A national study on the effects of air pollution and temperature on children's neurodevelopmental outcomes

一项关于空气污染和温度对儿童神经发育结果影响的全国研究

基本信息

批准号：
10585592
负责人：
Stefania Papatheodorou
金额：
$ 66.68万
依托单位：
HARVARD SCHOOL OF PUBLIC HEALTH
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-01-01 至 2027-10-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10585592
关键词：
8 year old Adverse effects Age Air Air Pollutants Air Pollution Area Attention deficit hyperactivity disorder Behavior Disorders Big Data Birth Body mass index Brain Caring Characteristics Chemicals Child Childhood Clinical Data Code Complex Confidence Intervals Data Data Sources Databases Developmental Coordination Disorders Diagnosis Economics Education Elements Environment Environmental Exposure Environmental Risk Factor Etiology Exposure to Fetus Goals Health Health protection Heat Waves Heritability Incidence Income Individual Infant Intellectual functioning disability Intervention Joints Knowledge Language Disorders Learning Disabilities Location Marital Status Mediating Medicaid Medical Mental Health Metals Methods Modeling Modification Neurodevelopmental Disorder Nitrogen Dioxide Outcome Ozone Pathway interactions Pediatric cohort Pollution Predictive Value Predisposition Pregnancy Pregnant Women Prevalence Privatization Productivity Public Health Race Regulation Research Resources Risk Risk Factors Role Sample Size Scientific Evaluation Smoking Socioeconomic Status Source Speech Disorders Statistical Methods System Temperature Uncertainty Work adverse pregnancy outcome autism spectrum disorder climate change cohort cost developmental disease early childhood epidemiology study fine particles follow-up hazard implementation barriers innovation modifiable risk non-genetic novel pollutant population based postnatal prenatal sex social socioeconomic disadvantage spatiotemporal

项目摘要

PROJECT SUMMARY/ABSTRACT Evidence suggests that the prevalence of certain developmental disorders, specifically autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD), has increased sharply in recent decades. Recent studies have shown a moderate heritability for neurodevelopmental delays (NDDs), suggesting a nongenetic component contributing to its etiology. The estimated annual cost of environmentally mediated NDDs in US children is $18.3 billion. Epidemiologic studies examined prenatal and early childhood exposure to air pollutants and NDDs, with non-conclusive evidence on the effects of different pollutants, interactions, sensitive windows of exposure and chemical components of PM2.5. In addition, the role of socioeconomic status (SES) in these associations is complex. Our overarching goal is to comprehensively investigate the independent and joint prenatal and early childhood exposure to PM2.5, NO2 and O3, PM2.5 chemical components and interactions with temperature on NDDs as well as effect modification by SES. The specific aims of this application are: 1) Quantify the association prenatal and early childhood exposure to PM2.5, NO2, O3, temperature and NDDs, 2) Examine the association between prenatal and early childhood exposure to PM2.5 chemical speciation and NDDs, and 3) Examine pathways and synergistic effects, among environmental exposures and SES on NDDs. We have established a birth cohort of more than 4 million pregnancies from two population-based databases—the Medicaid Analytic eXtract and IBM MarketScan—that include rich information on location and individual-level characteristics. By 8 years of age, 23.9% of publicly insured children and 11.0% of privately insured children received a diagnosis of 1 or more NDDs. For all pollutants, PM2.5 chemical components and temperature, we have validated highly resolved daily predictions for the entire continental US. The unique composition of these two cohorts, allows us to determine the extent to which SES modifies these associations. For our analyses, we will adjust for a wide range of individual-level characteristics and spatiotemporal covariates. We will estimate hazard ratios and their 95% confidence intervals using cox regression, distributed-linear/non-linear lag models, and we will examine effect modification by infant sex. We will use advanced statistical methods to estimate the effects of mixtures. Our prior work and data support both the hypothesis for and the feasibility of the proposed study. The proposed research is innovative because it will be the first study to: 1) investigate associations between air pollutants, temperature and NDDs on a national scale; 2) use state-of-the-art spatiotemporal models to assess individual exposures to PM2.5, NO2, O3 and temperature; 3) employ innovative resources of clinical data by leveraging two large pregnancy cohorts. The proposed research is of great significance because it will guide decisions and pollutant regulations to protect the health of pregnant women and children, inform heat wave warning systems, potentially reducing rates of NDDs and subsequent social, financial, and public health burden.

项目概要/摘要有证据表明某些发育障碍的患病率，特别是自闭症谱系近几十年来，注意力缺陷多动障碍（ASD）和注意力缺陷多动障碍（ADHD）急剧增加。最近的研究表明神经发育迟缓（NDD）具有中等遗传力，这表明造成其病因的非遗传因素环境介导的 NDD 的估计年度成本。流行病学研究调查了产前和儿童早期的空气暴露情况，影响了美国儿童 183 亿美元。污染物和 NDD，对不同污染物的影响、相互作用、敏感 PM2.5 的暴露窗口和化学成分此外，社会经济地位 (SES) 在其中的作用。这些协会很复杂，我们的首要目标是全面调查独立和联合的情况。产前和儿童早期接触 PM2.5、NO2 和 O3、PM2.5 化学成分及其相互作用 NDD 上的温度以及 SES 的效果修改该应用的具体目标是： 1) 量化。产前和儿童早期接触 PM2.5、NO2、O3、温度和 NDD 的关联，2) 检查产前和儿童早期接触 PM2.5 化学形态与 NDD 之间的关联，以及 3) 检查环境暴露和 SES 对 NDD 的路径和协同效应。从两个基于人口的数据库建立了超过 400 万次怀孕的出生队列—— Medicaid Analytic eXtract 和 IBM MarketScan — 包括有关位置和个人级别的丰富信息到 8 岁，有 23.9% 的公共保险儿童和 11.0% 的私人保险儿童。对于所有污染物、PM2.5 化学成分和温度，我们得到了 1 个或多个 NDD 的诊断。验证了对整个美国大陆的高精度每日预测。两个队列，使我们能够确定 SES 改变这些关联的程度。我们将根据各种个体水平特征和时空协变量进行调整。使用 cox 回归、分布式线性/非线性滞后模型计算风险比及其 95% 置信区间，我们将检查婴儿性别的影响。我们将使用先进的统计方法来估计。我们之前的工作和数据支持了所提出的假设和可行性。拟议的研究具有创新性，因为它将是第一个旨在：1）调查关联的研究。国家范围内的空气污染物、温度和 NDD 之间的关系；2) 使用最先进的时空模型评估个人对 PM2.5、NO2、O3 和温度的暴露情况；3) 利用临床数据的创新资源；通过利用两个大型妊娠队列，拟议的研究具有重要意义，因为它将指导。保护孕妇和儿童健康的决定和污染物法规，为热浪提供信息预警系统，有可能降低 NDD 发生率以及随后的社会、财政和公共卫生负担。