Long-term exposure to air pollution and infant mortality: a systematic review and meta-analysis

Background and Aim: Infant mortality – a common global indicator of population health – is a pressing public health concern. In this systematic review and meta-analysis, we reviewed the available literature for epidemiologic evidence of the association between long-term criteria air pollution exposure and all cause infant mortality. Methods: Relevant publications were identified through PubMed and Web of Science databases using comprehensive search terms then 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. When more than 2 eligible studies, we performed meta-analyses, using both fixed and random effects methods, and estimated pooled odds ratios (ORs) and 95% confidence intervals (95%CI) for criteria pollutants (nitrogen dioxide (NO2), sulfur dioxide (SO2), coarse particulate matter (PM10), fine particulate matter (PM2.5), ozone (O3), carbon monoxide (CO)) and all cause infant 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, 7 included extractable effect estimates for PM2.5, 5 for PM10, and 3 for CO. We could not conduct meta-analyses for O3, NO2, or SO2 because each only had 2 eligible studies with extractable effect estimates. The pooled OR (95%CI) for a 5-µg/m3 increase in PM2.5 concentration was 1.52 (95%CI: 0.54, 1.14), for a 1-ppm increase in CO concentration was 1.07 (95%CI: 1.00, 1.14), and for a 5-µg/m3 increase in PM10 concentration was 1.04 (95%CI: 1.03, 1.06). Conclusions: Increased long-term exposure to CO and PM10 is associated with all cause infant mortality across studies.

Impact/Purpose

In this systematic review and meta-analysis, we reviewed the available literature for epidemiologic evidence of the association between long-term criteria air pollution exposure and all cause infant mortality.

Citation

Luben, Tom, A. Wilkie, K. Rappazzo, A. Krajewski, F. Njie, K. Park, AND S. Zelasky. Long-term exposure to air pollution and infant mortality: a systematic review and meta-analysis. Society for Epidemiologic Research (SER), Portland, OR, June 13 - 16, 2023.