the road networks, while PM2.5 concentrations were generally higher in the south-western part of the study area, especially in Qilihe District. Air pollution concentrations decreased substantially with increasing building floors. In Project 4, I studied a subset of the population in Project 1 - 8,087 births with maternal home and work addresses in Lanzhou urban area. Maternal exposures during the entire pregnancy were estimated for PM 10, PM2.5, and NO2, using government monitoring data or the above LUR models depending on the data availability. Spatial predictors including road densities, industrial areas, and proximity to major point sources were also investigated. I found clusters of adverse birth outcomes located in the southwestern corner of the study area, where major point sources were concentrated. Maternal exposures to PM10 were significantly associated with increased risks of CHD (OR: 2.23, 95% CI: 1.38, 3.58, per IQR), and reduced birth weight (-21.06 g, 95% CI: - 38.52, -3.59 g, per IQR). PM2.5 was marginally associated with reduced birth weight, and showed positive effect estimates for low birth weight (LBW) risks. Increasing distance to major point sources showed protective effects for all the birth outcomes, and the association was marginally significant for LBW (OR: 0.82, 95% CI: 0.67, 1.00). LUR models showed smaller confidence intervals of effect estimates than exposures based on limited government monitoring data. Maternal exposures to particles are associated with increased risks of adverse birth outcomes in the Lanzhou urban area. Local-scale studies investigating air pollution exposures and related health risks at high spatiotemporal resolutions are valuable to disentangle health effects of different air pollutants. Lanzhou government and citizens should take protective measures to reduce air pollution exposures of pregnant women.

ISBN: 9780438907362Subjects--Topical Terms:

578282
Environmental Health.

Air Pollution and Adverse Birth Outcomes in Lanzhou, China.
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500 $a Source: Dissertations Abstracts International, Volume: 80-09, Section: B.
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506 $a This item must not be added to any third party search indexes.
506 $a This item must not be sold to any third party vendors.
520 $a A growing body of literature showed associations between maternal exposures to air pollution during pregnancy and adverse birth outcomes. However, these associations are not conclusive, and limited evidence was reported in developing countries with high air pollution levels. The inconsistencies of previous studies might be due to different exposure assessment methods or different pollution and population characteristics. Recent studies estimated exposures using models with high spatiotemporal resolution, such as land use regression (LUR) models with temporal adjustment, in efforts to improve exposure and risk assessment. However, previous findings were conflicted on whether spatiotemporal exposure estimates lead to higher risk estimates, compared to exposures with mainly temporal variations, which were common in earlier studies with government monitoring data. This dissertation comprehensively investigated maternal exposures to air pollution with various temporal and spatial variations, and related risks of adverse birth outcomes, aiming to shed light on which air pollutants or pollution sources could be most responsible, and what the local government or citizens could do to reduce newborn's risks in Lanzhou, China. This dissertation's research framework could be an example for future work in other similar cities with high pollution levels and health burdens. In Project 1, I investigated 8,969 singleton live births in Gansu Provincial Maternity and Child Care Hospital in Lanzhou, China from 2010-2012. Maternal exposures to PM10, NO2, and SO2 were estimated using government monitoring data. An interquartile range (IQR) increase in PMK() exposures tripled the congenital heart defects (CHD) risks of the newborns during the first trimester (OR: 3.10; 95% CI: 1.28, 7.51), and more than doubled the CHD risks during the entire pregnancy (OR: 2.28; 95% CI: 1.45, 3.60). For the entire pregnancy, NO2 exposures showed similar effect estimates with PM10 exposures. To my best knowledge, this was the first study (published in 2015) investigating the relationships between air pollution and heart defects in China, and showed larger effect sizes than previous studies in other countries. To improve exposure assessment based on limited government monitors in Project 1, I conducted 2-stage air pollution sampling campaigns and developed LUR models to characterize air pollution exposures at high spatial resolution in Lanzhou urban area (Project 2 and 3). In Project 2, I demonstrated a cost-effective framework of monitoring network design, and obtained preliminary understanding of air pollution distributions. The first-stage monitoring network was developed using stratified-random sampling, and consisted 47 sampling sites representing wide ranges of spatial characteristics. At these sampling sites, NO2 was measured, which was used to develop a preliminary LUR model (R2: 71%). The regression mapping showed high spatial variability of NO2 that was not captured by limited government monitors. Based on the pilot measurements, a statistical simulation procedure was developed and allocated additional 28 sampling sites to the existing network, forming the second-stage monitoring network with a total of 75 sampling sites. In Project 3, based on the second-stage network, NO2 and PM 2.5 were measured in 4 seasons of 2016-2017 both at the ground level and higher floors. Well-validated LUR models were developed and explained 71% and 77% variances of NO2 and PM2.5 measurements, respectively. The prediction maps showed that NO2 distributions closely followed the road networks, while PM2.5 concentrations were generally higher in the south-western part of the study area, especially in Qilihe District. Air pollution concentrations decreased substantially with increasing building floors. In Project 4, I studied a subset of the population in Project 1 - 8,087 births with maternal home and work addresses in Lanzhou urban area. Maternal exposures during the entire pregnancy were estimated for PM 10, PM2.5, and NO2, using government monitoring data or the above LUR models depending on the data availability. Spatial predictors including road densities, industrial areas, and proximity to major point sources were also investigated. I found clusters of adverse birth outcomes located in the southwestern corner of the study area, where major point sources were concentrated. Maternal exposures to PM10 were significantly associated with increased risks of CHD (OR: 2.23, 95% CI: 1.38, 3.58, per IQR), and reduced birth weight (-21.06 g, 95% CI: - 38.52, -3.59 g, per IQR). PM2.5 was marginally associated with reduced birth weight, and showed positive effect estimates for low birth weight (LBW) risks. Increasing distance to major point sources showed protective effects for all the birth outcomes, and the association was marginally significant for LBW (OR: 0.82, 95% CI: 0.67, 1.00). LUR models showed smaller confidence intervals of effect estimates than exposures based on limited government monitoring data. Maternal exposures to particles are associated with increased risks of adverse birth outcomes in the Lanzhou urban area. Local-scale studies investigating air pollution exposures and related health risks at high spatiotemporal resolutions are valuable to disentangle health effects of different air pollutants. Lanzhou government and citizens should take protective measures to reduce air pollution exposures of pregnant women.
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