Maternal residential proximity to Toxics Release Inventory sites and preterm birth 公开

White, Jamie Suzanne (2012)

Permanent URL: https://etd.library.emory.edu/concern/etds/th83kz455?locale=zh
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Abstract

This study was a secondary data analysis that examined the relationship between maternal residential proximity to Toxics Release Inventory (TRI) sites and preterm birth (PTB). A secondary outcome of interest was low birth weight (LBW). Study participants included 21,314 randomly selected singleton live births in Texas from 2001 to 2005 without congenital anomalies. Among total births, 8.53% were preterm and 5.82% were LBW, with and increased prevalence of PTB (11.31%) and LBW (9.58%) among non-Hispanic blacks. Geocoded maternal residence and ambient air pollution emission data from 977 TRI sites was used to determine exposure status. Using Geographic Information Systems (GIS), births with maternal residence within a one mile radius of a TRI site were classified as exposed. The effect of total emissions as well as specific chemical emissions or groups of chemical emissions on gestational age at birth and birth weight was explored. The prevalence of exposure varied from 1.14% to 13.54% depending on the exposure group of interest. Logistic and linear regression models controlling for several known risk factors of PTB and LBW were used to analyze the data in Statistical Analysis Software (SAS). Results for all regression models were generally consistent with no association. The null results may be partially attributable to non-differential exposure misclassification. This study found no evidence of a relationship between maternal residential proximity to TRI sites and PTB or LBW for any chemical exposure groups of interest. There was no evidence of a dose-response relationship for any exposure of interest. There was also no significant or consistent evidence of effect modification by race/ethnicity.

Table of Contents

Introduction 1

Preterm birth (PTB) and low birth weight (LBW) in the United States 1

Epidemiology of preterm birth and low birth weight 1

Risk factors for preterm birth and low birth weight 2

Racial/ethnic disparities in preterm birth and low birth weight 5

Seasonality of preterm birth and low birth weight 6

Etiology of preterm birth and low birth weight 6

Morbidity and mortality associated with preterm birth and low birth weight 7

Social consequences of preterm birth and low birth weight 8

Economic burden of preterm birth and low birth weight 8

Healthy People objectives and Health Babies campaigns 9

Toxics Release Sites 10

Toxics Release Inventory Program 10

Toxic sites and social justice 11

Ambient air pollution and adverse birth outcomes 12

Aims of current research 15

Materials and Methods 16

Study population 16

Birth data 16

Air pollution data 16

Exposure status 17

Modeling design 18

Dose-response 19

2005 sub-analysis 19

Calendar year 19

Seasonality 19

Missing data 22

Results 22

Exposure data 22

Outcome data 22

Population characteristics 22

Estimates of effect 23

Race/ethnicity 23

2005 sub-analysis 24

Seasonality 24

Calendar year 25

Missing data 25

Discussion 34

Strengths 34

Weaknesses 36

Conclusion 38

Literature Cited 39

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