Measuring Burden of Disease Attributable to Air Pollution Due to Preterm Birth Complications and Infant Death in Paris Using Disability-Adjusted Life Years (DALYs).

Séverine Deguen,Guadalupe Perez Marchetta,Wahida Kihal-Talantikite

doi:10.3390/ijerph17217841

Abstract

Several studies have found maternal exposure to particulate matter pollution was associated with adverse birth outcomes, including infant mortality and preterm birth. In this context, our study aims to quantify the air pollution burden of disease due to preterm birth complications and infant death in Paris, with particular attention to people living in the most deprived census blocks. Data on infant death and preterm birth was available from the birth and death certificates. The postal address of mother’s newborn was converted in census block number. A socioeconomic deprivation index was built at the census block level. Average annual ambient concentrations of PM10 were modelled at census block level using the ESMERALDA atmospheric modelling system. The number of infant deaths attributed to PM10 exposure is expressed in years of life lost. We used a three-step compartmental model to appraise neurodevelopmental impairment among survivors of preterm birth. We estimated that 12.8 infant deaths per 100,000 live births may be attributable to PM10 exposure, and about one third of these infants lived in deprived census blocks. In addition, we found that approximately 4.8% of preterm births could be attributable to PM10 exposure, and approximately 1.9% of these infants died (corresponding to about 5.75 deaths per 100,000 live birth). Quantification of environmental hazard-related health impacts for children at local level is essential to prioritizing interventions. Our study suggests that additional effort is needed to reduce the risk of complications and deaths related to air pollution exposure, especially among preterm births. Because of widespread exposure to air pollution, significant health benefits could be achieved through regulatory interventions aimed at reducing exposure of the population as a whole, and particularly of the most vulnerable, such as children and pregnant women.

Highlights

The fact that preterm birth is associated with increased neonatal morbidity and mortality is well established
In terms of preterm birth complications, we found that about 13% of infant deaths occurred in families living in the least deprived census blocks, whereas this percentage increased to 20% for those living in the most deprived census blocks
Our finding is coherent with a US study published in 2004 [26], whose risk assessment study suggested that outdoor air pollution above a threshold fixed at 12 μg/m3 PM10 would contribute in a substantial way to post-neonatal infant mortality: About 14.7 infant deaths per

Summary

Introduction

The fact that preterm birth is associated with increased neonatal morbidity and mortality is well established. The main complications of preterm birth include both several morbidity in adulthood and neurodevelopmental impairments that may, for instance, increase the risk of cerebral palsy which affects long-term physical health [1]. Preterm birth is known to be an important risk factor. Res. Public Health 2020, 17, 7841; doi:10.3390/ijerph17217841 www.mdpi.com/journal/ijerph

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