The Effect of Particulate Air Pollution on Infant Mortality in the Short Term: The Case of Ankara Province in 2018-2020

Öz

Background: Today, nine out of 10 people on a global scale live in an air pollution environment above the limit values determined. It is predicted that particulate air pollution is a risk factor for 5.3% of deaths under the age of one in Türkiye. In order to examine the causes of infant deaths and take necessary precautions, it is important to investigate air pollution and the possibilities of infant death due to. Aims: This study was carried out to examine the relationship between Particulate Matter (PM) 2.5 and (PM)10 levels observed in Ankara between the years 2018-2020 and infant deaths that occurred at that time. Methods: To examine the relationship poisson regression model, in which the terms formed by the flexible cubic spline function, were mainly used. The effect of each 10 μg/m3 increase in PM2.5 and PM10 on infant mortality, taking into account lags of up to seven days by adjusting for seasonal trends and air temperature effects, was determined by relative risk (RR) and 95% confidence intervals (CI) analyzed by calculation. Results: In the evaluated period, 1295 infant deaths occurred in 754 of 1096 days. The three-year average of the daily average PM2.5 and PM10 levels detected in Ankara is above the limit values. Conclusion: The effect of particulate air pollution on infant mortality in the first week was not detected, this relationship may become detectable when different variables such as possible effect modifiers are included in the models applied. The subject should also be examined under such different conditions.

Anahtar Kelimeler

• Environmental epidemiology
• Time series
• Air pollution
• Infant mortality

Proje Numarası

YOK

Partiküler Hava Kirliliğinin Bebek Ölümlerine Kısa Dönemdeki Etkisi: 2018-2020 Yılları Ankara İli Örneği

Öz

Genel bilgiler: Günümüzde küresel ölçekte her 10 kişiden dokuzu hava kirliliği sınır değerlerin üstünde olan yerlerde yaşamaktadır. Türkiye’de bir yaş altı ölümlerin %5,3’ünün risk faktörünün partiküler hava kirliliği olduğu öngörülmektedir. Bebek ölümlerinin nedenlerinin incelenerek gerekli önlemlerin alınabilmesi açısından hava kirliliği ve kirliliğe bağlı erken ölüm olasılıklarının araştırılması önemlidir. Amaç : Bu çalışma, Ankara'da 2018-2020 yılları arasında gözlenen Partikül Madde (PM) 2.5 ve (PM)10 düzeyleri ile o dönemde meydana gelen bebek ölümleri arasındaki ilişkiyi incelemek amacıyla yapılmıştır. Yöntem: Partiküler hava kirliliğinin bebek ölümleriyle olan ilişkisinin irdelenmesinde temel olarak esnek kübik spline fonksiyonuyla oluşturulan Poisson regresyon modeli kullanılmıştır. Mevsimsel trendler ve hava sıcaklığı etkisi arındırılarak yedi güne kadar olan etki gecikmeleri (lag) göz önüne alınıp her 10 μg/m3’lük PM2.5 ve PM10 artışının bebek ölümleri üzerine olan etkisi rölatif risk (RR) ve %95 güven aralıkları (GA) hesaplanarak incelenmiştir. Sonuçlar: Ankara’da saptanan günlük ortalama PM2.5 ve PM10 düzeyinin üç yıllık ortalaması limit değerlerin üzerindedir ve değerlendirilen zaman diliminde, 1096 günün 754’ünde 1295 bebek ölümü gerçekleşmiştir. Yapılan hesaplamalarda hem PM2.5 hem de PM10’un yüksek değerlerine maruziyet günü ve sonraki ilk üç günde ölüm riskinde değişiklik yokken sonraki günlerde ölüm riskinin anlamlı olarak düştüğü ve yedinci günde bu farkın ortadan kalktığı gözlemlenmiştir. Sonuçta PM2.5 ve PM10 ile yapılan hesaplamalar, partiküler hava kirliliğinin ilk haftada bebek ölümleri üzerine etkisi gösterilememiştir. Tartışma: Partiküler hava kirliliğinin ilk haftada bebek ölümleri üzerine etkisi saptanmamasına rağmen uygulanan modellere olası etki düzenleyiciler gibi farklı değişkenler dahil edildiğinde bu ilişki saptanır hale gelebilir. Konunun bu gibi farklı koşullarla da incelenmesi gerekmektedir.

