Ambient air pollution and risk of congenital anomalies in England, 1991–1999
- 1Public Health and Primary Care Research Group, Institute of Nursing Research, University of Ulster, Newtownabbey, UK
- 2Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London UK
- 3Centre for Research in Environmental Epidemiology (CREAL), Municipal Institute of Medical Research, Barcelona, Spain
- 4Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- 5North Thames (West) Congenital Anomalies Register, Harrow, UK
- 6National Perinatal Epidemiology Unit, Oxford, UK
- 7Wessex Clinical Genetics Service, Southampton, UK
- Correspondence to Professor Helen Dolk, Room 12L09, University of Ulster, Shore Road, Newtownabbey, Co. Antrim, BT37 0QB, UK;
- Accepted 6 August 2009
- Published Online First 9 October 2009
Objectives To investigate whether there is an association between risk of congenital anomaly and annual ward level exposure to air pollution in England during the 1990s.
Methods A geographical study was conducted across four regions of England using population-based congenital anomaly registers, 1991–1999. Exposure was measured as 1996 annual mean background sulphur dioxide (SO2), nitrogen dioxide (NO2) and particulate matter (PM10) concentrations at census ward level (n=1474). Poisson regression, controlling for maternal age, area socioeconomic deprivation and hospital catchment area, was used to estimate relative risk for an increase in pollution from the 10th to the 90th centile.
Results For non-chromosomal anomalies combined, relative risks were 0.99 (95% CI 0.93 to 1.05) for SO2, 0.97 (95% CI 0.84 to 1.11) for NO2 and 0.89 (95% CI 0.75 to 1.07) for PM10. For chromosomal anomalies, relative risks were 1.06 (95% CI 0.98 to 1.15) for SO2, 1.11 (95% CI 0.95 to 1.30) for NO2 and 1.18 (95% CI 0.97 to 1.42) for PM10. Raised risks were found for tetralogy of Fallot and SO2 (RR=1.38, 95% CI 1.07 to 1.79), NO2 (RR=1.44, 95% CI 0.71 to 2.93) and PM10 (RR=1.48, 95% CI 0.57 to 3.84), which is of interest in light of previously reported associations between this cardiac anomaly and other air pollutants.
Conclusions While air pollution in the 1990s did not lead to sustained geographical differences in the overall congenital anomaly rate in England, further research regarding specific anomalies is indicated.
Linked articles 051201.
Funding The study was supported by the Department of Health (London) Policy Research Programme. The views expressed are not necessarily those of the Department of Health. JR is funded by a Personal Award Scheme Career Scientist Award from the National Institute of Health Research.
Competing interests None.
Ethics approval This study was conducted with the approval of the London School of Hygiene & Tropical Medicine Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.