Academic journal article Environmental Health Perspectives

The Effects of the World Trade Center Event on Birth Outcomes among Term Deliveries at Three Lower Manhattan Hospitals

Academic journal article Environmental Health Perspectives

The Effects of the World Trade Center Event on Birth Outcomes among Term Deliveries at Three Lower Manhattan Hospitals

Article excerpt

The effects of prenatal exposure to pollutants from the World Trade Center (WTC) disaster on fetal growth and subsequent health and development of exposed children remain a source of concern. We assessed the impact of gestational timing of the disaster and distance from the WTC in the 4 weeks after 11 September on the birth outcomes of 300 nonsmoking women who were pregnant at the time of the event. They were recruited at delivery between December 2001 and June 2002 from three hospitals close to the WTC site. Residential and work addresses of all participants for each of the 4 weeks after 11 September 2001 were geocoded for classification by place and timing of exposure. Average daily hours spent at each location were based on the women's reports for each week. Biomedical pregnancy and delivery data extracted from the medical records of each mother and newborn included medical complications, type of delivery, length of gestation, birth weight, birth length, and head circumference. Term infants born to women who were pregnant on 11 September 2001 and who were living within a 2-mile radius of the WTC during the month after the event showed significant decrements in term birth weight (-149 g) and birth length (-0.82 cm), compared with infants born to the other pregnant women studied, after controlling for sociodemographic and biomedical risk factors. The decrements remained significant with adjustment for gestational duration (-122 g and -0.74 cm, respectively). Women in the first trimester of pregnancy at the time of the WTC event delivered infants with significantly shorter gestation (-3.6 days) and a smaller head circumference (-0.48 cm), compared with women at later stages of pregnancy, regardless of the distance of their residence or work sites from the WTC. The observed adverse effects suggest an impact of pollutants and/or stress related to the WTC disaster and have implications for the health and development of exposed children. Key words: birth length, birth weight, geographic information systems, gestational duration, head circumference, newborns, World Trade Center. Environ Health Perspect 112:1772-1778 (2004). doi:10.1289/ehp.7348 available via http://dx.doi.org/[Online 8 September 2004]

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At the time of the World Trade Center (WTC) tragedy, scientists and community members raised concerns about the effects on pregnant women and their children of exposure to the dust, smoke, and fumes. Analysis of dust samples from lower Manhattan in the days after the WTC event yielded a wide range of toxicants and irritants from building debris and combustion products (Lioy et al. 2002; McGee et al. 2003; Offenburg et al. 2003). These included a variety of neurodevelopmental toxicants and carcinogens such as polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), polychlorinated dibenzodioxins, polychlorinated dibenzofurans, pesticides, other hydrocarbons, and metals (Chen and Thurston 2002; Jeffrey et al. 2003; Lioy et al. 2002; McKinney et al. 2002; Offenburg et al. 2003). The WTC plume contained high levels of PAHs, levels that spiked 1.8 km (1.1 mile) northeast of the WTC site several times in September and October 2001, with a peak on 3 October, during an inversion that brought smoke back to ground level. Similarly, measurements of trace elements, including lead, taken five blocks from the WTC site spiked in September and October (Service 2003), indicating variability in ambient exposures throughout the month after the event.

The fetus is thought to be more sensitive than the adult to a range of ambient pollutants, including PAHs, with recent studies showing a higher rate of genetic damage from PAHs and slower clearance of other toxicants in the newborn compared with the mother (Perera et al. 2003). Fetal growth effects of PAHs and other pollutants have been demonstrated (Dejmek et al. 1999, 2000; Perera et al. 1998; Wilhelm and Ritz 2003); specifically, prenatal exposure to airborne PAHs was associated with reduced birth weight, birth length, and head circumference (Perera et al. …

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