Anahtar Kelimeler

• Çevre epidemiyolojisi
• Zaman serisi
• Hava kirliliği
• Bebek ölümü

Destekleyen Kurum

YOK

Proje Numarası

YOK

Teşekkür

YOK

Kaynakça

1. 1. World Health Organization. Air pollution. Accessed October 21, 2021. https://www.who.int/health-topics/air-pollution#tab=tab_1
2. 2. World Health Organization. WHO Global Air Quality Guidelines: Particulate Matter (PM2.5 and PM10), Ozone, Nitrogen Dioxide, Sulfur Dioxide and Carbon Monoxide [Internet].; 2021. Accessed November 24, 2022. p. 73-74. https://www.ncbi.nlm.nih.gov/books/NBK574594/
3. 3. IQAir. World Air Quality Report: Region and city PM2.5 ranking.; 2020. p. 11. https://www.iqair.com/world-most-polluted-cities/world-air-quality-report-2020-en.pdf
4. 4. Temiz Hava Hakkı Platformu. Kara Rapor 2021: Hava Kirliliği ve Sağlık Etkileri.; 2021. Accessed November 7, 2021. p. 6. https://www.temizhavahakki.com/wp-content/uploads/2021/09/KaraRapor2021.pdf
5. 5. Schnelle Jr KB, Dunn RF, Ternes ME. Air Pollution Control Technology Handbook. 2nd ed. CRC press; 2015. p. 19-22.
6. 6. Ritchie H, Roser M. Causes of death. Our world in data. Published online 2018. https://ourworldindata.org/causes-of-death
7. 7. Pope CA. Epidemiology of fine particulate air pollution and human health: biologic mechanisms and who’s at risk? Environ Health Perspect. 2000;108(suppl 4):713-723. doi:10.1289/ehp.108-1637679
8. 8. Liuhua S, Antonella Z, Itai K, et al. Low-Concentration PM2.5 and Mortality: Estimating Acute and Chronic Effects in a Population-Based Study. Environ Health Perspect. 2016;124(1):46-52. doi:10.1289/ehp.1409111

