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Ambient Air Pollution and Risk of Congenital Anomalies in England, 1991-99
  1. Helen Dolk1,*,
  2. Ben Armstrong2,
  3. Kate Lachowycz2,
  4. M Vrijheid3,
  5. Judith Rankin4,
  6. L Abramsky5,
  7. Patricia Boyd6,
  8. Diana Wellesley7
  1. 1 University of Ulster, United Kingdom;
  2. 2 London School of Hygiene & Tropical Medicine, United Kingdom;
  3. 3 International Agency for Research on Cancer, United Kingdom;
  4. 4 Institute of Health and Society, University of Newcastle, France;
  5. 5 North Thames West Congenital Anomalies Register, United Kingdom;
  6. 6 National Perinatal Epidemiology Unit, United Kingdom;
  7. 7 Wessex Congenital Anomalies Register, United Kingdom
  1. Correspondence to: Helen Dolk, Epidemiology & Health Services Research,, University of Ulster, Epidemiology & Health Services Research,, Room 15E07A,, School of Nursing, University of Ulster,, Newtownabbey, BT37 0QB, United Kingdom; h.dolk{at}


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 with population-based congenital anomaly registers, 1991-99. Exposure was measured as 1996 annual mean background SO2, PM10 and NO2 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 0.93-1.05) for SO2, 0.97 (95%CI 0.84-1.11) for NO2, 0.89(95%CI 0.75-1.07) for PM10. For chromosomal anomalies, relative risks were 1.06 (95%CI 0.98-1.15) for SO2, 1.11 (95%CI 0.95-1.30) for NO2, 1.18 (0.97-1.42) for PM10. Raised risks were found for Tetralogy of Fallot and SO2 (RR=1.38, 95%CI 1.07-1.79), NO2 (RR=1.44, 95%CI 0.71-2.93) and PM10 (RR=1.48, 95%CI 0.57-3.84), of interest in the 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 overall congenital anomaly rate in England, further research regarding specific anomalies is indicated.

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