Pre- and postnatal exposure to multiple ambient air pollutants and child behavioral problems at five years of age

Abstract

BACKGROUND AND AIM: Ambient air pollution is emerging as a risk factor for adverse neurological problems and early childhood diseases. This study purposed to evaluate the association between pre- and postnatal exposure to multiple air pollutants and childhood behavioural problems using some statistical models. METHODS: This study used the data from the MOCEH study, which is a prospective birth cohort study in Republic of Korea. Average exposure levels to PM2.5 during the pre- and postnatal periods were estimated using the Community Multiscale Air Quality (CMAQ) model. Other air pollutants were predicted using the kriging model. Mother-child pairs who completed the Korean version of the Child Behavior Checklist at five years of age were included. Primary outcomes were children’s behavioural problems scores of total, internalizing, and externalizing. Multivariate linear regression (MLR) for each pollutants and weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) for multiple exposure to six air pollutants and pre- and postnatal periods were applied. RESULTS:In the MLR analysis, PM2.5, PM10, and NO2 exposure during the first trimester were positively associated with the internalizing problem score. In the WQS regression analysis, the air pollutant index during the first trimester was positively associated with total problems score and PM10 had the strongest individual weights in the air pollutant index. The postnatal air pollutant index at 0–6 months was also positively associated with the internalizing problem score and SO2 and NO2 had strong individual weights. In the BKMR model analysis, the overall effect of multiple air pollutants during the first trimester and at 0–6 months was significantly associated with behavioural problems. CONCLUSIONS:When comparing the results from different models, PM2.5 and PM10 exposures during the first trimester were identified as important factors associated with behavioral problems. Future studies investigating the effects of multiple air pollutants by applying diverse statistical methods are needed. KEYWORDS: Air pollution, Birth cohort study, Multiple exposure, Behavioral problem, children