9. 9. Brauer M, Lencar C, Tamburic L, Koehoorn M, Demers P, Karr C. A cohort study of traffic-related air pollution impacts on birth outcomes. Environ Health Perspect. 2008;116(5):680-686. doi:10.1289/ehp.10952
10. 10. Hathout EH, Beeson WL, Ischander M, Rao R, Mace JW. Air pollution and type 1 diabetes in children. Pediatr Diabetes. 2006;7(2):81-87. doi:10.1111/j.1399-543X.2006.00150.x
11. 11. Roberts AL, Lyall K, Hart JE, et al. Perinatal air pollutant exposures and autism spectrum disorder in the children of Nurses’ Health Study II participants. Environ Health Perspect. 2013;121(8):978-984. doi:10.1289/ehp.1206187
12. 12. Calderón-Garcidueñas L, Torres-Jardón R, Kulesza RJ, Park SB, D’Angiulli A. Air pollution and detrimental effects on children’s brain. The need for a multidisciplinary approach to the issue complexity and challenges. Front Hum Neurosci. 2014;8:613. doi:10.3389/fnhum.2014.00613
13. 13. Tong S, Colditz P. Air pollution and sudden infant death syndrome: a literature review. Paediatr Perinat Epidemiol. 2004;18(5):327-335. doi: https://doi.org/10.1111/j.1365-3016.2004.00565.x
14. 14. Global Health Data Exchange. GBD Results Tool | GHDx. Accessed November 5, 2021. http://ghdx.healthdata.org/gbd-results-tool
15. 15. Roberts S, Switzer P. Mortality displacement and distributed lag models. Inhal Toxicol. 2004;16(14):879-888. doi:10.1080/08958370490519598
16. 16. Katsouyanni K, Schwartz J, Spix C, et al. Short term effects of air pollution on health: A European approach using epidemiologic time series data: The APHEA protocol. J Epidemiol Community Health (1978). 1996;50 Suppl 1:S12-8. doi:https://doi.org/10.1136%2Fjech.50.suppl_1.s12
17. 17. Carbajal-Arroyo L, Miranda-Soberanis V, Medina-Ramón M, et al. Effect of PM10 and O3 on infant mortality among residents in the Mexico City Metropolitan Area: A case-crossover analysis, 1997-2005. J Epidemiol Community Health (1978). 2011;65:715-721. doi:10.1136/jech.2009.101212
18. 18. Yang CY, Hsieh HJ, Tsai SS, Wu TN, Chiu HF. Correlation Between Air Pollution and Postneonatal Mortality in a Subtropical City: Taipei, Taiwan. J Toxicol Environ Health A. 2006;69(22):2033-2040. doi:10.1080/15287390600746181
19. 19. Hajat S, Armstrong B, Wilkinson P, Busby A, Dolk H. Outdoor air pollution and infant mortality: analysis of daily time-series data in 10 English cities. J Epidemiol Community Health (1978). 2007;61(8):719-722. doi:10.1136/jech.2006.053942
20. 20. Loomis D, Castillejos M, Gold DR, McDonnell W, Borja-Aburto VH. Air Pollution and Infant Mortality in Mexico City. Epidemiology. 1999;10(2). https://journals.lww.com/epidem/Fulltext/1999/03000/Air_Pollution_and_Infant_Mortality_in_Mexico_City.6.aspx
21. 21. Ha EH, Lee JT, Kim H, et al. Infant Susceptibility of Mortality to Air Pollution in Seoul, South Korea. Pediatrics. 2003;111(2):284-290. doi:10.1542/peds.111.2.284
22. 22. Tsai SS, Chen CC, Hsieh HJ, Chang CC, Yang CY. Air Pollution and Postneonatal Mortality in a Tropical City: Kaohsiung, Taiwan. Inhal Toxicol. 2006;18(3):185-189. doi:10.1080/08958370500434214
23. 23. Son JY, Cho YS, Lee JT. Effects of Air Pollution on Postneonatal Infant Mortality Among Firstborn Infants in Seoul, Korea: Case-Crossover and Time-Series Analyses. Arch Environ Occup Health. 2008;63(3):108-113. doi:10.3200/AEOH.63.3.108-113
24. 24. Yorifuji T, Kashima S, Doi H. Acute exposure to fine and coarse particulate matter and infant mortality in Tokyo, Japan (2002–2013). Science of The Total Environment. 2016;551-552:66-72. doi:10.1016/J.SCITOTENV.2016.01.211
25. 25. Hans S, M MS, Christel F, Frans F, Benoit N, S NT. Does Air Pollution Trigger Infant Mortality in Western Europe? A Case-Crossover Study. Environ Health Perspect. 2011;119(7):1017-1022. doi:10.1289/ehp.1002913
26. 26. Woodruff TJ, Grillo J, Schoendorf KC. The relationship between selected causes of postneonatal infant mortality and particulate air pollution in the United States. Environ Health Perspect. 1997;105(6):608-612. doi:10.1289/ehp.97105608
27. 27. OECD iLibrary. Unmet health care needs. Health at a Glance: Europe 2020: State of Health in the EU Cycle. Published 2022. Accessed April 25, 2022. https://www.oecd-ilibrary.org/sites/667fed97-en/index.html?itemId=/content/component/667fed97-en
28. 28. Davies D, Hartfield D, Wren T. Children who “grow up” in hospital: Inpatient stays of six months or longer. Paediatr Child Health. 2014;19(10):533-536. doi:10.1093/pch/19.10.533