Systematic Review of Short-term Air Pollution Exposure and Infant Mortality

Background and Aim: Infant mortality is a widely reported indicator of population health and a leading public health concern. In this systematic review and meta-analysis, we review the available literature for epidemiologic evidence of the association between short-term criteria air pollution exposure and infant mortality. Methods: Relevant publications were identified through PubMed and Web of Science databases using comprehensive search terms and screened using predefined inclusion/exclusion criteria. We extracted data from included studies and applied a systematic rubric for evaluating study quality across domains including participant selection, outcome, exposure, confounding, analysis, selective reporting, sensitivity, and overall quality. We performed meta-analyses, using both fixed and random effects methods, and estimated pooled odds ratios (ORs) and 95% confidence intervals for criteria pollutants (nitrogen dioxide (NO2), sulfur dioxide (SO2), coarse particulate matter (PM10), fine particulate matter (PM2.5), ozone (O3), carbon monoxide (CO)) and infant mortality, neonatal mortality, or post-neonatal mortality. Results: Our search returned 549 studies. We excluded 490 studies in the abstract screening phase and an additional 37 studies in the full text screening phase, leaving 22 studies for inclusion. Among these 22 studies, 14 included effect estimates for PM10, 13 for O3, 11 for both NO2 and CO, 8 for SO2, and 3 for PM2.5. The pooled ORs (95%CI) with the greatest magnitudes were for a 10 ppb increase in SO2 or NO2 concentration in the days before death (1.07 [95%CI: 1.02, 1.12], 1.04 [95%CI: 1.01, 1.08], respectively). The pooled ORs for PM10 and PM2.5 were 1.02 (95%CI: 1.00, 1.03) and 1.02 (95%CI: 1.00, 1.03), and the pooled ORs for CO and O3 were 1.01 (95%CI: 1.00, 1.02) and 0.99 (95%CI: 0.97, 1.01).  Conclusions: Increased exposure to SO2, NO2, PM10 or PM2.5 is associated with infant mortality across studies. This abstract does not reflect EPA policy.

Impact/Purpose

Background and Aim: Infant mortality is a widely reported indicator of population health and a leading public health concern. In this systematic review and meta-analysis, we review the available literature for epidemiologic evidence of the association between short-term criteria air pollution exposure and infant mortality.

Citation

Luben, T., A. Wilkie, A. Krajewski, F. Njie, K. Park, S. Zelasky, AND K. Rappazzo. Systematic Review of Short-term Air Pollution Exposure and Infant Mortality. International Society for Environmental Epidemiology (ISEE) - North American Chapter, Corvallis, OR, June 19 - 22, 2023.