Fine Particulate Matter (P[M.Sub.2.5]) Air Pollution and Selected Causes of Postneonatal Infant Mortality in California
Woodruff, Tracey J., Parker, Jennifer D., Schoendorf, Kenneth C., Environmental Health Perspectives
Studies suggest that airborne particulate matter (PM) may be associated with postneonatal infant mortality, particularly with respiratory causes and sudden infant death syndrome (SIDS). To further explore this issue, we examined the relationship between long-term exposure to fine PM air pollution and postneonatal infant mortality in California. We linked monitoring data for PM [less than or equal to] 2.5 [micro]m in aerodynamic diameter ([PM.sub.2.5]) to infants born in California in 1999 and 2000 using maternal addresses for mothers who lived within 5 miles of a [PM.sub.2.5] monitor. We matched each postneonatal infant death to four infants surviving to 1 year of age, by birth weight category and date of birth (within 2 weeks). For each matched set, we calculated exposure as the average [PM.sub.2.5] concentration over the period of life for the infant who died. We used conditional logistic regression to estimate the odds of postneonatal all-cause, respiratory-related, SIDS, and external-cause (a control category) mortality by exposure to [PM.sub.2.5], controlling for the matched sets and maternal demographic factors. We matched 788 postneonatal infant deaths to 3,089 infant survivors, with 51 and 120 postueonatal deaths due to respiratory causes and SIDS, respectively. We found an adjusted odds ratio for a 10-[micro]g/[m.sup.3] increase in [PM.sub.2.5] of 1.07 [95% confidence interval (CI), 0.93-1.24] for overall postneonatal mortality, 2.13 (95% CI, 1.12-4.05) for respiratory-related postueonatai mortality, 0.82 (95% CI, 0.55-1.23) for SIDS, and 0.83 (95% CI, 0.50-1.39) for external causes. The California findings add further evidence of a PM air pollution effect on respiratory-related postueonatal infant mortality. Key words: air pollution, infant mortality, particulate matter air pollution, [PM.sub.2.5], posmeonatal. doi:10.1289/ehp.8484 available via http://dx.doi.org/ [Online 13 January 2006]
High air pollution levels have been linked to infant mortality. An early example is the London Fog episode of 1952, where a sharp increase in particulate matter (PM) air pollution led to increased mortality among infants and older adults (Her Majesty's Public Health Service 1954). Contemporary studies in countries with relatively high PM air pollution levels have also found an association between infant mortality and PM air pollution (Bobak and Leon 1999; Ha et al. 2003; Loomis et al. 1999). These studies further suggest that PM air pollution is associated with postneonatal mortality (deaths occurring after 28 days of life), with respiratory causes having the highest association (Bobak and Leon 1999; Ha et al. 2003). However, these countries have relatively high ambient air pollution compared with concentrations in North America. A study using U.S. data from 1989 through 1991 found that longer-term exposure to PM air pollution was associated with postneonatal deaths attributable to respiratory-related causes and sudden infant death syndrome (SIDS) (Woodruff et al. 1997). A follow-up study examining annual concentrations of PM air pollution in 1990 confirmed the original analysis and also found that carbon monoxide was not related to infant mortality (Lipfert et al. 2000). However, a study in Canada found that short-term increases in nitrogen dioxide and sulfur dioxide, and not PM air pollution, were associated with SIDS between 1984 and 1999 (Dales et al. 2004). Recent reviews of infant mortality and air pollution have suggested that air pollution seems to be most consistently associated with postneonatal mortality from respiratory causes and possibly SIDS, but further research is needed to clarify these relationships (Glinianaia et al. 2004; Tong and Colditz 2004).
Until recently, studies evaluating the relationship between air pollution and mortality in adults and infants have focused on PM [less than or equal to] 10 [micro]m in aerodynamic diameter ([PM.sub.10]). Since the late 1980s, this PM has been the focus of health studies because it is respirable. …